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Experimental exposure of healthy subjects with emissions from a gas metal arc welding process—part II: biomonitoring of chromium and nickel

Abstract Objectives The objective of this study was to investigate whether there is a relationship between the external exposure dose of chromium and nickel caused by a metal active gas welding process with a solid high-alloyed steel welding wire and inner exposure of subjects. In order to perform welding fume exposure under controlled and standardized conditions, the investigations were conducted in the “Aachen Workplace Simulation Laboratory”. Methods To perform biological monitoring of chromium and nickel, blood and urine samples of 12 healthy male non-smokers who never worked as welders were collected before and after a 6-h exposure to ambient air (0 mg/m3) and to welding fumes of a metal active gas welding process once with a concentration of the welding fume of 1 mg/m3 and once with a concentration of 2.5 mg/m3. Results Although the internal exposure to chromium and nickel in this study was comparatively low, the subjects showed significantly increased concentrations of these metals in urine after exposure to welding fume compared to the values at baseline. Moreover, the observed increase was significantly dose dependent for both of the substances. Conclusion For the biological monitoring of chromium and nickel in urine of subjects exposed to welding fumes, a dependency on exposure dose was seen under standardized conditions after a single exposure over a period of 6 h. Thus, this study contributes to a better understanding of the relationship between ambient and biological exposures from welding fumes and provides a good basis for evaluating future biological threshold values for these metals in welding occupation. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00420-012-0738-8Authors Monika Gube, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyPeter Brand, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyThomas Schettgen, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyJens Bertram, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyKerstin Gerards, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, GermanyUwe Reisgen, ISF—Welding and Joining Institute, RWTH Aachen University, Pontstraße 49, 52062 Aachen, GermanyThomas Kraus, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Exposure of healthy subjects with emissions from a gas metal arc welding process: part 3—biological effect markers and lung function

Abstract Background Metal active gas welding (MAG) is a widely-used welding technique resulting in high emissions of welding fume particles. This study investigated whether short-term exposure to these fume particles results in changes in lung function and early stages of inflammatory reactions. Methods Twelve healthy, young male subjects were exposed to MAG fumes for 6 h with three different exposure concentrations in a three-fold cross-over study design. Exposure was performed in the “Aachen Workplace Simulation Laboratory” under controlled conditions with constant fume concentration. Fume concentrations were 0, 1, and 2.5 mg m−3 in randomized order. Before and after each exposure, spirometry, and impulse oscillometry were performed and breath condensate samples were collected in order to quantify inflammatory markers like Nitrate, Nitrite, Nitrotyrosine, Hydroxyprolin and Malondialdehyde. Results A significant dependency on the exposure concentration could not be established for any of the endpoint parameters. Conclusion In healthy, young subjects neither changes in spirometry nor changes in inflammatory markers measured in exhaled breath condensate could be detected after short-term exposure. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00420-012-0740-1Authors P. Brand, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyK. Bischof, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyL. Siry, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyJ. Bertram, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyT. Schettgen, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyU. Reisgen, ISF—Welding and Joining Institute, Aachen University of Technology, Pontstraße 49, 52062 Aachen, GermanyT. Kraus, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, GermanyM. Gube, Institute for Occupational and Social Medicine, Aachen University of Technology, Pauwelsstr. 30, 52074 Aachen, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Exposure of healthy subjects with emissions from a gas metal arc welding process: part 1—exposure technique and external exposure

Abstract Background Studies concerning welding fume–related adverse health effects in welders are hampered by the heterogeneity of workplace situations, resulting in complex and non-standardized exposure conditions. Methods In order to carry out welding fume exposure studies under controlled and standardized conditions, the Aachen Workplace Simulation Laboratory was developed. This laboratory consists of an emission room, in which welding fume is produced, and an exposure room in which human subjects are exposed to these fumes. Both rooms are connected by a ventilation system which allows the welding fume concentration to be regulated. Particle mass concentration was measured with a TEOM microbalance and the particle number-size distribution using a Grimm SMPS device. Results In a study, which is the subject of this paper, it has been shown that welding fume concentration can easily be regulated between 1 and about 3 mg m−3. The chosen concentration can be kept constant for more than 8 h. However, transport of the particles from the emission room into the exposure room leads to a change in particle size distribution, which is probably due to coagulation of the fraction of smallest particles. Conclusion The Aachen Workplace Simulation Laboratory is suitable for controlled exposure studies with human subjects. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00420-012-0739-7Authors P. Brand, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, GermanyP. Havlicek, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, GermanyM. Steiners, ISF, Welding and Joining Institute, Aachen University of Technology, Pontstraße 49, 52062 Aachen, GermanyK. Holzinger, ISF, Welding and Joining Institute, Aachen University of Technology, Pontstraße 49, 52062 Aachen, GermanyU. Reisgen, ISF, Welding and Joining Institute, Aachen University of Technology, Pontstraße 49, 52062 Aachen, GermanyT. Kraus, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, GermanyM. Gube, Institute for Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Comparison between the first and second versions of the Copenhagen Psychosocial Questionnaire: psychosocial risk factors for a high need for recovery after work

Abstract Purpose The Copenhagen Psychosocial Questionnaire (COPSOQ I) was developed as a tool to assess a broad range of psychosocial work environment factors and was recently revised (COPSOQ II). The research question in this study was: Do COPSOQ II-scales predict a high need for recovery (NFR) after work better than COPSOQ I-scales? Methods A cross-sectional questionnaire study was conducted in 990 subjects (84.5% response), employed in the public sector. Psychosocial factors were assessed by COPSOQ I and COPSOQ II. Multivariate logistic regression analysis was used to calculate the odds ratios for the presence of a high NFR, controlled for gender, age, physical workload and other relevant occupational and non-occupational factors. Analyses were performed for COPSOQ I and COPSOQ II separately. Results In both COPSOQ versions, ‘quantitative demands’ (p < 0.001) and ‘job insecurity’ (p < 0.005) were significantly associated with a high NFR. Additionally, in the COPSOQ I model, ‘demands for hiding emotions’ (p < 0.05) and ‘degrees of freedom’ (p < 0.05), and in the COPSOQ II model ‘emotional demands’ (p < 0.05) and ‘commitment to the workplace’ (p < 0.005) were significant as well. ‘Degrees of freedom’ was omitted by the developers in the revised COPSOQ II. Reintroducing it into the COPSOQ II model did not alter the existing associations, but pointed out ‘degrees of freedom’ to be an additional important dimension (p < 0.05). The COPSOQ II model with ‘degrees of freedom’ included also had the best data fit. Conclusions The results suggested the COPSOQ II to be better predictive than COPSOQ I for a high NFR, but also indicated that ‘degrees of freedom’ should be included into the COPSOQ II when studying the NFR as outcome parameter. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-012-0741-0Authors Philippe Kiss, Securex, Occupational Health Service, Brouwerijstraat 1, 9031 Ghent, Drongen, BelgiumMarc De Meester, Securex, Occupational Health Service, Brouwerijstraat 1, 9031 Ghent, Drongen, BelgiumAndré Kruse, Securex, Occupational Health Service, Brouwerijstraat 1, 9031 Ghent, Drongen, BelgiumBrigitte Chavée, Securex, Occupational Health Service, Brouwerijstraat 1, 9031 Ghent, Drongen, BelgiumLutgart Braeckman, Department of Public Health, Ghent University, Ghent, Belgium Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Lung function decline and blood lead among residents nearby to industrial complex

Abstract Purpose This study was to ascertain the risk factors of pulmonary function decline (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC]) among those exposed to lead in the vicinity of industrial complex. Methods In total, 263 men and women, aged over 30, were recruited from two cities during a 2-year follow-up. Spirometry testing was conducted first at baseline and then after 2-years of follow-up. The change in FVC and FEV1 during the study period was analyzed according to blood lead (BPb), urinary cotinine, and 1-hydroxypyrene, after controlling for sex, height, baseline FVC or FEV1, and airway hyperresponsiveness. Results With increase in age, both FEV1 and FVC declined. More marked decline in FVC was noted for men than for women (p < 0.05), while the decline in FEV1 was not. Biological variables, especially height (p < 0.05) and pulmonary status (p < 0.0001), were associated with the decline in both FEV1 and FVC. Even after controlling these other variables, blood lead level was also significantly associated with the decline of FVC. Conclusions Even though the decline in FEV1 and FVC with aging was within a normal range, people with smaller height were more vulnerable to the decline of both FEV1 and FVC and especially higher level of BPb was accompanied with larger decline of FVC. Oxidative stress in relation to lead accumulation in adult may contribute to rapid aging of pulmonary function. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-012-0743-yAuthors Yun-Suk Pak, Department of Occupational and Environmental Medicine, School of Public Health and Institute of Health and Environment, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul, 151-742 KoreaAeri Oh, Department of Occupational and Environmental Medicine, School of Public Health and Institute of Health and Environment, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul, 151-742 KoreaYoung Lim Kho, School of Human and Environmental Science, Eulji University, Seongnam, KoreaDomyung Paek, Department of Occupational and Environmental Medicine, School of Public Health and Institute of Health and Environment, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul, 151-742 Korea Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Sickness presenteeism is more than an alternative to sickness absence: results from the population-based SLOSH study

Abstract Purpose Sickness presenteeism, defined as ‘going to work despite judging that one should have reported in sick’, is usually considered to be a complementary alternative to sickness absence. Nonetheless, several studies have reported a positive association between sickness absence and sickness presenteeism. The aim of the present study was to investigate whether the contemporaneous positive association between sickness absence and sickness presenteeism can be explained by illness, work incapacity, and/or work environment. Methods A cross-sectional study based on answers to a comprehensive questionnaire from 8,304 working women and men, those in the second wave of the nationally representative Swedish Longitudinal Occupational Survey of Health. Logistic regression was used to investigate the association between sickness presenteeism and sickness absence. Results Sickness absence was strongly associated with sickness presenteeism. Sickness absence of 1–7 days during a 12-month period more than doubled the odds of also having sickness presenteeism of more than 8 days during the same 12-month period (OR = 2.11; 95% CI: 1.79–2.49). Adjusting for age and sex did not attenuate the association; further adjustment for work environment, self-rated health, chronic diseases, and work capacity reduced the odds somewhat, but they remained highly significant (OR = 1.88; 95% CI: 1.56–2.25). Conclusions The results suggest that sickness presenteeism is not, as earlier hypothesised, just an alternative to sickness absence, given a certain level of health or work incapacity. Other, so far unknown explanations for both sickness absence and sickness presenteeism must be sought. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-012-0735-yAuthors Constanze Leineweber, Stress Research Institute, Stockholm University, 106 91 Stockholm, SwedenHugo Westerlund, Stress Research Institute, Stockholm University, 106 91 Stockholm, SwedenJan Hagberg, The Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77 Stockholm, SwedenPia Svedberg, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, SwedenKristina Alexanderson, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Worrying exposure to trace elements in the population of Kinshasa, Democratic Republic of Congo (DRC)

Abstract Background and objectives The particularly high rate of urbanization in Kinshasa (Democratic Republic of Congo) is associated with environmental degradation. Outdoor and indoor air pollution, as well as water pollution and waste accumulation, are issues of major concern. However, little documented information exists on the nature and extent of this pollution. A biomonitoring study was conducted to document exposure to trace elements in a representative sample of the population in Kinshasa. Methods Fifteen trace elements were measured by ICP-MS, CV-AAS, or HG-AFS in spot urine samples from 220 individuals (50.5% women) aged 6–70 years living in the urban area and from 50 additional subjects from the rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Results Overall, living in urban Kinshasa was associated with elevated levels of several parameters in urine as compared to the population living in the rural area (Asi, Ba, Cd, Cr, and V) as well as compared to an urban population of the southeast of Congo (Al, As, Cd, Cr, Cu, Pb, Mn, Ni, Se, V, and Zn). Elevated levels were also found by comparison with the reference values in databases involving American, Canadian, French, or German populations. Conclusions This study provides the first biomonitoring database in the population of Kinshasa, revealing elevated levels for most urinary TE as compared to other databases. Toxicologically relevant elements such as Al, As, Cd, Pb, and Hg reach levels of public health concern. Content Type Journal ArticleCategory Original ArticlePages 1-13DOI 10.1007/s00420-012-0733-0Authors J. Tuakuila, Environmental Chemistry, Faculty of Sciences, Université de Kinshasa, Kinshasa, Democratic Republic of CongoD. Lison, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53, box 52.02.12, 1200 Brussels, BelgiumA.-C. Lantin, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53, box 52.02.12, 1200 Brussels, BelgiumF. Mbuyi, Environmental Chemistry, Faculty of Sciences, Université de Kinshasa, Kinshasa, Democratic Republic of CongoG. Deumer, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53, box 52.02.12, 1200 Brussels, BelgiumV. Haufroid, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53, box 52.02.12, 1200 Brussels, BelgiumP. Hoet, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53, box 52.02.12, 1200 Brussels, Belgium Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Is work engagement related to work ability beyond working conditions and lifestyle factors?

Abstract Purpose To examine the associations of age, lifestyle and work-related factors, and particularly work engagement with the work ability index (WAI) and its sub-dimensions. Methods Step-wise regression analysis with a sample of Finnish firefighters (n = 403) was used. The outcome variables were the WAI and its six sub-dimensions. The independent variables consisted of age, lifestyle variables (alcohol consumption, BMI, smoking, physical exercise, and sleep problems), working conditions (job demands, physical workload, supervisory relations, and task resources), and work engagement. The outcome variables and all the variables related to lifestyle, working conditions, and work engagement were measured in 2009. Work ability at baseline 10 years earlier was adjusted for in the models. Results Work engagement, age, physical exercise, sleep problems, and physical workload were associated with the WAI. All independent variables, except BMI and alcohol consumption, were associated with at least one sub-dimension of the WAI after controlling the baseline WAI. Lifestyle variables, working conditions, and work engagement were more strongly related to the subjective WAI sub-dimensions than to the two more objective WAI sub-dimensions. Conclusions Work engagement was significantly associated with work ability even after adjusting for various factors, indicating its importance in promoting work ability. Other key factors for good work ability were frequent exercise, good sleep, non-smoking, low job demands, low physical workload, and high task resources. More specifically, this study suggests that in maintaining work ability, it is valuable not only to promote lifestyle factors or working conditions, but also to enhance employees’ positive state of work engagement. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-012-0732-1Authors Auli Airila, Department of Social Research, University of Helsinki, Helsinki, FinlandJari Hakanen, Finnish Institute of Occupational Health, Work Organizations, Topeliuksenkatu 41 a A, 00250 Helsinki, FinlandAnne Punakallio, Finnish Institute of Occupational Health, Work Organizations, Topeliuksenkatu 41 a A, 00250 Helsinki, FinlandSirpa Lusa, Finnish Institute of Occupational Health, Work Organizations, Topeliuksenkatu 41 a A, 00250 Helsinki, FinlandRitva Luukkonen, Finnish Institute of Occupational Health, Work Organizations, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Variation in benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) among general Japanese populations with no anthropogenic exposure to cadmium

Abstract Background The use of benchmark dose (BMD) and the 95% lower confidence limit of benchmark dose (BMDL) have been gaining popularity not only in experimental studies but also in epidemiological studies including those on toxicology of cadmium (Cd), a ubiquitous hazardous element in the environment. However, the reproducibility of BMD and BMDL values has seldom been examined. Objectives This study was initiated to determine whether consistent BMD and BMDL values are obtained for similar non-exposed populations, i.e., the populations with no anthropogenic exposure to Cd in a single nation of Japan. Methods Cd (an exposure marker), α1-microglobulin (α1-MG), β2-microglobulin (β2-MG) and N-acetyl-β-D-glucosaminidase (NAG) (three effect markers of tubular dysfunction) levels in the urine of adult Japanese women from five previous publications of this study group were examined. Overall, data were available for 17,375 cases (in 16 prefectures) regarding Cd, α1-MG and β2-MG, and 6,409 cases (in ten prefectures) regarding NAG. The data were used to calculate BMD and BMDL values taking advantage of the hybrid approach (Budtz-Jǿrgensen et al. in Biometrics 57:698–706, 2001). It was possible to calculate BMD and BMDL values for α1-MG and β2-MG for all of the 16 prefectures with 17,375 cases, whereas the values for NAG were successfully calculated for nine prefectures with 5,843 cases. Results The application gave BMD values of 1.92, 2.46 and 2.32 μg Cd/g cr for α1-MG, β2-MG and NAG, respectively, and BMDL values of 1.83, 2.32 and 2.09 μg Cd/g cr. Large inter-prefectural variations were observed in the BMD and BMDL; there was about fourfold difference both in BMD and in BMDL calculated for α1-MG and β2-MG in 16 prefectures, and the variation was greater (i.e., by about sevenfold) in BMD and BMDL for NAG in nine prefectures. A survey of relevant literature revealed variation in BMD and BMDL values of similar folds as observed in the present analyses in five studies of Japanese populations. Multiple regression analyses taking BMD or BMDL as a dependent variable and age, CR concentration and Cd concentration as independent variables showed both BMD and BMDL were significantly influenced by Cd concentration in cases of α1-MG and β2-MG, whereas BMD and BMDL for NAG was by CR. Conclusions Even when the analysis was conducted in a single nation, both BMD and BMDL for the Cd effect markers varied by ca. fourfold when examining α1-MG or β2-MG and the values varied by ca. sevenfold for NAG among Cd-non-exposed populations. The most influential factors in the study population may include urine density and Cd levels in the urine. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-012-0734-zAuthors Sonoko Sakuragi, Kyoto Industrial Health Association (Mibu Office), 4-1 Mibu-Shujaku-cho, Nakagyo-ku, Kyoto, 604-8871 JapanKen Takahashi, Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 JapanTsutomu Hoshuyama, Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555 JapanJiro Moriguchi, Kyoto Industrial Health Association (Mibu Office), 4-1 Mibu-Shujaku-cho, Nakagyo-ku, Kyoto, 604-8871 JapanFumiko Ohashi, Kyoto Industrial Health Association (Main Office), 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto, 604-8472 JapanYoshinari Fukui, Kyoto Industrial Health Association (Main Office), 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto, 604-8472 JapanMasayuki Ikeda, Kyoto Industrial Health Association (Main Office), 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto, 604-8472 Japan Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The good character at work: an initial study on the contribution of character strengths in identifying healthy and unhealthy work-related behavior and experience patterns

Abstract Purpose Positive psychological functioning has been related to various positive work-related outcome variables, such as job satisfaction or work engagement. The aim of the present study was to examine the relations between morally positively valued traits (i.e., strengths of character) and work-related behaviors. Method A sample of 887 adult women completed the Values in Action Inventory of Strengths (VIA-IS) and the Work-related Behavior and Experience Patterns Questionnaire (AVEM) in an online survey. Results Those assigned to healthy work-related behavior and experience patterns differed in their strengths profiles from those that demonstrated unhealthy patterns (i.e., burnout type) in a predictable way. Especially the strengths of zest, persistence, hope, and curiosity seemed to play a key role in healthy and ambitious work behavior. Conclusions The study underlines the relevance of character strengths in work settings and suggests that interventions based on character strengths could substantiate interventions already existing at the workplace in order to enhance positive work outcomes further (e.g., work satisfaction, engagement). Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-012-0736-xAuthors F. Gander, Section on Personality and Assessment, Department of Psychology, University of Zurich, Binzmühlestrasse 14/7, 8050 Zurich, SwitzerlandR. T. Proyer, Section on Personality and Assessment, Department of Psychology, University of Zurich, Binzmühlestrasse 14/7, 8050 Zurich, SwitzerlandW. Ruch, Section on Personality and Assessment, Department of Psychology, University of Zurich, Binzmühlestrasse 14/7, 8050 Zurich, SwitzerlandT. Wyss, Section on Personality and Assessment, Department of Psychology, University of Zurich, Binzmühlestrasse 14/7, 8050 Zurich, Switzerland Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Blood cadmium and moderate-to-severe glomerular dysfunction in Korean adults: analysis of KNHANES 2005–2008 data

Abstract Purpose The objective of this study was to evaluate the association between blood cadmium (Cd) and moderate-to-severe glomerular dysfunction in a Korean population using a representative sample. Methods A cross-sectional study was used to evaluate the association between blood Cd and glomerular dysfunction. Based on the Korean National Health and Nutrition Examination Survey (2005–2008), individual blood Cd was measured in 2,992 adults, aged between 20 and 65. Results After adjusting for survey years, age, sociodemographic factors, and health behaviors, the odds ratio for moderate-to-severe glomerular dysfunction (<60 mL/min per 1.73 m2) was 1.97 (95% CI: 1.28–3.07) when comparing the highest with the lowest blood Cd quartile in Korean women. However, in Korean men, there was no association between blood Cd and moderate-to-severe glomerular dysfunction. Conclusions These findings support the consideration of Cd as a risk factor for glomerular dysfunction in the female population. Furthermore, environmental heavy metal monitoring and an institutional strategy should be implemented to reduce Cd exposure in the general population. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-012-0737-9Authors Jun-Pyo Myong, Graduate School of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaHyoung-Ryoul Kim, Department of Preventive Medicine and Catholic Industrial Medical Center, The Catholic University of Korea, College of Medicine, 505 BanPo-dong Seocho-gu, Seoul, 137-701 Republic of KoreaDean Baker, Center for Occupational and Environmental Health, University of California, Irvine, CA, USABongKyoo Choi, Center for Occupational and Environmental Health, University of California, Irvine, CA, USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses

Abstract Purpose To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. Methods This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6–10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). Results Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57–3.28; and OR, 1.91; 95% CI, 1.39–2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts. Conclusion Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0730-8Authors Pei-Chen Lin, Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, TaiwanChung-Hey Chen, Institute of Allied Health Sciences and Department of Nursing, National Cheng Kung University, Tainan, TaiwanShung-Mei Pan, Department of Nursing, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanChih-Hong Pan, Institute of Occupational Safety and Health, Council of Labor Affairs, Executive Yuan, New Taipei City, TaiwanChiou-Jong Chen, Institute of Occupational Safety and Health, Council of Labor Affairs, Executive Yuan, New Taipei City, TaiwanYao-Mei Chen, College of Nursing, Kaohsiung Medical University, Kaohsiung, TaiwanHsin-Chia Hung, Department of Nursing, Meiho University, 912 No. 23 Pingguang Road, PingTung, TaiwanMing-Tsang Wu, Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Mental health and patterns of work-related coping behaviour in a German sample of student teachers: a cross-sectional study

Abstract Purpose The aim of this cross-sectional study was to evaluate the mental health of student teachers, to analyse the extent to which they feel prepared for their profession by the university curriculum and to investigate patterns of coping with occupational stress. Methods A sample of 481 German student teachers was investigated using two standardised instruments: GHQ-12 (General Health Questionnaire) and AVEM (Arbeitsbezogenes Verhaltens- und Erlebensmuster), an occupational stress and coping questionnaire describing four patterns of work-related coping behaviour. In addition, we asked how well the student teachers felt that the curriculum prepared them for their profession. Results Forty-four per cent of the student teachers report impaired mental health in the second teacher training period, indicated by a GHQ value equal to or over the cut-off of four. The AVEM responses revealed more than 40% showing risk patterns (A or B) compared to only 26.3% displaying a healthy coping style (G), while 32.8% demonstrate an unambitious style (S). These GHQ values are inversely correlated with the extent to which student teachers feel prepared for their work by the university curriculum. Conclusions Our data indicate a problematic stress level for student teachers in the second training phase (high exposure to health risks and unfavourable coping styles). Since teaching is clearly an extremely demanding job, it is vital that teacher training systems contribute towards protecting the health of teachers by focusing on fostering healthy personal attitudes and equipping young teachers with coping styles and skills that will better prepare them for the challenges facing them in their daily work. Self-care health management should also be part of the teacher training curriculum. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00420-011-0731-7Authors Linda Zimmermann, Department of Medical Psychology and Medical Sociology, University Medical Centre Freiburg, Hebelstr. 29, 79104 Freiburg, GermanyThomas Unterbrink, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Hauptstr. 8, 79104 Freiburg, GermanyRuth Pfeifer, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Hauptstr. 8, 79104 Freiburg, GermanyMichael Wirsching, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Hauptstr. 8, 79104 Freiburg, GermanyUwe Rose, Department of Mental Health and Cognitive Capacity, Federal Institute for Occupational Safety and Health, Noeldnerstr. 40-42, 10317 Berlin, GermanyUlrich Stößel, Department of Medical Psychology and Medical Sociology, University Medical Centre Freiburg, Hebelstr. 29, 79104 Freiburg, GermanyMatthias Nübling, FFAS, Freiburg Research Centre of Occupational and Social Medicine, Bertholdstr. 27, 79098 Freiburg, GermanyVeronika Buhl-Grießhaber, Staatliches Seminar für Didaktik und Lehrerausbildung (Bereich Gymnasien), Oltmannsstr. 22, 79100 Freiburg, GermanyMarkus Frommhold, Staatliches Seminar für Didaktik und Lehrerausbildung (Bereich Gymnasien), Oltmannsstr. 22, 79100 Freiburg, GermanyUwe Schaarschmidt, COPING, Psychological Diagnosis and Human Resource Development, Schaarschmidt and Fischer OG, Untere Hauptstr. 30, 2485 Wampersdorf, AustriaJoachim Bauer, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Hauptstr. 8, 79104 Freiburg, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Absenteeism due to voice disorders in female teachers: a public health problem

Abstract Objective This study estimates the prevalence of absenteeism due to voice disorders among teachers and investigates individual and contextual factors associated with it. Methods The study involved 1,980 teachers from 76 municipal schools. The response rate was 85%. The survey was carried out between May 2004 and July 2005 using a self-administered structured questionnaire containing sociodemographic, lifestyle, health, and work-related questions. The dependent variable was obtained from answers to the following question: In the last 2 weeks, have you missed work because of voice problems? Logistic regression analysis was used to determine the associated factors. Results Voice-related absenteeism in the prior 2 weeks was reported by 66 teachers (3.35%). During their entire careers, approximately one-third of teachers missed work at least once due to voice problems. In the final model, factors associated with recent absenteeism were as follows: witnessing violence by students or parents one or more times (OR = 2.10; 95% CI = 1.14–3.90), presence of depression or anxiety (OR = 2.03; 95% CI = 1.09–3.78), upper respiratory problems in the prior 2 weeks (OR = 2.85; 95% CI = 1.53–5.29), and absenteeism because of voice problems during the preceding 6 months (OR = 15.79; 95% CI = 8.18–30.45). Conclusions The results encourage new approaches to the problems of absenteeism in the educational sector and contribute to addressing the weaknesses of economic and administrative approaches to the phenomenon. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00420-011-0729-1Authors Adriane Mesquita de Medeiros, Department of Social and Preventive Medicine, Federal University of Minas Gerais, UFMG, Av. Alfredo Balena, 190/705, Belo Horizonte, MG 30310-100, BrazilAda Ávila Assunção, Department of Social and Preventive Medicine, Federal University of Minas Gerais, UFMG, Av. Alfredo Balena, 190/705, Belo Horizonte, MG 30310-100, BrazilSandhi Maria Barreto, Department of Social and Preventive Medicine, Federal University of Minas Gerais, UFMG, Av. Alfredo Balena, 190/705, Belo Horizonte, MG 30310-100, Brazil Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Measuring short-term and long-term physiological stress effects by cortisol reactivity in saliva and hair

Abstract Purpose The aims of this study were to investigate (1) the concurrent relationship between short-term and long-term stress reactivity measured by cortisol excretion and (2) the relationship of these physiological stress effects with self-reported stress and need for recovery after work (NFR). Methods Participants were production workers in the meat-processing industry. Short-term cortisol excretion was calculated by summing 18 saliva samples, sampled over a 3-day period. Samples were delivered by 37 participants. Twenty-nine of them also supplied one hair sample of at least 3 cm in length for an analysis of long-term (3 months) cortisol excretion. All of them filled in a short questionnaire on self-reported stress and NFR. Self-reported stress was assessed by a three-item stress screener; NFR was assessed by an 11-item scale. Results Short-term and long-term cortisol excretion are significantly, but moderately, associated (r = 0.41, P = 0.03). Short-term and long-term cortisol excretion correlated weakly to self-reported stress and NFR (correlations varied from −0.04 to 0.21). Conclusions Short-term and long-term physiological stress excretion levels are moderately associated. Physiological stress effects assessed from saliva and hair cannot be used interchangeably with self-reported stress because they only correlate weakly. To better predict long-term cortisol excretion in workers, the predictive value of short-term cortisol excretion must be evaluated in a prognostic longitudinal study in a working population. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00420-011-0727-3Authors Berry J. van Holland, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The NetherlandsMonique H. W. Frings-Dresen, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The NetherlandsJudith K. Sluiter, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Associations between psychosocial work environment and hypertension among non-Western immigrant and Danish cleaners

Abstract Introduction Non-Western cleaners have reported better psychosocial work environment but worse health compared with their Danish colleagues. The aim of this study was to compare the association between psychosocial work environment and hypertension among non-Western immigrant cleaners and Danish cleaners. Methods Two hundred and eighty-five cleaners from nine workplaces in Denmark participated in this cross-sectional study. The cleaners were identified as non-Western immigrants (n = 137) or Danes (n = 148). Blood pressure was measured in a seated position, and psychosocial work environment was assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). In each population, multivariate logistic regressions were applied testing for an association between each of the COPSOQ scales and hypertension. Results Models adjusted for age, sex, BMI, smoking, workplace and physical work exertion showed that high Trust regarding management (OR = 0.50) and high Predictability (OR = 0.63) were statistically significantly associated with low prevalence of hypertension in the Danish population. In the immigrant population, no significant associations were found. Analyses on interaction effects showed that associations between Meaning of work and hypertension were significantly different among the two populations (p < 0.05). Conclusions Psychosocial work factors were associated with hypertension among Danes, but not among non-Western immigrants. This divergent association between psychosocial work environment and hypertension between Danes and non-Western immigrant cleaners may be explained by different perceptions of psychosocial work environment. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00420-011-0728-2Authors Kasper Olesen, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkIsabella G. Carneiro, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkMarie B. Jørgensen, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkReiner Rugulies, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkCharlotte D. N. Rasmussen, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkKaren Søgaard, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, DenmarkAndreas Holtermann, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, DenmarkMari-Ann Flyvholm, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Job stress and job satisfaction of physicians in private practice: comparison of German and Norwegian physicians

Abstract Purpose This study examined job satisfaction and job stress of German compared to Norwegian physicians in private practice. Methods A representative sample of physicians in private practice of Schleswig–Holstein, Germany (N = 414) and a nationwide sample of Norwegian general practitioners and private practice specialists (N = 340) were surveyed in a cross-sectional design in 2010. The questionnaire comprised the standard instruments “Job Satisfaction Scale (JSS)” and a short form of the “Effort-Reward Imbalance Questionnaire (ERI)”. Results Norwegian physicians scored significantly higher (<0.01) on all items of the job satisfaction scale compared to German physicians (M 5.57, SD 0.74 vs. M 4.78, SD 1.01). The effect size was highest for the items freedom to choose method (d = 1.012), rate of pay (d = 0.941), and overall job satisfaction (d = 0.931). While there was no significant difference in the mean of the overall effort scale between German and Norwegian physicians, Norwegian physicians scored significantly higher (p < 0.01) on the reward scale. A larger proportion of German physicians (27.6%) presented with an effort/reward ratio beyond 1.0, indicating a risky level of work-related stress, compared to only 10.3% of Norwegian physicians. Working hours, effort, reward, and country differences accounted for 37.4% of the explained variance of job satisfaction. Conclusions Job satisfaction and reward were significantly higher in Norwegian than in German physicians. An almost threefold higher proportion of German physicians exhibited a high level of work-related stress. Findings call for active prevention and health promotion among stressed practicing physicians, with a special focus on improved working conditions. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-011-0725-5Authors Edgar Voltmer, Department of Health and Behavioral Sciences, Friedensau Adventist University, An der Ihle 19, 39291 Friedensau, GermanyJudith Rosta, The Research Institute of the Norwegian Medical Association, P.O.B. 1152 Sentrum, 0107 Oslo, NorwayJohannes Siegrist, Department of Medical Sociology, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, GermanyOlaf G. Aasland, The Research Institute of the Norwegian Medical Association, P.O.B. 1152 Sentrum, 0107 Oslo, Norway Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

A weight-of-evidence review of colorectal cancer in pesticide applicators: the agricultural health study and other epidemiologic studies

Abstract Objective To systematically evaluate epidemiologic studies on pesticides and colon cancer and rectal cancer in agricultural pesticide applicator populations using a transparent “weight-of-evidence” (WOE) methodological approach. Methods Twenty-nine (29) publications from the Agricultural Health Study (AHS) and 13 additional epidemiologic studies were identified that reported data for pesticide applicators and/or specific pesticide compounds and colorectal, colon, or rectal cancer. The AHS evaluated pesticide applicators as well as dose–response associations for specific pesticide compounds, whereas the large majority of non-AHS evaluated applicators but did not analyze specific compounds or dose–response trends. This WOE assessment of 153 different pesticide–outcome pairs emphasized several key evidentiary features: existence of statistically significant relative risks, magnitude of observed associations, results from the most reliable exposure assessments, and evidence of convincing dose–response relationships (i.e., those monotonically increasing, with statistically significant trend tests). Results Occupation as a pesticide applicator or pesticide application as a farming-related function was not associated with increasing the risk of colon or rectal cancer. Deficits of colon or rectal cancer were observed across most studies of pesticide applicators. After applying the WOE methodology to the epidemiologic studies of specific pesticide compounds and colon or rectal cancer, a number of pesticide–outcome pairs were identified and evaluated further based on positive statistical associations. Of these, only two—aldicarb and colon cancer and imazethapyr and proximal colon cancer—appears to warrant further discussion regarding a possible causal relationship, although the epidemiologic data are limited. For the remainder, a lack of a clear dose–response trend, inconsistencies in associations between exposure metrics and comparison groups, imprecise associations, variable participation rates for analyses of specific compounds, and the reliance upon data from one study (the AHS) limit interpretation regarding risk. Conclusion The available epidemiologic evidence does not support a causal relationship between occupation as a pesticide applicator or specific pesticide exposures and colon or rectal cancer. Content Type Journal ArticleCategory ReviewPages 1-31DOI 10.1007/s00420-011-0723-7Authors Dominik D. Alexander, Exponent Inc, Health Sciences Practice, 525 W Monroe St., Suite 1050, Chicago, IL 60661, USADouglas L. Weed, DLW Consulting Services, LLC, Salt Lake City, UT, USAPamela J. Mink, Emory University, Atlanta, GA, USAMeghan E. Mitchell, New York, NY, USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Evaluation of genotoxic effects of lead in pottery-glaze workers using micronucleus assay, alkaline comet assay and DNA diffusion assay

Abstract Purpose We investigated genotoxic effects of occupational exposure to lead acetate in pottery-glaze ceramic workers. Methods The study was carried out in 30 exposed workers and 30 matched controls, to whom several biochemical parameters—the blood lead (B-Pb; range: exposed, 41.68–404.77; controls, 12–52) and cadmium (B-Cd) level, the activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), the level of vitamin B12 and folate in serum—were measured. The genotoxic effects were evaluated by the alkaline comet assay, the DNA diffusion assay and micronucleus test in peripheral blood lymphocytes. Results Subjects exposed to lead had significantly higher B-Pb level and, consequently, increased values of tail intensity (TI), frequency of apoptotic and necrotic cells, and frequency of micronuclei (MN). In contrast, their activity of ALAD, the level of vitamin B12 and folate in serum were significantly lower compared to controls. Poisson regression analysis showed a significant correlation of profession, duration of exposure, smoking, level of cadmium in blood, ALAD and EP with primary DNA damage. A majority of primary damage repairs in a short period after exposure to a genotoxic agent. In addition, the influence of gender and level of vitamin B12 and folate in serum MN frequency in exposed group was observed. Conclusions In this study, DNA diffusion and micronucleus test showed higher influence of tested parameters to DNA damage. The results indicate a need for concomitant use of at least two different biomarkers of exposure when estimating a genetic risk of lead exposure. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00420-011-0726-4Authors V. Kašuba, Mutagenesis Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR 10000 Zagreb, CroatiaR. Rozgaj, Mutagenesis Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR 10000 Zagreb, CroatiaM. Milić, Mutagenesis Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR 10000 Zagreb, CroatiaD. Želježić, Mutagenesis Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR 10000 Zagreb, CroatiaN. Kopjar, Mutagenesis Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, HR 10000 Zagreb, CroatiaA. Pizent, Unit for Analytical Toxicology and Mineral Metabolism, Institute for Medical Research and Occupational Health, Zagreb, CroatiaZ. Kljaković-Gašpić, Unit for Analytical Toxicology and Mineral Metabolism, Institute for Medical Research and Occupational Health, Zagreb, CroatiaA. Jazbec, Faculty of Forestry, University of Zagreb, Svetošimunska 25, Zagreb, Croatia Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The relationship between immigration and mental health: what is the role of workplace psychosocial factors

Abstract Background To study the relationship between immigration and mental health considering the psychosocial factors in the workplace. Methods Multistage cluster sampling was used (final sample: 7,612 workers). Workers whose country of origin was unknown were excluded from the study (study population: 7,555). The information was collected between 2004 and 2005 using a standardized questionnaire, and interviews were conducted in respondents’ homes. The risk of poor mental health according to psychosocial factor, using the native, non-exposed workers as a reference, was calculated using log-binomial models. The prevalence ratio (PR) and confidence intervals (CI 95%) were estimated from crude data and from data adjusted for sex, age, and occupational category. Results Immigrants who experienced high quantitative demands (PR = 1.46; CI 95%:1.34–1.59), high emotional demands (PR = 1.42; CI 95%:1.301.56), high demands for hiding emotions (PR = 1.35; CI 95%:1.21–1.50), low possibilities for development (PR = 1.21; CI 95%:1.09–1.33), low levels of support from coworkers (PR = 1.41; CI 95%:1.30–1.53), and low esteem (PR = 1.53; CI 95%:1.42–1.66) perceived worse mental health. Equally, the study found that the immigrants with a high influence (PR = 1.19; CI 95%:1.09–1.29) and high control over working times (PR = 1.25; CI 95%:1.14–1.36) also reported worse mental health. We also found that native workers exposed to these factors also perceived worse mental health than those who were not exposed and that even, at times, they were at greater risk than exposed immigrants. Conclusions Differences in mental health between exposed and non-exposed wage earners, whether immigrant or native workers, indicate the importance of taking action to reduce psychosocial factors, as this would benefit both native and immigrant workers. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00420-011-0724-6Authors Ariadna Font, Union Institute of Work, Environment and Health (ISTAS), Via Laietana, 16, 6a., 08003 Barcelona, SpainSalvador Moncada, Union Institute of Work, Environment and Health (ISTAS), Via Laietana, 16, 6a., 08003 Barcelona, SpainFernando G. Benavides, Center for Research in Occupational Health, Pompeu Fabra University, Barcelona, Spain Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Factors associated with the ability and willingness to continue working until the age of 65 in construction workers

Abstract Objectives The working population is aging and a shortage of workers is expected in the construction industry. As a consequence, it is considered necessary that construction workers extend their working life. The purpose of this study was to explore factors associated with construction workers’ ability and willingness to continue working until the age of 65. Methods In total, 5,610 construction workers that participated in the Netherlands Working Conditions Survey filled out questionnaires on demographics, work-related and health-related factors, and on the ability and willingness to continue working until the age of 65. Logistic regression analyses were applied. Results Older workers were more often able, but less willing, to continue working until the age of 65. Frequently using force, lower supervisor support, lower skill discretion, and the occurrence of musculoskeletal complaints were associated with both a lower ability and willingness to continue working. In addition, dangerous work, occasionally using force, working in awkward postures, lack of job autonomy, and reporting emotional exhaustion were associated with a lower ability to continue working, whereas working overtime was associated with a higher ability. Furthermore, low social support from colleagues was associated with a higher willingness. Conclusion In addition to physical job demands, psychosocial job characteristics play a significant role in both the ability and willingness to continue working until the age of 65 in construction workers. Moreover, preventing musculoskeletal complaints may support the ability and willingness to continue working, whereas preventing emotional exhaustion is relevant for the ability to continue working. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0719-3Authors Karen M. Oude Hengel, Netherlands Organisation for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The NetherlandsBirgitte M. Blatter, Netherlands Organisation for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The NetherlandsGoedele A. Geuskens, Netherlands Organisation for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The NetherlandsLando L. J. Koppes, Netherlands Organisation for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The NetherlandsPaulien M. Bongers, Netherlands Organisation for Applied Scientific Research TNO, P.O. Box 718, 2130 AS Hoofddorp, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The recognition of occupational diseases attributed to heavy workloads: experiences in Japan, Korea, and Taiwan

Abstract Objective Health problems caused by long working hours and work stress have gained growing concerns in Japan, Korea, and Taiwan. In all the three countries, cardiovascular, cerebrovascular, and mental disorders attributed to heavy workloads or stressful work events are considered compensable occupational diseases by workers’ compensation systems. This study compared the trends of such cases and correlated the trends with changes in working hours during the period from 1980 to 2010. Methods Data on occupational diseases were obtained from official statistics of the workers’ compensation systems. Information on working hours was obtained from official statistics and national surveys of employees. Results While occupational cardiovascular, cerebrovascular, and mental disorders attributed to work stress were increasingly compensated in all the three countries, the averaged working hours and the percentage of employees with long working hours had been in decline discordantly. Conclusion Findings of this study suggested that reducing working hours alone is unlikely to reduce the problems of work stress. There is an urgent need to monitor and regulate a wider range of psychosocial work hazards. Especially, precarious employment and its associated health risks should be targeted for effective prevention of stress-related health problems in the workplace. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0722-8Authors Yawen Cheng, Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17 Xu-Zhou Rd., Taipei, TaiwanJungsun Park, Department of Occupational Health, Korea Occupational Safety and Health Agency, Incheon, South KoreaYangho Kim, Department of Occupational and Environmental Medicine, College of Medicine, University of Ulsan, Ulsan, South KoreaNorito Kawakami, Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Which subgroups of fire fighters are more prone to work-related diminished health requirements?

Abstract Purpose To determine whether certain subgroups of fire fighters are prone to work-related diminished health requirements. Methods The health requirements for fire-fighting were tested in a workers’ health surveillance (WHS) setting. These health requirements included psychological, physical and sense-related components as well as cardiovascular risk factors. The odds ratio (OR) and 95% confidence interval (95% CI) for the presence of the diminished health requirements were calculated for the subgroups of gender, professionalism and age. Results The prevalence of diminished psychological requirements was equivalent among the subgroups, and no significant high-risk group was identified. As compared to men fire fighters, women fire fighters were more likely to have diminished physical requirements (OR 28.5; 95% CI 12.1–66.9) and less likely to have cardiovascular risk factors (OR 0.3; 0.1–0.5). As compared to volunteer fire fighters, professionals were less likely to have diminished physical requirements (OR 0.5; 0.3–0.9), but professionals had a higher prevalence of cardiovascular risk factors with an odds ratio of 1.9 (1.1–3.2). As compared to the youngest fire fighters, the oldest fire fighters were more likely to have diminished sense-related requirements (OR 7.1; 3.4–15.2); a similar comparison could be made between oldest and middle-aged fire fighters (OR 5.1; 2.5–10.5). In addition, the oldest fire fighters were more likely to have cardiovascular risk factors when compared to the youngest (OR 4.4; 1.7–11.1) and to the middle-aged fire fighters (OR 3.1; 1.2–7.9). Conclusions Subgroups (gender, professionalism and age) of fire fighters are prone to at least one specific work-related diminished health requirement. Therefore, parts of the WHS could be applied with more attention to these high-risk groups. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0720-xAuthors Marie-Christine J. Plat, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The NetherlandsMonique H. W. Frings-Dresen, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The NetherlandsJudith K. Sluiter, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Can labour contract differences in health and work-related attitudes be explained by quality of working life and job insecurity?

Abstract Study aim We hypothesise that due to a lower quality of working life and higher job insecurity, the health and work-related attitudes of temporary workers may be less positive compared to permanent workers. Therefore, we aimed to (1) examine differences between contract groups (i.e. permanent contract, temporary contract with prospect of permanent work, fixed-term contract, temporary agency contract and on-call contract) in the quality of working life, job insecurity, health and work-related attitudes and (2) investigate whether these latter contract group differences in health and work-related attitudes can be explained by differences in the quality of working life and/or job insecurity. Methods Data were collected from the Netherlands Working Conditions Survey 2008 (N = 21,639), and Hypotheses were tested using analysis of variance and cross-table analysis. Results Temporary work was associated with fewer task demands and lower autonomy and was more often passive or high-strain work, while permanent work was more often active work. Except for on-call work, temporary work was more insecure and associated with worse health and work-related attitude scores than permanent work. Finally, the quality of working life and job insecurity partly accounted for most contract differences in work-related attitudes but not in health. Conclusions Especially agency workers have a lower health status and worse work-related attitudes. Job redesign measures regarding their quality of working life and job insecurity are recommended. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-011-0718-4Authors Alfred F. Wagenaar, Department of Work and Organizational Psychology, Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The NetherlandsMichiel A. J. Kompier, Department of Work and Organizational Psychology, Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The NetherlandsIrene L. D. Houtman, TNO, Hoofddorp, The NetherlandsSeth van den Bossche, TNO, Hoofddorp, The NetherlandsPeter Smulders, TNO, Hoofddorp, The NetherlandsToon W. Taris, Department of Work and Organizational Psychology, Utrecht University, Utrecht, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Too little appreciation for great expenditure? Workload and resources in ICUs

Abstract Purpose The aim of this study was providing descriptive information and the comparative examination of job strain and mental health of nurses and physicians in different intensive care units (ICU). Methods The Effort–Reward Imbalance Questionnaire by Siegrist and standardized psychometric questionnaires, like Hospital Anxiety and Depression Scale, Impact of Event Scale, Brief Symptom Inventory, Social Support Questionnaire, and Life Satisfaction Questionnaire were used. Five ICUs of the same German medical school were included (N = 142). Results For all ICUs investigated, a significantly lower mental health and a high effort–reward imbalance were found when compared with other samples. Only a few differences between the wards or both professional groups (nurses vs. physicians) were noted. The values for social support were comparable with those of healthy controls but differed between the wards. The life satisfaction in our cohort was lower compared to a population-based sample but was significant different between the wards. Conclusions Our study demonstrates the high job strain in an ICU, largely independent of the professional group. Noteworthy, a high effort–reward imbalance was found that stands in positive relation to adverse health effects (anxiety, depression, and general mental health). As a consequence, necessary interventions like stress management, supervision, and communication trainings should consider ward-specific conditions of employment rather than professional affiliation. After these interventions, a follow-up study will be performed to examine beneficial effects on job strain and health. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0721-9Authors Stefanie Jasper, Department of Psychosomatics and Psychotherapy, OE 7160, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, GermanyMichael Stephan, Department of Psychosomatics and Psychotherapy, OE 7160, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, GermanyHani Al-Khalaf, Department of Plastic, Hand and Reconstructive Surgery, Burn Center Lower Saxony, Hannover Medical School, Hannover, GermanyHans-Oliver Rennekampff, Department of Plastic, Hand and Reconstructive Surgery, Burn Center Lower Saxony, Hannover Medical School, Hannover, GermanyPeter M. Vogt, Department of Plastic, Hand and Reconstructive Surgery, Burn Center Lower Saxony, Hannover Medical School, Hannover, GermanyUrsula Mirastschijski, Department of Plastic, Hand and Reconstructive Surgery, Burn Center Lower Saxony, Hannover Medical School, Hannover, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

High effectiveness of pandemic influenza A (H1N1) vaccination in healthcare workers from a Portuguese hospital

Abstract Objectives Vaccination of healthcare workers (HCWs) was made a high priority during the phase six pandemic of the novel influenza A H1N1 (pH1N1) virus. We surveyed adherence to pH1N1 vaccination and the incidence of pH1N1 infection between vaccinated and unvaccinated HCWs. Methods Employees at the S. João Hospital in Porto, Portugal, were offered pH1N1 vaccinations free of charge. Pandemrix® was the vaccine administered. As part of the pandemic plan, employees with influenza-like symptoms (ILS) were called upon to take an RT-PCR H1N1 test. If the test results were positive, they had to stay off work for at least 7 days. Sociodemographic data, vaccination status, contact with infectious patients, ILS and pH1N1 test results were documented in a standardised manner. Results The survey population comprised 5,592 employees. The vaccination rate was 30.8% (n = 1,720) for pH1N1 and 50.4% (n = 2,819) for the 2009/2010 seasonal trivalent inactivated influenza vaccine (TIV). One mild anaphylactic reaction occurred after pH1N1 vaccination. Minor local side effects occurred more often after pH1N1 vaccination than after 2009/2010 seasonal TIV (38.0% vs. 12.3%). Pandemic H1N1 infection was diagnosed in 97 HCWs (1.7%). Compared to employees with no regular patient contact, nurses (2.8%) had the highest risk of pH1N1 infection (adjusted OR 3.8; 95% CI 1.2–6.8). Vaccination reduced the pH1N1 infection risk (OR 0.12; 95% CI 0.05–0.29). Vaccine effectiveness was 90.4% (95% CI 73.5–97.3%). Conclusion Vaccination reduced the pH1N1 infection risk considerably. The pandemic plan to contain the pH1N1 infection was successful. Nurses had the highest risk of pH1N1 infection and are therefore a target group for vaccination measures. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00420-011-0714-8Authors José Torres Costa, Occupational Health Division, S. João Hospital, EPE, Porto, PortugalRui Silva, Occupational Health Division, S. João Hospital, EPE, Porto, PortugalMargarida Tavares, Medical School, Oporto University, Porto, PortugalAlbert Nienhaus, University Medical Centre Hamburg-Eppendorf, Institute for Health Service Research in Dermatology and Nursing, Martinistraße 52, 20246 Hamburg, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Neuromotor function in ship welders after cessation of manganese exposure

Abstract Purpose The aim of the present study was to investigate whether previous long-term exposure to manganese (Mn) via inhalation of welding fumes can cause persistent impairment in neuromotor function even long after cessation of exposure. Methods Quantitative tests of tremor, motor speed, manual dexterity, diadochokinesis, eye-hand coordination and postural stability were administered to 17 retired ship welders (mean age 69 years), with mean exposure time 28 years. The welders’ exposure had ceased on average 18 years before the study. A cumulative exposure index (CEI) was calculated for each of the former welders. The welders were compared with 21 referents from the same shipyards (mean age was 66 years). Results Former welders performed less well than referents in the grooved pegboard test, and poorer performance was associated with CEI. The performance in most of the other neurobehavioral tests was similar between groups, but the welders tended to perform slightly better than the referents in tests demanding hand steadiness. The latter finding may be due to a training effect from their former working tasks or selection bias into or out of this occupation. Conclusions In the present study of welders with previous welding fume exposure, former welders and referents performed similarly in most of the neurobehavioral tests. Previous adverse effects on the neuromotor system might have ceased, and decreased neuromotor function due to normal aging processes in both groups might have disguised any slight effect of previous Mn exposure. The poorer performance in the grooved pegboard test among welders may indicate an adverse effect on motor function of long-term exposure to Mn, but this finding has to be confirmed by other studies. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-011-0716-6Authors Gunilla Wastensson, Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, SwedenGerd Sallsten, Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, SwedenRita Bast-Pettersen, National Institute of Occupational Health, P.O. Box 8149 Dep, 0033 Oslo, NorwayLars Barregard, Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, P.O. Box 414, 405 30 Gothenburg, Sweden Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Simulation of urinary excretion of 1-hydroxypyrene in various scenarios of exposure to polycyclic aromatic hydrocarbons with a generic, cross-chemical predictive PBTK-model

Abstract Introduction A physiologically based toxicokinetic (PBTK) model can predict blood and urine concentrations, given a certain exposure scenario of inhalation, dermal and/or oral exposure. The recently developed PBTK-model IndusChemFate is a unified model that mimics the uptake, distribution, metabolism and elimination of a chemical in a reference human of 70 kg. Prediction of the uptake by inhalation is governed by pulmonary exchange to blood. Oral uptake is simulated as a bolus dose that is taken up at a first-order rate. Dermal uptake is estimated by the use of a novel dermal physiologically based module that considers dermal deposition rate and duration of deposition. Moreover, evaporation during skin contact is fully accounted for and related to the volatility of the substance. Partitioning of the chemical and metabolite(s) over blood and tissues is estimated by a Quantitative Structure–Property Relationship (QSPR) algorithm. The aim of this study was to test the generic PBTK-model by comparing measured urinary levels of 1-hydroxypyrene in various inhalation and dermal exposure scenarios with the result of model simulations. Experimental In the last three decades, numerous biomonitoring studies of PAH-exposed humans were published that used the bioindicator 1-hydroxypyrene (1-OH-pyrene) in urine. Longitudinal studies that encompass both dosimetry and biomonitoring with repeated sampling in time were selected to test the accuracy of the PBTK-model by comparing the reported concentrations of 1-OHP in urine with the model-predicted values. Two controlled human volunteer studies and three field studies of workers exposed to polycyclic aromatic hydrocarbons (PAH) were included. Results The urinary pyrene-metabolite levels of a controlled human inhalation study, a transdermal uptake study of bitumen fume, efficacy of respirator use in electrode paste workers, cokery workers in shale oil industry and a longitudinal study of five coke liquefaction workers were compared to the PBTK-predicted values. The simulations showed that the model-predicted concentrations of urinary pyrene and metabolites over time, as well as peak-concentrations and total excreted amount in different exposure scenarios of inhalation and transdermal exposure were in all comparisons within an order of magnitude. The model predicts that only a very small fraction is excreted in urine as parent pyrene and as free 1-OH-pyrene. The predominant urinary metabolite is 1-OH-pyrene-glucuronide. Enterohepatic circulation of 1-OH-pyrene-glucuronide seems the reason of the delayed release from the body. Conclusions It appeared that urinary excretion of pyrene and pyrene-metabolites in humans is predictable with the PBTK-model. The model outcomes have a satisfying accuracy for early testing, in so-called 1st tier simulations and in range finding. This newly developed generic PBTK-model IndusChemFate is a tool that can be used to do early explorations of the significance of uptake of pyrene in the human body following industrial or environmental exposure scenarios. And it can be used to optimize the sampling time and urine sampling frequency of a biomonitoring program. Content Type Journal ArticleCategory Original ArticlePages 1-14DOI 10.1007/s00420-011-0713-9Authors Frans Jongeneelen, IndusTox Consult, Universitair Bedrijven Centrum, Toernooiveld 100, 6525 EC, Nijmegen, The NetherlandsWil ten Berge, Santoxar, Westervoort, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Working conditions of female part-time and full-time teachers in relation to health status

Abstract Purpose Teacher’s volume of employment and health status are controversially discussed in the current literature. This study focused on female teachers with part-time versus full-time jobs in association with working conditions and health status depending on age. Method A sample of 263 part-time and 367 full-time female teachers (average age 46.7 ± 7.8 vs. 46.0 ± 6.3) participated in an occupational health screening. Specific work conditions, stressors (job history-questionnaire) and effort–reward–imbalance ratio (ERI-Q) were measured and their relationships to mental and physical health were analysed. Health status was quantified by complaints (BFB questionnaire), general mental health status (GHQ-12) and cardiovascular risk factors. Results On average, teachers in part-time positions reported 36 and in full-time positions 42 h per week. The effort–reward ratios were significantly associated with the volume of employment. Teachers in part-time jobs had only a slightly lower ERI-ratio. There were no differences between full-time and part-time teachers regarding health status. Eighteen percentage of both groups reported impaired mental health (GHQ ≥ 5), 48% of part-time teachers and 53% of full-time teachers suffered from high blood pressure. Low physical fitness was observed in 12% of part-time and 6% of full-time teachers. In this study, neither the volume of employment nor working conditions were found to be significantly correlated with health status. Conclusion Part-time and full-time employment status did not appear to influence health in the teaching profession. Although there are differences in quantitative working demands, while the health status does not differ between both teacher groups. Content Type Journal ArticleCategory Original ArticlePages 1-13DOI 10.1007/s00420-011-0715-7Authors Reingard Seibt, Faculty of Medicine Carl Gustav Carus, Institute and Clinic of Occupational and Social Medicine, Technische Universität Dresden (TUD), Fetscherstraße 74, 01307 Dresden, GermanyAnnerose Matz, Faculty of Medicine Carl Gustav Carus, Institute and Clinic of Occupational and Social Medicine, Technische Universität Dresden (TUD), Fetscherstraße 74, 01307 Dresden, GermanyJanice Hegewald, Faculty of Medicine Carl Gustav Carus, Institute and Clinic of Occupational and Social Medicine, Technische Universität Dresden (TUD), Fetscherstraße 74, 01307 Dresden, GermanySilvia Spitzer, Faculty of Medicine Carl Gustav Carus, Institute and Clinic of Occupational and Social Medicine, Technische Universität Dresden (TUD), Fetscherstraße 74, 01307 Dresden, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The relative contribution of work exposure, leisure time exposure, and individual characteristics in the onset of arm–wrist–hand and neck–shoulder symptoms among office workers

Abstract Purpose To identify the risk factors for the onset of arm–wrist–hand and neck–shoulder symptoms among office workers and to estimate the relative contribution of these risk factors by calculating Population Attributable Fractions (PAFs). Methods A prospective cohort study was conducted among 1951 office workers with a follow-up duration of 2 years. Data on self-reported risk factors were collected at baseline and after 1 year of follow-up. Every 3 months, the occurrence of upper extremity symptoms was assessed using questionnaires. PAFs for individual risk factors were estimated based on Rate ratios (RRs) obtained from Poisson regression using Generalized Estimation Equations. Results Previous disabling symptoms were identified as the most important risk factor for the onset of arm–wrist–hand and neck–shoulder symptoms. Modifiable risk factors for arm–wrist–hand symptoms with relatively large PAFs were: at least 4 h per day of self-reported computer use at work, high level of overcommitment, and low task variation and for neck-shoulder symptoms: supporting the arms during keyboard use and at least 4 h per day of self-reported mouse use at work. Compared to having 0 or 1 risk factor, the RR for arm–wrist–hand symptoms increased to 6.2 (95% CI 3.7–10.5) for having 5–7 potentially modifiable risk factors and for neck–shoulder symptoms to 3.0 (95% CI 2.1–4.4) for having 4 or 5 potentially modifiable risk factors. Conclusion Preventive interventions at the population level should be aimed at changing modifiable risk factors with large PAFs. At the individual level, preventive interventions should be aimed at changing multiple modifiable risk factors simultaneously. Content Type Journal ArticleCategory Original ArticlePages 1-16DOI 10.1007/s00420-011-0717-5Authors Maaike A. Huysmans, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsStefan IJmker, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsBirgitte M. Blatter, Body@Work Research Centre on Physical Activity, Work and Health, TNO-VU/VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsDirk L. Knol, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsWillem van Mechelen, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsPaulien M. Bongers, Body@Work Research Centre on Physical Activity, Work and Health, TNO-VU/VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, The NetherlandsAllard J. van der Beek, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Burnout and effort–reward imbalance improvement for teachers by a manual-based group program

Abstract Objective We developed a manual-based psychological group program aimed at teachers and focussing on their professional relationships. The intervention comprised ten sessions over a 10-month period. The aim of the program was to strengthen teachers’ health. We investigated whether the effects of our intervention, during which the MBI and ERI were applied, result in general alleviation of occupational stress experienced by teachers. Methods This is a randomized controlled trial. All teachers (N = 2,484) of two school types (grammar schools and secondary modern schools) in 3 districts of southwestern Germany were invited to take part in our program. All teachers declaring their interest (N = 337) in the intervention were included in the project. They were randomly assigned to either the intervention group (N = 171) or to the control group (N = 166). Results We found that teachers who participated in at least 50% of the program benefited from this short intervention. Significant improvement was achieved on the two MBI scales, Emotional Exhaustion and Personal Accomplishment, as well as on the ERI subscale Appreciation. Conclusion Teachers’ occupational stress level may be decreased by taking part in a short manual-based psychological group intervention that focuses on more effective handling of interpersonal problems in school. Therefore, teachers should receive support and guidance in developing the appropriate skills necessary to cope with stress appropriately. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0712-xAuthors Thomas Unterbrink, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyRuth Pfeifer, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyLorena Krippeit, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyLinda Zimmermann, Department of Medical Psychology and Medical Sociology, University of Freiburg, Hebelstr. 29, 79104 Freiburg, GermanyUwe Rose, Department of Mental Health and Cognitive Capacity, Federal Institute for Occupational Safety and Health, Noeldnerstrasse 40-42, 10317 Berlin, GermanyAndreas Joos, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyArmin Hartmann, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyMichael Wirsching, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, GermanyJoachim Bauer, Department of Psychosomatic Medicine and Psychotherapy, Freiburg University Medical School, Hauptstrasse. 8, 79104 Freiburg, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Longitudinal evidence for the association between work-related physical exposures and neck and/or shoulder complaints: a systematic review

Abstract Background Most existing reviews focus on evidence for the association between neck and/or shoulder complaints and physical exposures at the workplace gathered from cross-sectional studies. In comparison, this review summarizes existing evidence from longitudinal studies only. Methods A systematic literature research was conducted in Medline and EMBASE (1975–2009), and all studies were scanned by at least two researchers according to strict inclusion criteria. Levels of evidence were assigned according to the number of studies reporting similar findings, and according to the methodological quality of the included studies. Results Altogether 21 longitudinal studies (19 high-quality studies) met the inclusion criteria and were included in this review. In comparison with former reviews, we found strong evidence for an association between shoulder complaints and manual material handling (MMH) (range between Odds Ratio (OR) 1.4 and 4.9), vibration (range between OR 1.6 and OR 2.5), trunk flexion or rotation (range between OR 1.8 and OR 5.1), and working with hands above shoulder level (range between OR 1.1 and OR 1.8). Apart from that, the included studies confirmed existing knowledge on the association between physical exposures at the workplace and neck and/or shoulder complaints. Conclusions This analysis of longitudinal studies allowed for new evidence with regard to four cause-effect chains between physical exposures at work and the development of shoulder, neck and neck/shoulder complaints. As outcome variables varied greatly among the included studies, harmonization in studies on musculoskeletal research is desirable. Content Type Journal ArticleCategory Review ArticlePages 1-17DOI 10.1007/s00420-011-0701-0Authors Julia Mayer, Medical Faculty, Institute of Occupational and Social Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, GermanyThomas Kraus, Medical Faculty, Institute of Occupational and Social Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, GermanyElke Ochsmann, Medical Faculty, Institute of Occupational and Social Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

A cross-sectional study of psychosocial work environment and stress in the Danish symphony orchestras

Abstract Purpose To investigate psychosocial work environment and stress in Danish symphony orchestra musicians. Methods This was a cross-sectional questionnaire survey of psychosocial work factors and stress symptoms among 441 musicians in six Danish symphony orchestras. The response rate was 78% (n = 342). The questions were from COPSOQ (Copenhagen Psychosocial Questionnaire). Mean values of 19 COPSOQ-scales were compared by gender and instrument group. The results for the musicians were compared with results for the general Danish work force (COPSOQ database). Results Female musicians reported higher work demands and higher stress symptoms than their male colleagues. Between instrument groups, 2nd violinists seemed to be of particular risk compared with the other instrumental groups in aspects of work pace, work organization, and content, whereas 1st violinists perceived higher emotional stress compared with 2nd violinists. The musicians’ experience of increased work demands as well as deteriorated, work organization and job content, interpersonal relations and leadership, and work-individual interface was significantly associated with increasing stress symptoms. Compared to the general workforce independently of gender, Danish symphony orchestra musicians reported higher emotional demands, lower influence, lower social support, lower sense of community, and lower job satisfaction. However, the musicians reported a higher commitment to the workplace. Conclusions The findings indicate a more demanding psychosocial work environment exposure among symphony orchestra musicians than among Danish workers in general. Critical results are the relatively high work demands, low influence, and low social support, females being of higher risk than males. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-011-0710-zAuthors Gitte Juel Holst, Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, DenmarkHelene M. Paarup, Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, DenmarkJesper Baelum, Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The effects of metallothionein 2A polymorphism on lead metabolism: are pregnant women with a heterozygote genotype for metallothionein 2A polymorphism and their newborns at risk of having higher blood lead levels?

Abstract Objectives Numerous studies indicate that certain genetic polymorphisms modify lead toxicokinetics. Metallothioneins are protective against the toxicity of many metals, including lead. The aim of this study was to determine whether the maternal metallothionein 2A (MT2A) -5 A/G single-nucleotide polymorphism is related to the lead levels in maternal blood, placental tissue and cord blood in 91 pregnant women and their newborns. Methods Venous blood from the mother was collected to investigate lead levels and MT2A polymorphism. Cord blood and placenta were collected for lead levels. Analyses were made using an Atomic Absorption Graphite Furnace Spectrophotometer. Standard PCR–RFLP technique was used to determine MT2A polymorphism. Results Blood lead levels of heterozygote genotype (AG) mothers were statistically higher than those of homozygote genotype (AA) (P < 0.05). Maternal lead levels were significantly associated with cord blood lead levels for pregnant women with AA genotype (P < 0.001). This association was not statistically significant for pregnant women with AG. In contrast, the mean value of cord blood lead level for newborns with mothers of AG genotype was slightly higher than others, though the difference was not significant. No significant difference existed in placenta lead levels between the groups. Conclusion This study suggests that pregnant women with AG genotype for MT2A polymorphism might have high blood lead levels and their newborns may be at risk of low-level cord blood lead variation. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00420-011-0711-yAuthors Deniz Tekin, Institute of Forensic Sciences, Ankara University, Dikimevi, 06590 Ankara, TurkeyZeliha Kayaaltı, Institute of Forensic Sciences, Ankara University, Dikimevi, 06590 Ankara, TurkeyTülin Söylemezoğlu, Institute of Forensic Sciences, Ankara University, Dikimevi, 06590 Ankara, Turkey Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

On-site screening of farming-induced chronic obstructive pulmonary disease with the use of an electronic mini-spirometer: results of a pilot study in Brittany, France

Abstract Purpose Dairy farming is a risk factor for the development of chronic obstructive pulmonary disease (COPD). We assessed the prevalence of farming-induced COPD (FI-COPD) using a new screening device, and we analyzed symptoms and occupational risk factors. Methods We performed on-site screening study of bronchial obstruction using an electronic mini-spirometer (EMS) on an entire population of dairy farmers (n = 147) from two villages in Brittany, France. Suspected bronchial obstruction (FEV1/FEV6 <0.8) was confirmed with standardized lung function tests (FEV1/FVC ≤0.7). We assessed past medical histories, respiratory symptoms, and occupational tasks of subjects with bronchial obstruction; asthmatics were defined as atopic and/or reversible; smoking-induced COPD patients were defined as non-reversible, non-atopic with smoking histories (≥5 PY); and FI-COPD patients were defined as non-reversible, non-atopic, and non-smokers. Results Using the EMS, 30.6% (n = 45) of dairy farmers were suspected of bronchial obstruction and underwent standardized spirometry. The FEV1/FEV6 ratio and FEV1/FVC ratio were in good agreement (r² = 0.66, P < 0.0001). The prevalence of confirmed bronchial obstruction was 9.5% (n = 14), which included 4 asthmatics, 3 smoking-induced COPD subjects, and 7 FI-COPD subjects. All the COPD patients were GOLD Stage II, and none were aware of their respiratory disease. Foddering duration was significantly higher in FI-COPD subjects compared with non-obstructive subjects, with 44 versus 17 min/day, respectively. Conclusions The EMS was a convenient mean of screening for bronchial obstruction, especially in on-site settings, and allowed us to diagnose FI-COPD in a non-spontaneously complaining dairy farmer population. Foddering was considered a significant risk factor. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0708-6Authors Stephane Jouneau, Respiratory Department, Pontchaillou Hospital, Rennes 1 University, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceArnaud Boché, Respiratory Department, Pontchaillou Hospital, Rennes 1 University, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceGraziella Brinchault, Respiratory Department, Pontchaillou Hospital, Rennes 1 University, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceKristina Fekete, Respiratory Department, Pontchaillou Hospital, Rennes 1 University, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceStephanie Guillot, Physiology Department, Pontchaillou Hospital, Rennes 1 University, Rennes, FranceSahar Bayat, Medical Information Department, Pontchaillou Hospital, Rennes 1 University, Rennes, FranceBenoit Desrues, Respiratory Department, Pontchaillou Hospital, Rennes 1 University, 2 Rue Henri Le Guilloux, 35033 Rennes, France Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare

Abstract Purpose The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers. Methods Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004–2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1–30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up. Results At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17–1.85]), neck/shoulder (HR 1.60 [95% CI 1.27–2.02]) and knees (HR 1.92 [95% CI 1.52–2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09–1.82]) and knee pain (HR 1.69 [95% CI 1.32–2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions. Conclusion Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0709-5Authors Lars L. Andersen, National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, DenmarkThomas Clausen, National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, DenmarkOle S. Mortensen, National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, DenmarkHermann Burr, National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, DenmarkAndreas Holtermann, National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, Denmark Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Acute effects of mechanical shocks on finger blood flow: influence of shock repetition rate and shock magnitude

Abstract Objectives Finger blood flow is reduced by hand-transmitted vibration but there has been little study of the peripheral vascular response to repetitive mechanical shocks. This study investigated how reductions in finger blood flow depend on shock repetition rate and the peak and rms magnitude of acceleration. Methods Subjects attended seven sessions: six with repetitive mechanical shocks and a control session with no shocks. Each session comprised five successive 5-min periods: (1) no force and no vibration, (2) force and no vibration, (3) force and vibration, (4) force and no vibration and (5) no force and no vibration. During the second–fourth periods, the palm of the right hand applied 2-N force to a vibrator. During the third period, a 125-Hz mechanical shock was applied with one of four repetition rates (1.3, 5.3, 21 or 83.3/s) and one of three acceleration magnitudes (2.5, 5 or 10 ms−2 rms, unweighted). Finger blood flow was measured every 30 s in the middle and little fingers of the right (exposed) hand and the left (unexposed) hand. Results Different repetition rates (1.3–83.3 s−1) and different peak magnitudes (10–88 ms−2 peak) but the same rms acceleration (10 ms−2 rms) caused similar decreases in blood flow in fingers on exposed and unexposed hands. Shocks with a 83.3 s−1 repetition rate, peak magnitude of 10 ms−2 and rms acceleration of 10 ms−2 provoked greater reduction in finger blood flow than shocks with the same peak magnitude but lower repetition rate (21 or 5.3 s−1) and lower rms acceleration (5 or 2.5 ms−2). Conclusions For shocks similar to those based on 125-Hz oscillations with repetition rates between 1.3 and 83.3 s−1, acute reductions in finger blood flow can be predicted from the rms acceleration. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-011-0704-xAuthors Ying Ye, Human Factors Research Unit, Institute of Sound and Vibration Research, University of Southampton, Southampton, SO17 1BJ UKMarcella Mauro, Clinical Unit of Occupational Medicine, Department of Medicine, Surgery and Health Sciences, Trieste General Hospitals, University of Trieste, Trieste, 34129 ItalyMassimo Bovenzi, Clinical Unit of Occupational Medicine, Department of Medicine, Surgery and Health Sciences, Trieste General Hospitals, University of Trieste, Trieste, 34129 ItalyMichael J. Griffin, Human Factors Research Unit, Institute of Sound and Vibration Research, University of Southampton, Southampton, SO17 1BJ UK Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

A time-stratified case-crossover study of fine particulate matter air pollution and mortality in Guangzhou, China

Abstract Objectives Few studies in China investigate health impact of fine particulate matter (PM2.5) due to lack of monitoring data and the findings are controversial. The aim of this study is to examine the short-association between PM2.5 and daily mortality in Guangzhou, the economic center of south China. Methods In Guangzhou, we measured daily PM2.5 concentrations between 2007 and 2008 and conducted a time-stratified case-crossover analysis to explore the association between PM2.5 and daily mortality, and examine potential effect modifiers including age, sex, and education. Results The averaged PM2.5 concentration in 2007–2008 was 70.1 μg/m3 in Guangzhou, which was approximately seven times higher than the WHO Air Quality Guidelines for PM2.5 (annual average: 10 μg/m3). Regression analysis showed that ambient PM2.5 was associated with mortality from all causes and cardiorespiratory diseases. An increase of 10 μg/m3 in 2-day moving average (lag01) concentration of PM2.5 corresponds to 0.90% [95% confidence interval (CI): 0.55, 1.26%] increase of total mortality, 1.22% (95% CI: 0.63, 1.68%) increase of cardiovascular mortality, and 0.97% (95% CI: 0.16, 1.79%) increase of respiratory mortality. The associations were stronger in the elderly (aged 65 years or more), in females, and in those with low education level, but the differences were statistically insignificant. After adjustment for nitrogen dioxide (NO2), however, the effects of PM2.5 decreased and became statistically insignificant. Conclusions Our findings provided new information for the adverse health effects of PM2.5 in China, and may have some implications for environmental policy making and standard setting in Guangzhou. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00420-011-0707-7Authors Chunxue Yang, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, ChinaXiaowu Peng, South China Institute of Environmental Sciences (SCIES), Ministry of Environmental Protection (MEP), Guangzhou, 510655 ChinaWei Huang, Center for Environment and Health, Peking University, Beijing, ChinaRenjie Chen, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, ChinaZhencheng Xu, South China Institute of Environmental Sciences (SCIES), Ministry of Environmental Protection (MEP), Guangzhou, 510655 ChinaBingheng Chen, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, ChinaHaidong Kan, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Biological reference values for chemical compounds in the work area (BARs): an approach for evaluating biomonitoring data

Abstract Biological monitoring is a routine method that has been applied in occupational medical practice for many years. A requirement for its application is the availability of criteria suitable for evaluating biomonitoring data. Health-based threshold values are particularly useful as a criterion, yet only for substances for which effect thresholds can reliably be determined. For substances for which the concept of health-based threshold values is not applicable, the Working Group Setting of Threshold Limit Values in Biological Materials of the DFG Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area has recently established “Biologische Arbeitsstoff-Referenzwerte” (BARs, Biological Reference Values for Chemical Compounds in the Work Area) as an approach for evaluating biomonitoring data. The BAR represents the upper reference concentration of a biomarker in the general adult population without occupational exposure to the agent. It is derived from biomonitoring data of a sample of a defined population group. In general, a BAR corresponds to the 95th percentile of the sample distribution. Ideally, national environmental surveys including human biomonitoring results are used as basis for deriving BARs. The influence of age, sex, social status, residential area and life style factors on background exposure is considered in the evaluation of these values. Because tobacco smoking is the most frequent influencing factor, several BARs have been determined for non-smokers only. To date, BARs for 17 substances or substance groups are listed in the List of MAK and BAT Values 2011. BARs for another five substances have been discussed, but have not been established because of the insufficient scientific database. Establishing the BARs aims to facilitate the evaluation of human exposure to chemical compounds for which no health-based threshold values can be derived but an adequate assessment of exposure is required due to their toxicity. The application of BARs does not permit a toxicological evaluation, but does allow the occurrence and the extent of occupational exposure to hazardous substances to be proved. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00420-011-0699-3Authors Thomas Göen, Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Schillerstrasse 25, 91054 Erlangen, GermanyKarl-Heinz Schaller, Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Schillerstrasse 25, 91054 Erlangen, GermanyHans Drexler, Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Schillerstrasse 25, 91054 Erlangen, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Depressive symptoms in junior doctors: a follow-up study on work-related determinants

Abstract Purpose The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors—a professional group that is vulnerable to depression. Methods We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3. Results The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25–1.50) and negatively by professional tenure (0.54; 0.31–0.96), free weekends (0.52; 0.28–0.97), and job autonomy (0.35; 0.18–0.65). Conclusions After controlling for demographic and working time influences, findings suggest that junior doctors’ perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00420-011-0706-8Authors Matthias Weigl, Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336 Munich, GermanySeverin Hornung, Department of Management and Marketing, The Hong Kong Polytechnic University, Hong Kong, SAR, ChinaRaluca Petru, Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336 Munich, GermanyJürgen Glaser, Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstr. 1, 80336 Munich, GermanyPeter Angerer, Institute for Occupational, and Social Medicine, Universitätsklinikum, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Do work ability and job involvement channel later personal goals in retirement? An 11-year follow-up study

Abstract Objective The present study investigates the role of work ability and job involvement in personal life goals later in retirement. Methods The study is based on longitudinal research on Finnish employees working in managerial positions. At the study baseline (in 1996), 120 employed managers responded to a questionnaire regarding their work ability and job involvement, and 11 years later (in 2007) when they were retired, they responded to an open-ended question regarding their personal goals. The retired participants were 58–76 years old (M = 66 years), and they had been retired for 1–10 years (M = 4.3 years, SD = 2.9). Results On the basis of the participants’ responses to the open-ended question, six main content categories of personal goals were formed. According to these categories, the personal goals in retirement focused on (1) hobbies and leisure time, (2) social relationships, (3) health and well-being, (4) housing and finance, (5) self-development and ideology, and (6) other activities. The managers with better work ability and job involvement at the baseline of the study had fewer personal goals related to health and well-being later in retirement. In addition, better work ability predicted more personal goals related to self-development and ideology views. Conclusions The preceding work ability and job involvement seem to channel personal goal pursuit in retirement. Thus, sustaining employees’ work ability and job involvement are not only essential for developing employees’ ability to cope with work demands but also for their functional capacity in their later stages of life, such as in retirement. Content Type Journal ArticleCategory Original ArticlePages 1-12DOI 10.1007/s00420-011-0705-9Authors Taru Feldt, University of Jyväskylä, Jyväskylä, FinlandKatriina Hyvönen, University of Jyväskylä, Jyväskylä, FinlandTerhi Oja-Lipasti, University of Jyväskylä, Jyväskylä, FinlandUlla Kinnunen, University of Jyväskylä, Jyväskylä, FinlandKatariina Salmela-Aro, University of Jyväskylä, Jyväskylä, Finland Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers

Abstract Purpose Literature suggests a relationship between overweight and obesity, and mental health problems, but data regarding prevalence rates are scarce. This study aimed to determine the prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers. Methods Data were used from the Netherlands Working Conditions Survey (NWCS), which is representative for Dutch employees (n = 43,928). Based on self-reported body mass index (BMI), workers were classified into underweight, healthy weight, overweight, and obesity. Respondents indicated whether they suffered from chronic psychological complaints. Emotional exhaustion was measured by using the UBOS subscale. Logistic regression analyses were used to test differences in prevalence across weight categories, with healthy weight as the reference group. Analyses were stratified for gender, age, education, and occupation. Results Of the obese workers, 15.7% reported emotional exhaustion and 3.7% reported chronic psychological complaints. These prevalence rates were significantly higher than among healthy weight workers. A significant J shape was found with healthy weight workers reporting the lowest prevalence of both indicators of mental health problems. This J shape was generally also seen among the gender, age, education, and occupation subgroups, though not consistently significant. Conclusion Considering the proportion of obese workers that also suffers from psychological co-morbidities, interventions targeting obesity should take this into account. As weight-related stigma may play a role in the risk for mental health problems among obese workers, future longitudinal research on the mechanisms for the relation between overweight and mental health problems are recommended. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0703-yAuthors Karin I. Proper, Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The NetherlandsLando L. J. Koppes, TNO, Division Work and Employment, Hoofddorp, The NetherlandsMarianne H. J. van Zwieten, TNO, Division Work and Employment, Hoofddorp, The NetherlandsWanda J. E. Bemelmans, Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Analysis of occupational stress in a high fashion clothing factory with upper limb biomechanical overload

Abstract Purpose To study job stress and upper limb biomechanical overload due to repetitive and forceful manual activities in a factory producing high fashion clothing. Methods A total of 518 workers (433 women and 85 men) were investigated to determine anxiety, occupational stress (using the Italian version of the Karasek Job Content Questionnaire) and perception of symptoms (using the Italian version of the Somatization scale of Symptom Checklist SCL-90). Biomechanical overload was analyzed using the OCRA Check list. Results Biomechanical assessment did not reveal high-risk jobs, except for cutting. Although the perception of anxiety and job insecurity was within the normal range, all the workers showed a high level of job strain (correlated with the perception of symptoms) due to very low decision latitude. Conclusion Occupational stress resulted partially in line with biomechanical risk factors; however, the perception of low decision latitude seems to play a major role in determining job strain. Interactions between physical and psychological factors cannot be demonstrated. Anyway, simultaneous long-term monitoring of occupational stress features and biomechanical overload could guide workplace interventions aimed at reducing the risk of adverse health effects. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0702-zAuthors Laura Forcella, Occupational Health Unit, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyRoberta Bonfiglioli, Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, Alma Mater Studiorum-University of Bologna, Bologna, ItalyPiero Cutilli, EurErg, Ergoteam s.r.l., Rome, ItalyEugenio Siciliano, CONTARP (Consulenza Tecnica Regionale Accertamento rischi e Prevenzione), INAIL (Italian Workers’ Compensation Authority) Abruzzo, L’Aquila, ItalyAngela Di Donato, Occupational Health Unit, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyMarta Di Nicola, Laboratory of Biostatistics, Department of Biomedical Sciences, University “G. d’Annunzio”, Chieti, ItalyAndrea Antonucci, Occupational Health Unit, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyLuca Di Giampaolo, Occupational Health Unit, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyPaolo Boscolo, Occupational Health Unit, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyFrancesco Saverio Violante, Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, Alma Mater Studiorum-University of Bologna, Bologna, Italy Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Inventory of the chemicals and the exposure of the workers’ skin to these at two leather factories in Indonesia

Abstract Purpose Tannery workers are exposed to hazardous chemicals. Tannery work is outsourced to newly industrialized countries (NICs) where attention into occupational health hazards is limited. In this study, we investigated the skin exposure to hazardous chemicals in tannery workers and determined the prevalence of occupational skin diseases (OSDs) at tanneries in a NIC. Methods A cross-sectional study on the observation of the working process and an inventory and risk assessment of the chemicals used. Classification of chemicals as potential sensitizers/irritants and a qualitative assessment of exposure to these chemicals. Workers were examined and interviewed using Nordic Occupational Skin Questionnaire-2002/LONG. Results The risk of OSDs at the investigated tanneries was mainly related to the exposure of the workers’ skin to chemicals in hot and humid environmental conditions. In 472 workers, 12% reported a current OSD and 9% reported a history of OSD. In 10% of all cases, an OSD was confirmed by a dermatologist and 7.4% had an occupational contact dermatitis (OCD). We observed that personal protective equipment (PPE) used was mainly because of skin problems in the past and not as a primary protection against OSD. Conclusion We observed a high frequency and prolonged exposure to many skin hazardous factors in tannery work although PPE was relatively easily available and which was generally used as a secondary preventative measure. The observed point-prevalence in this study was at the same level as that reported for other high-risk OSDs in Western countries and other tanneries in NICs. However, the observed point-prevalence in this study was lower than that reported in India and Korea. The results of our study and those of other studies at tanneries from other NICs were probably influenced by Healthy Worker Survivor Effect (HWSE). Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00420-011-0700-1Authors Sri Awalia Febriana, Department of Dermatology & Venereology, Gadjah Mada University, Yogyakarta, IndonesiaFrank Jungbauer, Department of Dermatology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The NetherlandsHardyanto Soebono, Department of Dermatology & Venereology, Gadjah Mada University, Yogyakarta, IndonesiaPieter-Jan Coenraads, Department of Dermatology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30 001, 9700 RB Groningen, The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

High pesticide exposure events and central nervous system function among pesticide applicators in the Agricultural Health Study

Abstract Purpose While acute pesticide poisoning can be associated with persistent adverse central nervous system (CNS) effects, little is known about the effect of one or more episodic and unusually high pesticide exposure events (HPEE) that typically do not result in acute poisoning. The objective of this investigation was to examine the association between ever having an HPEE and CNS function among licensed pesticide applicators enrolled in the Agricultural Health Study (AHS). Methods In 2006–2008, 693 male participants with no history of a physician-diagnosed pesticide poisoning completed nine neurobehavioral tests to assess memory, motor speed, sustained attention, verbal learning, and visual scanning and processing. Information on ever having an HPEE and pesticide poisonings was obtained from previous AHS interviews. Associations between ever having an HPEE and neurobehavioral outcomes were estimated with linear regression controlling for age and outcome-specific covariates. Results A history of ever having an HPEE was reported by 156 (23%) participants. Adverse associations were observed between ever having an HPEE and two of the nine neurobehavioral tests. On a test of visual scanning and processing (Digit-Symbol), participants who ever had an HPEE were 4.2 s slower (95% CI: −7.27, −1.11) than those without an HPEE, equivalent to the effect of 3.9 years of age in this population. On a test of visual scanning and motor speed (Sequences A), participants who ever had an HPEE were 2.5 s slower (95% CI: −4.53, −0.41) than those without an HPEE, equivalent to the effect of 3.9 years of age. No significant associations were observed between participants who ever had an HPEE and the remaining neurobehavioral tests. Conclusions One or more HPEE may contribute to adverse CNS outcomes independent of diagnosed pesticide poisoning. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-011-0694-8Authors Sarah E. Starks, Department of Occupational and Environmental Health, University of Iowa, University of Iowa Research Park, 140 IREH, Iowa City, IA 52242-5000, USAFred Gerr, Department of Occupational and Environmental Health, University of Iowa, University of Iowa Research Park, 140 IREH, Iowa City, IA 52242-5000, USAFreya Kamel, Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, MD A3-05, PO Box 12233, Research Triangle Park, NC 27709, USACharles F. Lynch, Department of Epidemiology, University of Iowa, C21-L GH, Iowa City, IA 52242, USAMichael C. Alavanja, Department of Health and Human Services, National Cancer Institute, NIH, Executive Plaza South, Room 8000, Rockville, MD 20852, USADale P. Sandler, Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, MD A3-05, PO Box 12233, Research Triangle Park, NC 27709, USAJane A. Hoppin, Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, MD A3-05, PO Box 12233, Research Triangle Park, NC 27709, USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Response to the letter to the editor entitled “Regarding long-term lead elimination from plasma and whole blood after poisoning”

Response to the letter to the editor entitled “Regarding long-term lead elimination from plasma and whole blood after poisoning” Content Type Journal ArticleCategory Letter to the EditorPages 1-1DOI 10.1007/s00420-011-0697-5Authors G. Rentschler, Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, SwedenK. Broberg, Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, SwedenT. Lundh, Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, SwedenS. Skerfving, Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, Sweden Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Multivariate, longitudinal analysis of the impact of changes in office work environments on surface electromyography measures

Abstract Purpose To detect impacts of changes in work environment and worker-equipment interface variables upon surface electromyography (EMG) measures using multivariate, longitudinal analysis. Methods For 33 office workers, yearly measurements (1999–2001) were taken during normal work. Independent variables were related to work environment (expert-observed equipment dimensions, work organization on questionnaire) and interface (expert-observed postures, self-reported workstation-equipment relative fit i.e. inside or outside guidelines-informed location, and 30 min video-based task analysis). Internal mechanical exposure (EMG) was recorded bilaterally from extensor carpi radialis brevis (ECRB) and upper trapezius sites, each side, also for 30 min. Dependent variables were amplitude probability distribution functions (APDF 50 and 90%) and gaptime for entire record EMG (over all tasks) and task-specific EMG (for four separate tasks). Multivariate mixed models used independent variables to predict EMG measures (4 muscle sites × (1 entire record + 4 task specific) = 20 models total). Results Among EMG measures, 9/16 means and 2/16 variances were significantly different across years (p < 0.1). Environment and interface variables explained part of the variation in EMG measures in 13/20 models. The most consistent predictors included: (1) increased monitor distance predicted reduced APDFs and increased gaptimes; (2) wrist extension <20° predicted decreases in left ECRB APDFs; (3) keyboard location within guidelines predicted improvements in all right ECRB EMG measures during keyboarding; and (4) longer task duration predicted higher APDFs and lower gaptimes. Conclusion Longitudinal analysis with multivariate models can detect the impacts of changes in environment and interface exposures on EMG measures among office workers. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00420-011-0696-6Authors D. C. Cole, Institute for Work and Health, Toronto, ON, CanadaC. Chen, Institute for Work and Health, Toronto, ON, CanadaS. Hogg-Johnson, Institute for Work and Health, Toronto, ON, CanadaD. Van Eerd, Institute for Work and Health, Toronto, ON, CanadaA. Mazumder, Department of Statistics, University of Oxford, Oxford, UKR. P. Wells, Institute for Work and Health, Toronto, ON, CanadaWorksite Upper Extremity Research Group Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Regarding “Long-term lead elimination from plasma and whole blood after poisoning”

Regarding “Long-term lead elimination from plasma and whole blood after poisoning” Content Type Journal ArticleCategory Letter to the EditorPages 1-1DOI 10.1007/s00420-011-0698-4Authors Hossein Sanaei-Zadeh, Department of Forensic Medicine and Toxicology, Tehran University of Medical Sciences, Hazrat Rasoul Akram Hospital, Niayesh Street, Sattar-Khan Ave., 1445613131 Tehran, Iran Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Prevalence of and risk factors for subjective symptoms in urban preschool children without a cause identified by the guardian

Abstract Objective The aim of this study was to explore the prevalence of and the risk factors for subjective symptoms without an identified cause by the guardian (SSWICG) in urban preschool children. Methods A questionnaire was used to collect information from 661 urban preschool children. The subjective symptoms were cited from the MM075NA Indoor Environment Quality Investigation Questionnaire. Information about living conditions, kindergarten and outdoor environments was collected, as well as health information from each child. Results The prevalence of SSWICG reached 31%, among which the prevalence of general symptoms in the central nervous system (CNS) reached 54.6%. Univariate analysis showed that the materials that made indoor furniture, walls and doors, indoor biological factors, outdoor pollution sources near the house and traffic pollution were associated with SSWICG and mucosal, dermal and general symptoms in the CNS subgroups. Multivariate analysis also showed that furniture materials, traffic pollution, kindergarten environment quality and allergies were associated. Conclusions The prevalence of SSWICG was relatively high. Possible risk factors include indoor furnishing materials, allergy, traffic pollution and kindergarten environmental pollution. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0693-9Authors Bing-Ling Wang, Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, No.140 HanZhong Rd., Nanjing, 210029 ChinaXi-Ling Li, Institute of Child Health Care, Nanjing Maternity and Child Health Care Hospital, No. 123 Tianfeixiang, Nanjing, 210004 ChinaXiao-Bo Xu, Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, No.140 HanZhong Rd., Nanjing, 210029 ChinaYong-Gang Sun, Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, No.140 HanZhong Rd., Nanjing, 210029 ChinaQi Zhang, Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, No.140 HanZhong Rd., Nanjing, 210029 China Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Evaluating chromosomal damage in workers exposed to hexavalent chromium and the modulating role of polymorphisms of DNA repair genes

Abstract Purpose Welders have been chronically exposed to hexavalent chromium with potential consequences on chromosomal integrity. Our study is focused on the extent of any such chromosomal aberrations with respect to chromium levels in the blood of welders as well as on the tentative modulating role of polymorphisms in DNA repair genes XPD Lys751Gln, XPG Asn114His, XPC Lys939Gln, hOGG1 Ser326Cys and XRCC1 Arg399Gln on chromosomal damage. Methods The study was conducted on 144 individuals consisting of 73 welders exposed to chromium for 10.2 ± 1.67 years and 71 control individuals without known exposures. Chromosomal aberrations, their chromatid-type and chromosome-type aberrations were detected by conventional cytogenetic analysis. XPD, XPG, XPC, hOGG1 and XRCC1 gene polymorphisms were assayed for by Taqman SNP genotyping assay (“Assay-by-Demand”) using Real-Time allelic discrimination on AB 7500 equipment. Chromium concentration in the blood was determined by atomic absorption spectrophotometry. Results The level of chromium in the blood of welders ranged between 0.032 and 0.182 μmol l−1 and was significantly higher than that in controls (0.07 ± 0.04 μmol l−1 vs. 0.03 ± 0.007 μmol l−1). Parameters of chromosomal damage were similar in both the exposed and the control individuals (1.89% vs. 1.70% for total chromosomal aberrations, 0.97% vs. 0.88% for chromosome-type and 0.92% vs. 0.80% for chromatid-type, respectively). Chromatid-type of aberrations positively correlated with the level of chromium in the blood (r = 0.28; P = 0.02). Significantly higher total chromosomal aberrations were detected in individuals with homozygous variant polymorphism in XRCC1 Arg399Gln gene as compared to those with heterozygous and homozygous wild-type genotypes (2.20, 1.89 and 1.48%, respectively; P = 0.01). A similar tendency was found for chromatid-type aberrations (1.30% for homozygous variant genotype bearers, 0.94% for those with heterozygous genotype and 0.75% for carriers of homozygous wild-type genotype, respectively; P = 0.04). Conclusions Although no apparent increase in chromosomal damage was recorded in chromium-exposed welders in comparison with controls, genetic make-up in DNA repair genes may increase susceptibility toward adverse effect of chromium. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00420-011-0684-xAuthors Erika Halasova, Department of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4, 03645 Martin, SlovakiaTatiana Matakova, Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaLudovit Musak, Department of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4, 03645 Martin, SlovakiaVeronika Polakova, Institute of Experimental Medicine, Academy of Sciences CR, Prague, Czech RepublicLucia Letkova, Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaDusan Dobrota, Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaPavel Vodicka, Institute of Experimental Medicine, Academy of Sciences CR, Prague, Czech Republic Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

In this issue of Occupational Medicine

Gustave Caillebotte The House Painters 1877

Health and safety of the older worker

Background In the UK, increasing numbers of paid employees are over 60 years with further increases expected as the state pension age rises. Some concern surrounds possible increased work-related illness and accidents for people working beyond the age of 60. Aims To identify the available evidence for health and safety risks of workers over age 60 years with respect to factors associated with injuries and accidents. Methods Databases searched included PUBMED, OSHUpdate, National Institute for Occupational Safety and Health (NIOSHTIC-2), SafetyLit, the UK The Health and Safety Executive (HSELINE) and the Canadian Centre for Occupational Health and Safety until December 2009. Inclusion criteria were workers aged over 60 years. Findings were grouped into occupational accidents and injuries and individual and workplace factors that may have influenced risk of injury to the over-60s. Results Very little direct evidence was found concerning safety practices and health risks of workers over age 60. Some safety risks were associated with specific physical declines such as age-related hearing loss. Overall, these workers had fewer accidents and injuries but these were more likely to be serious or fatal when they occurred. There was no strong evidence that work patterns, including shift work or overtime, affected safety. Protective, compensatory strategies or experience may maintain safe working practices. Conclusions Implications for health and safety risks cannot be assessed without longitudinal research on workforces with substantial numbers of workers over age 60 in order to address the healthy worker effect.

Psychosocial stress among Danish vicars

Background Burnout and depression are common among clergy members of several religions and denominations. Despite this, no studies have analysed whether differences in psychosocial workloads between vicars and others explain their higher prevalence of stress-related symptoms. Aims To test the hypothesis that elements of the job strain model (high work demands, low decision latitude and/or low job support) are mediators of the excess prevalence of stress-related health complaints among vicars compared with other employees in the Church of Denmark. Methods Data for this cross-sectional study were collected by means of a self-administered questionnaire sent to all employees in 500 Danish parishes (n = 2254). Results The study response rate was 73%, 35% of respondents were vicars and 43% were female. Compared with other employees, vicars felt quiet and relaxed less often (53 versus 67%), had less time for pleasure and relaxation (28 versus 11%) and felt happy and satisfied (53 versus 67%) less often. Vicars had significantly higher quantitative, cognitive and emotional work demands, lower work support, less influence on whom to collaborate with and less influence on their workload. Psychosocial workloads were more favourable for the vicars who had greater influence on job decisions and on job organization. The higher prevalence of stress-related symptoms among vicars was strongly modified by high work demands, in particular high quantitative demands. Conclusions The higher prevalence of stress-related symptoms among vicars could largely be attributed to high-quantitative work demands.

In search of the black stuff

Workplace health improvement: perspectives of environmental health officers

Background Environmental health practice in the field of occupational health and safety is traditionally concerned with protecting health relating to the workplace. However, little is currently known about environmental health officers’ (EHOs) perceptions of their role in workplace health improvement, a pertinent topic in light of the recent government agenda for improving the health of the workforce in the UK. Aims To explore how EHOs perceive workplace health improvement and its relevance to their professional role. Methods A qualitative methodology was employed, using a case-study design with thematic analysis of 15 transcripts of in-depth telephone interviews with EHOs working in London, UK. Results EHOs view themselves primarily as enforcement officers, with legislation guiding their understandings of workplace health. Many interpret work-related ill health in terms of safety and physical injury and do not feel competent in assessing broader psychosocial elements of ill health. However, a few EHOs welcomed the opportunity to promote health in the workplace, recognizing the importance of prevention. Conclusions This study indicates a gap between the contemporary EHO role framed by professional bodies as holistic and contributing to public health goals and the role perceived by EHOs ‘on the ground’. A more traditional, protective and enforcement-based approach persists among EHOs in this sample, and few feel they have skills to address determinants beyond physical hazards to health. Yet, a minority of EHOs adopted a more health-promoting approach, suggesting that the potential contribution of EHOs to the workplace health improvement agenda should be explored further.

Early work patterns for gynaecological cancer survivors in the USA

Background Little is known about the balance between work demands and treatment plans for >4.3 million working-age cancer survivors in the USA. Aims To describe changes in work status for gynaecological cancer survivors during the first 6 months following diagnosis and their experience with their employers’ programmes and policies. Methods One hundred and ten gynaecological cancer survivors who were working at the time of their cancer diagnosis completed a survey. Case record reviews documented their clinical characteristics and treatment details. Results Ninety-five women (86%) had surgery; 81 (74%) received chemotherapy, radiotherapy or both in addition to surgery. Nine per cent of women said that they changed their treatment plan because of their jobs; in contrast, 62% of women said that they changed their work situation to accommodate their treatment plan. Overall, the most common month for women to stop working was Month 1 (41%), to decrease hours was Month 2 (32%) and to increase hours was Month 6 (8%). Twenty-eight per cent of women were aware of employer policies that assisted the return to work process; 70% of women were familiar with the Family and Medical Leave Act (FMLA) and 56% with the Americans with Disabilities Act (ADA). Only 26% completed a formal request for work accommodations. After 6 months, 56 of 83 women (67%) remained working or had returned to work. Conclusions Work patterns varied for these gynaecological cancer survivors over the first 6 months following diagnosis. Opportunities exist to improve communication about work and treatment expectations between cancer survivors, occupational health professionals, employers and treating clinicians.

Occupation and risk of non-Hodgkin's lymphoma in Singapore

Background Some epidemiological studies have reported that teachers may be at increased risk of non-Hodgkin’s lymphoma (NHL), but results are inconsistent. Aims To examine the possible association between occupation and risk of NHL in the Singapore population. Methods A hospital-based interviewer-administered case–control study was carried out in five major hospitals in Singapore between April 2004 and December 2008. A complete occupational history, which included all jobs lasting over 1 year since graduation from school, was obtained for each participant. The Singapore Standard Occupational Classification was used for coding all occupations recorded. Results Eight hundred and thirty controls and 465 NHL cases, comprising B-cell (n = 404, 87%) as well as T- and NK-cell (n = 61, 13%) neoplasms, were recruited. Having ever worked as a teacher was associated with a significantly higher risk of NHL (adjusted OR 2.04, 95% CI 1.12–3.72). Teachers who had taught for ≤10 years had a significantly higher risk of NHL (adjusted OR 2.44, 95% CI 1.11–5.34), but we did not observe an elevated risk for those who reported teaching for >10 years. Among the 31 teachers with NHL, 23% taught in upper secondary schools, with equal proportions (13%) teaching in primary and pre-primary schools, respectively. The remainder taught in other settings. Conclusions Teachers come into frequent contact with children and may consequently have higher rates of exposure to common infectious agents. Therefore, the hypothesis of an infective aetiology of NHL may be supported by our findings.

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Quality of work life in doctors working with cancer patients

Background Although studies have shown that medical residents experience poor psychological health and poor organizational conditions, their quality of work life (QWL) had not been measured. A new tool, the Quality of Work Life Systemic Inventory (QWLSI), proposes to fill the gap in the definition and assessment of this concept. Aims To confirm the convergent validity of the QWLSI, analyse Belgian medical residents’ QWL with the QWLSI and discuss an intervention methodology based on the analysis of the QWLSI. Methods One hundred and thirteen medical residents participated between 2002 and 2006. They completed the QWLSI, the Maslach Burnout Inventory and the Job Stress Survey to confirm the correspondence between these three tools. Results Residents’ low QWL predicted high emotional exhaustion (β = 0.282; P < 0.01) and job stress (β = 0.370; P < 0.001) levels, confirming the convergent validity. This sample of medical residents had an average QWL (μ = 5.8; SD = 3.1). However, their QWL was very low for three subscales: arrangement of work schedule (μ = 9; SD = 6.3), support offered to employee (μ = 7.6; SD = 6.1) and working relationship with superiors (μ = 6.9; SD = 5.3). Conclusions The results confirm that the QWLSI can provide an indication of workers’ health well-being and of organizational performance in different areas of work life. The problem factors found among Belgian medical residents suggest that prevention should focus on reduction of work hours, development of support and change in leadership style.

Why I now watch my step as an occupational physician ...

Does muscle strength predict future musculoskeletal disorders and sickness absence?

Background High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results. Aims To investigate the association between low muscle strength and future musculoskeletal disorders and long-term sickness absence. Methods Muscle strength in trunk flexion and extension, shoulder elevation and abduction as well as handgrip was recorded from a representative sample of Danish workers (n = 421) in 1995. Musculoskeletal disorders were reported 5 years later (in 2000). Information on long-term sickness absence was retrieved from a register of social transfer payments in the period 1996–2007. Results Regression analyses adjusted for age, gender, smoking, body mass index and physical work demands showed that workers with low muscle strength (the lowest quartile) of trunk extension and flexion, shoulder elevation and abduction and handgrip did not have a significantly increased risk for future musculoskeletal disorders or long term sickness absence compared with stronger workers. Conclusions Low muscle strength does not seem to be a good predictor for musculoskeletal disorders and long-term sickness absence in the general working population.

Unit cohesion and mental health in the UK armed forces

Background Unit cohesion is recognized as a potentially modifiable factor in the aetiology of mental illness among military personnel. Aims To examine the association between unit cohesion and probable post-traumatic stress disorder (PTSD), common mental disorder and alcohol misuse, in UK armed forces personnel deployed to Iraq. Methods A sample of 4901 male UK armed forces personnel who had deployed to Iraq was drawn from a cohort of personnel who participated in a cross-sectional postal questionnaire study between June 2004 and March 2006. Information was collected on socio-demographic and military characteristics, deployment experiences and information on current health. Results Perceived interest from seniors was associated with less probable PTSD [odds ratio (OR) 0.42, 95% confidence interval (CI) 0.26–0.67] and common mental disorder (OR 0.68, 95% CI 0.53–0.87). Among regular personnel, feeling well informed was associated with less common mental disorder (OR 0.74, 95% CI 0.58–0.95) and comradeship was associated with greater alcohol misuse (OR 1.98, 95% CI 1.19–3.28). Feeling able to talk about personal problems was associated with less alcohol misuse among reserve personnel (OR 0.31, 95% CI 0.16–0.60). The general construct of unit cohesion was predictive of less probable PTSD (OR 0.69, 95% CI 0.58–0.81) and common mental disorder (OR 0.80, 95% CI 0.73–0.87). Conclusions Unit cohesion had a linear association with less probable PTSD and common mental disorder. Of the individual items, perception of leadership was associated with less probable PTSD and common mental disorder. Comradeship was associated with greater alcohol misuse among regular personnel, while feeling able to talk about personal problems was associated with less alcohol misuse for reserve personnel.

Peer review audit of occupational health reports--process and outcomes

Background Peer review is widely used in the selection and publication of scientific research. Its application in clinical practice is emerging, particularly with increased emphasis on clinical governance and the imminent introduction of revalidation. Aims To formalize our peer review process of occupational health (OH) reports and formally assess the outcomes of this process. Methods A prospective internal audit was carried out of all peer reviewed OH reports between June and August 2010. An abbreviated assessment form, based on Questions 4–12 of the Sheffield Assessment Instrument for Letters (SAIL) was utilized. The report was assessed using the abbreviated SAIL, with one of four possible outcome options—no action, no changes made to report following discussion with author, changes made without discussion with author and changes made following discussion with author. Results The audit identified that 27% of OH reports required modifications. Eighteen per cent were related to typographical errors, spelling, grammar and administrative fields being incomplete. Nine per cent were related to more complex reasons, most commonly, all the manager’s questions not being addressed, review arrangements not being clear and the report not being clear and understandable to the intended readership. Conclusions Peer review can be a useful tool in improving the standard of OH reports, specifically picking up minor errors and potentially more significant areas of concern. It can also be a valuable educational tool in terms of personal feedback, benchmarking and exposure to different styles of report writing.

Who contributes to the occupational health evidence base?

Background Whilst there has been recognition of the need to strengthen the evidence base for occupational health in the UK, it is not clear how much different groups contribute to the emerging research. Aims To establish the research contribution from different types of organization and how this has changed. Methods All original research papers published in Occupational Medicine in the 5-year periods July 1996 to June 2001 and July 2006 to June 2011 were reviewed. The lead authors’ affiliations were classified in the most relevant sector. Results The number of research papers published by authors affiliated to UK organizations was greater in the past 5 years than in a similar period a decade ago. The increase is wholly explained by a large increase in papers from universities. About one-fifth of all papers published in Occupational Medicine from UK sources had a principal affiliation with the National Health Service (NHS). The number of papers affiliated to large private sector companies reduced from 14 to 2. No papers arose from the work of established specialists employed by the large commercial providers of occupational health services. Conclusions Services provided in the NHS and other public sector organizations are important contributors of new evidence in occupational health. Commissioners of public sector services should take account of the importance of this to the research and innovation in occupational health.

Effect of working conditions on non-work-related sickness absence

Background There is limited evidence of the role of working conditions as prognostic factors for non-work-related sickness absence (i.e. absence due to injuries or diseases of non-occupational origin). Aims To analyse the association between working conditions and time to return to work (RTW) in workers with long-term (>15 days) non-work-related sickness absence. Methods We followed up a total of 655 workers, who completed a baseline questionnaire including physical and psychosocial work factors, until their non-work-related long-term sickness absence ended. Time to RTW was determined based on the health insurance company register. Cox proportional hazard models were constructed to evaluate the associations between working conditions and time to RTW. Results A self-perceived high level of physical activity at work and work with back twisted or bent were related to longer duration of sickness absence. We did not find any strong evidence of associations between psychosocial work factors and time to RTW, although higher job insecurity and low reward showed marginal statistical significance. Conclusions Hazardous physical working conditions are associated with longer duration of non-work-related sickness absence. Workplace ergonomic interventions could conceivably shorten the length of sickness absence that has not originated at work.

Disulfiram reaction in an artist exposed to solvents

This case report describes an artist on treatment for alcoholism with disulfiram (Antabuse) who suffered chronic symptoms similar to those of a disulfiram alcohol reaction, which we attribute to his occupational exposure to products containing alcohol and other solvents. Symptoms abated with strict precautions to prevent exposure, although gradually returned over the course of months, causing him eventually to stop the medication. Medical practitioners should be aware of possible adverse interactions between occupational solvent exposures and disulfiram.

Dusting down older technologies

Respiratory symptoms in insect breeders

Response to: Managing Black when in the red, challenges for general practice

Response to Dr Cohen's letter

OCCUPATIONAL MEDICINE CALENDAR

The Oxford Handbook of Stress, Health and Coping

Patty's Industrial Hygiene

Two Minute Talks to Improve Psychological and Behavioral Health

New Principles of Best Practice in Clinical Audit

Case Studies in Biomedical Ethics

Health Information for Overseas Travel (the 'Yellow Book')

Managing Trauma in the Workplace--Supporting Workers and Organizations

Medically Unexplained Symptoms, Somatisation and Bodily Distress: Developing Better Clinical Services

Environmental Health: From Global to Local

Chronic disease prevention, asbestos exposure in diamond miners

How I Use It: iGoogle, RSS feeds and aggregators

Hidden impairments, the Equality Act and occupational physicians

Bullying at work and onset of a major depressive episode among Danish female eldercare workers.

Bullying at work and onset of a major depressive episode among Danish female eldercare workers. Scand J Work Environ Health. 2012 Feb 2; Authors: Rugulies R, Madsen IE, Hjarsbech PU, Hogh A, Borg V, Carneiro IG, Aust B Abstract OBJECTIVE: The aim of this study was to analyze whether exposure to workplace bullying among 5701 female employees in the Danish eldercare sector increases the risk of onset of a major depressive episode (MDE). METHODS: Participants received questionnaires in 2004-2005 and again in 2006-2007. MDE was assessed with the Major Depression Inventory. We examined baseline bullying as a predictor of onset of MDE at follow-up using multiple logistic regression. We further conducted a cross-sectional analysis at the time of follow-up among participants who at baseline were free of bullying, MDE, and signs of reduced psychological health. Finally, we analyzed reciprocal effects, by using baseline bullying and baseline MDE as predictors for bullying and MDE at follow-up. RESULTS: Onset rates of MDE in the groups of no, occasional, and frequent bullying were 1.5%, 3.4%, and 11.3%, respectively. Odds ratios (OR) for onset of MDE were 2.22 [95% confidence interval (95% CI) 1.31-3.76] for occasional bullying and OR 8.45 (95% CI 4.04-17.70) for frequent bullying, after adjustment for covariates. In the cross-sectional analysis, OR were 6.29 (95% CI 2.52-15.68) for occasional bullying and 20.96 (95% CI 5.80-75.80) for frequent bullying. In the analyses on reciprocal effects, both baseline bullying [occasional: OR 2.12 (95% CI 1.29-3.48) and frequent: OR 6.39 (95% CI 3.10-13.17)] and baseline MDE [OR 7.18 (95% CI 3.60-14.30] predicted MDE at follow-up. However, only baseline bullying [occasional: OR 7.44 (95% CI 5.94-9.31) and frequent: OR 11.91 (95% CI 7.56-18.77)] but not baseline MDE [OR 0.93 (95% CI 0.47-1.84)] predicted bullying at follow-up. CONCLUSIONS: Workplace bullying increased the risk of MDE among female eldercare workers. MDE did not predict risk of bullying. Eliminating bullying at work may be an important contribution to the prevention of MDE. PMID: 22298126 [PubMed - as supplied by publisher]

Harmonization of Measurement Strategies for Exposure to Manufactured Nano-Objects; Report of a Workshop

The present paper summarizes the outcome of the discussions at the First International Scientific Workshop on Harmonization of Strategies to Measure and Analyze Exposure to (Manufactured) Nano-objects in Workplace Air that was organized and hosted by the Netherlands Organization for Applied Scientific Research (TNO) and the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) (Zeist, The Netherlands, December 2010). It reflects the discussions by 25 international participants in the area of occupational (nano) exposure assessment from Europe, USA, Japan, and Korea on nano-specific issues related to the three identified topics: (i) measurement strategies; (ii) analyzing, evaluating, and reporting of exposure data; and (iii) core information for (exposure) data storage. Preliminary recommendations were achieved with respect to (i) a multimetric approach to exposure assessment, a minimal set of data to be collected, and basic data analysis and reporting as well as (ii) a minimum set of contextual information to be collected and reported. Other issues that have been identified and are of great interest include (i) the need for guidance on statistical approaches to analyze time-series data and on electron microscopy analysis and its reporting and (ii) the need for and possible structure of a (joint) database to store and merge data. To make progress in the process of harmonization, it was concluded that achieving agreement among researchers on the preliminary recommendations of the workshop is urgent.

Does Daily Exposure to Whole-Body Vibration and Mechanical Shock Relate to the Prevalence of Low Back and Neck Pain in a Rural Workforce?

Objectives: To determine whether whole-body vibration (WBV) and mechanical shock exposure from quad bike use are associated with the prevalence of neck and low back pain (LBP) in New Zealand farmers and rural workers. Methods: Full-day WBV and mechanical shock exposures were gathered from 130 farmers and rural workers. Participants were surveyed for a history of neck or LBP in the past 7 days and in the past 12 months. Anthropometric, personal, and workplace data were also gathered. Results: Physical exposures (mechanical shocks), employee status, and low levels of workplace satisfaction are all significantly associated with the 12-month prevalence of LBP in this rural workforce that regularly use quad bikes. Both vibration and mechanical shock exposure were strongly associated with 12-month prevalence of neck pain. The 7-day prevalence of neck pain showed a non-significant association with mechanical shock and vibration. Conclusions: Knowledge of these findings will be valuable information for those who teach and advise on safe driving techniques for such vehicles in the rural workplace where reduction of physical exposures and injury rates is of high importance.

Electric and Magnetic Field Measurements in a High Voltage Center

This paper investigates the electric and magnetic fields inside a large high voltage center constituted both of 400/150 and 150/20 kV substation areas. Results of previous field measurements and calculations in substations, made by the authors of this paper or other researchers, are presented first. The basic data distinguishing the examined center from previously examined substations follow. The main results of the field measurements in the areas of the above-mentioned center are presented in relevant diagrams. General conclusions arising from the comparison of the measured field values with relevant reference levels in force for safe public and occupational exposure as well as with the results of previous research are finally given.

Exposure to Grain Dust in Great Britain

Airborne grain dust is a complex mixture of fragments of organic material from grain, plus mineral matter from soil, and possible insect, fungal, or bacterial contamination or their toxic products, such as endotoxin. In the 1990s, grain workers in Britain were frequently exposed to inhalable dust >10 mg.m–3 (8 h), with particularly high exposures being found at terminals where grain was imported or exported and in drying operations (personal exposure typically ~20 mg.m–3). Since then, the industry has made substantial progress in improving the control of airborne dust through better-designed processes, increased automation, and an improved focus on product quality. We have used information from the published scientific literature and a small survey of industry representatives to estimate current exposure levels. These data suggest that current long-term exposure to inhalable dust for most workers is on average less than ~3 mg.m–3, with perhaps 15–20% of individual personal exposures being >10 mg.m–3. There are no published data from Britain on short-term exposure during cleaning and other tasks. We have estimated average levels for a range of tasks and judge that the highest levels, for example during some cleaning activities and certain process tasks such as loading and packing, are probably ~10 mg.m–3. Endotoxin levels were judged likely to be <104 EU m–3 throughout the industry provided inhalable dust levels are <10 mg.m–3. There are no published exposure data on mycotoxin, respirable crystalline silica, and mite contamination but these are not considered to present widespread problems in the British industry. Further research should be carried out to confirm these findings.

Assessment of Exposure to PCDD/F, PCB, and PAH at a Basic Oxygen Steelmaking (BOS) and an Iron Ore Sintering Plant in the UK

An assessment was carried out at a UK integrated steelworks to investigate the exposure of workers via inhalation to dioxins [polychlorinated dibenzo-p-dioxins (PCDD/F)], polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons (PAH) including benzo[a]pyrene (B[a]P). Investigations focused on a basic oxygen steelmaking (BOS) plant and an iron ore sintering plant. The highest concentrations of PCDD/F and dioxin-like PCB were found at the BOS vessels and sinter strand area at the BOS and sinter plant, respectively. A risk assessment was carried out by comparing the daily intake of PCDD/F and PCB via inhalation with the recommended tolerable daily intake (TDI) proposed by the World Health Organisation (WHO). For the most exposed category of worker in this study (i.e. sinter plant workers inside the strand area), the estimated daily intake via inhalation was estimated to be 0.25 pg WHO-toxic equivalent concentrations (TEQ) kg–1 body weight (bw). Considering that the average UK adult exposure to PCDD/F from the diet is 1.8 pg WHO-TEQ kg–1 bw day–1, the results indicated that the estimated daily intake of PCDD/F and PCB via inhalation for sinter plant workers would not result in the recommended range of the TDI (1–4 pg WHO-TEQ kg–1 bw day–1) being exceeded. Cancer risks for a 40-year occupational exposure period were determined by multiplying the estimated intake by the inhalation cancer potency factor for 2,3,7,8-tetrachlorodibenzo-p-dioxin. For the most exposed category of worker, cancer risks from exposure to PCDD/F and PCB ranged from 2.5 x 10–6 to 5.2 x 10–5. Under most regulatory programmes, excess cancer risks between 1.0 x 10–6 and 1.0 x 10–4 indicate an acceptable range of cancer risk, suggesting a limited risk from PCDD/F and PCB exposure for workers in the sinter plant. With regard to PAH, B[a]P concentrations were typically <10 ng m–3 at all locations at both the sinter plant and the BOS plant. In several cases, particularly at the sinter plant, B[a]P concentrations were well below or only marginally above the target value of 1 ng m–3 specified in ambient air by the European Commission in the fourth ‘Daughter’ Directive of the Air Quality Framework Directive suggesting a very low risk of exposure for workers. For PAH, excess cancer risks ranged from 2.4 x 10–6 to 7.3 x 10–6 for BOS plant workers and from for 5.3 x 10–7 to 1.5 x 10–5 for sinter plant workers, well within the acceptable range proposed by the US EPA.

Asbestos Exposure During Uncontrolled Removal of Sprayed-on Asbestos

Asbestos-containing materials in place in buildings, especially sprayed-on asbestos, are still an important health threat. Clearance of these materials has to be operated by specifically trained workers wearing specific individual protection suits after containment of the contaminated area. Good work practices are, however, not always applied. We report the case of two workers hired for ~1 week to remove sprayed-on amosite asbestos during the remodeling of a former industrial hall. Regulatory protective equipments were not used. A legal action was initiated after disclosure of the working conditions. Medical examinations were performed 18 and 22 months after exposure. Workers denied any other asbestos exposure. Lung function tests and chest computed tomography scans were normal. Very high levels of asbestos fibers and bodies were discovered on mineralogical analysis of bronchoalveolar lavage fluid (BALF) by phase contrast light microscopy and analytical electron microscopy. All fibers were amosite. An extrapolation considering duration of exposure, breathing pattern, and BALF fiber content suggests that the workers were exposed to airborne fiber concentrations in the range from several tens to about a hundred World Health Organization fibers per milliliter air. In conclusion, exposures to historical airborne fiber levels prevailing half a century ago may still occur today when the work regulations are not applied. In these conditions, even very short exposures may result in considerable lung fiber retention in case of amphibole exposure with the subsequent risk for developing asbestos-related diseases. Fiber analysis in BALF is useful to clarify such exposures.

Asbestos-Related Diseases in Automobile Mechanics

Purpose: Automobile mechanics have been exposed to asbestos in the past, mainly due to the presence of chrysotile asbestos in brakes and clutches. Despite the large number of automobile mechanics, little is known about the non-malignant respiratory diseases observed in this population. The aim of this retrospective multicenter study was to analyse the frequency of pleural and parenchymal abnormalities on high-resolution computed tomography (HRCT) in a population of automobile mechanics. Methods: The study population consisted of 103 automobile mechanics with no other source of occupational exposure to asbestos, referred to three occupational health departments in the Paris area for systematic screening of asbestos-related diseases. All subjects were examined by HRCT and all images were reviewed separately by two independent readers; who in the case of disagreement discussed until they reached agreement. Multiple logistic regression models were constructed to investigate factors associated with pleural plaques. Results: Pleural plaques were observed in five cases (4.9%) and interstitial abnormalities consistent with asbestosis were observed in one case. After adjustment for age, smoking status, and a history of non-asbestos-related respiratory diseases, multiple logistic regression models showed a significant association between the duration of exposure to asbestos and pleural plaques. Conclusions: The asbestos exposure experienced by automobile mechanics may lead to pleural plaques. The low prevalence of non-malignant asbestos-related diseases, using a very sensitive diagnostic tool, is in favor of a low cumulative exposure to asbestos in this population of workers.

Oil Mist and Vapour Concentrations from Drilling Fluids: Inter- and Intra-laboratory Comparison of Chemical Analyses

Objectives: There are no recognized analytical methods for measuring oil mist and vapours arising from drilling fluids used in offshore petroleum drilling industry. To inform the future development of improved methods of analysis for oil mist and vapours this study assessed the inter- and intra-laboratory variability in oil mist and vapour analysis. In addition, sample losses during transportation and storage were assessed. Methods: Replicate samples for oil mist and vapour were collected using the 37-mm Millipore closed cassette and charcoal tube assembly. Sampling was conducted in a simulated shale shaker room, similar to that found offshore for processing drilling fluids. Samples were analysed at two different laboratories, one in Norway and one in the UK. Oil mist samples were analysed using Fourier transform infrared spectroscopy (FTIR), while oil vapour samples were analysed by gas chromatography (GC). Results: The comparison of replicate samples showed substantial within- and between-laboratory variability in reported oil mist concentrations. The variability in oil vapour results was considerably reduced compared to oil mist, provided that a common method of calibration and quantification was adopted. The study also showed that losses can occur during transportation and storage of samples. Conclusions: There is a need to develop a harmonized method for the quantification of oil mist on filter and oil vapour on charcoal supported by a suitable proficiency testing scheme for laboratories involved in the analysis of occupational hygiene samples for the petroleum industry. The uncertainties in oil mist and vapour measurement have substantial implications in relation to compliance with occupational exposure limits and also in the reliability of any exposure–response information reported in epidemiological studies.

Development of an Exposure Measurement Database on Five Lung Carcinogens (ExpoSYN) for Quantitative Retrospective Occupational Exposure Assessment

Background: SYNERGY is a large pooled analysis of case–control studies on the joint effects of occupational carcinogens and smoking in the development of lung cancer. A quantitative job-exposure matrix (JEM) will be developed to assign exposures to five major lung carcinogens [asbestos, chromium, nickel, polycyclic aromatic hydrocarbons (PAH), and respirable crystalline silica (RCS)]. We assembled an exposure database, called ExpoSYN, to enable such a quantitative exposure assessment. Methods: Existing exposure databases were identified and European and Canadian research institutes were approached to identify pertinent exposure measurement data. Results of individual air measurements were entered anonymized according to a standardized protocol. Results: The ExpoSYN database currently includes 356 551 measurements from 19 countries. In total, 140 666 personal and 215 885 stationary data points were available. Measurements were distributed over the five agents as follows: RCS (42%), asbestos (20%), chromium (16%), nickel (15%), and PAH (7%). The measurement data cover the time period from 1951 to present. However, only a small portion of measurements (1.4%) were performed prior to 1975. The major contributing countries for personal measurements were Germany (32%), UK (22%), France (14%), and Norway and Canada (both 11%). Conclusions: ExpoSYN is a unique occupational exposure database with measurements from 18 European countries and Canada covering a time period of >50 years. This database will be used to develop a country-, job-, and time period-specific quantitative JEM. This JEM will enable data-driven quantitative exposure assessment in a multinational pooled analysis of community-based lung cancer case–control studies.

Combining a Job-Exposure Matrix with Exposure Measurements to Assess Occupational Exposure to Benzene in a Population Cohort in Shanghai, China

Background: Generic job-exposure matrices (JEMs) are often used in population-based epidemiologic studies to assess occupational risk factors when only the job and industry information of each subject is available. JEM ratings are often based on professional judgment, are usually ordinal or semi-quantitative, and often do not account for changes in exposure over time. We present an empirical Bayesian framework that combines ordinal subjective JEM ratings with benzene measurements. Our aim was to better discriminate between job, industry, and time differences in exposure levels compared to using a JEM alone. Methods: We combined 63 221 short-term area air measurements of benzene exposure (1954–2000) collected during routine health and safety inspections in Shanghai, China, with independently developed JEM intensity ratings for each job and industry using a mixed-effects model. The fixed-effects terms included the JEM intensity ratings for job and industry (both ordinal, 0–3) and a time trend that we incorporated as a b-spline. The random-effects terms included job (n = 33) and industry nested within job (n = 399). We predicted the benzene concentration in two ways: (i) a calibrated JEM estimate was calculated using the fixed-effects model parameters for calendar year and JEM intensity ratings; (ii) a job-/industry-specific estimate was calculated using the fixed-effects model parameters and the best linear unbiased predictors from the random effects for job and industry using an empirical Bayes estimation procedure. Finally, we applied the predicted benzene exposures to a prospective population-based cohort of women in Shanghai, China (n = 74 942). Results: Exposure levels were 13 times higher in 1965 than in 2000 and declined at a rate that varied from 4 to 15% per year from 1965 to 1985, followed by a small peak in the mid-1990s. The job-/industry-specific estimates had greater differences between exposure levels than the calibrated JEM estimates (97.5th percentile/2.5th percentile exposure level, BGR95B: 20.4 versus 3.0, respectively). The calibrated JEM and job-/industry-specific estimates were moderately correlated in any given year (Pearson correlation, rp = 0.58). We classified only those jobs and industries with a job or industry JEM exposure probability rating of 3 (>50% of workers exposed) as exposed. As a result, 14.8% of the subjects and 8.7% of the employed person-years in the study population were classified as benzene exposed. The cumulative exposure metrics based on the calibrated JEM and job-/industry-specific estimates were highly correlated (rp = 0.88). Conclusions: We provide a useful framework for combining quantitative exposure data with expert-based exposure ratings in population-based studies that maximized the information from both sources. Our framework calibrated the ratings to a concentration scale between ratings and across time and provided a mechanism to estimate exposure when a job/industry group reported by a subject was not represented in the exposure database. It also allowed the job/industry groups’ exposure levels to deviate from the pooled average for their respective JEM intensity ratings.

Effectiveness of Three Decontamination Treatments against Influenza Virus Applied to Filtering Facepiece Respirators

Filtering facepiece respirators (FFRs) are recommended for use as precautions against airborne pathogenic microorganisms; however, during pandemics demand for FFRs may far exceed availability. Reuse of FFRs following decontamination has been proposed but few reported studies have addressed the feasibility. Concerns regarding biocidal efficacy, respirator performance post decontamination, decontamination cost, and user safety have impeded adoption of reuse measures. This study examined the effectiveness of three energetic decontamination methods [ultraviolet germicidal irradiation (UVGI), microwave-generated steam, and moist heat] on two National Institute for Occupational Safety and Health-certified N95 FFRs (3M models 1860s and 1870) contaminated with H5N1. An aerosol settling chamber was used to apply virus-laden droplets to FFRs in a method designed to simulate respiratory deposition of droplets onto surfaces. When FFRs were examined post decontamination by viral culture, all three decontamination methods were effective, reducing virus load by >4 log median tissue culture infective dose. Analysis of treated FFRs using a quantitative molecular amplification assay (quantitative real-time polymerase chain reaction) indicated that UVGI decontamination resulted in lower levels of detectable viral RNA than the other two methods. Filter performance was evaluated before and after decontamination using a 1% NaCl aerosol. As all FFRs displayed <5% penetration by 300-nm particles, no profound reduction in filtration performance was caused in the FFRs tested by exposure to virus and subsequent decontamination by the methods used. These findings indicate that, when properly implemented, these methods effectively decontaminate H5N1 on the two FFR models tested and do not drastically affect their filtering function; however, other considerations may influence decisions to reuse FFRs.

Protective Facemask Impact on Human Thermoregulation: An Overview

The use of protective facemasks (PFMs) negatively impacts respiratory and dermal mechanisms of human thermoregulation through impairment of convection, evaporation, and radiation processes. The relatively minor reported increases in core temperature directly attributable to the wearing of PFMs suggest that associated perceptions of increased body temperature may have a significant psychological component or that regional or global brain temperature changes are involved. Modifications in PFM structure, components, and materials might allow for improved heat dissipation and enhanced compliance with use.