Methods: A retrospective cohort mortality study followed all workers with at least one year of cumulative employment at the facility. The jobs held by cohort members were assigned to one of three exposure subgroups; high exposed, low exposed, and non-exposed, based on biological monitoring data for perfluorooctane sulphonate (PFOS).
Results: A total of 145 deaths were identified in the 2083 cohort members. Sixty five deaths occurred among workers ever employed in high exposed jobs. The overall mortality rates for the cohort and the exposure subcohorts were lower than expected in the general population. Two deaths from liver cancer were observed in the workers with at least one year of high or low exposure (standardised mortality ratio (SMR) 3.08, 95% CI 0.37 to 11.10). The risk of death from bladder cancer was increased for the entire cohort (three observed, SMR 4.81, 95% CI 0.99 to 14.06). All three bladder cancers occurred among workers who held a high exposure job (SMR 12.77, 95% CI 2.63 to 37.35). The bladder cancer cases primarily worked in non-production jobs, including maintenance and incinerator and wastewater treatment plant operations.
Conclusion: Workers employed in high exposure jobs had an increased number of deaths from bladder cancer; however it is not clear whether these three cases can be attributed to fluorochemical exposure, an unknown bladder carcinogen encountered during the course of maintenance work, and/or non-occupational exposures. With only three observed cases the possibility of a chance finding cannot be ruled out.
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下载免费PDF全文 Methods: The third national health and nutrition examination survey, 1988–1994 (NHANES III) was analyzed to determine the prevalence of work related asthma and wheezing and to identify initially defined industries at risk among United States workers aged 20 and older. Separate logistic models were developed with work related asthma and work related wheezing as outcomes. Work related asthma was defined as affirmative response to questions on self reported physician diagnosed asthma and work related symptoms of rhinitis, conjunctivitis, and asthma. Work related wheezing was defined as affirmative response to questions on self reported wheezing or whistling in the chest in the previous 12 months and work related symptoms of rhinitis, conjunctivitis, and asthma. All analyses were adjusted for age, sex, smoking, and atopy.
Results: The prevalence of work related asthma was 3.70% (95% confidence interval (95% CI) 2.88 to 4.52) and the prevalence of work related wheezing was 11.46% (95% CI 9.87 to 13.05). The main industries identified at risk of work related asthma and wheeze included the entertainment industry; agriculture, forestry, and fishing; construction; electrical machinery; repair services; and lodging places. The population attributable risk for work related asthma was 36.5% and work related wheezing was 28.5%.
Conclusions: The findings provide impetus for further research and actions by public health professionals which prioritise occupational asthma on the public health agenda. Future intervention strategies need to be developed for effective control and prevention of asthma in the workplace.
相似文献Methods: A total of 19 943 male employees from the German construction industry who underwent occupational health examinations between 1986 and 1992 were followed up until 1999/2000.
Results: A total of 818 deaths occurred during the 10 year follow up (SMR 0.71; 95% CI 0.66 to 0.76). Among those were 299 deaths due to cancer (SMR 0.89; 95% CI 0.79 to 1.00) and 312 deaths due to cardiovascular diseases (SMR 0.59; 95% CI 0.51 to 0.68). Increased risk of mortality was found for non-transport accidents (SMR 1.61; 95% CI 1.15 to 2.27), especially due to falls (SMR 1.87; 95% CI 1.18 to 2.92) and being struck by falling objects (SMR 1.90; 95% CI 0.88 to 3.64). Excess mortality due to non-transport accidents was highest among labourers and young and middle-aged workers. Risk of getting killed by falling objects was especially high for foreign workers (SMR 4.28; 95% CI 1.17 to 11.01) and labourers (SMR 6.01; 95% CI 1.63 to 15.29).
Conclusion: Fatal injuries due to falls and being struck by falling objects pose particular health hazards among construction workers. Further efforts are necessary to reduce the number of fatal accidents and should address young and middle-aged, semi-skilled and foreign workers, in particular. The lower than expected cancer mortality deserves careful interpretation and futher follow up of the cohort.
相似文献Methods: A longitudinal study of occupational mortality, based on official mortality files, with a population of 1 136 427 seafarer-years at risk.
Results: Of 835 traumatic work related deaths, 564 were caused by accidents, 55 by suicide, 17 by homicide, and 14 by drug or alcohol poisoning. The circumstances in which the other 185 deaths occurred, including 178 seafarers who disappeared at sea or were found drowned, were undetermined. The mortality rate for 530 fatal accidents that occurred at the workplace from 1976 to 2002, 46.6 per 100 000 seafarer-years, was 27.8 times higher than in the general workforce in Great Britain during the same time period. The fatal accident rate declined sharply since the 1970s, but the relative risk of a fatal accident was 16.0 in 1996–2002. There was no reduction in the suicide rate, which was comparable to that in most high risk occupations in Britain, from 1976 to 1995; but a decline since 1995.
Conclusions: Although there was a large decline in the fatal accident rate in British shipping, compared to the general workforce, seafaring has remained a hazardous occupation. Further prevention should focus on improvements in safety awareness among seafarers and shipping companies, reductions in hazardous working practices, and improvements in care for seafarers at risk of suicide.
相似文献Methods: Workers' compensation records were used to examine work related injuries among adolescents (15–19 years old), young adults (20–24 years old), and adults (25+ years old) between 1993 and 2000. The incidence of compensated injuries was calculated for each age group and compared by gender, industry, and type of injury. The presence and degree of permanent impairment in each age group was also examined.
Results: For males, adolescents and young adults had higher claim rates than adults. For females, adults had the highest claim rates and young adults the lowest. Rates of permanent impairment indicated that age was positively associated with severity of injury.
Conclusions: Indicators of health consequences, in particular presence of permanent impairment, provide preliminary evidence that compensated work injuries sustained by youth are not as serious as injuries sustained by adults. Nevertheless, there was evidence that some young workers sustain injuries that have long term consequences. Documenting the consequences of the injuries that young workers sustain has implications for secondary prevention efforts and health services policy.
相似文献Methods: A retrospective study, based on official mortality files, with a population of 440 355 fishermen-years at risk.
Results: Of 616 deaths in British fishing, 454 (74%) were due to accidents at work, and 394 (87%) of these fishermen drowned. A total of 270 accidents were caused by casualties to vessels and 184 by personal accidents. There was no significant decline in the fatal accident rate, 103.1 per 100 000 fishermen-years, between 1976 and 1995. The fatal accident rate was 52.4 times higher (95% CI 42.9 to 63.8) than for all workers in Great Britain during the same period, and this relative risk increased through the 1980s up to 76.6 during 1991–95. Relative risks with the construction (12.3) and manufacturing (46.0) industries were higher than 5 and 20 respectively, during 1959–68. Trawlers foundering in adverse weather was the most frequent cause of mortality from casualties to vessels (115 deaths), and 82 of 145 personal accidents at sea arose during operations involving trawling nets.
Conclusions: When compared with shore based industries, fishing remains at least as hazardous as before. Prevention should be aimed, most importantly, at the unnecessary operation of small vessels and trawling net manoeuvres in hazardous weather and sea conditions. Other measures should focus on preventing falls overboard, reducing fatigue, a more widespread use of personal flotation devices, and improvements in weather forecast evaluation.
相似文献Methods: Complaints and symptoms related to the indoor environment experienced by office workers were collected from 122 workplaces in 1996–99 by using the modified Indoor Air Questionnaire established by the Finnish Institute of Occupational Health. Altogether 11 154 employees took part in the survey.
Results: The most common problems were dry air (35% of the respondents), stuffy air (34%), dust or dirt in the indoor environment (25%), and draught (22%). The most common work related symptoms were irritated, stuffy, or runny nose (20%), itching, burning, or irritation of the eyes (17%), and fatigue (16%). Women reported indoor air problems and work related symptoms more often than men. Allergic persons and smokers reported indoor air problems more often, and experienced work related symptoms more often than non-allergic persons and non-smokers.
Conclusions: The complaints and work related symptoms associated with indoor air problems were common in office workers. The present questionnaire is a suitable tool for the occupational health personnel in investigating indoor air problems and the data of the survey can be used as a reference when the results of a survey at work are being analysed.
相似文献 下载免费PDF全文 Results: The cumulative number of mesotheliomas up to 2000 was 235 in men (202 pleural, 33 peritoneal) and seven (all pleural) in women. There had been 231 deaths with mesothelioma (9% of known deaths).
Conclusions: The number of deaths in men with mesothelioma between 1987 and 2000 was at the low end of the predictions made earlier based on the number of cases to 1986. If this trend continues, it is predicted that about another 110 deaths with mesothelioma will occur in men by 2020.
相似文献 下载免费PDF全文 Methods: Respiratory health in 429 Chinese cotton textile workers (study group) and 449 silk textile workers (control group) was followed prospectively from 1981 to 1996. Byssinosis, chest tightness, and non-specific respiratory symptoms were assessed by means of identical standardised questionnaires at four time points. Exposures to cotton dust and endotoxin were estimated using area samples collected at each survey. Incidence and persistence of symptoms were examined in relation to cumulative exposure and exposure cessation using generalised estimating equations (GEE).
Results: Among cotton workers, the cumulative incidence of byssinosis and chest tightness was 24% and 23%, respectively, and was significantly more common in smokers than in non-smokers. A high proportion of symptoms was found to be intermittent, rather than persistent. Among silk workers, no typical byssinosis was identified; the incidence of chest tightness was 10%. Chronic bronchitis, cough, and dyspnoea were more common and persistent in the cotton group than in the silk group. Significantly lower odds ratios for symptoms were observed in cotton workers who left the cotton mills; risk was also related to years since last worked. Multivariate analysis indicated a trend for higher cumulative exposure to endotoxin in relation to a higher risk for byssinosis.
Conclusion: Chronic exposure to cotton dust is related to both work specific and non-specific respiratory symptoms. Byssinosis is more strongly associated with exposure to endotoxin than to dust. Cessation of exposure may improve the respiratory health of cotton textile workers; the improvement appears to increase with time since last exposure.
相似文献Methods: All municipalities in Sweden were contacted and asked to provide addresses of sewage workers and controls. Controls were recruited among other municipal workers not exposed to sewage, such as workers in drinking water plants and gardeners. A questionnaire was sent to the subjects and after two reminders, the response rate was 74% among sewage workers and 59% among controls.
Results: Significantly increased risks for airway symptoms, chronic bronchitis, and toxic pneumonitis, as well as central nervous system symptoms such as headache, unusual tiredness, and concentration difficulties were found among the sewage workers compared with controls. Furthermore, an increased risk for non-specific work related gastrointestinal symptoms was found among the sewage workers; an increased risk for joint pains, related to pains in more than four joints but not with loading, was also found.
Conclusions: The results of this questionnaire survey show an increased risk for airway, gastrointestinal, and general symptoms such as joint pains and central nervous system symptoms among sewage workers. Clinical investigations are needed to determine the cause of the reported symptoms among sewage workers, and further field studies are required to assess the causal agents.
相似文献Methods: Vital status was updated through 1998, and life table analyses were conducted.
Results: Mortality from all causes (2206 deaths, standardised mortality ratio (SMR) 0.92, 95% CI 0.88 to 0.96) and all cancers (SMR 0.89, 95% CI 0.82 to 0.97) was less than expected based on US mortality rates. A non-significant increase in mortality from myeloid leukaemia (15 deaths, SMR 1.44, 95% CI 0.80 to 2.37) was observed. Mortality from myeloid leukaemia was greatest among workers first exposed in the earliest years when exposures were presumably higher, among workers with 10 or more years of exposure, and among workers with 20 or more years since first exposure. No nasal or nasopharyngeal cancers were observed. Mortality from trachea, bronchus, and lung cancer (147 deaths, SMR 0.98, 95% CI 0.82 to 1.15) was not increased. Multiple cause mortality from leukaemia was increased almost twofold among workers with both 10 or more years of exposure and 20 years or more since first exposure (15 deaths, SMR 1.92, 95% CI 1.08 to 3.17). Multiple cause mortality from myeloid leukaemia among this group of workers was also significantly increased (8 deaths, SMR 2.55, 95% CI 1.10 to 5.03).
Conclusions: Results support a possible relation between formaldehyde exposure and myeloid leukaemia mortality. Previous epidemiological studies supporting a relation between formaldehyde exposure and leukaemia mortality have been primarily of formaldehyde exposed professional groups, not formaldehyde exposed industrial workers. Limitations include limited power to detect an excess for rare cancers such as nasal and nasopharyngeal cancers and lack of individual exposure estimates.
相似文献Methods: A total of 30 074 workers participated in the survey. They were asked to provide information on their job, including the time spent on repeated strenuous physical activities (RSPA) and the time spent on repeated bending, twisting, or reaching (RBTR) on a typical job. A case of back pain was defined as a worker who had back pain every day for a week or more during the past 12 months. Each case was asked to report the cause of back pain. Those who attributed their back pain to repeated activities (RA) or a single accident or injury (AI) were asked to recall whether they performed RA or had the AI at work.
Results: Whereas the prevalence of back pain increased as the number of working hours spent on RSPA or RBTR increased, the dose–response relations were not linear for either factor, suggesting the involvement of other unmeasured factors. The estimated overall prevalence of RA back pain was 8.9% among male workers and 5.9% among female workers. "Carpenters" had the highest prevalence (19.2%) and most cases (338 000) among the major occupations of men, and "nursing aides, orderlies, and attendants" had the highest prevalence (15.2%) and most cases (217 000) among the major occupations of women.
Conclusions: The number of hours spent on repeated activities at work was associated with the prevalence of back pain. This study identified high risk occupations for future research and intervention.
相似文献There was a 77% excess of deaths from these cancers in male textile workers as a whole compared with the male population of England and Wales, the excess being significant at the 0·1% level. An excess occurred in each of the three sites tongue (ICD 141), mouth (ICD 143, 144), and pharynx (ICD 145-148) and is significant at the 5% level in the first two sites but not in the third.
Fibre preparers had an excess of 330% which is significant at the 0·01% level. Weavers and knitters had a deficit of 32% and the remaining three groups had moderate excesses of from 32 to 85%, none of the four being statistically significant.
In the 1951 census there were 8 414 male cotton workers and 14 723 male wool workers engaged in fibre preparing. There was one death from oral cancer in cotton fibre preparers and 18 deaths in wool fibre preparers. The difference is significant at the 1% level. The difference is also significant for the individual sites pharynx and tongue but not mouth.
相似文献 下载免费PDF全文 Aims: To determine excess risk from lung cancer, mesothelioma, and all-cause mortality in a cohort of men exposed to tremolite, but no other form of asbestos.
Methods: Mortality by certified cause and various measures of exposure to tremolite and related amphibole fibres was assessed in a cohort of 406 vermiculite mineworkers in Libby, Montana, employed before 1963 and followed until 1999.
Results: Total deaths were: lung cancer 44 (SMR 2.40), non-malignant respiratory disease (NMRD) 51 (SMR 3.09), all causes 285 (SMR 1.27); included among the total were 12 deaths ascribed to mesothelioma (4.21% of all deaths). Adjusted linear increments in relative risks (per 100 f/ml.y), estimated by Poisson regression, were: lung cancer (0.36, 95% CI 0.03 to 1.20), NMRD (0.38, 95% CI 0.12 to 0.96), and all deaths (0.14, 95% CI 0.05 to 0.26).
Conclusions: The all-cause linear model would imply a 14% increase in mortality for mine workers exposed occupationally to 100 f/ml.y or about 3.2% for a general population exposed for 50 years to an ambient concentration of 0.1 f/ml. Amphibole fibres, tremolite in particular, are likely to be disproportionately responsible for cancer mortality in persons exposed to commercial chrysotile, but to what extent cannot be readily assessed.
相似文献There was an excess of deaths from cancer of the lung and bronchus (I.C.D. 162, 163) in printing trade workers as a whole compared with the male population of the region in which they worked, adjusted for age and calendar year of death. The excess was about 30% in London and about 40% in Manchester. Both these excesses are significant at the 1% level. In Manchester, but not in London, there was a concentration of excess (about 100%) in machine room men, again significant at the 1% level. White collar workers showed no difference between observed and expected deaths in London and only a small excess (20%, not significant at the 5% level) in Manchester.
There were small deficits of deaths from bronchitis (I.C.D. 500 to 502), about 10% for printing trade workers, and 30 to 40% for white collar workers, with little difference between London and Manchester. Neither deficit is significant at the 5% level because of the small numbers involved.
This survey does not provide any evidence about the cause of the overall small excess of deaths from lung cancer, which might or might not be occupational. The larger excess in the Manchester machine room men is more likely to be due to an occupational hazard.
相似文献Methods: Two year prospective study of newly employed workers from 12 diverse occupational settings. At baseline, 1081 subjects provided information on work related mechanical and psychosocial risk factors, and current pain status.
Results: In all, 803 (74%) subjects were free from shoulder pain at baseline. Of those, 638 (79%) responded at 12 months and 476 (88%) at 24 months. New onset shoulder pain was reported by 93 (15%) and 73 (15%) subjects respectively. An increased risk of symptom onset was found in subjects reporting mechanical exposures involving heavy weights including lifting with one or two hands, carrying on one shoulder, lifting at or above shoulder level, and pushing or pulling. Working with hands above shoulder level was also predictive of new onset shoulder pain. Of the psychosocial factors examined, the strongest predictor was monotonous work. Those individuals with any other previous pain also had an increased risk of new onset shoulder pain at follow up. In multivariate analysis, lifting heavy weights with one or two hands, pushing or pulling heavy weights, working with hands above shoulder level, and monotonous work were independently associated with new onset shoulder pain.
Conclusions: This study supports the hypothesised relation between mechanical risk factors and shoulder pain. In general, work related psychosocial factors were modestly associated with new onset shoulder pain. However, monotonous work was a strong risk factor for new onset shoulder pain.
相似文献Aims: To evaluate the influence of age at exposure on radiation risk estimates in an updated follow up of Hanford workers.
Methods: A cohort of 26 389 workers hired between 1944 and 1978 was followed through 1994 to ascertain vital status and causes of death. External radiation dose estimates were derived from personal dosimeters. Poisson regression was used to estimate associations between mortality and cumulative external radiation dose at all ages, and in specific age ranges.
Results: A total of 8153 deaths were identified, 2265 of which included cancer as an underlying or contributory cause. Estimates of the excess relative risk per Sievert (ERR/Sv) for cumulative radiation doses at all ages combined were negative for all cause and leukaemia and positive for all cancer and lung cancer. Cumulative doses accrued at ages below 35, 35–44, and 45–54 showed little association with mortality. For cumulative dose accrued at ages 55 and above (10 year lag), the estimated ERR/Sv for all cancers was 3.24 (90% CI: 0.80 to 6.17), primarily due to an association with lung cancer (ERR/Sv: 9.05, 90% CI: 2.96 to 17.92).
Conclusions: Associations between radiation and cancer mortality in this cohort are primarily a function of doses at older ages and deaths from lung cancer. The association of older age radiation exposures and cancer mortality is similar to observations from several other occupational studies.
相似文献Aim: To determine whether occupational exposures received in a modern nickel carbonyl refinery lead to increased risks of cancer, in particular nasal cancer and lung cancer.
Methods: The mortality experienced by a cohort of 812 workers employed at a nickel refinery was investigated. Study subjects were all male workforce employees first employed in the period 1953–92 who had at least five years' employment with the company. Observed numbers of cause specific deaths were compared with expectations based on national mortality rates; SMRs were also calculated by period from commencing employment, year of commencing employment, and type of work.
Results: Overall, standardised mortality ratios (SMRs) were close to 100 for all causes (Obs 191, SMR 96, 95% CI 83 to 111), all neoplasms (Obs 63, SMR 104, 95% CI 80 to 133), non-malignant diseases of the respiratory system (Obs 18, SMR 97, 95% CI 57 to 153), and diseases of the circulatory system (Obs 85, SMR 94, 95% CI 75 to 116). There were no significantly increased SMRs for any site of cancer. There was a non-significant excess for lung cancer (Obs 28, Exp 20.17, SMR 139, 95% CI 92 to 201), and in subgroup analyses a significantly increased SMR of 231 (Obs 9) was found for those 142 workers with at least five years' employment in the feed handling and nickel extraction departments. In the total cohort there was a single death from nasal cancer (Exp 0.10).
Conclusions: The non-significant excess of lung cancer deaths may well be a chance finding, but in light of previous studies some role for nickel exposures cannot be excluded.
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