Occupational risk factors for work-related disorders in greenhouse workers

Aim This study reviews the evidence on the association between working in greenhouses and the occurrence of muscelosckeletal, reproductive and respiratory disorders, dermal effects, cancer and neurobehavioral effects. Subjects and methods PUBMED, MEDLINE and EBSCO literature bases were searched to identify epidemiological studies conducted over 1996–2006 that focused on the health outcomes of greenhouse workers. Three exclusion criteria were used to limit the selection to studies with quantitative assessment of the association between work-related risk factors and health disorders: lack of data on work-related risk factors, lack of a suitable risk estimate for work-related risk factors or of sufficient information that allowed calculation of a risk estimate and serious methodological concerns in relation to the purpose of this review (strong selection bias, very low response rate, recall bias). Results The analysis indicates that greenhouse exposure is associated with an increased risk of respiratory disorders, sensitization to allergens and skin reactions. Exposure to dust, bacteria, allergens, fungi and gases may cause or exacerbate asthma, asthma-like syndrome, mucous membrane irritation, chronic bronchitis and dermatitis. The results of the review showed that male workers employed in greenhouse horticulture for more than 10 years had a decreased median sperm concentration. The data on the effect of working in greenhouses on the time to pregnancy are unequivocal, but most of them indicate a relationship between a decreased fecundability ratio and greenhouse work, this referring mostly to pesticide exposure. There are also some indications that greenhouse work may contribute to musculoskeletal and neurobehavioral disorders, but only a few epidemiological studies have corroborated these findings. Some studies present evidence for the carcinogenicity of the pesticides used in greenhouses. Conclusion The results of this literature review imply a necessity to increase an awareness of the possible adverse health effects among greenhouse workers occupationally exposed to pesticides, biological agents or other factors of their specific work environment. On behalf of the DIRERAF partners: 1. Department of Hygiene and Epidemiology, Medical School University of Athens a. Associate Professor Athena Linos M.D., M.P.H., F.A.C.E b. Mr. Christos Chatzis M.D. c. Mr. Dimitrios Zikos RN d. Dimitrios Kouimintzis M.D. e. Euagelia Hronopoulou M.D. 2. Institute of Preventive Medicine, Environmental and Occupational Health a. Ioanna Kotsioni BA, MSc b. Eirini Papageorgiou BA, MSc 3. Nofer Institute of Occupational Medicine, Lodz 4. International Centre for Pesticides and Health Risk Prevention 5. Institut Municipal d’Investigacio Medical 6. Erasmus University, Rotterdam 7. Dresden University of Technology 8. Charles University of Prague 9. Finnish Institute of Occupational Health 10. Medical University of Sofia 11. Institute of Rural Health, Bratislava Review J. Jurewicz, D. Kouimintzis, A. Burdorf, W. Hanke, C. Chatzis, A. Linos     

Occupational risk factors for radial tunnel syndrome in industrial workers

OBJECTIVES: The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. CONCLUSIONS: The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination.     

Occupational (and non-occupational) risk factors for musculoskeletal disorders

BACKGROUND: Musculoskeletal disorders are an important cause of disability and absence from work in industrialized countries. A number of studies reported the importance of occupational, personal and psycho-social factors in the aetiology of these work-related disorders. OBJECTIVES AND METHODS: To stress the complex relationships existing between risk factors, reporting findings from reviews and original studies regarding two of the most significant musculoskeletal disorders: carpal tunnel syndrome (CTS) and low back pain (LBP). CONCLUSIONS: More detailed epidemiological studies are needed to explore the interactions between risk (and protective) factors, since these can play the role of determinants, confounders or effect modifiers.     

Strenuous working conditions and musculo-skeletal disorders among female hospital workers

The relations between working conditions and various aspects of health among female hospital workers were studied in 26 departments of large hospitals in the Paris area in 1986; 90% of the workers of these departments filled in a questionnaire about their working conditions, sociodemographic characteristics and health in the previous 12 months and attended a medical examination. The study sample included 1505 women. The main cause of sick leave was musculoskeletal disorders and affected 16% of the women. Back pain was described by 47% of the women, and treatment for musculo-skeletal disorders by 28%. Three working conditions were considered to characterize the posture at work: standing more than six hours a day, bending over more than ten times per hour, and maintaining an uncomfortable posture. A cumulative posture index was constructed by adding for each worker the number of the working conditions to which she had been exposed. A cumulative lifting index was constructed in a similar way from the four following characteristics: lifting weights of more than 15 kg, lifting patients more than ten times a day, making beds normally or often, and pushing beds or trolleys more than ten minutes a day. A mixed index was then constructed associating the two previous ones. The relations between these indexes and musculoskeletal disorders (MSD) were studied after adjustment for potential confounders such as age, obesity, number of children, travel duration, sport practice, occupational level, number of years in the occupation, previous attack of back pain, and mental health (assessed by the score to the general health questionnaire). The logistic regressions of MSD indicators on the mixed index and other risk factors showed that MSD was about twice as frequent among women with a maximal load in posture and/or in lifting than among women with no more than one medium index (tiring posture or lifting). These facts support the necessity for improvement of the work load in hospitals.     

Occupational and individual factors in acute shoulder-neck disorders among industrial workers.

Twenty workers, consecutively attending the industrial health care centre for the first time with acute shoulder-neck pains, were subject to extensive rheumatological and ergonomic examinations. In seven patients congenital malformations for diseases causing musculoskeletal symptoms, or both, were probable aetiological factors. In the remaining 13 patients a significantly higher load was found on both shoulders (assessed by biomechanical film analysis) than in matched control. Age, anthropometric measures, muscle strength, or HLAB27 did not appear as significant predisposing factors. Most patients could return to work within a year.     

汽车制造工人颈部职业性肌肉骨骼疾患及危险因素探讨

目的调查汽车制造工人职业性肌肉骨骼疾患(WMSDs)发病情况,探讨其颈部WMSDs的危险因素。方法采用整群抽样方法,选择广州市1家汽车整车及1家零部件生产企业共8 356名作业人员为研究对象,采用《北欧肌肉骨骼疾患问卷(修改版)》(NMQ)调查WMSDs患病情况,多因素Logistic回归分析颈部WMSDs影响因素,并对危险因素接触情况进行调查分析。结果研究对象WMSDs年患病率为44.6%,其中颈部WMSDs患病率为25.4%(2 126/8 356),以发动机生产及总装岗位作业工人的颈部WMSDs较高,年患病率分别为30.6%、26.3%。多因素Logistic回归分析结果显示,颈部WMSDs的主要危险因素包括年龄、工龄、以不舒服的姿势工作、每天从事同样的工作、涉及到寒冷凉风或气温变化、经常加班、腰背部经常重复同一动作、颈部前倾或后仰、颈部长时间保持同一姿势。调查发现,84.9%的研究对象每天从事同样的工作,总装岗位最高(89.0%);83.5%的作业工人经常加班;81.6%的作业工人工作中颈部前倾或后仰,以发动机生产岗位最为突出(87.5%)。结论汽车制造作业人员WMSDs患病率...     

Occupational risk factors associated with voice disorders among teachers

PURPOSE: This study was designed to determine the occupational risk factors associated with voice disorders among schoolteachers, a high-risk population for developing voice problems. METHODS: Telephone interviews were completed by 1243 teachers from Utah and Iowa. Response rates were 98% and 95%, respectively. Bivariate analyses were computed and assessed using chi-square test and Cochran-Mantel-Haenszel test, and logistic regression analyses were performed and resulting odds ratios assessed using 95% confidence intervals. RESULTS: Teachers of vocal music, drama, other performing arts and chemistry were at significantly greater risk of having a voice disorder (OR=2.2, 95% CI: 1.2-4.0; OR=2.1, 95% CI: 0.9-4.8; OR=1.6, 95% CI: 1.0-2.4; OR=2.0, 95% CI: 1.1-3.4), while teachers of special and vocational education had a significantly lower risk (OR=0.5, 95% CI: 0.3-0.7; OR=0.6, 95% CI: 0.4-0.9). When adjusted for the intensity of vocalization, only teachers of chemistry were significantly at risk (OR=2.0, 95% CI: 1.1-3.5) while teachers of special education continued to have less of a risk (OR=0.5, 95% CI: 0.4-0.8). Chronic voice disorders were more prevalent among teachers of vocal music (OR=4.1, 95% CI: 2.2-7.9) and less prevalent among teachers of vocational education (OR=0.29, 95% CI: 0.09-0.95). CONCLUSIONS: These findings suggest that teachers of specific courses are at greater risk of developing a voice disorder.     

某煤矿工人肌肉骨骼损伤情况及其危险因素

目的 了解我国煤矿工人肌肉骨骼损伤的流行病学特征,探讨职业和个体相关影响因素,为制定针对性预防措施和策略提供科学依据.方法 对某煤炭集团一矿区的1900名工人进行肌肉骨骼损伤的横断面调查,应用北欧肌肉骨骼损伤标准问卷调查评估肌肉骨骼损伤情况;采用logistic 回归分析法了解职业因素与肌肉骨骼损伤的相关性.结果 在过去的1年中,1205名煤矿工人自诉患有肌肉骨骼损伤,患病率为78.4%.尤其是腰痛最为常见,患病率高达59.5%.身体各部位肌肉骨骼损伤患病率随年龄的增长而升高,差异有统计学意义(P＜0.05).井下工人肌肉骨骼损伤患病率明显高于井上工人,其中肩、腰、膝部患病率的差异有统计学意义(P＜0.05).经logistic回归分析,重复性操作和不舒适的姿势是颈、肩部和上肢肌肉骨骼损伤的危险因素;重复性操作、搬举重物和大幅度弯腰皆与腰背痛有很强相关性.下肢疼痛与长期的站立和不舒适姿势有关.结论 煤矿工人的职业因素与肌肉骨骼损伤具有很强的相关性.

Abstract：

Objective To explore the prevalence characteristics and influence factors related to occupation and individuals for musculoskeletal disorders of workers in Chinese mines. Methods In a crosssectional study of 1900 coal miners from a coal mine, the Standardized Nordic Questionnaire was used to assess the musculoskeletal disorders, and logistic regression analysis was performed to analyze the correlation between the occupational factor and he musculoskeletal disorders. Results During the past year, 1205 miners of 1537 miners (78.4%) complained of the musculoskeletal disorders. The morbidity of lumbago was 59.5%. The morbidity of the musculoskeletal disorders in different body sites of the miners increased significantly with age (P＜0.05). The morbidity of the musculoskeletal disorders in the underground workers was significantly higher than that in the ground workers. According to logistic regression analysis, the repetitive operation and awkward posture were the risk factors for the musculoskeletal disorders in neck,shoulder and upper limbs; the repetitive operation, moving heavy substance and stooping posture were related significantly to lumbago; the musculoskeletal disorders in lower limbs were associated with the long standing and awkward posture. Conclusion There is significant correlation between the occupational factors and the musculoskeletal disorders for coal miners.     

Occupational risk factors for pancreatic cancer among female textile workers in Shanghai, China

ObjectivesTo investigate whether occupational exposures to dusts and chemicals in the Shanghai textile industry are associated with risk of pancreatic cancer.MethodsA case cohort study nested in a cohort of 267 400 female textile workers in Shanghai, China was conducted among 180 incident pancreatic cancer cases and an age stratified randomly selected comparison subcohort (n = 3188). A complete occupational history of work in the textile industry was obtained for each woman, and was linked to a job exposure matrix developed for the textile industry to estimate exposures to specific dusts and chemicals. Cumulative exposures to cotton dust and endotoxin were reconstructed from historical and contemporaneous measurements.ResultsAfter adjusting for smoking status, a trend of decreasing risk of pancreatic cancer was observed for increasing cumulative exposures to cotton dust and endotoxin with a lag of 20 years. The hazard ratios for women cumulatively exposed to >143.4 mg/m³× years of cotton dust and >3530.6 EU/m³× years of endotoxin were 0.6 (95% CI 0.3 to 0.9) and 0.5 (95% CI 0.3 to 0.9), respectively, compared to unexposed women. There was little evidence that exposures to other textile dusts and chemicals were associated with risk of pancreatic cancer.ConclusionsOccupational exposure to cotton dust and endotoxin in the textile industry may have reduced risks of pancreatic cancer in this cohort. These associations should be replicated by others before making a firm conclusion of their possible effects on pancreatic cancer.     

Occupational risk factors for nasopharyngeal cancer among female textile workers in Shanghai, China

Aims

To investigate whether occupational exposure to dusts and chemicals in the Chinese textile industry are associated with risk of nasopharyngeal cancer.

Methods

Sixty seven nasopharyngeal carcinoma (NPC) cases identified during 1989–98 and a random sample (n = 3188) of women were included in a case cohort study nested in a cohort of 267 400 women textile workers in Shanghai, China. A complete occupational history of work in the textile industry was obtained for each woman. A job exposure matrix developed by experienced industrial hygienists was used to assess exposures to specific dusts and chemicals.

Results

Risk of NPC is associated with cumulative exposure to cotton dust. The hazard ratio for women cumulatively exposed to >143.4 mg/m³ × years of cotton dust was 3.6 (95% CI 1.8 to 7.2) compared with unexposed women. Trends of increasing risk were also found with increasing duration of exposure to acids and caustics (p = 0.05), and with years worked in dyeing processes (p = 0.06). Women who worked at least 10 years in dyeing processes had a 3.6‐fold excess risk of NPC (95% CI 1.0 to 12.1).

Conclusions

Occupational exposure to cotton dust, acids, and caustics, and work in dyeing and printing jobs in the textile industry may have increased risk of NPC in this cohort.     

Occupational risk factors for esophageal and stomach cancers among female textile workers in Shanghai, China

The authors evaluated associations between occupational exposures in the textile industry and the risks of esophageal cancer and stomach cancer. The authors conducted a case-cohort study nested in a cohort of female textile workers in Shanghai, China. One hundred and two workers with incident esophageal cancer and 646 workers with incident stomach cancer diagnosed between 1989 and 1998 were compared with an age-stratified reference subcohort (n = 3,188). Work histories were ascertained for all study subjects from factory personnel records or interviews. Exposures were reconstructed for chemicals and dusts by linking work history data with a job-exposure matrix developed for the Shanghai textile industry. Hazard ratios and 95 percent confidence intervals were calculated with Cox proportional hazards modeling adapted for the case-cohort design. Risk of esophageal cancer was associated with long-term (> or = 10 years) exposure to silica dust (hazard ratio = 15.8, 95% confidence interval: 3.5, 70.6) and metals (hazard ratio = 3.7, 95% confidence interval: 1.9, 7.1). Cumulative exposure to endotoxin, a contaminant of cotton dust, was inversely related to risks of both esophageal cancer (p-trend = 0.01) and stomach cancer (p-trend < 0.001) when exposures were lagged 20 years. Endotoxin has not been previously reported to be a protective factor for either stomach cancer or esophageal cancer and therefore warrants further study.     

Occupational risk factors for sarcoma subtypes

Herbicides, chlorophenols, and other occupational exposures are suspected risk factors for soft-tissue sarcoma, but the epidemiologic evidence is inconsistent. Given that soft-tissue sarcomas represent a heterogeneous mix of cancer subtypes and that these subtypes have different disease patterns by race, sex, and age at diagnosis, studying all soft-tissue sarcomas combined may mask subtype-specific associations. Using the Selected Cancers Study, a large population-based case-control study of sarcoma conducted among U.S. men aged 30 to 60 in 1984 to 1988, we explored the occupational risk factors for soft-tissue sarcoma subtypes and skeletal sarcoma. The analysis included 251 living sarcoma cases (48 dermatofibrosarcoma protuberans, 32 malignant fibrohistiocytic sarcoma, 67 leiomyosarcoma, 53 liposarcoma, and 51 skeletal sarcoma) and 1908 living controls. Exact conditional logistic regression models suggested patterns of subtype specificity for occupational exposures. Self-reported herbicide use was associated with malignant fibrohistiocytic sarcoma (OR = 2.9, 95% CI = 1.1-7.3). We found elevated risks for chlorophenol exposure and cutting oil exposure and malignant fibrohistiocytic sarcoma and leiomyosarcoma. We found no occupational risk factor for liposarcoma. Polytomous regression models identified different odds ratios across subtypes for plywood exposure and exposure to wood and saw dust. Although exploratory, this analysis suggests that occupational risk factors for sarcoma are not uniform across subtypes.     

Occupational risk factors for prostate cancer

BACKGROUND: Occupational risk factors for prostate cancer have been investigated with inconsistent findings. METHODS: This was a population-based case-control study of men in Northeastern Ontario, Canada. Cases (n = 760) were from the Ontario Cancer Registry, 50 to 84 years old, and diagnosed with prostate cancer between 1995 and 1998. Age-frequency matched controls (n = 1,632) were obtained from telephone listings. A questionnaire yielded information on occupational history and self-reported exposures to a list of occupational hazards. Exposures to these hazards were assessed by an occupational hygienist. RESULTS: An odds ratio estimate (OR) of 1.21 (95 percent confidence interval (% CI) 1.01, 1.46) was found for employment in trades, transport and equipment operators and related occupations, possibly related to exposure to whole-body vibration (OR = 1.38, 95% CI 1.07, 1.78). For the highest quartile of lifetime cumulative workplace physical activity an OR of 1.33 (95% CI 1.02, 1.74) was found. No statistically significant associations were found for any other occupational category or exposure. CONCLUSIONS: This study does not provide strong evidence for significant occupational risk factors for prostate cancer. However, whole-body vibration exposures, as well as physical activity, may be worth pursuing in future occupational studies.     

生物制药企业员工肌肉骨骼疾患及其危险因素研究

目的探讨生物药品制造企业员工职业性肌肉骨骼疾患(WMSDs)发生状况及可能的影响因素。方法采用流行病学横断面调查方法,选用《中文版肌肉骨骼疾患调查表》电子问卷系统对某生物制药厂部分车间286名员工近1年肌肉骨骼疾患的发生情况进行调查。结果该企业员工WMSDs的年发生率为664%,各部位肌肉骨骼疾患年发生率63%～458%,发病部位居前三位的依次是颈部(458%)、肩部(332%)和上背部(287%),下背部、手腕部、腿部、膝部和踝/足部WMSDs的发生率在不同工种之间的差异具有统计学意义(P005)。多因素Logistic回归分析显示,长时间保持低头姿势和背部弯曲分别是导致颈部和上背部WMSDs的危险因素(P005),休息时间充足和经常体育锻炼分别是预防颈部和上背部WMSDs的保护因素(P005)。结论生物制药企业员工WMSDs年发生率较高,亟需制定有针对性的干预措施,以降低WMSDs对员工健康的影响,如搬运过程中缩短手臂与身体的水平距离,调整不良作业姿势,减少重复性作业,合理安排工作时间等。