Occupational and environmental health

2020 ◽  
pp. 1638-1652
Author(s):  
Raymond Agius ◽  
Debasish Sen
Keyword(s):  
Environmental Factors ◽  
Occupational Diseases ◽  
Asbestos Exposure ◽  
Occupational Exposures ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Response Strength ◽  
Exposure Response ◽  
Key Issues ◽  
Strength Of Association

Occupational diseases are those for which work or, specifically, exposures in the workplace are necessary causes. The most prevalent occupational diseases in developed countries today are musculoskeletal and psychological disorders (usually stress-related conditions), but generally occupationally related malignancies (e.g. mesothelioma related to asbestos exposure) have the most serious outcomes. The proportion of all cancers attributable to occupational exposures is about 4%, with occupationally related cancers almost exclusively concentrated in manual workers aged 20 or over in sectors such as mining, agriculture, and industry. When presented with a patient whose illness might possibly have been caused or aggravated by work or by other environmental factors, the physician can usefully adopt an approach similar to that used for determining causation in epidemiological studies; the key issues being the temporality, reversibility, exposure-response, strength of association, and specificity of the illness with exposure to the factor in question.

scholarly journals Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom

2018 ◽  
Vol 75 (12) ◽  
pp. 898-903 ◽  
Author(s):  
Alison Reid ◽  
Peter Franklin ◽  
Geoffrey Berry ◽  
Susan Peters ◽  
Nita Sodhi-Berry ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Asbestos Exposure ◽  
Age Groups ◽  
Developed Countries ◽  
Incidence Rates ◽  
Cumulative Exposure ◽  
Survival Models ◽  
Response Relationship ◽  
Exposure Response ◽  
Long Latency

ObjectivesThe presence of asbestos in public buildings is a legacy of past asbestos use in many developed countries. Of particular concern is the amount and current condition in schools and the vulnerability of children to mesothelioma. Our aim was to compare the risk of mesothelioma between those exposed to blue asbestos as children and as adults at Wittenoom.MethodsPublic sources were used to establish the Wittenoom residents’ cohort. Mesothelioma incidence rates per 100 000 person-years at risk were derived for those first exposed to asbestos at Wittenoom as children (<15 years) or adults separately. Proportional hazards survival models examined the slope of the exposure-response relationship between asbestos exposure and incidence of mesothelioma in different sex and age groups.ResultsThe mesothelioma rate was lower among those first exposed as children (76.8 per 100 000) than those first exposed as adults (121.3 per 100 000). Adjusting for cumulative exposure to asbestos and sex, those exposed as adults had a greater risk of mesothelioma (adjusted HR 2.5, 95% CI 1.7 to 3.7). The slope of the exposure-response relationship did not differ between those exposed as children and those exposed as adults.ConclusionWe found no greater susceptibility to mesothelioma among those first exposed to asbestos as children than those first exposed as adults. However, given the long latency of mesothelioma, and the greater years of life yet to be lived by the Wittenoom children, it is likely that there will be more cases of mesothelioma in the future among those first exposed as children.

scholarly journals Validation of an Asbestos Job-Exposure Matrix (AsbJEM) in Australia: Exposure–Response Relationships for Malignant Mesothelioma

2019 ◽  
Vol 63 (7) ◽  
pp. 719-728 ◽  
Author(s):  
Hiroyuki Kamiya ◽  
Susan Peters ◽  
Nita Sodhi-Berry ◽  
Alison Reid ◽  
Len Gordon ◽  
...  
Keyword(s):  
Malignant Mesothelioma ◽  
Proportional Hazards ◽  
Asbestos Exposure ◽  
Occupational Exposures ◽  
Peak Frequency ◽  
Cox Proportional Hazards ◽  
Surveillance Program ◽  
Average Intensity ◽  
Job Exposure Matrix ◽  
Exposure Response

Abstract Objectives An asbestos job-exposure matrix (AsbJEM) has been developed to systematically and cost-effectively evaluate occupational exposures in population-based studies. The primary aim of this study was to examine the accuracy of the AsbJEM in determining exposure–response relationships between asbestos exposure estimates and malignant mesothelioma (MM) incidence (indirect validation). The secondary aim was to investigate whether the assumptions used in the development of the original AsbJEM provided accurate asbestos exposure estimates. Methods The study population consisted of participants in an annual health surveillance program, who had at least 3-month occupational asbestos exposure. Calculated asbestos exposure indices included cumulative asbestos exposure and the average exposure intensity, estimated using the AsbJEM and duration of employment. Asbestos and MM exposure–response relationships were compared between the original AsbJEM and its variations based on manipulations of the intensity, duration and frequency of exposure. Twenty-four exposure estimates were calculated for both cumulative asbestos exposure and the average exposure intensity using three exposure intensities (50th, 75th and 90th percentile of the range of mode exposure), four peak durations (15, 30, 60 and 120 min) and two patterns of peak frequency (original and doubled). Cox proportional hazards models were used to describe the associations between MM incidence and each of the cumulative and average intensity estimates. Results Data were collected from 1602 male participants. Of these, 40 developed MM during the study period. There were significant associations between MM incidence and both cumulative and average exposure intensity for all estimates. The strongest association, based on the regression-coefficient from the models, was found for the 50th percentile of mode exposure, 15-min peak duration and the doubled frequency of peak exposure. Using these assumptions, the hazard ratios for mesothelioma were 1 (reference), 1.91, 3.24 and 5.37 for the quartiles of cumulative asbestos exposure and 1 (reference), 1.84, 2.31 and 4.40 for the quartiles of the average exposure intensity, respectively. Conclusion The well-known positive exposure–response relationship between MM incidence and both estimated cumulative asbestos exposure and average exposure intensity was confirmed. The strongest relationship was found when the frequency of peak exposure in the AsbJEM was doubled from the originally published estimates.

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

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.

Global Oral Health Inequalities

2011 ◽  
Vol 23 (2) ◽  
pp. 227-236 ◽  
Author(s):  
S. Challacombe ◽  
M. Chidzonga ◽  
M. Glick ◽  
T. Hodgson ◽  
M. Magalhães ◽  
...  
Keyword(s):  
Oral Health ◽  
Sexually Transmitted Diseases ◽  
Fungal Infections ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Current Treatment ◽  
Health Priorities ◽  
Oral Manifestations ◽  
Sexually Transmitted ◽  
Mucosal Involvement

Four oral mucosal infections were identified as Global Oral Health Priorities: (a) HIV and associated viral, bacterial, and fungal infections; (b) tuberculosis; (c) NOMA; and (d) sexually transmitted diseases. Huge global inequalities exist in all four. HIV-associated infections constitute the major challenge. Oral manifestations of AIDS can be specifically diagnostic, indicating a significant role for dentists within health teams. The World Workshops in Oral Health & Disease in AIDS have identified a research program, elements of which are being implemented. Data on oral mucosal involvement in tuberculosis, syphilis, and gonorrhea are incomplete in developed countries and virtually non-existent in low- and middle-income countries, indicating the need for further epidemiological studies. Oral manifestations of tuberculosis and sexually transmitted diseases are largely associated with general health, so action programs should be integrated with agencies treating the systemic diseases. NOMA is very much in the oral health domain. It is a preventable disease associated with malnutrition and unidentified bacterial factors. Prevalence is probably grossly overestimated at present; but nevertheless it constitutes a challenge to the profession, especially in the NOMA belt. Current treatment is surgical, but plans for its eradication should be achievable. The global oral health community, especially the IADR, has a major role to play.

scholarly journals Associations between the spatiotemporal distribution of Kawasaki disease and environmental factors: evidence supporting a multifactorial etiologic model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tisiana Low ◽  
Brian W. McCrindle ◽  
Brigitte Mueller ◽  
Chun-Po S. Fan ◽  
Emily Somerset ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Environmental Factors ◽  
Disease Model ◽  
Information Criterion ◽  
Developed Countries ◽  
Spatiotemporal Distribution ◽  
Atmospheric Concentration ◽  
Related Factors ◽  
Temporal Correlations ◽  
Intestinal Infections

AbstractThe etiology of Kawasaki Disease (KD), the most common cause of acquired heart disease in children in developed countries, remains elusive, but could be multifactorial in nature as suggested by the numerous environmental and infectious exposures that have previously been linked to its epidemiology. There is still a lack of a comprehensive model describing these complex associations. We present a Bayesian disease model that provides insight in the spatiotemporal distribution of KD in Canada from 2004 to 2017. The disease model including environmental factors had improved Watanabe-Akaike information criterion (WAIC) compared to the base model which included only spatiotemporal and demographic effects and had excellent performance in recapitulating the spatiotemporal distribution of KD in Canada (98% and 86% spatial and temporal correlations, respectively). The model suggests an association between the distribution of KD and population composition, weather-related factors, aeroallergen exposure, pollution, atmospheric concentration of spores and algae, and the incidence of healthcare encounters for bacterial pneumonia or viral intestinal infections. This model could be the basis of a hypothetical data-driven framework for the spatiotemporal distribution of KD. It also generates novel hypotheses about the etiology of KD, and provides a basis for the future development of a predictive and surveillance model.

scholarly journals The Effect of Random Error in Exposure Measurement upon the Shape of the Exposure Response

Dose-Response ◽  
2005 ◽  
Vol 3 (4) ◽  
pp. dose-response.0 ◽  
Author(s):  
Kenny S. Crump
Keyword(s):  
Measurement Error ◽  
Measurement Errors ◽  
Epidemiological Data ◽  
Epidemiological Studies ◽  
Random Errors ◽  
Exposure Measurement ◽  
Considerable Uncertainty ◽  
Exposure Response ◽  
Log Normal ◽  
Normally Distributed

Although statistical analyses of epidemiological data usually treat the exposure variable as being known without error, estimated exposures in epidemiological studies often involve considerable uncertainty. This paper investigates the theoretical effect of random errors in exposure measurement upon the observed shape of the exposure response. The model utilized assumes that true exposures are log-normally distributed, and multiplicative measurement errors are also log-normally distributed and independent of the true exposures. Under these conditions it is shown that whenever the true exposure response is proportional to exposure to a power r, the observed exposure response is proportional to exposure to a power K, where K < r. This implies that the observed exposure response exaggerates risk, and by arbitrarily large amounts, at sufficiently small exposures. It also follows that a truly linear exposure response will appear to be supra-linear—i.e., a linear function of exposure raised to the K-th power, where K is less than 1.0. These conclusions hold generally under the stated log-normal assumptions whenever there is any amount of measurement error, including, in particular, when the measurement error is unbiased either in the natural or log scales. Equations are provided that express the observed exposure response in terms of the parameters of the underlying log-normal distribution. A limited investigation suggests that these conclusions do not depend upon the log-normal assumptions, but hold more widely. Because of this problem, in addition to other problems in exposure measurement, shapes of exposure responses derived empirically from epidemiological data should be treated very cautiously. In particular, one should be cautious in concluding that the true exposure response is supra-linear on the basis of an observed supra-linear form.

Increased severity of labor is the most important risk factor of occupational diseases at enterprises in the Arctic

2020 ◽  
pp. 26-34
Author(s):  
S.A. Syurin
Keyword(s):  
Occupational Diseases ◽  
Cumulative Effect ◽  
Occupational Exposures ◽  
The Arctic ◽  
Physical Factors ◽  
Mining Operations ◽  
Production Factors ◽  
Permissible Levels ◽  
The Russian Federation ◽  
Total Structure

In Russia, in the structure of harmful production factors that cause the development of occupational pathology, the severity of labor takes the second place. The aim of the study was to investigate the effect of increased labor severity on the occurrence, prevalence and structure of occupational diseases in workers at enterprises in the Arctic. The analysis included results of the monitoring study “Working conditions and occupational morbidity” of the population of the Arctic zone of Russia in 2008 – 2018. It was found that in 2008-2018 there was a significant increase in the etiological significance of increased labor severity in the development of occupational pathology: the share of the factor in the total structure of harmful occupational exposures increased from 7.4% to 8.9% (p <0.001), and that of occupational diseases caused by increased labor severity - from 18.6% to 46.9% (p <0.001). Two thirds of occupational diseases caused by the increased severity of labor occur in miners, and diseases of the musculoskeletal system dominate in their structure (80.1%). The risk of developing this group of occupational health disorders in 2018 was higher than in 2008: RR=3,95; CI 3,13-4,99; χ2 =155,9; р<0,001. In contrast to the Russian Federation as a whole, where the increased severity of labor ranks second among the occupational pathology causing factors (24.7%), in the Russian Arctic it came out on top in 2018 (46.9%), exceeding the cumulative effect of all physical factors (44.0%). When carrying out recreational activities and prevention of occupational pathology at enterprises in the Arctic, special attention should be paid to achieving permissible levels of labor severity among workers engaged in mining operations.

scholarly journals Impacts of Pesticide Exposure on Paddy Farmers’ Health

2013 ◽  
Vol 2 ◽  
pp. 18-25 ◽  
Author(s):  
Subhra Bhattacharjee ◽  
MAZ Chowdhury ◽  
ANM Fakhruddin ◽  
MK Alam
Keyword(s):  
Pesticide Exposure ◽  
Multinomial Logistic Regression ◽  
Occupational Exposures ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Least Developed Countries ◽  
Excessive Sweating ◽  
Cross Sectional ◽  
Multinomial Logistic Regression Analysis ◽  
Paddy Farmers

Effects of pesticide exposure on farmer’s health are conducted mostly in developed countries, which is rare in least developed countries like Bangladesh. Here farmers had less guidance and instruction about the preventive measures to protect themselves and environment. This work was studied to assess the impacts of pesticide exposure on the paddy farmer’s health in two different Upazilas of Manikganj, Bangladesh. The study was conducted as cross-sectional study with quantitative and qualitative components. Five hundred eighty two farmers (368 sprayers and 214 non-sprayers) were interviewed. Chi-squared tests and multinomial logistic regression analysis were performed for statistical analysis. Three hundred sixty eight farmers (64.3%) sprayed pesticides and were directly exposed to chemicals. Among them 64.22% and 9.06%, farmers used moderately and highly hazardous pesticides, respectively. 257 farmers (69.8%) were not taken any protective measures to handle pesticides. Excessive sweating, burning eyes and fatigue were reported by 26.3%, 24.4% and 18.8% of the farmers, respectively. These types of symptoms were significantly associated among male farmers. The study reveals that due to lack of awareness, occupational exposures of pesticides among farmers are common in Bangladesh and it also emphasize the importance of use of personal protective equipments. Jahangirnagar University Environmental Bulletin, Vol.2, 18-25, 2013 DOI: http://dx.doi.org/10.3329/jueb.v2i0.16326

The House of Love and the Mental Hospital

2021 ◽  
Author(s):  
Murphy Halliburton
Keyword(s):  
Family Support ◽  
Family Involvement ◽  
Low Income ◽  
Global Mental Health ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Low Income Countries ◽  
Rehabilitation Centre

The Movement for Global Mental Health has defined the person suffering psychopathology in low-income countries as an abused and suffering subject in need of saving by biomedical psychiatry. Based on fieldwork in Kerala, South India, carried out at psychiatric clinics and a psychosocial rehabilitation centre, this paper examines patients’ experiences of illness, the degree and quality of family support, and attributions made to the role of ‘sneham’, or love, in recovery. The role of love and family involvement may help explain the provocative finding by WHO epidemiological studies that ‘developing’ countries – and India in particular – showed better rates of recovery from severe mental illness when compared to developed countries.

Obtaining Robust Causal Evidence from Observational Studies: Can Genetic Epidemiology Help?

2011 ◽  
Author(s):  
George Davey Smith
Keyword(s):  
Vitamin E ◽  
New England ◽  
Observational Studies ◽  
Hormone Replacement ◽  
Developed Countries ◽  
Epidemiological Studies ◽  
Health Study ◽  
High Profile ◽  
Chd Risk

Observational epidemiological studies have clearly made important contributions to understanding the determinants of population health. However, there have been high-profile problems with this approach, highlighted by apparently contradictory findings emerging from observational studies and from randomized controlled trials (RCTs) of the same issue. These situations, of which the best known probably relates to the use of hormone-replacement therapy (HRT) in coronary heart disease (CHD) prevention, have been discussed elsewhere (Davey Smith & Ebrahim, 2002) . The HRT controversy is covered elsewhere in this volume (see Chapter 5). Here, I will discuss two examples. First, consider the use of vitamin E supplements and CHD risk. Several observational studies have suggested that the use of vitamin E supplements is associated with a reduced risk of CHD, two of the most influential being the Health Professionals Follow-Up Study (Rimm et al., 1993) and the Nurses’ Health Study (Stampfer et al., 1993), both published in the New England Journal of Medicine in 1993. Findings from one of these studies are presented in Figure 9.1, where it can be seen that even short-term use of vitamin E supplements was associated with reduced CHD risk, which persisted after adjustment for confounding factors. demonstrates that nearly half of U.S. adults are taking either vitamin E supplements or multivitamin/multimineral supplements that generally contain vitamin E (Radimer et al., 2004). presents data from three available time points, where there appears to have been a particular increase in vitamin E use following 1993 (Millen, Dodd, & Subar, 2004), possibly consequent upon the publication of the two observational studies already mentioned, which have received nearly 3,000 citations between them since publication. The apparently strong observational evidence with respect to vitamin E and reduced CHD risk, which may have influenced the very high current use of vitamin E supplements in developed countries, was unfortunately not realized in RCTs, in which no benefit from vitamin E supplementation use is seen.

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