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PubMed1986

A case-referent study of lung cancer, occupational exposures and smoking. I. Comparison of title-based and exposure-based occupational information.

The role of occupational exposures and smoking in the development of lung cancer has been studied among 176 male incident lung cancer cases and 176 referents admitted to two county hospitals in southeast Norway during 1979-1983. After the allocation of all occupational titles in the Nordic Classification of Occupations into three exposure groups according to potential exposure to respiratory carcinogens and other contaminants, each subject was classified according to exposure status of main occupation and number of years in each exposure category. An excess risk of lung cancer was observed both among those in possibly exposed occupations and among those definitely exposed. A more than threefold excess risk was observed among subjects with more than 30 years in exposed occupations. Exposure to 22 agents/processes was further assessed by a separate questionnaire and estimated simultaneously in a logistic regression model. Elevated risks were associated with exposure to asbestos and several other agents/processes, which largely correlated to each other. Smoking was strongly associated with all histological subtypes of lung cancer, while for occupational exposures the risk ratio was highest for small cell carcinoma and lowest for adenocarcinoma. Very high risk ratios for lung cancer were observed among heavy smokers in exposed occupations.

Adult↗

PubMed2002

Polymorphism of glutathione S-transferase T1, M1 and P1 genes in a Shanghai population: patients with occupational or non-occupational bladder cancer.

OBJECTIVE: Glutathione S-transferases are involved in the conjugation of xenobiotics. To explore whether GSTs polymorphisms are involved in the development of occupational or non-occupational bladder cancer, polymorphism frequencies of GSTT1, M1 and P1 were investigated in a normal population, which had been settled in a rural area in Shanghai suburb for at least 5 generations as well as in a group of patients with benzidine exposure related occupational bladder cancer in Shanghai dyestuff industry and a group of patients with non-occupational bladder cancer. METHODS: PCR based procedures were performed in the study populations to confirm the genotypes of GSTT1, M1 and P1. RESULTS: The polymorphisms at locus of GSTP1-A1578G in the normal population differed significantly from those in Caucasians or African Americans. All the subjects genotyped so far (n = 118) bore only homogenous wild genotype (C2293/C2293) at GSTP1-C2293T locus. This locus seemed to be a monomorphic in Shanghai population. No significant difference in GSTT1 and GSTM1 polymorphic form frequencies could be confirmed among three groups of subjects. An overrepresentation of GSTP1 AG or GG genotype corresponding a less stable and less effective isozyme protein was detected in patients with benzidine related occupational bladder cancer, compared with that in the normal population though a statistical significance was not yet reached (P = 0.09, OR = 1.96, 95% CI 0.89-4.32). CONCLUSION: This study suggests that GSTM1 or GSTT1 homozygous deficiency genotypes and their combination do not have a clear impact on bladder cancer incidence in a Shanghai population. It seems that GSTP1 polymorphism is not associated with non-occupational bladder cancer. GSTP1 AG or GG genotype has a higher frequency in the patients with benzidine related occupational bladder cancer, and further work is needed to confirm if GSTP1 AG or GG genotype plays a role in the development of occupational bladder cancer.

Adult↗

PubMed1996

[Clinical state, bronchial reactivity and atopic symptoms in patients with occupational bronchial asthma 3-4 years after cessation of occupational exposure].

The results of numerous studies of occupational bronchial asthma proved that bronchial spasticity and nonspecific bronchial hyperreactivity persists after cessation of occupational exposure. The aim of the study was to evaluate the condition of patients with bronchial asthma after cessation of occupational exposure. A group of 23 patients with bronchial asthma had been observed twice: 1-6 months after cessation of occupational exposure and then 36 or 48 months later. An analysis of the clinical progress, both during the diagnostic process and the control examination, was based on a questionnaire including questions on cough intensity, dysponca, mean daily use of aerosol beta-mimetics and daily oral and inhalatory doses of corticosteroids. The analysis covered the month during the year proceeding the examination in which patients found themselves in the best psychosomatic condition. During both periods considered by patients themselves as the best ones from the clinical point of view, respiratory function tests and allergological tests were performed. The majority of patients with occupational bronchial asthma had reported, 2-3 years after cessation of occupational exposure, subjective complaints which indicated the improvement of their clinical condition. In those patients, the decrease in the intensity of specific allergic reactions was not observed. In the majority of patients with occupational bronchial asthma nonspecific bronchial hyperreactivity has not diminished despite a two-year break in occupational exposure.

Adult↗

PubMed2001

[Incidence of occupation-related skin diseases in skin-exposure occupational groups].

BACKGROUND AND OBJECTIVE: Occupational skin diseases (OSD) rank at the top of occupational diseases in Germany. We studied the cases with initial medical report of an OSD reported to our Register of OSD in North Bavaria (BKH-N). PATIENTS/METHODS: From 1990-99 5.285 cases were closed and recorded. Since the number of employees in the different occupations was known, a population-based study was performed to investigate incidences and demographic characteristics in occupations classified into 24 groups. RESULTS: In the occupational groups in 3.097 cases a work-related skin disease was stated. The estimated overall incidence was 6.7 cases per 10,000 workers per year. The highest incidence was in hairdressers (97.4), bakers (33.2), and florists (23.9), while the largest number of cases was in hairdressers (856), health services (481), and metal-surface workers (260). The median age of all cases was 25 years. In 1.611 cases (52%) a delayed-type sensitisation with occupational relevance was perceived. CONCLUSIONS: The descriptive data of the BKH-N highlight occupational groups being at risk for OSD. The results assist in working out prevention measures aiming on lowering the incidence of OSD.

Adult↗

PubMed1994

Occupation, occupational exposure to chemicals and rheumatological disease. A register based cohort study.

The cumulative incidence of rheumatoid arthritis (RA) was compared between different occupations, and between different exposure groups based on a job-exposure matrix (JEM). The study population comprised those subjects who in 1980 lived in one of 13 Swedish counties, were born between 1905 and 1945, and who had stated the same occupation in the censuses of 1960 and 1970, a total of 375,035 men and 140,139 women. The study population was followed concerning hospital care for rheumatoid arthritis in 1981-1983 by lineage to the Swedish Hospital Discharge Register. In general there were rather small differences in the relative risk of RA in different exposure groups and different occupations. Most of the occupations associated with an increased risk of RA were occupations in which it was possible to work when the disease was present, i.e. cost accountants, estimating clerks and working proprietors in the retail trade. However, an increased relative risk of RA was also observed in some occupations where selection of RA patients out of heavy work should have biased genuinely increased relative risks towards unity. Such occupations were farmers, upholsterers, lacquerers, concrete workers, and hair-dressers. Substantial handling of organic solvents, according to the JEM, was associated with an increased relative risk.

Adult↗

PubMed2003

Occupational conditions exceed the importance of non-occupational conditions and ill health in explaining future unemployment among women and men.

BACKGROUND: Unemployment is relatively common today, but the importance of work characteristics in relation to future unemployment has seldom been studied. METHODS: The relation between occupational and non-occupational factors, as well as ill health, in 1993 and unemployment in 1997 has been examined using an exploratory approach. Both analyses of associations and cluster analysis have been performed. RESULTS: Reduced psychological well-being and some occupational factors mainly related to job insecurity and, among women, also few opportunities for development at work--were found to be risk indicators for unemployment later on. To some extent, also earlier unemployment periods predicted unemployment in 1997. The influence of reduced psychological well-being and earlier unemployment periods on the associations between occupational factors in 1993 and 1997 consisted mainly of a decrease of the influence of job insecurity. Seven clusters were identified. One of them was male dominated, where the level of unemployment was very high and the individuals had reduced psychological well-being, insecure working conditions and demanding living conditions. The female equivalent was characterised by a high level of unemployment, multi-demands at work and poor musculoskeletal health. CONCLUSIONS: Reduced psychological well-being and job insecurity were risk indicators for later unemployment among both genders, as were also few opportunities for development at work among women. These factors predicted unemployment, also when age and other non-occupational factors were taken into consideration. The cluster analysis identified groups of individuals with highly demanding occupational and non-occupational conditions in 1993 and a high level of unemployment in 1997.

Adolescent↗

PubMed1994

Comparison of perceived occupational health needs among managers, employee representatives and occupational physicians.

The aim of this study was to assess how occupational health providers view the importance of different occupational health functions compared with their customers (managers and union representatives). A postal survey was undertaken requesting that managers of medium and large companies, union representatives and occupational physicians rank in order of importance 13 listed functions of an occupational health service which have appeared in the published literature. The results were analysed and tabulated to allow comparison of the responses among the four groups. The two functions ranked as most important by all four groups were advice on the work environment and advice on medical retirement. Dental services as an occupational health service function were ranked as least important by all four groups, with provision of physiotherapy services by occupational health departments also perceived as relatively unimportant by managers of medium and large companies. A wide discrepancy of views was revealed between physicians, managers and unions over the importance of immunization for travel and work and the rehabilitation and resettlement of sick and injured workers. The physicians ranked these functions as more important than the managers or union representatives. Managers of medium-sized companies also ranked counselling in the workplace much higher than the other respondents. The study shows the dilemma that occupational health services may face in deciding what functions should be provided compared to what their customers wish to be provided.

Administrative Personnel↗

PubMed2003

Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure.

Occupational skin diseases are among the most frequent work-related diseases in industrialized countries. Good occupational skin disease statistics exist in few countries. Questionnaire studies are needed to get more data on the epidemiology of occupational skin diseases. The Nordic Occupational Skin Questionnaire Group has developed a new questionnaire tool - Nordic Occupational Skin Questionnaire (NOSQ-2002) - for surveys on work-related skin disease and exposures to environmental factors. The 2 NOSQ-2002 questionnaires have been compiled by using existing questionnaires and experience. NOSQ-2002/SHORT is a ready-to-use 4-page questionnaire for screening and monitoring occupational skin diseases, e.g. in a population or workplace. All the questions in the short questionnaire (NOSQ-2002/SHORT) are included in the long version, NOSQ-2002/LONG, which contains a pool of questions to be chosen according to research needs and tailored to specific populations. The NOSQ-2002 report includes, in addition to the questionnaires, a comprehensive manual for researchers on planning and conducting a questionnaire survey on hand eczema and relevant exposures. NOSQ-2002 questionnaires have been compiled in English and translated into Danish, Swedish, Finnish and Icelandic. The use of NOSQ-2002 will benefit research on occupational skin diseases by providing more standardized data, which can be compared between studies and countries.

Dermatitis, Occupational↗

PubMed1998

Breast cancer risk and lifetime occupational history: employment in professional and managerial occupations.

OBJECTIVE: In this case-control study, occupational histories were used to assess the relation between risk of breast cancer and employment in professional and managerial occupations while adjusting for reproductive and other risk factors. METHODS: Incident, primary, female cases of breast cancer diagnosed between 1986 and 1991, and randomly selected controls were interviewed to obtain detailed medical, reproductive, and occupational histories. Mantel-Haenszel crude odds ratios (OR) and 95% confidence intervals (95% CIs) were used to estimate risk of breast cancer related to the job of longest duration. Unconditional logistic regression was used to estimate crude and adjusted ORs and 95% CIs associated with having ever been employed and duration of employment in a professional or managerial occupation. RESULTS: A non-significant threefold increase in risk was found among premenopausal women whose major job was in the occupational category of precision production, craft, and repair (95% CI 0.90 to 20.35). No increase in risk was found for premenopausal women whose major job was a managerial or professional occupation. However, an inverse relation between risk of premenopausal breast cancer and having ever held a professional or managerial job was observed (OR 0.53, 95% CI 0.34 to 0.82). This relation was strongest for women who worked one to 10 years (OR 0.47, 95% CI 0.29 to 0.77). Postmenopausal breast cancer was not related to professional and managerial employment. CONCLUSIONS: In this population, employment in professional and managerial occupations is not associated with postmenopausal risk of breast cancer, but seems to be related to a reduction in risk of premenopausal breast cancer. Methodological limitations of this study including response rates are discussed.

Adult↗

PubMedDate not supplied

Occupational therapy students' perspectives on occupation as an agent that promotes healthful lifestyles.

OBJECTIVES: This study was conducted to determine occupational therapy students' perspectives on occupation as an agent that promotes healthful lifestyles, what factors influence these perspectives, and the extent to which formal classroom instruction in occupation as a health-promoting agent influenced their perspective transformation. METHOD: Through a precourse and postcourse survey, weekly log sheets, and audiotaped class discussions, data regarding attitudes and beliefs about health promotion were collected from 23 occupational therapy master's students enrolled in the course Wellness Through Occupation. The data were analyzed with a priori concept coding to determine whether perspective transformation occurred as a result of formal classroom instruction. RESULTS: Participants indicated that family values, previous formal and informal instruction, and personal experience were the major factors that influenced their perspectives on occupation as an agent that promotes a healthful lifestyle. The results demonstrated that participants had a perspective transformation, which is the first step in the behavioral change process. CONCLUSION: Formal classroom instruction can be a factor in promoting healthful lifestyles through occupation. Such instruction can be an important step in empowering people to take responsibility for their own health.

Adult↗

PubMed1997

Ethical issues in occupational medicine practice: knowledge and attitudes of occupational physicians.

Views on ethical conduct in occupational medicine practice can vary from country to country and even between occupational health practitioners. However, there are many areas of common agreement, and this is apparent on comparing guidance documents on ethics produced by several different organizations. The usefulness of these documents will depend in part on how aware practitioners are of their existence. A standardized questionnaire administered to 70 occupational physicians in the Netherlands, UK, and Singapore showed that there was a lack of awareness of guidance documents on ethics, even for publications from their own countries. Only five of the 70 respondents consulted an ethics document in the past year. In addition to publications, other avenues were used for advice on ethical issues. There was a difference in opinion between the physicians from Singapore and those from the two European countries on whether specific occupational health activities were ethical. These findings reinforce the need for international guidance on ethics to take into account differences in attitudes and practice between countries. On many issues there was no unanimity of opinion, even between occupational physicians from the same country. This may be an indication of the complexity of ethical matters, and provides a rationale for publishing guidance on ethics in occupational medicine.

Adult↗

PubMed2006

Personal and non-occupational risk factors and occupational injury/illness.

BACKGROUND: The materials handling industry performs is an essential function in the world economy, however, it is plagued with occupationally related injuries and illnesses. Understanding the risk factors may assist this industry in alleviating these injuries and illnesses, as well as their associated costs. METHODS: Forty-eight personal and non-occupational risk factors were measured and evaluated for statistically significant relationships with occupational injury in 442 volunteer manual material handlers who worked for three different companies, at nine US locations, with 15 different job descriptions. OSHA 200 logs were used to ascertain evidence of occupational injury within this population for 1 year after the testing and measurement was completed. RESULTS: Higher occurrences of injury were significantly associated with six risk factors in the univariate model (odds ratios 1.51-4.00). The significantly (P < 0.05) related risk factors in the univariate model were aerobic power, smoking status, perceived fitness level, fishing/hunting as a hobby, speed limit obeyance, and witnessing or being involved in a violent fight. In the multivariate analysis, five risk factors (aerobic power, smoking status, percent body fat, body mass index, and sit-and-reach measured flexibility) were significantly (P < 0.05) associated with occupational injury. Odds ratios in the multivariate analysis varied from 1.42 to 10.11. CONCLUSION: Evidence of an association of occupational injury occurrence with certain risk factors presented in personal and non-occupational univariate and multivariate models is shown. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse.

Adult↗

PubMed1994

Medical and occupational preconditions for vibration-induced spinal disorders: occupational disease no. 2110 in Germany.

The current state of scientific knowledge of the biodynamic behaviour of the vertebral column under the influence of whole-body vibration whilst sitting and results from epidemiological studies caused the medical board of experts on occupational health of the Federal Ministry of Labour in Germany to add a new occupational disease to the official list of occupational diseases. The occupational disease "diseases of the lumber spine from disc degeneration caused by long-term (mainly vertical) whole-body vibration exposure" has been introduced. The medical preconditions with the symptoms and the diagnostic methods are presented. With regard to the occupational preconditions for the acknowledgement of this occupational disease, a procedure is suggested which leads to the determination of the total occupational vibration exposure dose. Another requirement for recognition is that the chronic recurrent complaints have caused the patient to avoid any form of vibration exposure.

Biomechanical Phenomena↗

PubMed1988

Occupational skin disease in Finland. An analysis of 10 years of statistics from an occupational dermatology clinic.

An analysis of 10 years (1974-1983) of statistics was carried out at the Institute of Occupational Health, Helsinki, Section of Dermatology, which is devoted to occupational dermatology. A total of 1,082 cases of occupational skin diseases were diagnosed during this period. Allergic (50.1%) and toxic eczema (47.1%) comprised the majority of occupational cases of dermatosis. The most frequent causes of allergic occupational eczemas were rubber chemicals (19.9%), chromates (18.8%), and epoxy resins (13.1%). If the metals (chromium, nickel and cobalt) were considered as a group, they formed the largest category (28.4%), followed by the plastic materials (27.7%). Detergents (37.8%), followed by organic solvents (16.1%), were responsible for most of the irritant (toxic) eczemas. Occupational skin diseases currently make up about 20% of all occupational diseases in Finland, but the percentage is decreasing.

Allergens↗

PubMed2001

Occupational dermatitis in a highly industrialized Italian region: the experience of four occupational health departments.

There is a need for several research centers to carry out coordinated large-scale evaluation of the spread of occupational irritant and allergic dermatitis. The Occupational Health Departments of Bergamo, Brescia, Lecco and Cremona therefore decided to join their experiences and bring together all the cases of occupational irritant and allergic dermatitis diagnosed by these Departments between 1993 and 1998. In this period, 1169 cases of occupational dermatitis were diagnosed, subdivided into 768 cases of allergic contact dermatitis (ACD), 337 of irritant contact dermatitis (ICD), 54 of urticaria and 10 of airborne contact dermatitis, and there has not been a trend towards increase of occupational dermatitis over the years. Our population included 724 males and 445 females and average latency after the beginning of exposure to occupational allergens was 8.01 years for ACD, 6.4 for ICD, 3.22 for urticaria and 5.57 for airborne contact dermatitis. The frequency of atopy was 33.9%, in females and 19.5% in males. The frequency of atopy was particularly high (89%) in subjects with urticaria. Among subjects with allergic dermatitis, 362 had had only one sensitization while 406 had had two or more sensitizations. The working areas where we found the highest number of ACD were metal working industry, building, health care workers and hairdressers and the frequency of ICD was high in metal workers and health care workers. Most of the cases of urticaria were diagnosed in health care workers (68.5%) and the main causing agent was latex. These are only preliminary data but occupations at risk and the substances expected to be the most frequent etiological agents do not differ significantly from those reported in the literature. It is hoped that as a result of this project there will be in the future: standardization of diagnostic procedures, uniform assessment of allergological risk in working environments not yet fully investigated, standardization of preventative measures and proper evaluation of their effectiveness.

Adult↗

PubMed2003

Occupational physical activity across occupational categories.

This study investigated the amount of physical activity that occurs during normal working hours, highlighting the occupational differences in physical activity by occupational category. Data were collected by means of a self-administered questionnaire (Tecumseh Occupational Physical Activity Questionnaire [TOQ]), which measures past year Occupational Physical Activity (OPA) and by a motion-sensing device (Yamax DigiWalker Pedometer SW - 700). Ninety male and female participants aged 18-62 years participated in the study. Participants were stratified by occupational category according to the Australian Standard Classification of Occupations (ASCO), which was then condensed into professional, white-collar and blue-collar workers. The results showed significant (p < .05) increases in OPA from the professional category (least active) through to the blue-collar workers (most active) in terms of walking activity. Mean daily step counts were 2,835, 3,616 and 8,757 for professional, white-collar and blue-collar respectively. Occupational Physical Activity Scores and Work Activity Units (WAU) in MET - min x wk(-1) from the TOQ showed similar patterns, with blue collar reporting significantly (p < .05) more past year OPA than their white-collar and professional workers. Significant correlations were also shown between the pedometer (step-count data) and the TOQ (r = .38 - .74, p < .01).

Adult↗

PubMed1995

Validity of mother's report of father's occupation in a study of paternal occupation and congenital malformations.

Agreement between the mother's and father's report of the father's occupation was assessed in a case-control study of paternal occupation and birth defects. Cases were identified from births registered with the Metropolitan Atlanta Congenital Defects Program between 1968 and 1980; controls were selected from liveborn infants without defects. Both parents were sought for interview, and each parent was asked about the father's job history for 2 years prior to the infant's death. This concordance analysis is based on 3,739 case infants and 2,279 control infants for whom both parents were interviewed. The authors considered the father's report of his occupation as correct, and they assessed the ability of the mother to report the same occupation(s) during a 7-month period around conception. The exact agreement between mother's and father's report of the father's occupation was 59%. Agreement improved slightly with increasing family income and when fathers were college graduates. Female partners were not accurate proxy respondents in this study of paternal occupation and birth defects, which suggests that investigators should interview both parents in studies of paternal exposures and reproductive outcomes, i.e., mothers for pregnancy history and maternal confounders and fathers for occupational history and paternal confounders.

Case-Control Studies↗

PubMed1994

Occupation and lung cancer mortality among women: using occupation to target smoking cessation programs for women.

Lung cancer mortality rates are increasing for women, despite the fact that 90% of these deaths could be prevented by smoking cessation. Targeted workplace smoking cessation programs may increase the effectiveness of lung cancer prevention for women. This study uses proportionate mortality ratio analysis of occupationally coded death certificates, from 28 states between 1979 and 1990, to identify occupations in which women are at high risk of lung cancer mortality. The study found gender and racial variation in the results for broad occupational groups. Blue-collar occupations associated with potentially carcinogenic workplace exposures also had elevated proportionate mortality ratios, probably reflecting both occupational and tobacco exposure. For women, specific occupations such as managers and financial officers revealed significant elevations in lung cancer mortality. Cessation programs targeting women in these occupational groups may increase the effectiveness of lung cancer prevention.

Adult↗