Effects of Computer-based Stress Management Training on Psychological Well-being and Work Performance in Japanese Employees: A Cluster Randomized Controlled Trial

This study evaluated the effectiveness of a computer-based stress management training (SMT) program in improving employees’ psychological well-being and work performance. A total of 12 work units (N=263) were randomly assigned to either an intervention group (8 work units, n=142) or to a wait-list control group (4 work units, n=121). All participants were requested to answer online questionnaires assessing psychological well-being as a primary outcome, and coping style, social support, and knowledge about stress management as secondary outcomes at baseline (T0), immediately after the intervention (T1), and 2 months after the intervention (T2). The group × time interaction was tested using a mixed-model repeated measures ANOVA. Results showed a group × time interaction for “knowledge about stress management” in the entire sample. Among participants who had more than 3 d of training, a significant group × time interaction was observed for “problem-solving” and “avoidance and suppression” as well as “knowledge about stress management.” Our computer-based stress management program was effective for improving knowledge about stress management. It was also effective for improving coping skills in instances where participants had enough time (at least 3 d) to complete all sessions.     

Big Data in occupational medicine: the convergence of -omics sciences,participatory research and e-health

Background:New occupational hazards and risks are emerging in our progressively globalized society, in which ageing, migration, wild urbanization and rapid economic growth have led to unprecedented biological, chemical and physical exposures, linked to novel technologies, products and duty cycles. A focus shift from worker health to worker/citizen and community health is crucial. One of the major revolutions of the last decades is the computerization and digitization of the work process, the so-called “work 4.0”, and of the workplace.Objectives:To explore the roles and implications of Big Data in the new occupational medicine settings.Methods:Comprehensive literature search.Results:Big Data are characterized by volume, variety, veracity, velocity, and value. They come both from wet-lab techniques (“molecular Big Data”) and computational infrastructures, including databases, sensors and smart devices (“computational Big Data” and “digital Big Data”).Conclusions:In the light of novel hazards and thanks to new analytical approaches, molecular and digital underpinnings become extremely important in occupational medicine. Computational and digital tools can enable us to uncover new relationships between exposures and work-related diseases; to monitor the public reaction to novel risk factors associated to occupational diseases; to identify exposure-related changes in disease natural history; and to evaluate preventive workplace practices and legislative measures adopted for workplace health and safety.Key words: work 4.0, new information and communication technologies, exposomics, occupational medicine     

Assessment of Nanoparticle Exposure in Nanosilica Handling Process: Including Characteristics of Nanoparticles Leaking from a Vacuum Cleaner

Nanosilica is one of the most widely used nanomaterials across the world. However, their assessment data on the occupational exposure to nanoparticles is insufficient. The present study performed an exposure monitoring in workplace environments where synthetic powders are prepared using fumed nanosilica. Furthermore, after it was observed during exposure monitoring that nanoparticles were emitted through leakage in a vacuum cleaner (even with a HEPA-filter installed in it), the properties of the leaked nanoparticles were also investigated. Workers were exposed to high-concentration nanosilica emitted into the air while pouring it into a container or transferring the container. The use of a vacuum cleaner with a leak (caused by an inadequate sealing) was found to be the origin of nanosilica dispersion in the indoor air. While the particle size of the nanosilica that emitted into the air (during the handling of nanosilica by a worker) was mostly over 100 nm or several microns (µm) due to the coagulation of particles, the size of nanosilica that leaked out of vacuum cleaner was almost similar to the primary size (mode diameter 11.5 nm). Analysis of area samples resulted in 20% (60% in terms of peak concentration) less than the analysis of the personals sample.     

Association of active and passive smoking with occupational injury in manual workers: a cross-sectional study of the 2011 Korean working conditions survey

This study was conducted to investigate the relationship of active and passive smoking with occupational injury among manual workers. Data from the 2011 Korean Working Conditions Survey were analyzed for 12,507 manual workers aged ≥15 yr. Overall, 60.4% of men and 5.8% of women were current smokers. The prevalence of injury was higher among never smokers who were exposed to secondhand smoke (SHS) (7.7% in men and 8.1% in women) than current smokers (4.2% in men and 4.1% in women). After controlling for potential confounders, in men, compared to those who never smoked and were not exposed to SHS, people who never smoked and were exposed to SHS (adjusted odds ratio (aOR)=3.7, 2.2–6.4) and current smokers (aOR=2.5, 1.6–3.8) were more likely to experience injury. Among women, the aORs of occupational injury were 8.4 (4.2–16.7) for never smoking women with occasional exposure to SHS and 3.5 (95% CI: 1.4–8.7) for current smokers, in comparison to never smoking women who were never exposed to SHS at work (reference group). The present study suggests that exposure to SHS is a possible risk factor of occupational injury for never smoking men and women.     

The Influence of Break Timing on the Sleep Quantity and Quality of Fly-in, Fly-out Shiftworkers

Although shift and break timing is known to affect the sleep of shiftworkers, this has not been demonstrated in Fly-in, Fly-out (FIFO) settings which, compared to residential based settings, may be favourable for sleep. This study investigated the sleep quantity and quality of shiftworkers working a FIFO operation comprising of shifts, and therefore breaks, across the 24-h day. The sleep of 24 males (50.43 ± 8.57 yr) was measured using actigraphy and sleep diaries. Morning breaks were associated with less sleep (09:00–12:00 h; 4.4 ± 1.3 h) and a poorer sleep quality (06:00–09:00 h; 3.1 ± 1.0, “average”) compared to breaks beginning between 00:00 h and 03:00 h (6.8 ± 1.7 h; 2.2 ± 0.9, “good”). Sleep efficiency remained constant regardless of break timing (85.9 ± 5.0% to 89.9 ± 3.5%). Results indicate that even in operations such as FIFO where sleeping conditions are near-optimal and the break duration is held constant, the influence of the endogenous circadian pacemaker on sleep duration is evident.     

Harmonized definition of occupational burnout: A systematic review,semantic analysis,and Delphi consensus in 29 countries

Objective:A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET).Methods:First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition.Results:We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists’ comments as follows: “In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems”. A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it.Conclusion:This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.     

Angiosarcoma of the liver in Great Britain in proximity to vinyl chloride sites.

OBJECTIVES: To study the incidence of angiosarcoma of the liver in England and Wales 1979-86 and Scotland 1975-87. To investigate whether any non-occupational neighbourhood cases occurred near a vinyl chloride site. METHODS: This is a geographical study of incident cases among the general population of Great Britain. Diagnosis of angiosarcoma of the liver was based mainly on the national cancer registry, the world register of cases among vinyl chloride workers, and the register of cases (including histological review) maintained by the Health and Safety Executive. Proximity (< 10 km) of residence to a vinyl chloride site was based on postcode of address at the time of diagnosis. RESULTS: 55 cases were ascribed to angiosarcoma of the liver in England and Wales with a further six cases in Scotland (annual incidence in Great Britain from all sources of around 1.4 cases per 10 million population). There were two cases with documented exposure to Thorotrast, and 10 cases among vinyl chloride workers. There were no vinyl chloride sites in Scotland. Among the 25 cases in England and Wales with histological diagnosis after review by a panel of pathologists, only 15 were confirmed as angiosarcoma, and one of the two Scottish cases after histological review was also confirmed. Overall, 11 cases ascribed to angiosarcoma were resident within 10 km of a vinyl chloride site; nine were vinyl chloride workers, one further case on histological review was not considered to have been correctly diagnosed as angiosarcoma, and the remaining case, confirmed as angiosarcoma, was employed at a vinyl chloride factory during the late 1950s, although not as a vinyl chloride worker. CONCLUSION: The incidence of angiosarcoma of the liver in Great Britain remains extremely rare. The one confirmed case in a non-vinyl chloride worker within 10 km of a site must nevertheless be presumed to have been exposed to vinyl chloride in the workplace. In the period of study, there were no confirmed non-occupationally exposed cases of angiosarcoma among residents living near a vinyl chloride site in Great Britain.     

Fall Prevention Research and Practice: A Total Worker Safety Approach

Slips, trips, and falls (STF) represent a serious hazard to workers and occupants in many industries, homes, and communities. Often, the cause of a STF incident is multifactorial, encompassing human, environmental, and task risk factors. A STF-related disability can greatly diminish the occupational capability and quality of life of individuals in both the workplace and the home. Countering STF hazards and risks both on and off the job and on all aspects of control measures is a “total worker safety” matter, a challenging yet tangible undertaking. As the federal organization responsible for conducting research for the prevention of work-related injuries in the United States, the National Institute for Occupational Safety and Health (NIOSH) has been conducting research on STF controls for some decades. Many NIOSH research outcomes have been utilized for STF prevention in workplaces, with potential for prevention in homes as well. This paper summarizes the concept of total worker safety for STF control, NIOSH priority research goals, major activities, and accomplishments, and some emerging issues on STF. The strategic planning process for the NIOSH research goals and some identified research focuses are applicable to the development and implementation of global STF research goals.     

Identifying gaps in COVID-19 health equity data reporting in Canada using a scorecard approach

ObjectiveTo assess health equity-oriented COVID-19 reporting across Canadian provinces and territories, using a scorecard approach.MethodsA scan was performed of provincial and territorial reporting of five data elements (cumulative totals of tests, cases, hospitalizations, deaths, and population size) across three units of aggregation (province or territory level, health regions, and local areas) (15 “overall” indicators), and for four vulnerable settings (long-term care and detention facilities, schools, and homeless shelters) and eight social markers (age, sex, immigration status, race/ethnicity, healthcare worker status, occupational sector, income, and education) (180 “equity-related” indicators) as of December 31, 2020. Per indicator, one point was awarded if case-delimited data were released, 0.7 points if only summary statistics were reported, and 0 if neither was provided. Results were presented using a scorecard approach.ResultsOverall, information was more complete for cases and deaths than for tests, hospitalizations, and population size denominators needed for rate estimation. Information provided on jurisdictions and their regions, overall, tended to be more available (average score of 58%, “D”) than that for equity-related indicators (average score of 17%, “F”). Only British Columbia, Alberta, and Ontario provided case-delimited data, with Ontario and Alberta providing case information for local areas. No jurisdiction reported on outcomes according to patients’ immigration status, race/ethnicity, income, or education. Though several provinces reported on cases in long-term care facilities, only Ontario and Quebec provided detailed information for detention facilities and schools, and only Ontario reported on cases within homeless shelters and across occupational sectors.ConclusionOne year into the pandemic, socially stratified reporting for COVID-19 outcomes remains sparse in Canada. However, several “best practices” in health equity-oriented reporting were observed and set a relevant precedent for all jurisdictions to follow for this pandemic and future ones.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00496-6.     

Healthy worker effect in cohort studies on chronic bronchitis

OBJECTIVES: Despite the recognition of selection biases arising from the healthy worker effect in occupational mortality studies, the possibility of similar effects in occupational cohort studies on respiratory symptoms is not well known. Two mechanisms are responsible for the healthy worker effect in respiratory cohort studies. One is health-based selection of workers into employment (healthy him effect), and the other is health-based differential losses to follow-up (healthy worker survivor effect). The aim of the present paper was to estimate the magnitude of the healthy worker survivor effect in cohort studies of symptoms of chronic bronchitis. METHODS: A meta-analysis of occupational cohort studies of symptoms of chronic bronchitis was performed that included published articles identified in searches of the Medline bibliographic databases between 1980 and March 2001 and the reference lists of the located articles. RESULTS: Eight cohort studies were identified using an a priori selection criterion. The pooled odds ratio of the prevalence of chronic bronchitis for subjects leaving the cohorts was 1.23 when these subjects were compared with those who remained under study (95% confidence interval 1.04-1A4). CONCLUSIONS: The prevalence of respiratory symptoms among exposed workers may he underestimated if the healthy worker survivor effect is not taken into account     

Considerations for Incorporating “Well-Being” in Public Policy for Workers and Workplaces

Action to address workforce functioning and productivity requires a broader approach than the traditional scope of occupational safety and health. Focus on “well-being” may be one way to develop a more encompassing objective. Well-being is widely cited in public policy pronouncements, but often as “. . . and well-being” (e.g., health and well-being). It is generally not defined in policy and rarely operationalized for functional use. Many definitions of well-being exist in the occupational realm. Generally, it is a synonym for health and a summative term to describe a flourishing worker who benefits from a safe, supportive workplace, engages in satisfying work, and enjoys a fulfilling work life. We identified issues for considering well-being in public policy related to workers and the workplace.Major changes in population demographics and the world of work have significant implications for the workforce, business, and the nation.1–8 New patterns of hazards, resulting from the interaction of work and nonwork factors, are affecting the workforce.1,2,8–11 As a consequence, there is a need for an overarching or unifying concept that can be operationalized to optimize the benefits of work and simultaneously address these overlapping hazards. Traditionally, the distinct disciplines of occupational safety and health, human resources, health promotion, economics, and law have addressed work and nonwork factors from specialized perspectives, but today changes in the world of work require a holistic view.There are numerous definitions of well-being within and between disciplines, with subjective and objective orientations addressing such conceptualizations as happiness, flourishing, income, health, autonomy, and capability.12–22 Well-being is widely cited in public policy pronouncements, but often in the conjunctive form of “. . . and well-being” (as in health and well-being). It is rarely defined or operationalized in policy.In this article, we consider if the concept of “well-being” is useful in addressing contemporary issues related to work and the workforce and, if so, whether it can be operationalized for public policy and what the implications are of doing so. We discuss the need to evaluate a broad range of work and nonwork variables related to worker health and safety and to develop a unified approach to this evaluation. We discuss the potential of well-being to serve as a unifying concept, with focus on the definitions and determinants of well-being. Within this part of the discussion, we touch on topics of responsibility for well-being. We also explore issues of importance when one is incorporating well-being into public policy. We present examples of the incorporation of the principles of well-being into public policy, and the results thus far of the implementation of such guidance. We describe research needs for assessing well-being, particularly the need to operationalize this construct for empirical analysis. We aim to contribute to the ongoing efforts of occupational safety and health and public health researchers, practitioners, and policymakers to protect working populations.     

Effects of Physical Examination and Diet Consultation on Serum Cholesterol and Health-behavior in the Korean Pilots Employed in Commercial Airline

An objective of this study is to search how physical examination and diet consultation can influence those risk factors of cardiovascular disease. The subjects were 326 pilots of the “B” airline company in Korea whose total cholesterol values were over 220 mg/dl on their regular physical examinations from April 2006 to December 2008. They were divided into two groups, one who had diet consultation (an intervention group) and a control group. The physical examination components used to each group were body mass index (BMI), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG). The behavioral, anthropometric and biomedical measurements were collected at each visit. This study compares and investigates the changes of serum cholesterol and also the health-behavior at each physical examination. Within the intervention group significant improvements were observed for total cholesterol, BMI (body mass index) and HDL (high density lipoprotein). The normalizing rates for cholesterol level to decrease down to lower than 200 mg/dl were 17.7% in intervention group and 8.7% in control group, which is statistically significantly higher among the intervention group. The odds ratio of diet consultation was 2.80 (95% CI=1.35–5.79), which indicates that it is a significantly contributing factor to normalize the serum cholesterol value down to lower than 200 mg/dl. Based on result, it is recommended to have regular physical examination and intensive management with diet and exercise consultation.     

Tetrachloroethylene Exposure and Bladder Cancer Risk: A Meta-Analysis of Dry-Cleaning-Worker Studies

Background: In 2012, the International Agency for Research on Cancer classified tetrachloroethylene, used in the production of chemicals and the primary solvent used in dry cleaning, as “probably carcinogenic to humans” based on limited evidence of an increased risk of bladder cancer in dry cleaners.Objectives: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry.Methods: Random-effects meta-analyses were carried out separately for occupational exposure to tetrachloroethylene and employment as a dry cleaner. We qualitatively summarized exposure–response data because of the limited number of studies available.Results: The meta-relative risk (mRR) among tetrachloroethylene-exposed workers was 1.08 (95% CI: 0.82, 1.42; three studies; 463 exposed cases). For employment as a dry cleaner, the overall mRR was 1.47 (95% CI: 1.16, 1.85; seven studies; 139 exposed cases), and for smoking-adjusted studies, the mRR was 1.50 (95% CI: 0.80, 2.84; 4 case–control studies).Conclusions: Our meta-analysis demonstrates an increased risk of bladder cancer in dry cleaners, reported in both cohort and case–control studies, and some evidence for an exposure–response relationship. Although dry cleaners incur mixed exposures, tetrachloroethylene could be responsible for the excess risk of bladder cancer because it is the primary solvent used and it is the only chemical commonly used by dry cleaners that is currently identified as a potential bladder carcinogen. Relatively crude approaches in exposure assessment in the studies of “tetrachloroethylene-exposed workers” may have attenuated the relative risks.Citation: Vlaanderen J, Straif K, Ruder A, Blair A, Hansen J, Lynge E, Charbotel B, Loomis D, Kauppinen T, Kyyronen P, Pukkala E, Weiderpass E, Guha N. 2014. Tetrachloroethylene exposure and bladder cancer risk: a meta-analysis of dry-cleaning-worker studies. Environ Health Perspect 122:661–666; http://dx.doi.org/10.1289/ehp.1307055     

Demonstration of the healthy worker survivor effect in a cohort of workers in the construction industry

OBJECTIVES—To assess the potential of a healthy worker survivor effect due to differential occupational mobility in a cohort of construction workers.
METHODS—A cohort of 10 809 male employees in the German construction industry aged 15-64 years was followed up for occupational mobility, early retirement due to permanent disability, and total mortality from 1986 to 1994. Using the Cox''s proportional hazards model of relative rates (RRs) with 95% confidence intervals (95% CIs) of occupational mobility, early retirement and total mortality were estimated according to medical diagnoses at baseline after adjustment for various covariates.
RESULTS—During follow up, 2472 subjects changed employment, 359 employees were granted a disability pension for health reasons and 188 subjects died. A wide range of chronic diseases was associated with increased rates of early retirement and total mortality but not occupational mobility. However, a healthy worker survivor effect was identified related to disorders of the back and spine (ninth revision of the international classification of diseases, ICD-9, code 720-4), a common predictor of both occupational mobility (RR 1.17, 95% CI 1.04 to 1.32) and early retirement (RR 1.50, 95% CI 1.20 to 1.88). In total, there were about as many events of occupational changes (n = 41) as events of early retirement due to permanent disability (n = 39) significantly attributable to disorders of the back and spine. Differential occupational mobility preceded differential early retirement due to permanent disability by more than one decade.
CONCLUSIONS—These findings show the need to consider a healthy worker survivor effect due to occupational mobility in occupational epidemiological research. Furthermore these results underline the necessity of further health promotion targeting work related conditions in the construction industry.


     

Behavioral Variables Associated with Obesity in Police Officers

Past research has documented that non-behavioral variables (such as long work hours, exposure to police stressors) are associated with obesity risk in police officers, but limited research has examined behavioral variables that might be targeted by Employee Assistance Programs for police weight management. The present study compared non-obese and obese officers for behavioral variables found associated with obesity in other adult samples: physical activity (cardiovascular, strength-training, stretching), sleep duration, and consumption of alcohol, fruit and vegetables, and snack foods. Participants included 172 male police officers who completed questionnaires to report height and weight, used to calculate body mass index (BMI = kg/m²) and to divide them into “non-obese” and “obese” groups. They also reported the above behaviors and six non-behavioral variables found associated with obesity risk: age, health problems, family support, police work hours, police stressors, police support. ANCOVAs compared each behavioral variable across obesity status (non-obese, obese), with the six non-behavioral variables used as covariates. Results revealed that cardiovascular and strength-training physical activity were the only behavioral variables that differed significantly between non-obese and obese police officers. The use of self-reported height and weight values may provide Employee Assistance Program with improved cost, time, and officer participation.     

Illness Absences Among Beryllium Sensitized Workers

Objectives. This study examined absence rates among US Department of Energy workers who had beryllium sensitization (BeS) or were diagnosed with chronic beryllium disease (CBD) compared with those of other workers.Methods. We used the lymphocyte proliferation test to determine beryllium sensitivity. In addition, we applied multivariable logistic regression to compare absences from 2002 to 2011 between workers with BeS or CBD to those without, and survival analysis to compare time to first absence by beryllium sensitization status. Finally, we examined beryllium status by occupational group.Results. Fewer than 3% of the 19 305 workers were BeS, and workers with BeS or CBD had more total absences (odds ratio [OR] = 1.31; 95% confidence interval [CI] = 1.18, 1.46) and respiratory absences (OR = 1.51; 95% CI = 1.24, 1.84) than did other workers. Time to first absence for all causes and for respiratory conditions occurred earlier for workers with BeS or CBD than for other workers. Line operators and crafts personnel were at increased risk for BeS or CBD.Conclusions. Although not considered “diseased,” workers with BeS have higher absenteeism compared with nonsensitized workers.The US Department of Energy (DOE) oversees a unique industrial complex in which diverse activities in research, production, and dismantlement have the potential for workplace exposures to a variety of chemical hazards. The Illness and Injury Surveillance Program (IISP) began in 1990, in response to the DOE’s legislative mandate1,2 to monitor the health of its workers. By 2011, there were 15 sites encompassing 164 000 workers participating in the IISP. All workers absent 5 or more consecutive workdays (or 40 hours) were included in the IISP. The 5-day calendar requirement corresponds with the DOE Order 5480.8 that requires workers absent 5 workdays report to the site’s occupational medicine clinic to be pronounced “fit for duty” before returning to work. A worker could have multiple absences in a given year. The IISP database contains worker health information, including dates and medical condition related to an absence from work, demographic data, and job titles. Annual site-specific surveillance reports were produced from 1992 through 2010, and worker health summaries3,4 presented analyses of IISP data over time and from multiple sites.Beryllium is a lightweight, strong, hard silver-gray metallic element with many industrial applications. Beryllium has been used extensively in the DOE complex in its nuclear operations. Although the potential for exposure in the current workplace is far less than from early operations, federal regulations5 require DOE sites to: (1) determine whether employees are at risk for chronic beryllium disease (CBD), (2) implement CBD prevention programs, and 3) report health and exposure data to the Beryllium-Associated Worker Registry (BAWR).The BAWR, established in 2002, collects information on all DOE workers potentially at risk for occupational exposure to beryllium. It covers 27 DOE contractor facilities and contains information on 28 429 workers tested for beryllium sensitization (BeS). Medical information in the BAWR database includes the results and dates of all beryllium lymphocyte proliferation tests (BeLPTs). The BeLPT is a blood test that measures the proliferation of lymphocytes exposed to beryllium in vitro. The BeLPT result is said to be abnormal when lymphocytes proliferate more rapidly in the presence of beryllium than in the absence of beryllium. A worker is classified as having BeS if there are (1) 2 or more abnormal BeLPTs, (2) 1 abnormal BeLPT and 2 or more borderline BeLPTs, or (3) an abnormal BeLPT from cells collected from a bronchoalveolar lavage. The abnormal or borderline BeLPTs do not have to be sequential for a worker to be considered sensitized. A worker with an abnormal BeLPT is removed from further work with beryllium.CBD, a disease of the lungs caused by inhaling beryllium powder or fumes, is characterized by granuloma formation in and eventual scarring of lung tissue. While BeS is not a disease, a worker sensitized to beryllium is at increased risk for CBD. If a worker has been diagnosed with CBD, the diagnostic information and date are included in the BAWR.A site’s participation in the IISP was independent of the use of beryllium at the site. The site occupational medical department assigned a unique pseudo-identifier to each worker, which allowed the records in the IISP and the BAWR to be linked. The IISP and BAWR electronic data files do not contain any personal identifiers to protect the workers’ identities. A worker may not opt out of either registry. The de-identified records are stored in 2 independent databases maintained at the Oak Ridge Associated Universities, a contractor to the DOE Office of Environment, Health, Safety, and Security. Investigators have found that alterations in gas exchange and the pulmonary vascular bed occur early in beryllium disease.6 In a study of early pulmonary function test abnormalities, 21 patients with BeS had similar baseline chest x-rays, pulmonary function, and exercise tolerance as nonsensitized individuals. However, measurable physiologic abnormalities were found at the time of diagnosis in 12 (57%) of these individuals. We postulated that physiological abnormalities could lead to prolonged absences attributed to illnesses among workers with BeS or CBD. The objective of this analysis was to determine if illness absence rates differed among workers with BeS or CBD compared with workers who were BeLPT normal. Access to data from the IISP and the BAWR provided a unique opportunity to conduct this investigation and allowed a quantitative examination of this relationship.A second objective of this investigation was to determine if workers in certain occupational groups were more likely to have BeS or CBD than other workers. Job titles were organized into 7 occupational groups: administrative support, professionals, line operators, crafts, technical support, service, and security and fire. Line operators and craft workers were determined a priori to have highest potential exposure to beryllium. Line operators were most likely to be involved in machining and grinding beryllium or beryllium alloy parts; craft workers, which included laborers, were also at higher risk for exposure to beryllium because of work assignments in areas where beryllium activities were present. Occupational groups were defined in the IISP so it was not possible to refine analyses by specific job titles, and specific job tasks could vary from site to site.Several studies compared BeS and CBD occurrence among occupational groups. Compared with workers in other job categories, machinists had the highest BeS rates (4.7%).7 In a study of 55 monitored workers with BeS, 17 individuals who developed CBD were more likely to have been machinists.8 In a case-control study, those with BeS and CBD were more likely to have worked as machinists than were controls (odds ratio [OR] = 4.4; 95% confidence interval [CI] = 1.1, 17.5).9 Workers in the rod and wire production area of a plant using copper-beryllium alloys had significantly higher prevalence of BeS (10%) or CBD (6%) than did workers in other areas of the plant with lower beryllium air levels (P < .05).10 Construction workers at 3 DOE sites where beryllium activities occurred were at increased risk for at least 1 abnormal BeLPT from activities (maintenance, repair, renovation, and demolition) conducted at those buildings.11 The risk of BeS was elevated among individuals working in a Nevada Test Site building where beryllium parts were machined (OR = 2.52; 95% CI = 1.02, 6.19).12 Workers who machined or ground copper-beryllium alloys appeared at increased risk for BeS compared with workers with low potential beryllium exposure (OR = 2.6; 95% CI = 0.23, 29.9).13     

Spontaneous abortions and reproductive selection mechanisms in the rubber and leather industry in Finland

ABSTRACT Spontaneous abortions in hospitals were analysed from two sources—membership files of the Union of Rubber and Leather Workers (about 10 000 women) and records of the personnel of a rubber factory (about 1600 women). Two frequencies of spontaneous abortions were calculated for each population analysed: rate (No spontaneous abortions X 100/No pregnancies) and ratio (No spontaneous abortions X 100/No births). The two frequencies were increased for all union members compared with all Finnish women. The frequencies, however, did not appreciably differ when the pregnancies occurred during union membership as compared with the pregnancies before or after membership. The frequency of spontaneous abortions was higher for the short-time union members than for those employed for longer periods, but the increased frequency did not correlate with union membership. The employees of a rubber factory had slightly fewer spontaneous abortions on average than the community population. The women employed in the rubber factory for three to 23 months were found to have appreciably higher frequencies of spontaneous abortions than the women employed for longer periods. The present study showed the feasibility of using cases of spontaneous abortions in hospitals in an occupational study with longitudinal employment data. Women with short periods of employment appeared to have more spontaneous abortions than those with longer periods of employment suggesting the presence of selection mechanisms, perhaps with some analogies to the “healthy worker effect” in occupational mortality studies. The presence of such selection mechanisms deserve serious consideration in occupational reproductive epidemiology.     

Gastric cancer mortality rates by occupation and industry among male and female workers aged 25–64 years in Japan

Differences in risk for gastric cancer exist among occupations and industries in Japan. Using a 2015 national dataset, we estimated the mortality rates due to gastric cancer in Japanese male and female workers aged 25–64 yr. Regression models were used to estimate the mortality rate ratios separately for men and women with adjustment for age. The occupation with the highest risk ratio was “Service” in men (2.06, 95% confidence interval: 1.63–2.61) and “Construction and Mining” in women compared with “Sales”. For industries, workers in “Mining”, “Electricity, Gas, Heat supply and Water”, “Fisheries”, “Agriculture and Forestry”, and “Construction” had a higher mortality risk. Our results showed that occupations and industries with higher mortality rates in men had the same trend as the results from 2010, and occupations and industries with higher mortality rates in women were almost the same as those in men. The analyses also indicated that managerial and professional workers in Japan had higher mortality as opposed to developed Western countries. In conclusion, this study suggests that occupations and industries still impact men and women’s health in terms of mortality due to gastric cancer in Japan.