Descriptive characteristics of occupational exposures and medical follow-up in the cohort of workers of the Siberian Group of Chemical Enterprises in Seversk, Russia

ObjectivesTo date, only a few studies have investigated the associations between occupational exposures and respiratory outcomes longitudinally in the general population. We investigated the associations between occupational exposures and the development of respiratory symptoms and airway obstruction in the Lifelines Cohort Study.MethodsWe included 35 739 occupationally active subjects with data on chronic cough, chronic phlegm, chronic bronchitis or airway obstruction at baseline and approximately 4.5 years follow-up. Exposures to biological dust, mineral dust, gases/fumes, pesticides, solvents and metals in the current job at baseline were estimated with the ALOHA+job-exposure matrix (JEM). Airway obstruction was defined as FEV1/FVC below the lower limit of normal. Logistic regression analysis adjusted for baseline covariates was used to investigate the associations.ResultsAt follow-up, 1888 (6.0%), 1495 (4.7%), 710 (2.5%) and 508 (4.5%) subjects had developed chronic cough, chronic phlegm, chronic bronchitis and airway obstruction, respectively. High exposure to biological dust was associated with a higher odds to develop chronic cough and chronic bronchitis. High exposure to pesticides was associated with a higher odds for the development of all respiratory symptoms and airway obstruction. In the multiple exposures analyses, only the association between pesticides exposure and respiratory symptoms remained.ConclusionsSubjects exposed to high pesticides had a higher odds to develop respiratory symptoms on average 4.5 years later. Control measures should be taken to reduce pesticides exposure among the working population to prevent respiratory symptoms and airway obstruction.

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Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey

Thorax ◽

10.1136/thoraxjnl-2017-211158 ◽

2018 ◽

Vol 73 (11) ◽

pp. 1008-1015 ◽

Cited By ~ 21

Author(s):

Theodore Lytras ◽

Manolis Kogevinas ◽

Hans Kromhout ◽

Anne-Elie Carsin ◽

Josep M Antó ◽

...

Keyword(s):

European Community ◽

Health Survey ◽

Respiratory Health ◽

Population Attributable Fraction ◽

Occupational Exposures ◽

Evidence Base ◽

Job Exposure Matrix ◽

Increased Risk ◽

Lower Limit Of Normal

BackgroundOccupational exposures have been associated with an increased risk of COPD. However, few studies have related objectively assessed occupational exposures to prospectively assessed incidence of COPD, using postbronchodilator lung function tests. Our objective was to examine the effect of occupational exposures on COPD incidence in the European Community Respiratory Health Survey.MethodsGeneral population samples aged 20–44 were randomly selected in 1991–1993 and followed up 20 years later (2010–2012). Spirometry was performed at baseline and at follow-up, with incident COPD defined using a lower limit of normal criterion for postbronchodilator FEV1/FVC. Only participants without COPD and without current asthma at baseline were included. Coded job histories during follow-up were linked to a Job-Exposure Matrix, generating occupational exposure estimates to 12 categories of agents. Their association with COPD incidence was examined in log-binomial models fitted in a Bayesian framework.Findings3343 participants fulfilled the inclusion criteria; 89 of them had COPD at follow-up (1.4 cases/1000 person-years). Participants exposed to biological dust had a higher incidence of COPD compared with those unexposed (relative risk (RR) 1.6, 95% CI 1.1 to 2.3), as did those exposed to gases and fumes (RR 1.5, 95% CI 1.0 to 2.2) and pesticides (RR 2.2, 95% CI 1.1 to 3.8). The combined population attributable fraction for these exposures was 21.0%.InterpretationThese results substantially strengthen the evidence base for occupational exposures as an important risk factor for COPD.

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Influence of job assignment on melanoma (MEL) incidence in commercial aircrew.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21058 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21058-e21058

Author(s):

Lee D. Cranmer

Keyword(s):

Meta Analysis ◽

Occupational Exposures ◽

Study Groups ◽

Job Assignment ◽

Commercial Aircraft ◽

Cabin Crew ◽

Different Types ◽

Keywords Cancer ◽

The Difference

e21058 Background: Commercial cabin and cockpit aircrews are at increased cutaneous MEL risk. Occupational and social factors have been invoked to explain this. However, the two groups work in on-board environments with different types/levels of potential exposures. Meta-analysis is conducted to address the hypothesis that differences exist in aircrew MEL risk based on location of in-aircraft job assignment, reflecting differential etiologic occupational exposures. Methods: Medline was searched with the keywords “Cancer,” “Aviation,” and “Melanoma.” Included studies: (1) primarily focused on cutaneous MEL; (2) were in commercial aircrew; (3) measured risk vs a general population; (4) measured risk by Standardized Incidence Ratio (SIR) with 95% confidence intervals (CI); (5) defined the gender distribution; and (7) defined cabin vs cockpit job assignment. Summary SIRs and CIs were calculated using maximum-likelihood, random effects meta-analysis. Values obtained were compared to one another using a z-test, with p < 0.05 pre-specified for null hypothesis rejection. Results: 6 primary studies were identified in the initial search. These were screened for other pertinent references. The secondary search yielded an additional 9 primary studies. For cabin crew, 10 study groups from 6 studies were included. 411,561 person-years of follow-up among 28,093 subjects (86% female) were included (SIR 2.18, 95% CI 1.83-2.60). For cockpit crew, data from 9 studies representing 830,670 person-years of follow-up among 45,986 subjects (1% female) were included (SIR 2.44, 95% CI 1.94-3.08). z-test for the difference indicated that the two SIR values were not statistically different ( z= 0.77, p = 0.441). Conclusions: Though cockpit crew demonstrate an increased SIR vs cabin crew, this is not statistically significant. These results suggest that occupational exposures in different locations within commercial aircraft does not influence MEL risk. Other factors, such as cosmic radiation, non-aircraft occupational exposures and avocational exposures, should be the targets of further assessment.

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Two cases of asbestosis and one case of rounded atelectasis due to non-occupational asbestos exposure

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2008.410 ◽

2016 ◽

Vol 69 (1) ◽

Author(s):

S.M. Candura ◽

A. Binarelli ◽

G. Ragno ◽

F. Scafa

Keyword(s):

Occupational Diseases ◽

Asbestos Exposure ◽

Occupational Exposures ◽

Respiratory Illnesses ◽

Pleural Plaques ◽

Long Latency ◽

Asbestos Cement ◽

Progression Of Disease ◽

Contaminated Area

Asbestos is a well-known cause of several neoplastic (malignant mesothelioma, lung cancer) and non-neoplastic (asbestosis, pleuropathies) occupational diseases. Lower-level exposure in the general environment may induce pleural plaques and thickenings, and is associated with an increased mesothelioma risk. We present two patients (a 68-year-old man and a 72-year-old woman) who developed asbestosis (in association with pleural plaques and calcifications), and a 78-year-old man who developed rounded atelectasis (with pleural plaques and benign effusion), after living for several decades in the proximity of large Italian asbestos-cement plant. None of them had been exposed to asbestos occupationally. Besides living in a contaminated area, the woman used to clean the work clothes of her brother, who was employed in the local asbestos factory. The three cases indicate that non-neoplastic, long-latency asbestos-related diseases which are usually observed as a consequence of occupational exposures, may rarely develop in subjects living in contaminated geographical sites and buildings. These unusual environmental diseases raise the diagnostic problem of differentiating them from other, more common respiratory illnesses, and impose the duties of patient notification, assessment and follow-up, to assess the possibility of progression of disease and increased neoplastic risk.

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Occupational exposure to HIV and use of post-exposure prophylaxis in a general hospital in North Central, Nigeria.

International Journal of Occupational Safety and Health ◽

10.3126/ijosh.v3i1.6635 ◽

2013 ◽

Vol 3 (1) ◽

pp. 11-17 ◽

Cited By ~ 2

Author(s):

Abiola O Olaleye ◽

Olorunfemi A Ogundele ◽

Babatunde I Awokola ◽

Oladele S Olatunya ◽

Omolara A Olaleye ◽

...

Keyword(s):

Occupational Exposure ◽

General Hospital ◽

Health Workers ◽

Central Zone ◽

Occupational Exposures ◽

Post Exposure Prophylaxis ◽

North Central ◽

Post Exposure ◽

Exposure Prophylaxis

Occupational exposures to blood borne pathogens including HIV have been well studied. However, limited studies exist about the utilization of post exposure prophylaxis and follow-up in Nigeria. The objectives of the study were to describe the characteristics of occupational exposure to HIV, the utilization of post exposure prophylaxis (PEP) among health workers, and the proportion of exposed health workers reporting for follow-up three months after exposure. A cross sectional descriptive study involving ninety three health workers was carried out at a general hospital located in an urban area in North Central zone of Nigeria. A simple random sampling technique was used. The prevalence of occupational exposure, utilization of post exposure prophylaxis and follow-up rate were assessed using self administered questionnaire. Data analysis was done using SPSS version 16 and descriptive analysis was carried out. It was reported that, 73.1% of respondents at least one or more occupational exposures to HIV and other blood borne pathogens through accidental needle injury/prick, blood splash on a fresh wound or conjunctiva exposure in the last one year. Needle stick injury occurred in 83.8% of all respondents who had occupational exposures. 8.8% of exposed respondents commenced post exposure prophylaxis with two-thirds completing the post exposure prophylaxis regimen. Only one (25%) of those who completed the regimen reported for follow-up. Occupational exposures to HIV are common among health workers. The rates of utilization of post exposure prophylaxis and follow-up were low. DOI: http://dx.doi.org/10.3126/ijosh.v3i1.6635 International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 11-17

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O3D.2 45 years of follow-up for cancer for jobs and occupational exposures in 15 millions in five nordic countries – NOCCA

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.73 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A27.2-A28

Author(s):

Johnni Hansen ◽

Jan Ivar Martinsen ◽

Elisabete Weiderpass ◽

Kristina Kjærheim ◽

Pär Sparén ◽

...

Keyword(s):

Occupational Exposures ◽

Quality Data ◽

Wood Dust ◽

Calendar Time ◽

Occupational Setting ◽

Tobacco Workers ◽

Time Specific ◽

A Minor ◽

Risk Of Cancer

IntroductionA majority of established human carcinogens have been discovered in the occupational setting. For most cancers, including even frequent cancers like colorectal, prostate and breast, however, only a minor fraction of the overall causes has been identified so far. Therefore, it is obvious than even more carcinogens can be discovered through studies of occupation and cancer. This can be facilitated by the use of big high quality data.MethodsOur study covers 15 million working-aged persons who participated in population censuses between 1960 and 1990 in Denmark, Finland, Iceland, Norway and Sweden. These persons have been followed-up for cancer and divided into 70 cancer categories. Further, country and calendar time specific job exposure matrices (JEM) are developed for 30 documented and potential carcinogens, including e.g. asbestos, formaldehyde, wood dust, quartz and several specific metals and organic solvents.ResultsIn total 2.8 million incident cancer cases are diagnosed in these people during the follow-up. Even for all cancers combined, there is a wide statistically significant variation among men from a relative risk (RR) of 0.79 in domestic assistants to 1.48 in waiters. The occupations with the highest RR also includes workers producing beverage and tobacco, seamen and chimney sweeps. Among women, the overall RR varied from 0.58 in seafarers to 1.27 in tobacco workers. Low RRs were found for farmers, gardeners and forestry workers in both genders. We have also estimated RRs after exposure to e.g. various metals, solvents, formaldehyde and wood dust. Additional examples from the over 50 papers published so far based on this comprehensive on-going cohort will be presented.ConclusionsThe present study shows that the risk of cancer is highly dependent on occupation and specific occupational exposures.

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O3D.1 Omega-net inventory of occupational cohorts

Occupational and Environmental Medicine ◽

10.1136/oem-2019-epi.72 ◽

2019 ◽

Vol 76 (Suppl 1) ◽

pp. A27.1-A27

Author(s):

Michelle C Turner ◽

Vivi Schlünssen ◽

Gemma Castano-Vinyals ◽

Lode Godderis ◽

Malcolm Sim ◽

...

Keyword(s):

Occupational Exposures ◽

Scientific Output ◽

Research Strategy ◽

Access To Information ◽

Web Based ◽

Integrated Research ◽

International Partner ◽

European Health ◽

The Eu

Europe currently has some of the most valuable occupational, industrial, and population cohorts worldwide. However, in recent years there has been limited coordination and promotion of European health research on occupation and employment. OMEGA-NET is a COST Action (2017–2021) funded by the EU, currently involving researchers from 29 European countries and an increasing number of near neighbour and international partner countries. The overarching concept is to create a network to advance i) collaboration of existing cohorts, ii) coordination and harmonisation of exposure assessment, and iii) facilitation of an integrated research strategy for occupational health in Europe. As part of this work, OMEGA-NET is currently building an online searchable ‘Inventory of Occupational Cohorts’. We will inventory epidemiological, occupational, population, and registry-based cohorts with data on occupational exposures and health effects. The inventory will include cohorts with data that is potentially accessible; that have collected information on occupation and/or industry or at least one occupational exposure; and have at least one follow-up point with health outcomes. Cohorts will be identified through systematic searches and personal records. An initial search identified more than sixty cohorts including more than 40 million persons with information on occupation. Researchers responsible for the cohorts will be contacted and asked to complete a web-based questionnaire. An online searchable ‘Inventory of Occupational Cohorts’ database will be developed to make the information publicly accessible and to facilitate researcher and policy-maker access to information from past and ongoing cohort studies. Users will be able to search for specific exposures and outcomes and extract basic information on the methodology of the cohorts. The OMEGA-NET Inventory of Occupational Cohorts will be the most comprehensive inventory of occupational cohorts worldwide and is expected to enhance scientific output from individual studies, and facilitate pooled studies, data sharing, and more efficient use of existing cohorts.

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The OMEGA-NET International Inventory of Occupational Cohorts

Annals of Work Exposures and Health ◽

10.1093/annweh/wxaa039 ◽

2020 ◽

Vol 64 (6) ◽

pp. 565-568

Author(s):

Manolis Kogevinas ◽

Vivi Schlünssen ◽

Ingrid S Mehlum ◽

Michelle C Turner

Keyword(s):

Occupational Exposure ◽

Policy Development ◽

Large Scale ◽

Intervention Studies ◽

Occupational Exposures ◽

Case Control ◽

Case Control Studies ◽

Occupational Information ◽

Research And Policy

Abstract In a recent count of cohort studies in Europe capturing information on occupation and/or occupational exposures, we estimated that there are more than 60 major studies with some type of occupational information that enrolled over 30 million persons. With few exceptions there have been no large-scale analyses systematically combining cohorts from this extraordinary resource. We present the development of an inventory of cohorts with occupational information in Europe and internationally and describe the online interactive tool with detailed information on existing cohorts. The OMEGA-NET inventory can be accessed at http://occupationalcohorts.net/ includes cohorts, case-control studies nested within cohorts and intervention studies that are active or can substantiate that their data are potentially accessible; that include data on occupation and/or industry or at least one occupational exposure; and that have at least one follow-up, either already conducted or planned. We expect that this open access inventory will be an important prerequisite for use of this resource of existing studies for research and policy development.

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Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis

Infection Control and Hospital Epidemiology ◽

10.1086/672271 ◽

2013 ◽

Vol 34 (9) ◽

pp. 875-892 ◽

Cited By ~ 184

Author(s):

David T. Kuhar ◽

David K. Henderson ◽

Kimberly A. Struble ◽

Walid Heneine ◽

Vasavi Thomas ◽

...

Keyword(s):

Public Health ◽

Human Immunodeficiency Virus ◽

Hiv Testing ◽

Public Health Service ◽

Occupational Exposures ◽

Expert Consultation ◽

Postexposure Prophylaxis ◽

Immunodeficiency Virus ◽

Hiv Exposure

This report updates US Public Health Service recommendations for the management of healthcare personnel (HCP) who experience occupational exposure to blood and/or other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens and the duration of HIV follow-up testing for exposed personnel have been updated. This report emphasizes the importance of primary prevention strategies, the prompt reporting and management of occupational exposures, adherence to recommended HIV PEP regimens when indicated for an exposure, expert consultation in management of exposures, follow-up of exposed HCP to improve adherence to PEP, and careful monitoring for adverse events related to treatment, as well as for virologie, immunologic, and serologic signs of infection. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns, and institutions should take steps to ensure that staff are aware of both the importance of and the institutional mechanisms available for reporting and seeking care for such exposures. The following is a summary of recommendations: (1) PEP is recommended when occupational exposures to HIV occur; (2) the HIV status of the exposure source patient should be determined, if possible, to guide need for HIV PEP; (3) PEP medication regimens should be started as soon as possible after occupational exposure to HIV, and they should be continued for a 4-week duration; (4) new recommendation—PEP medication regimens should contain 3 (or more) antiretroviral drugs (listed in Appendix A) for all occupational exposures to HIV; (5) expert consultation is recommended for any occupational exposures to HIV and at a minimum for situations described in Box 1; (6) close follow-up for exposed personnel (Box 2) should be provided that includes counseling, baseline and follow-up HIV testing, and monitoring for drug toxicity; follow-up appointments should begin within 72 hours of an HIV exposure; and (7) new recommendation—if a newer fourth-generation combination HIV p24 antigen-HIV antibody test is utilized for follow-up HIV testing of exposed HCP, HIV testing may be concluded 4 months after exposure (Box 2); if a newer testing platform is not available, follow-up HIV testing is typically concluded 6 months after an HIV exposure.

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