Alcohol consumption in the Australian coal mining industry

Objectives

To investigate patterns of alcohol use within the coal mining industry, and associations with the personal, social, workplace and employment characteristics.

Design

8 mine sites across 3 eastern Australian states were surveyed, selected to encompass key geographic characteristics (accessibility and remoteness) and mine type (open cut and underground). Problematic alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT) to determine: (1) overall risky or hazardous drinking behaviour; and (2) frequency of single-occasion drinking (6 or more drinks on 1 occasion).

Results

A total of 1457 employees completed the survey, of which 45.7% of male and 17.0% of female participants reported levels of alcohol use within the range considered as risky or hazardous, considerably higher than the national average. Hierarchical linear regression revealed a significant contribution of many individual level factors associated with AUDIT scores: younger age, male, current smoking status; illicit substance use; previous alcohol and other drug use (AOD) problems; and higher psychological distress. Workplace factors associated with alcohol use included working in mining primarily for the high remuneration, and the type of mining, with underground miners reporting higher alcohol use than open-cut miners.

Conclusions

Our findings provide support for the need to address alcohol use in the coal mining industry over and above routine on-site testing for alcohol use.

http://ift.tt/2f5in4g

IJERPH, Vol. 13, Pages 1066: Associations of Breast Cancer Risk Factors with Premenopausal Sex Hormones in Women with Very Low Breast Cancer Risk

Breast cancer incidence rates are low but rising in urban Mongolia. We collected reproductive and lifestyle factor information and measured anthropometrics and serum sex steroid concentrations among 314 premenopausal women living in Ulaanbaatar, Mongolia. Mean differences in hormone concentrations by these factors were calculated using age-adjusted quadratic regression splines. Estrone and estradiol in college-educated women were, respectively, 18.2% (p = 0.03) and 23.6% (p = 0.03) lower than in high-school-educated women. Progesterone concentrations appeared 55.8% lower (p = 0.10) in women residing in modern housing compared with women living in traditional housing (gers), although this finding was not statistically significant. Testosterone concentrations were positively associated with adiposity and central fat distribution % difference for highest vs. lowest quarter for body mass index (17.1% (p = 0.001)) and waist-to-height ratio (15.1% (p = 0.005)). Estrogens were higher in the follicular phase of women who breastfed each child for shorter durations. A distinct hormonal profile was associated with an urban lifestyle in premenopausal, Mongol women. In particular, heavier, more-educated women living in urban dwellings had higher testosterone and lower estrogen and progesterone levels. Higher breast cancer incidence in urban compared with rural women suggest that the hormonal profile associated with a more traditional lifestyle may be protective among Mongol women.

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IJERPH, Vol. 13, Pages 1068: Benzene Exposure Alters Expression of Enzymes Involved in Fatty Acid β-Oxidation in Male C3H/He Mice

Benzene is a well-known hematotoxic carcinogen that can cause leukemia and a variety of blood disorders. Our previous study indicated that benzene disturbs levels of metabolites in the fatty acid β-oxidation (FAO) pathway, which is crucial for the maintenance and function of hematopoietic and leukemic cells. The present research aims to investigate the effects of benzene on changes in the expression of key enzymes in the FAO pathway in male C3H/He mice. Results showed that benzene exposure caused reduced peripheral white blood cell (WBC), red blood cell (RBC), platelet (Pit) counts, and hemoglobin (Hgb) concentration. Investigation of the effects of benzene on the expression of FA transport- and β-oxidation-related enzymes showed that expression of proteins Cpt1a, Crat, Acaa2, Aldh1l2, Acadvl, Crot, Echs1, and Hadha was significantly increased. The ATP levels and mitochondrial membrane potential decreased in mice exposed to benzene. Meanwhile, reactive oxygen species (ROS), hydrogen peroxide (H2O2), and malondialdehyde (MDA) levels were significantly increased in the benzene group. Our results indicate that benzene induces increased expression of FA transport and β-oxidation enzymes, mitochondrial dysfunction, and oxidative stress, which may play a role in benzene-induced hematotoxicity.

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IJERPH, Vol. 13, Pages 1065: Work and Wellbeing in the 21st Century †

The nature of work and the way it is conceptualised has been evolving since the dawn of humankind.[...]

http://ift.tt/2eTwyIJ

Complex and comprehensive method for reliability calculation of structures under fire exposure

Publication date: November 2016
Source:Fire Safety Journal, Volume 86
Author(s): Tamás Balogh, László Gergely Vigh
Numerous recent studies have pointed out that in case of extreme effects (such as fire or seismic effects) the reliability level of structures is lower than in case of conventional effects. Proper estimation of reliability in fire design situation is complicated since there is no comprehensive methodology defined for it; and the commonly used methods apply great simplifications. In former studies the reliability calculations are carried out mainly for simple, separated elements, while simple structural behaviour is assumed. Further research work is needed to refine rules and define targeted safety levels required by fire codes. The current study presents methodology for calculating the reliability of structures subjected to fire; its main novelties are as follows: a) the reliability calculation is not limited to a single, isolated element but the whole structure as a complex system is considered; b) the methodology is capable of taking any type of fire curve into account; c) in the reliability analysis nonlinear global analysis of the whole structure is involved; d) the structural reliability is assessed on time basis. To justify the applicability of the proposed methodology, reliability analysis for a tapered steel frame protected by intumescent coating is presented as an illustrative numerical example. Probability of its failure is calculated by using First Order Reliability Method; the computed failure probabilities are verified by using Monte Carlo Simulation. FORM approximation underestimates the failure probability, the observed error is within −1% to −34%. Based on the results, it has been found that for low and moderate consequence classes the calculated reliability indices are in better agreement with the recommendations of ISO 2394 standard and Joint Committee on Structural Safety than with the values recommended in EN 1990:2002 standard.



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A 3D numerical study of detonation wave propagation in various angled bending tubes

Publication date: November 2016
Source:Fire Safety Journal, Volume 86
Author(s): C. Luo, J. Zanganeh, B. Moghtaderi
This paper conducts a numerical study of detonation wave propagations in 30m and 73m long straight/varying angle bending detonation tubes with inner diameters of 0.5m and 1.05m, respectively, which are filled with varying stoichiometric methane-air mixtures. In the study a 3D numerical model was established by combining a compressible one-step global reaction hot model with the k-ω shear-stress transport (SST) turbulent model. In order to resolve the thin detonation wave front, a dynamically refined mesh near the high pressure gradient is adopted. The initial conditions of the model are obtained from the 1D detonation model. The present model was first verified by comparing the numerical results against the published measurements. The pressure distributions and detonation wave speeds across the tubes and bends were then predicted by using this 3D model.

Graphical abstract

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IJERPH, Vol. 13, Pages 1064: Air Pollution Exposure in Relation to the Commute to School: A Bradford UK Case Study

Walking School Buses (WSBs) provide a safe alternative to being driven to school. Children benefit from the contribution the exercise provides towards their daily exercise target, it gives children practical experience with respect to road safety and it helps to relieve traffic congestion around the entrance to their school. Walking routes are designed largely based in road safety considerations, catchment need and the availability of parent support. However, little attention is given to the air pollution exposure experienced by children during their journey to school, despite the commuting microenvironment being an important contributor to a child’s daily air pollution exposure. This study aims to quantify the air pollution exposure experienced by children walking to school and those being driven by car. A school was chosen in Bradford, UK. Three adult participants carried out the journey to and from school, each carrying a P-Trak ultrafine particle (UFP) count monitor. One participant travelled the journey to school by car while the other two walked, each on opposite sides of the road for the majority of the journey. Data collection was carried out over a period of two weeks, for a total of five journeys to school in the morning and five on the way home at the end of the school day. Results of the study suggest that car commuters experience lower levels of air pollution dose due to lower exposure and reduced commute times. The largest reductions in exposure for pedestrians can be achieved by avoiding close proximity to traffic queuing up at intersections, and, where possible, walking on the side of the road opposite the traffic, especially during the morning commuting period. Major intersections should also be avoided as they were associated with peak exposures. Steps to ensure that the phasing of lights is optimised to minimise pedestrian waiting time would also help reduce exposure. If possible, busy roads should be avoided altogether. By the careful design of WSB routes, taking into account air pollution, children will be able to experience the benefits that walking to school brings while minimizing their air pollution exposure during their commute to and from school.

http://ift.tt/2eSlGO9

IJERPH, Vol. 13, Pages 1058: Ferritin Level Is Positively Associated with Chronic Kidney Disease in Korean Men, Based on the 2010–2012 Korean National Health and Nutrition Examination Survey

(1) Background: Oxidative stress and inflammation are associated with higher risk of chronic kidney disease (CKD). Serum ferritin concentrations correlate with total iron levels and systemic inflammation. (2) Methods: This study was cross-sectionally designed, based on the 2010–2012 Korean National Health and Nutrition Examination Survey (KNHANES). According to ferritin values, 13,462 participants (6082 men and 7380 women) were categorized into the normal- and high-ferritin groups (cut-off points: 200 ng/mL in men, 150 ng/mL in women). (3) Results: The mean ages of men and women were 44.5 and 48.4 years, respectively. The percentage of participants categorized into the high-ferritin group was 15.1% for men and 3.6% for women. The estimated glomerular filtration rate levels in the normal- and high-ferritin groups were 93.2 and 93.8 mL/min/1.73 m2 for men and 97.1 and 87.7 mL/min/1.73 m2 for women, respectively. The prevalence of CKD in the normal- and high-ferritin groups was 2.6% and 3.9% for men and 3.2% and 8.1% for women, respectively. Compared with the normal-ferritin group, the odds ratios (95% confidence intervals) for CKD of the high-ferritin group were 1.573 (1.014–2.441) in men and 1.061 (0.381–2.955) in women, after adjustments for age and other covariates. (4) Conclusions: High ferritin levels were associated with a higher risk of CKD in men but not in women.

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IJERPH, Vol. 13, Pages 1063: Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls

Introduction: Work-related traumatic brain injury (TBI) caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect across different heights of fall. Methods: We collected a nationwide, prospective database of work-related injury patients who visited the 10 emergency departments between July 2010 and October 2012. All of the adult patients who experienced work-related fall injuries were eligible, excluding cases with unknown safety helmet use and height of fall. Primary and secondary endpoints were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of safety helmet use and height of fall for study outcomes, and adjusted for any potential confounders. Results: A total of 1298 patients who suffered from work-related fall injuries were enrolled. The industrial or construction area was the most common place of fall injury occurrence, and 45.0% were wearing safety helmets at the time of fall injuries. The safety helmet group was less likely to have intracranial injury comparing with the no safety helmet group (the adjusted odds ratios (ORs) (95% confidence interval (CI)): 0.42 (0.24–0.73)), however, there was no statistical difference of in-hospital mortality between two groups (the adjusted ORs (95% CI): 0.83 (0.34–2.03). In the interaction analysis, preventive effects of safety helmet on intracranial injury were significant within 4 m height of fall. Conclusions: A safety helmet is associated with prevention of intracranial injury resulting from work-related fall and the effect is preserved within 4 m height of fall. Therefore, wearing a safety helmet can be an intervention for protecting fall-related intracranial injury in the workplace.

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IJERPH, Vol. 13, Pages 1062: Construction of a Seasonal Difference-Geographically and Temporally Weighted Regression (SD-GTWR) Model and Comparative Analysis with GWR-Based Models for Hemorrhagic Fever with Renal Syndrome (HFRS) in Hubei Province (China)

Hemorrhagic fever with renal syndrome (HFRS) is considered a globally distributed infectious disease which results in many deaths annually in Hubei Province, China. In order to conduct a better analysis and accurately predict HFRS incidence in Hubei Province, a new model named Seasonal Difference-Geographically and Temporally Weighted Regression (SD-GTWR) was constructed. The SD-GTWR model, which integrates the analysis and relationship of seasonal difference, spatial and temporal characteristics of HFRS (HFRS was characterized by spatiotemporal heterogeneity and it is seasonally distributed), was designed to illustrate the latent relationships between the spatio-temporal pattern of the HFRS epidemic and its influencing factors. Experiments from the study demonstrated that SD-GTWR model is superior to traditional models such as GWR- based models in terms of the efficiency and the ability of providing influencing factor analysis.

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Running Memory for Clinical Handoffs: A Look at Active and Passive Processing

Objective:

The goal of the present study was to examine the effects of domain-relevant expertise on running memory and the ability to process handoffs of information. In addition, the role of active or passive processing was examined.

Background:

Currently, there is little research that addresses how individuals with different levels of expertise process information in running memory when the information is needed to perform a real-world task.

Method:

Three groups of participants differing in their level of clinical expertise (novice, intermediate, and expert) performed an abstract running memory span task and two tasks resembling real-world activities, a clinical handoff task and an air traffic control (ATC) handoff task. For all tasks, list length and the amount of information to be recalled were manipulated.

Results:

Regarding processing strategy, all participants used passive processing for the running memory span and ATC tasks. The novices also used passive processing for the clinical task. The experts, however, appeared to use more active processing, and the intermediates fell in between.

Conclusion:

Overall, the results indicated that individuals with clinical expertise and a developed mental model rely more on active processing of incoming information for the clinical task while individuals with little or no knowledge rely on passive processing.

Application:

The results have implications about how training should be developed to aid less experienced personnel identify what information should be included in a handoff and what should not.

http://ift.tt/2eOjYu3

IJERPH, Vol. 13, Pages 1060: Patterns of Smoking Behaviour in Low-Income Pregnant Women: A Cohort Study of Differential Effects on Infant Birth Weight

Maternal smoking accounts for 20%–30% of low birth weight (BW). Second-Hand Smoke (SHS) also negatively affects BW. This cohort study explored the differential effect of smoking patterns during pregnancy on infant BW. Smoking status for 652 self-reported smokers attending public ante-natal clinics was assessed at baseline (V1 first ante-natal visit), 28–32 weeks (V2) and one week after birth (V3). Multivariable generalised linear regression models tested smoking patterns (continuing to smoke, sustained quitting, partial quitting) on BW adjusting for household smoking and other co-variates. Total quitting showed a median increase of 288 g in BW (95% CI (confidence intervals): 153.1–423 g, p < 0.001), compared to partial quitting (147 g, (95% CI: 50–244 g), p < 0.003). In partial quitters, increased BW was observed only in females 218 g, (95% CI: 81–355 g), p = 0.002). Household SHS showed a specific negative influence on pre-term but not term BW. This study suggests that, for low-income women, quitting or partial quitting during pregnancy both have a positive influence on infant BW. Whether others in the household smoke is also important.

http://ift.tt/2eWLG8Y

Aircraft noise exposure and hypertension

Increasing traffic by all modes of transport has led to a general rise in noise pollution. The European Environment Agency recently compared data on aircraft noise between 2007 and 2012, and observed that in Europe there had been a general increase in people exposed to aircraft noise.1

Over the last decade, a number of epidemiological studies have found traffic noise to be associated with cardiovascular disease, including hypertension, ischaemic heart disease and stroke.2–5 Although the evidence is increasing, well-designed studies within this area are still needed. Most studies on traffic noise and hypertension have focused on road traffic noise, and a meta-analysis from 2012 based on 24 studies found a small, but statistically significant association between road traffic noise and hypertension.3 It is, however, unclear whether these results can readily be applied to aircraft noise, as only a few...

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IJERPH, Vol. 13, Pages 1055: Drinking and Driving among Recent Latino Immigrants: The Impact of Neighborhoods and Social Support

Latinos are disproportionately impacted by drinking and driving arrests and alcohol-related fatal crashes. Why, and how, these disparities occur remains unclear. The neighborhood environments that recent Latino immigrants encounter in their host communities can potentially influence health behaviors over time, including the propensity to engage in drinking and driving. This cross-sectional study utilizes a sample of 467 documented and undocumented adult recent Latino immigrants in the United States to answer the following research questions: (a) How do neighborhood-level factors, combined with social support, impact drinking and driving risk behaviors?; and (b) Does acculturative stress moderate the effects of those associations? Results indicate neighborhood-level factors (informal social control and social capital) have protective effects against drinking and driving risk behaviors via the mediating mechanism of social support. Acculturative stress moderated associations between neighborhood informal social control and social support, whereby the protective effects of informal social control on social support were not present for those immigrants with higher levels of acculturative stress. Our findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest that, in the process of developing prevention programs tailored to Latino immigrants, greater attention must be paid to neighborhood-level factors.

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IJERPH, Vol. 13, Pages 1059: System Dynamics Model and Simulation of Employee Work-Family Conflict in the Construction Industry

The construction industry is a demanding work environment where employees’ work-family conflict is particularly prominent. This conflict has a significant impact on job and family satisfaction and performance of employees. In order to analyze the dynamic evolution of construction industry employee’s work-family conflict between work and family domains, this paper constructs a bi-directional dynamic model framework of work-family conflict by referring to the relevant literature. Consequently, a system dynamics model of employee’s work-family conflict in the construction industry is established, and a simulation is conducted. The simulation results indicate that construction industry employees experience work interference with family conflict (WIFC) levels which are significantly greater than the family interference with work conflict (FIWC) levels. This study also revealed that improving work flexibility and organizational support can have a positive impact on the satisfaction and performance of construction industry employees from a work and family perspective. Furthermore, improving family support can only significantly improve employee job satisfaction.

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IJERPH, Vol. 13, Pages 1056: Noise Annoyance in Urban Children: A Cross-Sectional Population-Based Study

Acoustical and non-acoustical factors influencing noise annoyance in adults have been well-documented in recent years; however, similar knowledge is lacking in children. The aim of this study was to quantify the annoyance caused by chronic ambient noise at home in children and to assess the relationship between these children′s noise annoyance level and individual and contextual factors in the surrounding urban area. A cross sectional population-based study was conducted including 517 children attending primary school in a European city. Noise annoyance was measured using a self-report questionnaire adapted for children. Six noise exposure level indicators were built at different locations at increasing distances from the child′s bedroom window using a validated strategic noise map. Multilevel logistic models were constructed to investigate factors associated with noise annoyance in children. Noise indicators in front of the child′s bedroom (p ≤ 0.01), family residential satisfaction (p ≤ 0.03) and socioeconomic characteristics of the individuals and their neighbourhood (p ≤ 0.05) remained associated with child annoyance. These findings illustrate the complex relationships between our environment, how we may perceive it, social factors and health. Better understanding of these relationships will undoubtedly allow us to more effectively quantify the actual effect of noise on human health.

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IJERPH, Vol. 13, Pages 1053: The Comparative Study on the Rapid Decolorization of Azo, Anthraquinone and Triphenylmethane Dyes by Anaerobic Sludge

An anaerobic sludge (AS), capable of decolorizing a variety of synthetic dyes, was acclimated and is reported here. The sludge presented a much better dye decolorizing ability than that of different individual strains. A broad spectrum of dyes could be decolorized by the sludge. Continuous decolorization tests showed that the sludge exhibited the ability to decolorize repeated additions of dye. The chemical oxygen demand (COD) removal rate of the dye wastewater reached 52% after 12 h of incubation. Polymerase chain reaction and denaturing gradient gel electrophoresis (PCR-DGGE) profiles revealed that the microbial community changed as a result of varying initial concentrations of dyes. Phylogenetic analysis indicated that microbial populations in the sludge belonged to the phyla Acidobacteria, Firmicutes, Bacteroidetes, Chloroflexi and Proteobacteria. The degradation products of the three types of dye were identified. For azo dyes, the anaerobic sludge converted Methyl Orange to N,N-dimethylbenzene-1,4-diamine and 4-aminobenzenesulfonic acid; for triphenylmethane dyes, after Malachite Green was decolorized, the analyzed products were found to be a mixture of N,N-dimethylbenzenamine, 3-dimethyl-aminophenol and 4-dimethylaminobenzophenone; for anthraquinone dyes, two products (acetophenone and 2-methylbenzoic acid) were observed after Reactive Blue 19 decolorization. Together, these results suggest that the anaerobic sludge has promising potential for use in the treatment of industrial wastewater containing various types of dyes.

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IJERPH, Vol. 13, Pages 1061: Using Virtual Street Audits to Understand the Walkability of Older Adults’ Route Choices by Gender and Age

Walking for physical activity can bring important health benefits to older adults. In this population, walking has been related to various urban design features and street characteristics. To gain new insights into the microscale environmental details that might influence seniors’ walking, details which might be more amenable to change than neighbourhood level factors, we employed a reliable streetscape audit tool, in combination with Google Street View™, to evaluate the ‘walkability’ of where older adults choose to walk. Analysis of the routes selected by a purposive sample of independently mobile adults aged 65 years and over living in Edinburgh, UK, revealed a preference to walk in more walkable environments, alongside a willingness to walk in less supportive settings. At times, factors commonly considered important for walking, including wayfinding and legibility, user conflict, kerb paving quality, and lighting appeared to have little impact on older adults’ decisions about where to walk. The implications for policy, practice, and the emerging technique of virtual auditing are considered.

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IJERPH, Vol. 13, Pages 1054: Ultrafine Particle Metrics and Research Considerations: Review of the 2015 UFP Workshop

In February 2015, the United States Environmental Protection Agency (EPA) sponsored a workshop in Research Triangle Park, NC, USA to review the current state of the science one missions, air quality impacts, and health effects associated with exposures to ultrafine particles[1].[...]

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IJERPH, Vol. 13, Pages 1052: Lung Cancer Mortality Trends in China from 1988 to 2013: New Challenges and Opportunities for the Government

Background: As lung cancer has shown a continuously increasing trend in many countries, it is essential to stay abreast of lung cancer mortality information and take informed actions with a theoretical basis derived from appropriate and practical statistical methods. Methods: Age-specific rates were collected by gender and region (urban/rural) and analysed with descriptive methods and age-period-cohort models to estimate the trends in lung cancer mortality in China from 1988 to 2013. Results: Descriptive analysis revealed that the age-specific mortality rates of lung cancer in rural residents increased markedly over the last three decades, and there was no obvious increase in urban residents. APC analysis showed that the lung cancer mortality rates significantly increased with age (20–84), rose slightly with the time period, and decreased with the cohort, except for the rural cohorts born during the early years (1909–1928). The trends in the patterns of the period and cohort effects showed marked disparities between the urban and rural residents. Conclusions: Lung cancer mortality remains serious and is likely to continue to rise in China. Some known measures are suggested to be decisive factors in mitigating lung cancer, such as environmental conservation, medical security, and tobacco control, which should be implemented more vigorously over the long term in China, especially in rural areas.

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IJERPH, Vol. 13, Pages 1057: Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations

Children are at a greater risk than adults of developing cancer after being exposed to ionizing radiation. Because of their developing bodies and long life expectancy post-exposure, children require specific attention in the aftermath of nuclear accidents and when radiation is used for diagnosis or treatment purposes. In this review, we discuss the carcinogenic potential of pediatric exposures to ionizing radiation from accidental, diagnostic, and therapeutic modalities. Particular emphasis is given to leukemia and thyroid cancers as consequences of accidental exposures. We further discuss the evidence of cancers that arise as a result of radiotherapy and conclude the review with a summary on the available literature on the links between computer tomography (CT) and carcinogenesis. Appropriate actions taken to mitigate or minimize the negative health effects of pediatric exposures to ionizing radiation and future considerations are discussed.

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IJERPH, Vol. 13, Pages 1051: Water-Related Impacts of Climate Change on Agriculture and Subsequently on Public Health: A Review for Generalists with Particular Reference to Pakistan

Water-related impacts due to change in climatic conditions ranging from water scarcity to intense floods and storms are increasing in developing countries like Pakistan. Water quality and waterborne diseases like hepatitis, cholera, typhoid, malaria and dengue fever are increasing due to chaotic urbanization, industrialization, poor hygienic conditions, and inappropriate water management. The morbidity rate is high due to lack of health care facilities, especially in developing countries. Organizations linked to the Government of Pakistan (e.g., Ministry of Environment, Ministry of Climate Change, Planning and Development, Ministry of Forest, Irrigation and Public Health, Pakistan Meteorological Department, National Disaster Management, Pakistan Agricultural Research Centre, Pakistan Council for Research in Water Resources, and Global Change Impact Study Centre), United Nation organizations, provincial government departments, non-governmental organizations (e.g., Global Facility and Disaster Reduction), research centers linked to universities, and international organizations (International Institute for Sustainable Development, Food and Agriculture, Global Climate Fund and World Bank) are trying to reduce the water-related impacts of climate change, but due to lack of public awareness and health care infrastructure, the death rate is steadily increasing. This paper critically reviews the scientific studies and reports both at national and at international level benefiting generalists concerned with environmental and public health challenges. The article underlines the urgent need for water conservation, risk management, and the development of mitigation measures to cope with the water-related impacts of climate change on agriculture and subsequently on public health. Novel solutions and bioremediation methods have been presented to control environmental pollution and to promote awareness among the scientific community. The focus is on diverse strategies to handle the forthcoming challenges associated with water resources management.

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IJERPH, Vol. 13, Pages 1050: Identification of Vape Shops in Two North Carolina Counties: An Approach for States without Retailer Licensing

Stores that sell electronic nicotine delivery systems (ENDS) as their primary product are a new phenomenon and often termed “vape shops”. While vape shops are now regulated by state and federal agencies, not all states maintain lists of vape shops in operation. Standard ways of identifying tobacco retailers through off-premise alcohol permits and business listing services may not identify vape shops. We used four online business listing services (i.e., Google Maps, ReferenceUSA, YellowPages.com, Yelp) to identify vape shops in two counties in North Carolina (NC). In one county, we also assessed four vaping web sites. We drove primary and secondary roads to physically validate the identified stores and attempt to identify stores not listed online. To assess the accuracy of the online searches, we calculated sensitivity and positive predictive values (PPVs). This research was conducted in spring and summer 2016 and identified 28 vape shops online. We confirmed 16 vape shops (seven in Pitt County, NC, USA, and nine in Durham County, NC, USA). Online searches ranged in sensitivity, 62.5%–81.3%, and PPVs ranged from 73.3% to 92.3%. Because of the range of sensitivity found among the business listing services, state policymakers should consider uniform licensing requirements for vape and tobacco retailers to more easily track retailers and ensure compliance with regulations.

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Re: Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma

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IJERPH, Vol. 13, Pages 1046: Cytotoxicity of Odorous Compounds from Poultry Manure

Long-term exposure and inhalation of odorous compounds from poultry manure can be harmful to farm workers and the surrounding residents as well as animals. The aim of the present study was to determine the cytotoxicity and IC50 values of common odorous compounds such as ammonium, dimethylamine, trimethylamine, butyric acid, phenol, and indole in the chick liver hepatocellular carcinoma cell line LMH (Leghorn Male Hepatoma), in vitro, using MTT (3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide) and PrestoBlue cytotoxicity assays. The cells were microscopically examined for any morphological changes post treatment. Dimethylamine exhibited the strongest cytotoxic effect on LMH cells with an IC50 value of 0.06% and 0.04% after an exposure of 24 h and 48 h, respectively. Both ammonium and trimethylamine had comparable cytotoxicity and their IC50 values were 0.08% and 0.04% after 24 h and 48 h, respectively. Of note, indole had the lowest cytotoxicity as the majority of cells were viable even after 72 h exposure. Thus, the IC50 for indole was not calculated. Results achieved from both MTT and PrestoBlue assays were comparable. Moreover, the morphological changes induced by the tested odours in LMH cells resulted in monolayer destruction, cytoplasm vacuolisation, chromatin condensation, and changes in nucleus and cell shape. Our study showed harmful effects of odorous compounds in chick tissues.

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IJERPH, Vol. 13, Pages 1047: Heavy Metal Pollution from Gold Mines: Environmental Effects and Bacterial Strategies for Resistance

Mining activities can lead to the generation of large quantities of heavy metal laden wastes which are released in an uncontrolled manner, causing widespread contamination of the ecosystem. Though some heavy metals classified as essential are important for normal life physiological processes, higher concentrations above stipulated levels have deleterious effects on human health and biota. Bacteria able to withstand high concentrations of these heavy metals are found in the environment as a result of various inherent biochemical, physiological, and/or genetic mechanisms. These mechanisms can serve as potential tools for bioremediation of heavy metal polluted sites. This review focuses on the effects of heavy metal wastes generated from gold mining activities on the environment and the various mechanisms used by bacteria to counteract the effect of these heavy metals in their immediate environment.

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IJERPH, Vol. 13, Pages 1048: Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009–2010 and 2013–2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009–2010 to 2013–2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p < 0.05). Among nonsmokers, SHS exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = −10.9%; p < 0.05). Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms.

http://ift.tt/2dI4ye6

IJERPH, Vol. 13, Pages 1042: The Effects of a Skill-Based Intervention for Victims of Bullying in Brazil

This study’s objective was to verify whether improved social and emotional skills would reduce victimization among Brazilian 6th grade student victims of bullying. The targets of this intervention were victimized students; a total of 78 victims participated. A cognitive-behavioral intervention based on social and emotional skills was held in eight weekly sessions. The sessions focused on civility, the ability to make friends, self-control, emotional expressiveness, empathy, assertiveness, and interpersonal problem-solving capacity. Data were analyzed through Poisson regression models with random effects. Pre- and post-analyses reveal that intervention and comparison groups presented significant reduced victimization by bullying. No significant improvement was found in regard to difficulties in practicing social skills. Victimization reduction cannot be attributed to the program. This study contributes to the incipient literature addressing anti-bullying interventions conducted in developing countries and highlights the need for approaches that do not exclusively focus on the students’ individual aspects.

http://ift.tt/2eFWJCp

IJERPH, Vol. 13, Pages 1045: DALY-Based Health Risk Assessment of Construction Noise in Beijing, China

Noise produced by construction activities has become the second most serious acoustic polluting element in China. To provide industry practitioners with a better understanding of the health risks of construction noise and to aid in creating environmentally friendly construction plans during early construction stages, we developed a quantitative model to assess the health impairment risks (HIA) associated with construction noise for individuals living adjacent to construction sites. This model classifies noise-induced health impairments into four categories: cardiovascular disease, cognitive impairment, sleep disturbance, and annoyance, and uses disability-adjusted life years (DALYs) as an indicator of damage. Furthermore, the value of a statistical life (VSL) is used to transform DALYs into a monetary value based on the affected demographic characteristics, thereby offering policy makers a reliable theoretical foundation for establishing reasonable standards to compensate residents suffering from construction noise. A practical earthwork project in Beijing is used as a case study to demonstrate the applicability of the proposed model. The results indicate that construction noise could bring significant health risks to the neighboring resident community, with an estimated 34.51 DALYs of health damage and 20.47 million yuan in social costs. In particular, people aged 45–54 are most vulnerable to construction noise, with the greatest health risks being caused by sleep disturbance.

http://ift.tt/2eQGOAz

IJERPH, Vol. 13, Pages 1043: Crash Frequency Analysis Using Hurdle Models with Random Effects Considering Short-Term Panel Data

Random effect panel data hurdle models are established to research the daily crash frequency on a mountainous section of highway I-70 in Colorado. Road Weather Information System (RWIS) real-time traffic and weather and road surface conditions are merged into the models incorporating road characteristics. The random effect hurdle negative binomial (REHNB) model is developed to study the daily crash frequency along with three other competing models. The proposed model considers the serial correlation of observations, the unbalanced panel-data structure, and dominating zeroes. Based on several statistical tests, the REHNB model is identified as the most appropriate one among four candidate models for a typical mountainous highway. The results show that: (1) the presence of over-dispersion in the short-term crash frequency data is due to both excess zeros and unobserved heterogeneity in the crash data; and (2) the REHNB model is suitable for this type of data. Moreover, time-varying variables including weather conditions, road surface conditions and traffic conditions are found to play importation roles in crash frequency. Besides the methodological advancements, the proposed technology bears great potential for engineering applications to develop short-term crash frequency models by utilizing detailed data from field monitoring data such as RWIS, which is becoming more accessible around the world.

http://ift.tt/2ffdnwf

IJERPH, Vol. 13, Pages 1049: Psychological Predictors of Seeking Help from Mental Health Practitioners among a Large Sample of Polish Young Adults

Although the corresponding literature contains a substantial number of studies on the relationship between psychological factors and attitude towards seeking professional psychological help, the role of some determinants remains unexplored, especially among Polish young adults. The present study investigated diversity among a large cohort of Polish university students related to attitudes towards help-seeking and the regulative roles of gender, level of university education, health locus of control and sense of coherence. The total sample comprised 1706 participants who completed the following measures: Attitude Toward Seeking Professional Psychological Help Scale-SF, Multidimensional Health Locus of Control Scale, and Orientation to Life Questionnaire (SOC-29). They were recruited from various university faculties and courses by means of random selection. The findings revealed that, among socio-demographic variables, female gender moderately and graduate of university study strongly predict attitude towards seeking help. Internal locus of control and all domains of sense of coherence are significantly correlated with the scores related to the help-seeking attitude. Attitudes toward psychological help-seeking are significantly related to female gender, graduate university education, internal health locus of control and sense of coherence. Further research must be performed in Poland in order to validate these results in different age and social groups.

http://ift.tt/2eaoGBD

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries

Objectives The study aimed to (i) determine the influence of poor health on competing exit routes from paid employment among older workers in Europe, (ii) assess whether these risks are different among welfare state regimes in Europe, and (iii) evaluate differences in estimates between two different competing risk approaches. Methods The study population consisted of 5273 respondents (6-years follow-up) from the Survey of Health, Ageing, and Retirement in Europe (SHARE). The effect of poor health on exit routes from paid employment was assessed with a cause-specific Cox model and a Fine & Gray (F&G) model. These two competing risk analyses were used to calculate absolute risks of labor force exit among welfare state regimes in Europe. Results In both models, poor health was a risk factor for disability benefit [hazard ratio (HR) 3.36; subdistribution hazard ratio (SHR) 3.22], and unemployment (HR 1.43, SHR 1.32). Both models produced similar absolute risks. In countries with a Bismarckian welfare state regime, low-educated older workers living alone and in poor health had an 11% risk of disability benefit, 7% of unemployment, 46% of early retirement, and 7% of becoming economically inactive. In countries with a Scandinavian welfare state regime, the risks were 10%, 7%, 29%, and 3%, respectively, and in Southern European welfare state regimes 4%, 5%, 35%, and 7%. Conclusions Workers with poor health are more likely to leave the labor force than workers with good health. The absolute risks of early retirement and becoming economically inactive were lowest in countries with a Scandinavian welfare state regime. For disability benefit and unemployment, absolute risks were lowest in Southern European welfare state regimes. The direct estimation of absolute risks of leaving the labor force in the presence of competing exit routes is an appealing feature of the F&G model. by Reeuwijk KG, van Klaveren D, van Rijn RM, Burdorf A, Robroek SJW. doi:10.5271/sjweh.3600

http://ift.tt/2eQpFs5

Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme

Objective

With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans.

Methods

Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital.

Results

Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant.

Conclusions

Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.

http://ift.tt/2eBMAd7

Comparison of gestational dating methods and implications for exposure-outcome associations: an example with PM2.5 and preterm birth

Objectives

Estimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassification and inconsistencies in risk estimates, particularly if exposure assignment is also gestation-dependent. This paper examines a ‘what-if’ scenario in which alternative methods are used and attempts to elucidate how method choice affects observed results.

Methods

We constructed two 20-week gestational age cohorts of pregnancies between 2000 and 2005 (New Jersey, Pennsylvania, Ohio, USA) using live birth certificates: one defined preterm birth (PTB) status using CE and one using LMP. Within these, we estimated risk for 4 categories of preterm birth (PTBs per 10⁶ pregnancies) and risk differences (RD (95% CIs)) associated with exposure to particulate matter (PM_2.5).

Results

More births were classified preterm using LMP (16%) compared with CE (8%). RD divergences increased between cohorts as exposure period approached delivery. Among births between 28 and 31 weeks, week 7 PM_2.5 exposure conveyed RDs of 44 (21 to 67) for CE and 50 (18 to 82) for LMP populations, while week 24 exposure conveyed RDs of 33 (11 to 56) and –20 (–50 to 10), respectively.

Conclusions

Different results from analyses restricted to births with both CE and LMP are most likely due to differences in dating methods rather than selection issues. Results are sensitive to choice of gestational age estimation, though degree of sensitivity can vary by exposure timing. When both outcome and exposure depend on estimate of gestational age, awareness of nuances in the method used for estimation is critical.

http://ift.tt/2eD8euG

Nonstandard work arrangements and worker health and safety

Arrangements between those who perform work and those who provide jobs come in many different forms. Standard work arrangements now exist alongside several nonstandard arrangements: agency work, contract work, and gig work. While standard work arrangements are still the most prevalent types, the rise of nonstandard work arrangements, especially temporary agency, contract, and “gig” arrangements, and the potential effects of these new arrangements on worker health and safety have captured the attention of government, business, labor, and academia. This article describes the major work arrangements in use today, profiles the nonstandard workforce, discusses several legal questions about how established principles of labor and employment law apply to nonstandard work arrangements, summarizes findings published in the past 20 years about the health and safety risks for workers in nonstandard work arrangements, and outlines current research efforts in the area of healthy work design and worker well-being. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

http://ift.tt/2eCyZz8

Effectiveness of OSHA Outreach Training on carpenters’ work-related injury rates, Washington State 2000–2008

Introduction

Despite the size and breadth of OSHA's Outreach Training program for construction, information on its impact on work-related injury rates is limited.

Methods

In a 9-year dynamic cohort of 17,106 union carpenters in Washington State, the effectiveness of OSHA Outreach Training on workers’ compensation claims rate was explored. Injury rates were calculated by training status overall and by carpenters’ demographic and work characteristics using Poisson regression.

Results

OSHA Outreach Training resulted in a 13% non-significant reduction in injury claims rates overall. The protective effect was more pronounced for carpenters in their apprenticeship years, drywall installers, and with increasing time since training.

Conclusions

In line with these observed effects and prior research, it is unrealistic to expect OSHA Outreach Training alone to have large effects on union construction workers’ injury rates. Standard construction industry practice should include hazard awareness and protection training, coupled with more efficient approaches to injury control. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

http://ift.tt/2eB2xzX

Effects of psychosocial work factors and psychological distress on self-assessed work ability: A 7-year follow-up in a general working population

Background

Toinvestigate the effects of psychosocial work factors (PWF) and psychological distress (PD) on self-assessed work ability.

Methods

This follow-up study included 7,810 individuals (55%women) with good work ability at baseline. PWFandPD (measured by GHQ-12) were assessed at baseline and work ability at 7-year follow-up. Effects of PWF and PD on work ability were analyzed by logistic regression, odds ratios (OR) with 95% CI, and by mediation analysisusing 4-way decomposition.

Results

Low support was associated with poor work ability for both women and men (OR 1.78 and 1.89). For men, also low skill discretion was associated with poor work ability (OR 2.07). For both women and men, PD was associated with poor work ability (OR 3.41 and 1.84). PD did not act as an intermediate variablein the association between PWF and work ability.

Conclusion

Strategies for sustainable work ability should focus on both working conditions and health factors. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

http://ift.tt/2eCziKf

IJERPH, Vol. 13, Pages 1044: Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan

The indigenous Austronesian minority of Taiwan is heavily affected by health disparities which may include suffering from a greater burden of the tobacco epidemic. While a lack of representative data has historically precluded an investigation of the differences in smoking between Taiwanese ethnicities, these data have recently become available through an annual population-based telephone survey conducted by the Health Promotion Administration, Ministry of Health and Welfare (previously known as the Bureau of Health Promotion (BHP), Department of Health). We used the BHP monitoring data to observe the prevalence of smoking and environmental tobacco smoke exposure among indigenous and non-indigenous Taiwanese surrounding a tobacco welfare tax increase in 2006, investigate ethnic differences in smoking prevalence and environmental tobacco smoke exposure each year between 2005 and 2008, and perform multiple logistic regression to estimate measures of association between potential risk factors and smoking status. Despite significant ethnic and gender differences in smoking prevalence, smoking status was not found to be significantly associated with ethnicity after controlling for socioeconomic and demographic factors.

http://ift.tt/2dRQg9m

Human Error as an Emergent Property of Action Selection and Task Place-Holding

Objective:

A computational process model could explain how the dynamic interaction of human cognitive mechanisms produces each of multiple error types.

Background:

With increasing capability and complexity of technological systems, the potential severity of consequences of human error is magnified. Interruption greatly increases people’s error rates, as does the presence of other information to maintain in an active state.

Method:

The model executed as a software-instantiated Monte Carlo simulation. It drew on theoretical constructs such as associative spreading activation for prospective memory, explicit rehearsal strategies as a deliberate cognitive operation to aid retrospective memory, and decay.

Results:

The model replicated the 30% effect of interruptions on postcompletion error in Ratwani and Trafton’s Stock Trader task, the 45% interaction effect on postcompletion error of working memory capacity and working memory load from Byrne and Bovair’s Phaser Task, as well as the 5% perseveration and 3% omission effects of interruption from the UNRAVEL Task.

Conclusion:

Error classes including perseveration, omission, and postcompletion error fall naturally out of the theory.

Application:

The model explains post-interruption error in terms of task state representation and priming for recall of subsequent steps. Its performance suggests that task environments providing more cues to current task state will mitigate error caused by interruption. For example, interfaces could provide labeled progress indicators or facilities for operators to quickly write notes about their task states when interrupted.

http://ift.tt/2eiV4DP

Occupational exposures and chronic obstructive pulmonary disease (COPD): comparison of a COPD-specific job exposure matrix and expert-evaluated occupational exposures

Objectives

To compare the occupational exposure levels assigned by our National Institute for Occupational Safety and Health chronic obstructive pulmonary disease-specific job exposure matrix (NIOSH COPD JEM) and by expert evaluation of detailed occupational information for various jobs held by members of an integrated health plan in the Northwest USA.

Methods

We analysed data from a prior study examining COPD and occupational exposures. Jobs were assigned exposure levels using 2 methods: (1) the COPD JEM and (2) expert evaluation. Agreement (Cohen's coefficients), sensitivity and specificity were calculated to compare exposure levels assigned by the 2 methods for 8 exposure categories.

Results

indicated slight to moderate agreement (0.19–0.51) between the 2 methods and was highest for organic dust and overall exposure. Sensitivity of the matrix ranged from 33.9% to 68.5% and was highest for sensitisers, diesel exhaust and overall exposure. Specificity ranged from 74.7% to 97.1% and was highest for fumes, organic dust and mineral dust.

Conclusions

This COPD JEM was compared with exposures assigned by experts and offers a generalisable approach to assigning occupational exposure.

http://ift.tt/2e4lmbt

IJERPH, Vol. 13, Pages 1039: Tobacco Control Progress in Low and Middle Income Countries in Comparison to High Income Countries

The study aimed to describe worldwide levels and trends of tobacco control policy by comparing low and middle income countries with other income categories from 2007 to 2014 and to analyze the corresponding relation to recent changes in smoking prevalence. Policy measure data representing years 2007 to 2014 were collected from all available World Health Organization (WHO) reports on the global tobacco epidemic. Corresponding policy percentage scores (PS) were calculated based on MPOWER measures. Age-standardized smoking prevalence data for years 2010 and 2015 were collected from the WHO Global Health Observatory Data Repository. Trends of PS were analysed with respect to WHO region and OECD country income category. Scatter plots and regression analysis were used to depict the relationship between tobacco control policy of 2010 and change in smoking prevalence between 2015 and 2010 by sex and income category. Combined PS for all countries increased significantly from 47% in 2007 to 61% by 2014 (p < 0.001). When grouped by income category and region, policies were strengthened in all categories, albeit with varying progression. By 2014, tobacco control policy legislation had reached 45% in the Least Developed Countries (LDCs), 59% in Low Middle Income Countries (LMICs), 66% in Upper Middle Income Countries (UMICs) and 70% in High Income Countries (HICs). Overall, there was a negative relationship between higher policy scores and change in smoking prevalence. Although policy strengthening had been conducted between 2007 and 2014, room for considerable global improvement remains, particularly in LDCs.

http://ift.tt/2eJIvjk

IJERPH, Vol. 13, Pages 1040: Is Pedometer-Determined Physical Activity Decreasing in Czech Adults? Findings from 2008 to 2013

Objective measured trend data are important for public health practice. However, these data are rare for an adult population. Therefore, the aim of this study was to describe time trends in pedometer-determined physical activity of Czech adults (25–65 years) from 2008 to 2013. Participants were Czech national citizens whose physical activity was assessed objectively using a Yamax Digiwalker SW-700 pedometer (Yamax Corporation, Tokyo, Japan) for seven consecutive days in the period 2008 to 2013. The final sample was 4647 Czech adults [M age 41.4 ± 10 years; M body mass index (BMI) 25.1 ± 3.7 kg/m2]. The results showed that men took more steps/day (M (Mean) = 10,014; 95% CI (Confidence Interval) = 9864–10,164) than women (M = 9448; 95% CI = 9322–9673) in all age and BMI groups. Mean steps/day declined from 2008 to 2013 by 852 steps/day in men and 1491 steps/day in women. In the whole sample, the proportion of participants who had a sedentary lifestyle (<5000 steps/day) increased by 5.8%; the proportion taking ≥10,000 steps/day decreased by 15.8%. In 2013, men and women were 2.67 and 2.05 times, respectively, more likely to have a physically inactive lifestyle (<7500 steps/day) than in 2008. Conversely, in 2008, men and women were 1.68 and 2.46 times, respectively, less likely to have very active lifestyle (>12,500 steps/day). In conclusion, this study suggests that there has been a substantial reduction in physical activity in Czech adults over time.

http://ift.tt/2eJGPGr

IJERPH, Vol. 13, Pages 1041: UV “Indices”—What Do They Indicate?

Ultra-Violet (UV) radiation covers the spectrum of wavelengths from 100 to 400 nm. The potency and biological activity for a variety of endpoints differ by wavelength. For monitoring and communication purposes, different UV action spectra have been developed. These spectra use different weighting functions. The action spectrum for erythemal dose is the most widely used one. This erythemal dose per time or dose-rate has been further simplified into a “UV index”. Following this example, in our review we use the term “index” or (plural) “indices” in a more general description for all simplified single-value measures for any biologically effective UV dose, e.g., for human non-melanoma skin cancer and for previtamin D production rate. Ongoing discussion about the existence of an increased melanoma risk due to UV-A exposure underscores the uncertainties inherent in current weighting functions. Thus, we performed an online literature search to review the data basis for these indices, to understand their relevance for an individual, and to assess the applicability of the indices for a range of exposure scenarios. Even for natural (solar) UV, the spectral composition varies spatially and temporally. Artificial UV sources and personal protection introduce further variation to the spectral composition. Many biological effects are proposed for UV radiation. Only few endpoints have been studied sufficiently to estimate a reliable index. Weighting functions for chronic effects and most importantly for cancer endpoints have been developed in animal models, and often for proxy endpoints only. Epidemiological studies on biological effects of UV radiation should not only depend on single-value weighted UV dose estimates (indexes) but should strive for a more detailed description of the individual exposure. A better understanding of the adverse and beneficial effects of UV radiation by wavelength would also improve medical counseling and health communication regarding individual health-supportive behavior.

http://ift.tt/2dOVlPD

IJERPH, Vol. 13, Pages 1038: The Other Side: How does Informed Choice Affect Induced Abortions among Reproductive-Age Immigrant Women in China—A Cross-Sectional Study

This study attempted to explore how informed choice on contraceptive methods influenced induced abortions among reproductive-age immigrant women in China. A total of 3230 participants were recruited in Beijing, Shanghai, and Chongqing. Information on informed choice was collected by questionnaires. The annual incidence rate (spells) of induced abortions was 0.46 (1500/3230) among the participants. The sequence from the highest score to the lowest was long-term, short-term and natural contraceptive methods (p < 0.0001). Significant differences of rates in induced abortions were found in region, occupation, length of the first immigration up to now (year), purpose for immigration, number of children, marital status, sex preference, contraceptive methods, deciders of contraceptive methods and side effects. In the zero-inflated negative binomial model, the joint impacts showed when a participant with one child employed condoms or family planning service providers as the deciders of contraceptive methods introduced intrauterine devices, the occurrence of induced abortions was more likely to be reduced. Women who underwent side effects using pills were more likely to have had induced abortions.

http://ift.tt/2dC7Wr6

IJERPH, Vol. 13, Pages 1034: Family Affluence and the Eating Habits of 11- to 15-Year-Old Czech Adolescents: HBSC 2002 and 2014

Socioeconomic inequalities in eating habits have a profound impact on the health of adolescents. The aim of the present study was to evaluate socioeconomic disparities in the eating habits of Czech adolescents and to compare their change between 2002 and 2014. The data from the Czech Health Behavior in School-aged Children (HBSC) study conducted in 2002 and 2014 was utilized. The Family Affluence Scale (FAS) was used to assess socioeconomic disparities. Higher odds of daily consumption of fruit (2002: OR = 1.67; 2014: OR = 1.70, p < 0.001) and vegetables (2002: OR = 1.54; 2014: OR = 1.48, p < 0.001) were associated with high FAS in both genders. Adolescents with higher FAS were less likely to consume sweets (2002: OR = 0.72, p < 0.05) and more likely to eat breakfast on weekdays (2014: OR = 1.19, p < 0.05). In 2002 and 2014, the data showed lower odds of daily consumption of soft drinks (Low: OR = 0.47; Medium: OR = 0.43; High: OR = 0.41, p < 0.001), fruit (Low: OR = 0.73; Medium: OR = 0.74, p < 0.001; High: OR = 0.75, p < 0.05), sweets (Low: OR = 0.71; Medium: OR = 0.79, p < 0.001) and breakfast on weekends (High: OR = 0.70, p < 0.05), and a higher likelihood of eating breakfast on weekdays (Low: OR = 1.26, p < 0.01; Medium: OR = 1.13, p < 0.05). These findings play an important role in future public measures to improve dietary habits and decrease social inequalities in youth.

http://ift.tt/2dOUf6i

DNA damage assessment in the lymphocytes of construction painters by comet assay

Background:

Exposure to chemicals is inevitable for certain occupational groups, particularly in industrial countries. Some cytogenetic tests such as comet assay are effectively utilized to screen genotoxic effects of these chemicals in humans. The purpose of this study has been to assess the DNA damage in construction painters’ lymphocytes using the comet assay.

Methods:

Fourteen male construction painters with 1 year of required work experience were randomly selected from the list of Painter Union in Gonabad city, Iran. In addition, 14 healthy male non-painters were randomly selected as controls. The DNA damage degree was determined using a fluorescence microscope and CometScore software. The obtained data were analyzed employing independent t-test using SPSS software v. 14 at the significant level of p < 0.05.

Results:

All participants were non-smokers and non-alcoholics. No significant differences were found between the two groups in terms of age, weight, height, body mass index, and systolic and diastolic blood pressure. The DNA damage in the painter group was significantly greater than that of the control group. Tail length (µm) was 12.63 ± 6.54 versus 2.90 ± 0.84, tail DNA (%) was 4.33 ± 1.84 versus 1.29 ± 0.43, and tail moment (µm) was 1.85 ± 0.98 versus 0.14 ± 0.20 in painter and control groups (p < 0.001), respectively.

Conclusion:

The chemicals used in oil paint may increase the DNA damage in painter blood lymphocytes.

http://ift.tt/2egvxvi

Oral administration of low-dose bisphenol A promotes proliferation of ventral prostate and upregulates prostaglandin D2 synthase expression in adult rats

This study aims to assess the effect of low oral dose of bisphenol A (BPA) on proliferation of ventral prostate (VP) and expression of related genes in adult rats. Three-month-old male Sprague Dawley rats were treated daily with BPA (10, 30, or 90 µg/kg, per os), 17β-estradiol (E₂, 10.0 µg/kg, subcutaneously), or vehicle for 4 weeks. Treatment with 10 µg/kg BPA resulted in increased animal weight and VP epithelial height compared with the controls (p < 0.01), while such effects were less pronounced in higher BPA doses. Treatment with E₂ showed opposite effects, with significantly decreased animal weight and VP epithelial height (p < 0.01). Interestingly, BPA increased serum E₂ and reduced testosterone levels and significantly increased the estrogen to androgen ratio (p < 0.05). In addition, BPA slightly increased dihydrotestosterone (DHT) levels. Immunohistochemistry data showed that BPA significantly upregulated proliferating cell nuclear antigen expression (p < 0.01). Furthermore, microarray and reverse transcription polymerase chain reaction analyses showed that BPA induced upregulation of prostaglandin D₂ synthase (Ptgds), Fas, Pbef1, and complement factor B (Cfb)as well as downregulation of Pttg1 and Fabp4 in the VP. These results indicated that environmental exposure to low doses of BPA may induce proliferation of VP in adult rats by increasing the estrogen to androgen ratio and upregulating expression of Ptgds to promote production of DHT.

http://ift.tt/2dCqOpN

Formaldehyde exposure inhibits the expression of mammalian target of rapamycin in rat testis

Formaldehyde (FA), a ubiquitous environmental pollutant, has long been suspected of causing adverse male reproductive effects. However, the molecular and cellular mechanisms underlying this phenomenon remain elusive. The overall aim of this study is to clarify the role of mammalian target of rapamycin (mTOR) in male reproductive injuries induced by FA exposure, by which we can further understand the molecular mechanism of FA male reproductive toxicity. In this study, immunohistochemistry, Western blotting, and reverse transcription polymerase chain reaction analysis were used to detect the expression of mTOR molecule in testicular tissues. We found that FA exposure inhibits the expression of mTOR in a dose-dependent manner. Combined with our earlier finding, we found the decreasing expression of mTOR in testicular tissue were consistent with the changes of testicular structure and autophagy levels. In summary, our data suggested that mTOR molecule might be involved in male reproductive injuries induced by FA exposure.

http://ift.tt/2egujjE

Evaluation of DNA damage and DNA repair capacity in occupationally lead-exposed workers

Occupational lead (Pb) exposure remains a significant concern for workers in Turkey. Health hazards of Pb exposure have been investigated in various test systems, but results regarding its potential genotoxic effects on exposed populations are contradictory. In this study, a control group and an exposed group were studied, each consisting of 25 male subjects. Blood lead levels (BLLs) were estimated by graphite furnace atomic absorption spectrometry. Genotoxic effects of Pb exposure were studied in leukocytes by comet and challenge assays. The effect of Pb exposure to DNA repair capacity was evaluated following in vitro hydrogen peroxide exposure. Pb-exposed workers had significantly higher BLLs than the control group (p < 0.01). DNA damage in exposed workers had a significantly higher percentage of DNA in tail than the control group (p < 0.05). In the challenge assay, it was found that the mean DNA% repair capacity was significantly decreased in Pb-exposed workers (p < 0.01). The results indicated that occupational Pb exposure is associated with DNA damage and causes decrease in DNA% repair capacity, indicating a potential health concern for occupationally Pb-exposed populations.

http://ift.tt/2dCr6wJ

Polychlorinated biphenyls: New evidence from the last decade

Millions of pounds of polychlorinated biphenyl (PCB) compounds have been produced in multiple countries for industrial applications over the last several decades. PCB exposure induces various adverse health effects in animals and humans. Environmental and occupational exposures to PCBs have been associated with liver, kidney, endocrine, and neurodevelopmental adverse effects. We have collected and reviewed animal and human data cited in the US National Library of Medicine from 2000 to 2010. In brief, our review shows new evidence, that is, in animal studies, exposure to one of the PCBs, A1221, induces a significant alteration of serum luteinizing hormone. The effects were more profound in the F2 generation, particularly with respect to fluctuations in hormones and reproductive tract tissues across the estrous cycle. Morphological analyses of brain tissue from rats exposed to A1254 confirmed the results of an earlier work which showed that the relative size of the intra- and infrapyramidal (II-P) mossy fibers was smaller than that in the controls and also reduction in growth was selective for the II-P mossy fibers. PCB exposure increased anogenital distance and prostate size but decreased epididymal weight, epididymal sperm count, and motile epididymal sperm count. No effects were observed on testicular weight or size. The epidemiological data showed an association between diabetes mellitus prevalence and elevated concentrations of PCB 153. Additionally, prenatal PCB exposure studies were associated with a smaller thymic index at birth and could adversely affect immune responses to childhood vaccinations and resistance to respiratory infections. PCB exposure was also reported to adversely affect enamel development in children in a dose-dependent manner. Because PCBs and their metabolites are potential health hazards, understanding the risk factors associated with individual PCBs, PCB mixtures, and PCB metabolites is important. PCB exposures of vulnerable populations (pregnant women, fetuses, infants, and children) are of particular concern because of heightened sensitivity during this period of brain development.

http://ift.tt/2egvYpk

Mixed exposure to bacterial lipopolysaccharide and seafood proteases augments inflammatory signalling in an airway epithelial cell model (A549)

Seafood industry workers exhibit increased prevalence of respiratory symptoms due to exposure to bioaerosols containing a mixture of bioactive agents. In this study, a human pulmonary epithelial cell model (A549) was exposed to mixtures of bacterial lipopolysaccharide (LPS) and protease-activated receptor-2 (PAR-2) agonists H-Ser-Leu-Ile-Gly-Lys-Val-NH₂ (SLIGKV-NH₂), purified salmon (Salmo salar) trypsin or purified king crab (Paralithodes camtschaticus) trypsin. The inflammatory response was measured based on nuclear factor-kappa B (NF-B) activation of transcription in a luciferase reporter gene assay and interleukin 8 (IL-8) secretion in an enzyme-linked immunosorbent assay. We observed that mixtures of SLIGKV-NH₂ or trypsins with LPS augmented the activation of NF-B and secretion of IL-8. The effect on IL-8 secretion was synergistic when both trypsins and LPS were used in the lower concentration range. The results demonstrate that exposure to mixtures of agents that are relevant to seafood industry workplaces may lead to increased inflammatory signalling compared with exposure to the individual agents alone. Furthermore, the results indicate that synergism may occur with the combined exposure to seafood trypsins and LPS and is most likely to occur when exposure to either agent is low.

http://ift.tt/2dCtUdw

Kinetic and isotherm study of Sudan black B removal

In this research, the removal of Sudan black B (SBB) by cadmium hydroxide nanowires loaded on activated carbon is described. After optimizing the variables involved, Langmuir, Freundlich, Tempkin, and Dubinin–Radushkevich models were applied to fit the experimental data. The adsorbent correlation coefficient and error analysis indicated the applicability of Langmuir model for the interpretation of equilibrium data. Different kinetic models were applied to analyze the time evolution of removal data. It was found that low quantity of adsorbent (<0.03 g) is capable of removal of large amount of SBB in reasonably short time (<40 min). The adsorption process was found to be described by both pseudo–second-order kinetics and interparticle diffusion mechanism. The effects of variables such as pH, amount of adsorbent, and contact time on batch adsorption process were investigated and optimized.

http://ift.tt/2egvUWJ

Differential expression of metallothionein-1 and cytochrome p450-2a5 (cyp2a5) in mice in response to lead acetate exposure and industrial effluents in Ibadan, Nigeria

Metallothionein-1 (MT-1), cytochrome P450-2A (CYP2a) and other genes are involved in the detoxification of xenobiotics such as heavy metals and toxins. Changes in their expression precede overt toxic effects and can serve as a marker for exposure to pollutants. We used a mouse experimental system and quantitative reverse transcription polymerase chain reaction to determine changes in gene expression and the direction of change, in response to exposure to lead acetate (LA) and waste water (WW) from an industrial area in Ibadan. MT-1 and CYP2a5 genes were quickly and highly induced at different exposure periods and concentrations. MT-1 was mostly downregulated by the LA exposure, but upregulated by several folds on exposure to WW. CYP2a5 expression was mostly downregulated with LA exposure. The optimum expression of MT-1 and CYP2a5 genes induced by both LA and WW was at 48 h. We conclude that rapid assays to determine the direction of change in the expression of MT-1 and CYP2a5 could be a fast and reliable method in developing countries for screening humans exposed to pollutants from industrial waste.

http://ift.tt/2dCsXBP

Acute high-level toluene exposure decreases hippocampal neurogenesis in rats

Toluene is an organic solvent that is used in various industrial applications. Despite its usefulness, toluene has toxic effects on the brain and is a substance that is commonly abused. Toluene causes behavioral and functional abnormalities such as decreased memory capacity, cognitive impairment, and depression-like symptoms. However, the target sites and toxic mechanisms of inhaled toluene in the brain are poorly understood. In this study, we subjected Sprague-Dawley (SD) rats to acute high-level toluene exposure (7000 ppm) to investigate its neuronal toxicity, and in particular, its effect on neurogenesis in the hippocampus. In order to assay the effects of inhaled toluene on hippocampal neurogenesis, we measured the levels of neurogenesis markers Ki-67 and doublecortin (DCX) in the hippocampus 1, 2, 5, and 8 days after cessation of toluene exposure. In addition to assaying clinical signs, body weight, and bronchoalveolar lavage fluid, the liver, lungs, and kidneys were subjected to histopathological examination to investigate the toxic effects of high-level toluene exposure. Although abnormal neurological signs were observed after toluene exposure, these disappeared within 24 h and no toluene-related toxicological effects were observed in the liver, lungs, or kidneys. The animals exposed to toluene showed significantly decreased hippocampal neurogenesis, which persisted until the 8th and final day of measurement. Thus, acute high-level toluene exposure inhibited hippocampal neurogenesis and produced transient abnormal neurological signs, but did not produce toxicity in the other organs studied.

http://ift.tt/2egtAyK

Exertional heat illness and acute injury related to ambient wet bulb globe temperature

Background

The Deepwater Horizon disaster cleanup effort provided an opportunity to examine the effects of ambient thermal conditions on exertional heat illness (EHI) and acute injury (AI).

Methods

The outcomes were daily person-based frequencies of EHI and AI. Exposures were maximum estimated WBGT (WBGTmax) and severity. Previous day's cumulative effect was assessed by introducing previous day's WBGTmax into the model.

Results

EHI and AI were higher in workers exposed above a WBGTmax of 20°C (RR 1.40 and RR 1.06/°C, respectively). Exposures above 28°C-WBGTmax on the day of the EHI and/or the day before were associated with higher risk of EHI due to an interaction between previous day's environmental conditions and the current day (RRs from 1.0–10.4).

Conclusions

The risk for EHI and AI were higher with increasing WBGTmax. There was evidence of a cumulative effect from the prior day's WBGTmax for EHI. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

http://ift.tt/2eKzQyf

Work-related illness and injury claims among nationally certified athletic trainers reported to Washington and California from 2001 to 2011

Background

Little is known about the work-related injury and illnesses experienced by certified athletic trainers (AT).

Methods

The incidence and characteristics of injury/illness claims filed in two workers’ compensation systems were described from 2001 to 2011. Yearly populations at risk were estimated from National Athletic Trainers’ Association membership statistics. Incidence rate ratios (IRR) were reported by job setting.

Results

Claims were predominantly for traumatic injuries and disorders (82.7%: 45.7% sprains/strains, 12.0% open wounds, 6.5% bruises) and at these body sites (back 17.2%, fingers 12.3%, and knee 9.6%) and over half were caused by body motion and overexertion (51.5%). Compared with school settings, clinic/hospital settings had modestly higher claim rates (IRR = 1.29, 95% CI: 1.06–1.52) while other settings (e.g., professional or youth sport, nursing home) had lower claim rates (IRR = 0.63, 95% CI: 0.44–0.70).

Conclusions

These first known estimates of work-related injuries/illnesses among a growing healthcare profession help identify occupational tasks and settings imposing injury risk for ATs. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.

http://ift.tt/2enfzRa

Pulmonary function among latino thoroughbred horse farmworkers

Background

Latino thoroughbred workers may be at risk for developing abnormal pulmonary function related to occupational exposures.

Methods

Eighty worker participants were recruited via community-based purposive sampling. Questionnaires and spirometry tests were administered by trained lay health promoters. Demographic and occupational factors were assessed for associations with respiratory outcomes via multivariable logistic regression.

Results

Twenty-seven percent of participants exhibited abnormal pulmonary function (primarily restrictive), 79% reported any respiratory symptoms, and 94% infrequently used dust masks. Shorter duration of both current horse farm employment (≤5 years) and time living in the United States (≤10 years) increased the odds of abnormal pulmonary function. Shorter time living in the United States increased the odds of upper respiratory symptoms and shorter duration of current horse farm employment increased the odds of lower respiratory symptoms.

Conclusions

Abnormal pulmonary function was high among this vulnerable worker group, suggesting the need for increased dust mask usage and further exposure assessment. Am. J. Ind. Med. 9999:XX–XX, © 2016 Wiley Periodicals, Inc.

http://ift.tt/2eKwE5U

Reporting and prediction of work-related sickness absence by general practitioners

Background

Information on sickness absence (SA) duration in general practice is difficult to record. The duration of absence certified by general practitioners (GPs) can be viewed as a prognosis for return to work. The Health and Occupation Research network in General Practice (THOR-GP) collects SA information from GPs associated with cases of work-related ill-health. A sample of these cases is followed up 1 year retrospectively to gather information on the duration of absence.

Aims

To examine the extent of the underestimation of SA in routinely reported data and to investigate how well GPs predict patients’ return to work.

Methods

THOR-GPs submit case and SA information using a web-based form. GPs who submitted selected cases were asked about the total number of days of SA and whether the patient had returned to work.

Results

THOR-GPs’ routine SA data collection underestimated absence duration by 61%. According to the retrospective data, a much larger proportion of periods of absence due to work-related mental ill-health developed into long-term SA (60%) than episodes attributed to musculoskeletal disorders (32%). In over half the reported cases, the return to work was longer than the GP initially predicted.

Conclusions

THOR-GP prospectively reported SA data underestimated the total length of absence; however, these data can examine the episodic rates of absence within different groups. More accurate longitudinal data can be collected retrospectively. GPs’ ability to predict the length of time a patient will be away from work is important to enable treatment and rehabilitation planning in order to decrease the likelihood of a patient falling into long-term SA.

http://ift.tt/2dVMPMr

Occupational physicians perceptions and experience of appraisals for revalidation

Background

Formal, structured annual appraisals are now a regulatory requirement for all doctors and must meet the standards stipulated by the General Medical Council (GMC), including connection with a designated body.

Aims

To investigate occupational physicians’ opinions and experience of the first year of appraisals for revalidation.

Methods

Members of the Society of Occupational Medicine (SOM) were surveyed electronically regarding the appraisal process and its software. A quiz tested knowledge of the requirements and underlying principles and regulations of appraisal for revalidation.

Results

In total, 163 responses were received, with 57 free-text comments. Respondents spent a mean of 31h on the appraisal process (range 0–200h). Less than half of respondents said they had a clear understanding of the appraisal process. Most respondents (88 and 92%) reported difficulties with the appraisal process and the appraisal software. Only 22% felt the time taken for the appraisal process was proportionate to the value gained. Overall, there was support for appraisal and in particular for SOM appraisers, but only half of the respondents found it useful. The average quiz score was 11 out of 15 (74%) with only one respondent scoring full marks. About 25% of respondents were not aware that the responsible officer is obliged to act on any concerns raised. The free-text comments suggested that some physicians found the process costly and stressful.

Conclusions

The findings suggest that the time requirements and process of appraisal for occupational physicians could be improved, and clearer, comprehensive and more accessible guidance should be developed.

http://ift.tt/2ep1ljb

In the virtual issue on the occupational health of musicians

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Job insecurity, financial difficulties and mental health in Europe

Background

The recession has increased job insecurity in the European Union (EU) which may result in higher levels of psychological distress, burnout and anxiety.

Aims

To investigate the association of job insecurity and financial difficulties with mental health in 27 member states of the EU and to explore the moderating effect of having financial difficulties on the relationship between job insecurity and mental health.

Methods

The sample consisted of employed people from 27 European countries where the Eurobarometer survey (73.2 wave, 2010) was administered by the European Commission. Mental well-being and psychological distress were measured using the Vitality and Mental Health Index (MHI-5) subscales from the Short-Form 36-item health survey (SF-36v2). Linear regression including an interaction term was used to test the underlying factors in this study.

Results

Among the 12594 respondents, experiencing job insecurity was associated with lower Vitality [β = –3.82, 95% confidence interval (CI) –5.29 to –2.36] and MHI-5 (β = –3.48, 95% CI –4.91 to –2.04). Similarly, having financial difficulties was significantly correlated with lower Vitality (β = –8.65, 95% CI –12.07 to –5.24) and MHI-5 (β = –11.51, 95% CI –15.08 to –7.94). However, having financial difficulties did not moderate the relationship between job insecurity and both mental health scales.

Conclusions

This study highlights the negative effect of job insecurity and financial difficulties on mental health in the EU. Support to employees facing job security issues should be a priority regardless of the financial circumstances.

http://ift.tt/2ep4S0P

Why I became an occupational physician....

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Core competencies for UK occupational health nurses: a Delphi study

Background

Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice.

Aims

To identify current priorities among UK OHNs of the competencies required for OH practice.

Methods

A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions.

Results

Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. ‘Good clinical care’ was the principal domain ranked most important, followed by ‘general principles of assessment & management of occupational hazards to health’. ‘Research methods’ and ‘teaching & educational supervision’ were considered least important.

Conclusions

This study has established UK OHNs’ current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty’s goals for standard setting in OHN education and training.

http://ift.tt/2ep3wTY

The Stockholm Workshop Scale 30 years on--Is it still fit for purpose?

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Transformed occupational prospects for HIV-associated brain syndromes

Abstract We report a case of a full-time worker with late undiagnosed HIV disease presenting as encephalopathy with motor features and a manic-like picture. HIV encephalopathy was a terminal condition before the advent of combination highly active anti-retroviral therapy (HAART). Treatment with HAART, with follow-up in a neuropsychiatric service and rehabilitation involving the occupational health department of his employer, produced a successful return to work. This case demonstrates a remarkable transformation in occupational and other outcomes of HIV-related brain disease in the era of HAART.

http://ift.tt/2ep2wiA

Adam and Eve at their Labours. Genesis mosaics Cathedral of the Assumption Monreale, Sicily c. 1180

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In This Issue of Occupational Medicine

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Pregnancy outcome in partners of male professional divers in Norway

Background

Diving is associated with both acute and long-term effects in several organ systems. Reduced semen quality after extreme diving and a reduced proportion of males in the offspring of divers have previously been reported.

Aims

To study pregnancy outcomes in partners of professional male divers.

Methods

The cohort of divers registered with the Norwegian Inshore Diving Registry was linked to the Medical Birth Registry of Norway (MBRN).

Results

In total, 6186 male divers had 10395 children registered in the MBRN during the study period. Of these, 52% were boys, compared to 51% in the general population. The partners of a subgroup of divers who were most likely to be occupationally exposed at the time of conception reported that early miscarriage was more frequent (27%) than in the general population (21%; relative risk 1.21, 95% confidence interval 1.05–1.39). Otherwise, there was a lower risk of adverse pregnancy outcomes such as preterm birth, stillbirth, low birthweight, small for gestational age and low Apgar score compared to the general population. Birthweight above 4000g was more frequent.

Conclusions

We observed no reduced sex ratio in the offspring of occupational divers. Except for an increase in self-reported early miscarriage in the partners of exposed divers, we observed no excess risk of any of the adverse perinatal pregnancy outcomes studied.

http://ift.tt/2dVPl5b

Patient and physician views of accompanied consultations in occupational health

Background

Accompanied (triadic) consultations, or consultations where a third person is present, are poorly researched and little research has been carried out in an occupational health (OH) setting.

Aims

To elicit the views of patients and OH physicians about accompanied consultations.

Methods

OH receptionists gave a self-administered questionnaire to patients after they attended OH consultations with a companion. We interviewed participating OH physicians to ascertain their views on accompanied consultations.

Results

Twenty-six patient questionnaires were completed (response rate 52%). Seventy-three per cent (19) of responders were accompanied by a spouse and 12% (3) by non-family members. Patients reported their companion was helpful with recall of information (100%), supportive (100%), provided extra information to the physician (81%) and enabled them to discuss the outcome afterwards (92%). In two consultations, the companion attended to provide support on procedural matters. Patients were not concerned that the consultation might involve sensitive discussion or physical examination. OH physicians reported concerns that the companion would make the consultation more difficult or influence its outcome. They felt that written information, guidelines and training in how to manage accompanied consultations would be useful.

Conclusions

Patients who attended OH consultations with a companion felt the companion was beneficial to the consultation and did not have concerns about personal issues. OH physicians felt that further guidance and training on accompanied consultations would be useful. Written information could usefully be provided to patients attending an OH consultation with a companion.

http://ift.tt/2ep4RKj

Lifetime impact of injury on education, employment and income for Australians of labour force participation age

Background

Research shows that employment rates are low post injury.

Aims

To quantify the economic impact of a long-term injury and identify whether having a tertiary level of education attainment would offset this impact.

Methods

Cross-sectional analysis of the 2012 Survey of Disability, Aging and Carers, which is nationally representative of the Australian population.

Results

Males with any long-term injury had incomes 41% less than males with no chronic health condition (95% confidence interval [CI] –49.3%, –31.6%). For males with a long-term injury, there was no significant difference in the likelihood of being not in the labour force between those with and without a tertiary qualification (odds ratio [OR] 0.83, 95% CI 0.45–1.52). There was no significant difference in the incomes of females with any long-term injury compared with those with no chronic health conditions. For females with a long-term injury, there was a significant difference in the likelihood of being not in the labour force between those with and without a tertiary qualification (OR 0.37, 95% CI 0.17–0.80). If men with a long-term injury had the same probability of participating in the workforce as women, the percentage of men not in the labour force would reduce from 37 to 18%.

Conclusions

Having a long-term injury was a significant personal cost in terms of labour force absence and lower income for males regardless of higher education attainment. For females, sustaining a long-term injury did not appear to significantly affect income.

http://ift.tt/2dVPMMT

Supervised learning events: direct observation of procedural skills pilot

Background

Workplace-based assessment (WBA) is the assessment of specialist competence based on what a trainee doctor actually does in the workplace. Between January 2014 and January 2015, all UK occupational medicine (OM) trainees were invited to test a suite of direct observation of procedural skills (DOPS) tools designed in a supervised learning event (SLE) format. The Faculty of Occupational Medicine (FOM) Workplace-Based Assessment Advisory Group (WBAAG) studied feedback on the new format.

Aims

To assess the utility of the redesigned tools, including their acceptability, feasibility, usability and key aspects of their reliability and validity.

Methods

The face and content validity of the new forms were assessed by a comprehension trial (CT), inter-rater reliability by a video scoring exercise and usability and acceptability by an electronic survey of trainees and trainers.

Results

The CT of trainees and trainers indicated that the face and content validity of the revised tools were acceptable. Inter-rater reliability video assessments indicated there was consistency of grading among trainers. Sixty-eight per cent of trainees and 95% of trainers agreed that the redesigned tools were an improvement on the current WBA DOPS tools and 83% of trainees indicated the new tools encouraged them to reflect on their performance.

Conclusions

The results from this pilot study provided evidence to support a request to the General Medical Council (GMC) for the new SLE-DOPS forms to be used for WBA in OM. These changes were accepted by the GMC in January 2016 for implementation in April 2016.

http://ift.tt/2ep0dw6

Systematic review: risk factors for musculoskeletal disorders in musicians

Background

Although many musicians suffer from musculoskeletal disorders, aetiological factors are unclear.

Aims

To systematically search for and synthesize the best available evidence on risk factors for musculoskeletal disorders in musicians.

Methods

A database search was performed in PubMed, EMBASE, CINAHL, Pedro, OTseeker and Psychinfo. A manual search was conducted in the journals Medical Problems of Performing Artists and Psychology of Music. Studies with an objective to investigate determinants associated with playing-related musculoskeletal disorders were included. Papers were selected based on adequacy of statistical methods for the purpose of the study. Search, first screening and selection were performed by one author. Two reviewers independently performed the final selection using full-text reports. Methodological quality assessment was performed by two reviewers independently.

Results

One case–control and 14 cross-sectional studies were included. Methodological quality was in general low. Large heterogeneity existed in study design, population, measurement of determinant and outcome and analysis techniques. Data were presented descriptively. Consistent results were found indicating that previous musculoskeletal injury, music performance anxiety, high levels of stress and being a female playing a stringed instrument seemed to be associated with more musculoskeletal disorders. Influence over or support at work, orchestra category/status, exercise behaviour and cigarette smoking seemed to be unrelated with musculoskeletal disorders. No conclusions could be made on causality, as the current data only represent cross-sectional associations.

Conclusions

Because of lack of prospective studies, no causal relations could be identified in the aetiology of (playing-related) musculoskeletal disorders in instrumental musicians.

http://ift.tt/2dVR0I0

Poor sleep after military deployment: associations with mental health difficulties

Background

Sleep difficulties, alcohol use and mental illness are often related; military studies suggest that post-deployment is a high-risk period for sleep problems.

Aims

To examine the prevalence of post-deployment sleep difficulties in UK Armed Forces (UKAF) personnel and associations with alcohol use disorders (AUD) and any mental disorder (AMD) symptoms.

Methods

A prospective, self-report, observational study of UKAF members returning from Afghanistan, questionnaire data were collected immediately following and 6 months post-deployment.

Results

A total of 1636 participants provided study data at both time points. Twenty-three per cent of personnel reported sleep difficulties at follow-up; 11% reported sleep-related interference with daily functioning. Sleep problems were significantly associated with AUD and AMD. Initial post-deployment sleep problems were predictive of AMD but not AUD at follow-up.

Conclusions

The disclosure of alcohol misuse and mental ill-health in UKAF personnel is often inhibited by stigmatizing beliefs; detection could be enhanced by inquiring about sleep problems which may be less stigmatizing than direct enquiries about alcohol misuse and psychological well-being.

http://ift.tt/2ep13c6

Effectiveness of educational materials to prevent occupational low back pain

Background

Low back pain (LBP) in association with occupation is well documented. A subpopulation of workers can be defined as ‘non-heavy’ manual workers with either light or sedentary roles who may be at risk of LBP due to insufficient physical activity. Educational materials are a potential intervention, which are cost-effective and easily targeted at this population.

Aims

To investigate the evidence for using information material among ‘non-heavy’ manual workers and the effect on their sickness absence.

Methods

A search investigating the effect of educational material on LBP in non-heavy manual workers. Electronic databases were searched and selected references were reviewed. Specific key terms were used including: ‘worker’, ‘non-heavy manual’, ‘booklet’, ‘leaflet’, ‘advice’, ‘sickness’, ‘absenteeism’, ‘prevention’ and ‘low back pain’. Methodological quality was assessed by predefined criteria.

Results

Four studies were identified: one guideline review, one prospective study and two randomized controlled trials. Methodological quality was deemed moderate to high. There was insufficient evidence to show written education altered sickness absence. There was evidence that information given to workers can help change attitudes and beliefs about LBP.

Conclusions

Educational materials alone do not appear to reduce sickness absence for LBP in the ‘non-heavy’ manual working population. However, they can facilitate behavioural change and modify health beliefs and attitudes. Educational materials may be a useful medium to engage workers, provide information regarding practical modifications to their work environment and activities and potentially reduce psychological distress regarding ill-health at work.

http://ift.tt/2dVQh9S

Job stress and needlestick injuries: which targets for organizational interventions?

Background

Needlestick injuries (NSIs) represent a major concern for the safety of health care workers involved in clinical care. The percentage of health workers reporting these injuries varies between 9 and 38% and the occurrence of NSI is most frequent among employees having close clinical contact with patients or patient specimens. These injuries appear to occur most frequently where organizational factors contribute to the risk.

Aims

To investigate the interactions between organizational level interventions focused on work-related stress (WRS) and the occurrence of NSIs among nurses employed in hospital departments, and to determine the impact of such interventions on the safety budget.

Methods

Comparison of NSI occurrence among nurses employed in hospital health care departments in two 3-year periods, before and after interventions aimed at minimizing WRS. The economic cost of NSIs occurrence was calculated.

Results

The study group consisted of 765 nurses. The cumulative 3-year incidence of NSIs after the implementation of management stress interventions was significantly lower than the cumulative 3-year incidence observed before implementation (OR 0.60; 95% CI 0.43–0.83). A cost saving from managing fewer NSIs than during the first study period was found.

Conclusions

This study found a reduction in NSI occurrence and associated costs following an intervention to bring about proactive, integrated and comprehensive management of stress in the workplace.

http://ift.tt/2ep1jI5