Occupational exposure and health problems in small-scale industry workers in Dar es Salaam, Tanzania: a situation analysis

BACKGROUND: Workers in informal small-scale industries (SSI) in developing countries involved in welding, spray painting, woodwork and metalwork are exposed to various hazards with consequent risk to health. Aim To assess occupational exposure and health problems in SSI in Dar es Salaam, Tanzania. METHODS: Focused group discussions (FGD) were conducted among SSI workers. Participants were assessed for exposure to occupational and environmental hazards, the use of protective equipment and health complaints by interview. The findings were discussed with participants and potential interventions identified. RESULTS: Three hundred and ten workers were interviewed (response rate 98%). There was a high level (>90%) of self-reported exposure to either dust, fumes, noise or sunlight in certain occupational groups. There was low reported use of personal protective equipment. There was a high level of self-reported occupational health problems, particularly amongst welders and metalworkers. Workers reported their needs as permanent workplaces, information on work related hazards, water and sanitation, and legislation for SSI. CONCLUSIONS: In SSI in Tanzania, our study suggests that workers have high levels of exposure to multiple health hazards and that use of protective equipment is poor. This group of workers warrants improved occupational health and safety provision.     

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 relation of respiratory symptoms and ventilatory function to moderate occupational exposure in a general population. Results from the French PAARC study of 16,000 adults

Data from the French PAARC (Pollution Atmosphérique et Affections Respiratoires Chroniques) study were used to assess the effect of a priori moderate occupational exposure to dust, gases or chemical fumes on the prevalence of respiratory symptoms and ventilatory function. In this community-based population, without households 'headed' by manual workers, 34% of the 8692 men and 23% of the 7772 women, 25-59 years of age, ever occupationally active, reported some exposure. The studied relationships were adjusted for age, height, smoking habits, socio-occupational class, education and air pollution by logistic or linear regression methods. For men and women, some 50% increase (p less than 0.01) in chronic cough, chronic bronchitis, dyspnoea grade 2 and wheezing prevalence was observed in the exposed group compared to the never exposed, with the strongest association for wheezing. FEV1 and FEF25-75% were not associated with occupational exposure. Among men, FEV1/FVC and FEF25-75%/FVC were significantly lower (p less than 0.001 and p less than 0.05) among the exposed compared to never exposed, but FVC was significantly greater (p less than 0.05). Among women, occupational exposure was significantly related to a lower FEV1/FVC in the subgroup with a history of asthma or wheezing. Results suggest that occupational exposures of relatively low intensity, encountered in the non-industrial work places may constitute a non-negligible risk for respiratory health.     

Respiratory illnesses and ventilatory function among workers at a cement factory in a rapidly developing country

Chronic exposure to Portland cement dust has been reported to lead to a greater prevalence of chronic respiratory symptoms and a reduction of ventilatory capacity. The seriousness of pulmonary function impairment and respiratory disease has not been consistently associated with the degree of exposure. Regular use of appropriate personal protective equipment, if available at the worksite, could protect cement workers from adverse respiratory health effects. For a variety of reasons, industrial workers in rapidly developing countries do not adequately protect themselves through personal protective equipment. This study explores the prevalence of chronic respiratory symptoms and ventilatory function among cement workers and the practice of use of personal protective equipment at work. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, smoking profile and history of respiratory health among workers at a Portland cement plant (exposed) and workers occupationally unexposed to dust, fumes and gases (unexposed). Pulmonary function was assessed and pulmonary function impairment was calculated for the exposed and the unexposed workers. A higher percentage of the exposed workers reported recurrent and prolonged cough (30%), phlegm (25%), wheeze (8%), dyspnoea (21%), bronchitis (13%), sinusitis (27%), shortness of breath (8%) and bronchial asthma (6%). Among the unexposed, prevalences of these symptoms were 10, 5, 3, 5, 4, 11, 4 and 3%, respectively. Ventilatory function (VC, FVC, FEV(1), FEV(1)/VC, FEV(1)/FVC and PEF) was significantly lower in the exposed workers compared with unexposed workers. These differences could not be explained by age, body mass index (BMI) or pack-years smoked. Ventilatory function impairment, as measured by FEV(1)/FVC, showed that 36% of the exposed workers had some ventilatory function impairment compared with 10% of those unexposed. Certain jobs with greater exposure to cement dust had lower ventilatory function compared with others among the exposed workers. It was concluded that adverse respiratory health effects (increased frequency of respiratory symptoms and decreased ventilatory function) observed among cement workers could not be explained by age, BMI and smoking, and were probably caused by exposure to cement dust.     

Occupational skin cancers

Skin cancer due to occupation is more common than is generally recognized, although it is difficult to obtain an accurate estimate of its prevalence. Over the past two centuries, occupational skin cancers have particularly been due to industrial exposure of men (it seems more so than women) to chemical carcinogens such as polycyclic hydrocarbons (e.g. from coal tar products) or to arsenic. Industrial processes have improved in most Western countries to limit this type of exposure, but those with outdoor occupations are still exposed to solar ultraviolet irradiation without this being widely recognized as an industrial hazard. Ionizing radiation such as X-rays can also cause skin cancer. Occupational skin cancers often resemble skin tumours found in non-occupational subjects, e.g. basal cell carcinoma, squamous cell carcinoma and malignant melanoma, but some pre-malignant lesions can be more specific and point to an occupational origin, e.g. tar keratoses or arsenical keratoses. An uncommon but well-recognized cause of occupational skin cancer is that which results from scar formation following an industrial burn. In the future it will be necessary to focus on preventative measures, e.g. for outdoor workers, the need to cover up in the sun and use sun protective creams and a campaign for earlier recognition of skin cancers, which are usually curable if treated in their early stages.     

2010～2011年济南铁路地区企业职业病危害与职工健康状况调查

[目的]全面了解济南铁路局劳动作业场所职业病危害因素分布情况,掌握有害接触职工的健康状况,为开展职业健康监护等提供科学依据。[方法]2010年1月至2011年6月,发放调查表,对济南铁路局管辖内27家铁路单位进行调查。[结果]调查的27家铁路企业有职业病危害作业固定点323个,职业病危害因素主要是粉尘、噪声、高温、电离辐射和有毒物质。调查的30项职业安全卫生管理制度中,25项建有率超过50%。调查的接触职业病危害的6 984名职工中,高血压患病率为20.19%,高血脂罹患率为29.84%,高血糖患病率为6.27%,脂肪肝患病率为32.57%,肝囊肿患病率为6.29%,肝血管瘤患病率为1.78%,肾结石患病率为2.10%,肾囊肿患病率为4.45%,血红蛋白降低率为1.33%,白细胞减少率为0.37%,血小板减少率为0.43%。[结论]铁路单位存在多种职业病危害因素,职业病危害作业监测管理规定措施建有率较低;接触职业病危害的职工的脂肪肝和高血脂患病率较高。     

2010-2011年济南铁路地区企业职业病危害与职工健康状况调查

[目的]全面了解济南铁路局劳动作业场所职业病危害因素分布情况,掌握有害接触职工的健康状况,为开展职业健康监护等提供科学依据。[方法]2010年1月至2011年6月,发放调查表,对济南铁路局管辖内27家铁路单位进行调查。[结果]调查的27家铁路企业有职业病危害作业固定点323个,职业病危害因素主要是粉尘、噪声、高温、电离辐射和有毒物质。调查的30项职业安全卫生管理制度中,25项建有率超过50％。调查的接触职业病危害的6984名职工中,高血压患病率为20．19％,高血脂罹患率为29．84％,高血糖患病率为6．27％,脂肪肝患病率为32．57％,肝囊肿患病率为6．29％,肝血管瘤患病率为1．78％,肾结石患病率为2．10％,肾囊肿患病率为4．45％,血红蛋白降低率为1．33％,白细胞减少率为0．37％,血小板减少率为0．43%。[结论]铁路单位存在多种职业病危害因素,职业病危害作业监测管理规定措施建有率较低;接触职业病危害的职工的脂肪肝和高血脂患病率较高。     

Occupational and Environmental Risk Factors for Asthma in Rural Communities in China

Abstract

Respiratory allergens such as dust, gases/fumes, and hay smoke, which are frequently present in agricultural settings, can cause or aggravate asthma. The purpose of this study was to examine the relationships between occupational and environmental exposures and asthma in Chinese rural communities. The study population consisted of 28,946 people 15 years old or older, living in rural areas of Anhui province, China. A modified Mandarin translation of the ATS-DLD questionnaire was administered by trained interviewers to request information about exposures to specific occupational/environmental agents and respiratory disorders. In Huaining, the prevalence of wheezing was 3.8% for men; 2.1% for women; the prevalence of asthma was 1.6% for men; 1.8% for women. In Zongyang, the prevalence of wheezing was 2.7% for men; 1.9% for women; the prevalence of asthma was 1.7% for men; 1.2% for women. With control for potential confounders such as gender, age, residential area, education level, and smoking status, the pooled adjusted odds ratios (ORs) of wheezing and asthma for the group exposed to wood/hay smoke were 1.36 (95% CI: 1.14–1.61) and 1.27 (95% CI: 1.021.58), respectively. For coal-stove users, the pooled adjusted ORs were 1.47 (95% CI: 1.091.98) for wheezing and 1.51 (95% CI: 1.05–2.17) for asthma. After stratification of the subjects by dust type, the estimated ORs for wheezing were 1.58 (95% CI: 1.02–2.44) among the group exposed to inorganic dust and 3.03 (95% CI: 1.25–7.33) among the group exposed to metal dust. Asthma was not shown to be significantly associated with any specific dust type. Findings of the present study are consistent with previously reported adverse respiratory health effects related to occupational/environmental exposures to wood/hay smoke and dust, and indicate the need for further occupational disease surveillance in rural communities.     

A 24 year cohort study of mortality in slate workers in North Wales

AIM: To study mortality in slate workers in North Wales. METHODS: A cohort study, with a contemporaneous control group (quasi-experimental study) with follow-up from 1975 to 1998. The date and cause of death in those who had died were identified from the Office of National Statistics. RESULTS: Seven hundred twenty six slate workers and 529 age matched controls took part in the survey. We found a clear excess of death rate among slate workers compared with controls, having adjusted for age and smoking habit. This was largely restricted to those ages less than 75. Hazard ratio for all deaths was 1.24 [95% Confidence Interval (CI)=1.04-1.47, P=0.015]. The excess was mainly due to respiratory disease and pneumoconiosis. The hazard ratio for respiratory deaths was 1.85 (95% CI=1.21-2.82). CONCLUSION: It is likely that the excess deaths in the exposed group was due to exposure to slate dust. The accuracy of pneumoconiosis as a cause of death is questionable, but we lack radiographs close to death to confirm it.     

Occupational exposure to lignite and impact on respiratory system among heavy industry personnel

Objective is to evaluate the impact of occupational exposure to lignite dust on respiratory system. 103 blue-collar workers exposed to lignite dust and 62 controls completed a questionnaire on respiratory symptoms and underwent spirometry. Levels of lignite dust in workplace were measured. Univariate and multivariate analysis of the data were performed. The concentration of lignite dust varied from 0.6 to 1.4 mg/m3. Current smokers and workers exposed to lignite dust presented higher prevalence of chronic bronchitis symptoms and of FEV<80% and FEV1/FVC<70%. Multivariate analysis has shown that smoking and occupational exposure to lignite dust were independent predictors of chronic bronchitis symptoms, as well as of an obstructive ventilation pattern. Further analysis showed that exposed workers who were current smokers presented a five fold rate for developing an obstructive ventilation pattern in comparison to exposed workers non currently smokers. Occupational exposure to lignite dust and smoking were independent determinants of chronic bronchitis symptoms and obstructive ventilation pattern. There is some evidence for a combined effect of smoking and lignite dust exposure on respiratory system.     

某机械制造企业不同职业病危害对工人鼻和咽部的影响

[目的]探讨某机械制造企业不同职业病危害因素对工人鼻、咽部健康的影响,为在相关行业中提出针对性的预防控制措施提供参考。[方法]抽取广州市某机械制造企业2 014名工龄>1年的男性工人,进行横断面调查。在这些男性工人中,以不接触职业病危害因素或接触噪声的733名作业人员为对照组,接触电焊烟尘、锰尘、棉尘、砂轮磨尘、有机粉尘的619名作业人员作为粉尘接触组,接触汽车尾气、二甲苯、汽油的622名作业人员作为化学危害因素接触组,分析各组慢性鼻炎、慢性咽炎患病率情况,并对其可能的影响因素进行分析。[结果]慢性鼻炎患病率方面,粉尘接触组为13.6%(84/619),化学危害因素接触组为9.8%(61/622),对照组为13.1%(101/773),三组差异无统计学意义(P>0.05)。慢性咽炎患病率方面,粉尘接触组为69.1%(428/619),化学危害因素接触组为64.7%(402/622),对照组为42.3%(327/773),两组接触组慢性咽炎患病率无统计学差异(P>0.05/3),但均高于对照组,差异有统计学意义(P<0.05/3)。多因素logistic回归分析结果显示,尚未发现接触粉尘和接触化学危害因素对慢性鼻炎患病率的影响。与对照组比较,接触粉尘(OR=2.801,P<0.01)和接触化学危害因素(OR=2.362,P<0.01)可能均为患慢性咽炎的危险因素;与18~29岁年龄组相比,30~39岁年龄组(OR=1.361,P<0.01)、40~49岁年龄组(OR=1.516,P<0.01)、50~60岁年龄组(OR=2.444,P<0.01)患慢性咽炎的危险度可能增加;偶尔饮酒、偶尔吸烟、经常吸烟均可能为慢性咽炎的危险因素(OR=1.778、1.707、1.324,P<0.05)。[结论]职业性接触粉尘、化学有害因素可能对咽部疾病有重要影响,应督促工人正确合理使用防护用品;饮酒对鼻、咽部健康的影响尚需进一步的研究。     

某纳米粉体材料白炭黑制备项目职业病危害控制效果评价

目的对某纳米粉体材料白炭黑制备项目产生的职业病危害因素进行检测分析并对控制效果评价。方法采用现场职业卫生调查、工程分析、职业病危害因素检测检验。结果建设项目生产过程中产生或存在主要职业病危害因素有凝聚SiO2粉尘、氯气、氯化氢或盐酸、氢氧化钠、噪声、高温、热辐射等。经测定接尘工人接触粉尘浓度合格率为67%,气相SiO2制备车间中控操作工和包装工接触粉尘的浓度、包装工接触噪声强度超过职业接触限值。结论本项目属于职业病危害严重的建设项目,防护措施存在一些问题,但如能按报告的要求整改,可以通过竣工验收。     

Non-fatal occupational injury among active and passive smokers in small- and medium-scale manufacturing enterprises in Japan

Active smoking is a risk factor for occupational injury, whereas its association with passive smoking is unknown. To evaluate the contribution of active and passive smoking to non-fatal occupational injury in manufacturing sectors, 2302 randomly selected workers aged 16-83 years working in 244 small- and medium-scale enterprises in Yashio city, Japan, were surveyed by means of a self-administered questionnaire. Smoking history, exposure to passive smoking, and occupational injury were evaluated by self-report. Exposure levels to passive smoking were assessed separately at work and at home as never, occasional, or regular exposure. Overall, 61.4% of men and 22.3% of women were current smokers. Among never smokers, 62.2% of men and 68.6% of women reported exposure to passive smoking either at work or home. Prevalence of occupational injuries was 36.2% for never, 43.3% for former, and 41.2% for current smokers among men and 19.7% for never, 22.2% for former, and 25.2% for current smokers among women. Among never smoking men, odds ratios (ORs) of occupational injury were 2.11 when regularly exposed to passive smoking at work or at home (p=0.025), 2.27 at work (p=0.015), and 3.08 at home (p=0.106), in comparison to never smoking men who were never exposed to passive smoking either at work or at home (referent group). These associations were attenuated to be non-significant, after controlling for potential confounders. Never smoking men with occasional exposure to passive smoking were not significant ORs (1.11-1.19). In contrast, current and former smoking men had significant increases in adjusted ORs (1.57-2.00). In women exposed to smoking there was a non-significant increase in occupational injury. The present study indicates an expected increase in the risk of, occupational injury for current and former smoking men and suggests that exposure to passive smoking is a possible risk factor for never smoking men.     

职业接触粉尘及吸烟对死亡影响的前瞻性队列研究

目的 研究接尘和吸烟对死亡的影响。方法 以1989－1992年广州实施并建立的职工职业健康监护档案为基础资料，选年龄≥30岁的接尘工人和无任何粉尘及其他有害物质接触的职工（对照组）61648名为研究对象，进行前瞻性队列研究。结果 （1）队列失访28例，死亡1186例，以恶性肿瘤死亡为主；（2）本队列男性多于女性，年龄35－44岁，主要为工人，中学文化，已婚，率42．2％，饮酒率32．8％；（3）调整相应混杂因素后，全死因、恶性肿瘤和呼吸系疾病死亡接尘者相对危险度（RR）分别为1．24、1．34和1．96，与对照组比较，差异均有显著性（P＜0．01），吸烟者RR分别为1．16、1．37和1．63，与不吸烟者比，前二者差异有显著性（P＜0．01）；既接尘又吸烟者上述相应死因死亡1RR分别为1．48、1．85和3．12，明显高于单纯接尘或单纯吸烟者，差异有显著性（P＜0．01）；（4）接尘对死亡的影响主要表现在职业接触矽尘和木尘。结论 接尘与吸烟均可致死亡危险性增加，并存在协同作用。     

Respiratory symptoms and dermatoses among grinders and brazers of hard metal and stellite blades

The objectives of the study were to determine whether grindersand brazers of hard metal and stellite blades have more respiratorysymptoms and dermatoses than referents and to obtain informationon the relation between respiratory symptoms and combined exposureto cobalt and wood dust. Two groups of workers exposed to cobalt(108 workers in the manufacture or maintenance of tools and116 saw filers in the mechanical wood-processing industry) andtwo reference groups (106 rolling mill and 103 sawmill workers)were interviewed. The prevalence of ODTS-like symptoms (work-relatedcough, dyspnoea, or fever or chills) was higher for the sawfilers than the sawmill referents. After adjustment for age,time spent in present work, smoking and atopy, saw filers hada higher risk for fever or chills than the other study groups.When the cobalt-exposed and unexposed workers were comparedby smoking, differences in the prevalence of ODTS-like symptomswere found only for the non-smokers. The cobalt-exposed workersdid not have a higher risk of hand dermatoses or symptoms ofmetal allergy than the unexposed workers. It seems that combinedcobalt and wood dust exposure is associated with ODTS-like symptoms,especially among non-smoking workers.     

2010-2012年珠海市职业健康监护人群职业危害分析

目的掌握珠海市职业健康监护人群职业危害构成。方法按照国家职业健康监护技术规范要求,收集整理2010-2012年珠海市职业健康监护人群资料,分析职业健康监护人群主要职业危害因素。结果 2010-2012年珠海市职业健康监护131 955人,接触物理因素、化学因素、粉尘和其它职业危害因素人群分别为56 238人(42.6%)、50 521人(38.3%)、24 179人(18.3%)、1 017人(0.8%);噪声为主要物理职业危害因素,占82.1%(46 171/56 238)。3年共检出职业禁忌证人员3 892人,物理因素、接触化学因素、粉尘和其它职业危害因素的职业禁忌证构成比分别为71.7%(2791/3 892)、26.7%(1 041/3 892)、1.2%(47/3 892)、0.3%(13/3 892),以接触物理危害因素的禁忌证最多,噪声危害为主要物理职业危害因素禁忌证,占95.8%(2 675/2 791)。3年共检出疑似职业病37人,构成比居前三位的分别是化学因素所致疑似职业病29人(78.4%)、疑似尘肺6人(16.2%)和疑似职业性噪声聋2人(5.4%);疑似职业性中毒性肝病主要为化学因素所致疑似职业病,占58.6%(17/29)。结论珠海市职业健康监护人群主要职业危害因素为物理、化学和粉尘因素,并已引起职业禁忌证和疑似职业病,应加强噪声、肝毒物、粉尘等危害因素接触人员的健康监护监督指导。     

Knowledge and practices related to occupational hazards among cement workers in United arab emirates

Background: In United Arab Emirates (UAE), the rate of industrialization has increased significantly over the past decades. However, few studies have been conducted to investigate the occupational hazards and the knowledge & practice of the working population relevant to these hazards. Objectives: To assess the knowledge and practice of workers in cement factory in Ras Al-Khaimah, UAE on the occupational hazards of their work. Material and Methods: A cross-sectional study involving 153 cement factory workers. A semi- structured interview questionnaire was used to assess the knowledge and practice of workers towards occupational hazards in general and dust in particular. Results: The majority 114 (74.5 %) of the workers knew that exposure to the dust was a serious hazard to their health, but only 52.9 % of the workers knew the hazards other than the dust that were associated with their work. All the workers mentioned that they had been provided with masks to protect them from dust, however, only 28.8 % of them claimed that they used the masks all the time during working hours. The variables: years of education, being informed about the hazards associated with the worker's job, and attending a training course about occupational health and safety were found to have a significant influence on the workers' knowledge about the occupational hazards and on their use of the personal protective equipment at work. Conclusion and Recommendations: Despite the relatively high knowledge of the cement factory workers about the adverse health effects of exposure to dust, the use of respiratory protective equipment was poor. A program to promote safety education and the use of personal protective equipment among cement factory workers is recommended.     

Post-shift changes in pulmonary function in a cement factory in eastern Saudi Arabia

This cross-sectional study was conducted in 1992 in the oldest of three Portland cement producing factories in Eastern Saudi Arabia. The respirable dust level was in excess of the recommended ACGIH level in all sections. Spirometry was done for 149 cement workers and 348 controls, using a Vitalograph spirometer. FEV1, FVC, FEV1/FVC% and FEF25-75% were calculated and corrected to BTPS. A significantly higher post-shift reduction FEV1, FEV1/FVC% and FEF25-75% was observed in the exposed subjects. Multiple regression analysis showed a significant relationship between post-shift changes and exposure to cement dust but failed to support any relationship with smoking. These findings may indicate an increase in the bronchial muscle tone leading to some degree of bronchoconstriction as a result of an irritant effect induced by the acute exposure to cement dust.     

Association between bronchial hyper-reactivity and exposure to silicon carbide

A clinical study of 191 workers in the silicon carbide production industry was carried out in order to determine the prevalence of respiratory symptoms (wheezing, dyspnoea and breathlessness after exercise). Such symptoms occurred in 50 (26.1%) subjects, of whom 24 accepted testing for bronchial reactivity. Of these 24, 19 (79.2%) were positive. These findings suggest that exposure to SiC may be associated with bronchial hyper-reactivity. Positive results were more frequent in women than in men, while differences between smokers and non-smokers were insignificant, a phenomenon that has often been noted in persons exposed to massive risk.     

The inverse hazard law: blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers

Research on societal determinants of health suggests the existence of an "inverse hazard law," which we define as: "The accumulation of health hazards tends to vary inversely with the power and resources of the populations affected." Yet, little empirical research has systematically investigated this topic, including in relation to workplace exposures. We accordingly designed the United for Health study (Greater Boston Area, Massachusetts, 2003-2004) to investigate the joint distribution and health implications of workplace occupational hazards (dust, fumes, chemical, noise, ergonomic strain) and social hazards (racial discrimination, sexual harassment, workplace abuse). Focusing on blood pressure as our health outcome, we found that among the 1202 low-income multi-racial/ethnic working class participants in our cohort - of whom 40% lived below the US poverty line - 79% reported exposure to at least one social hazard and 82% to at least one high-exposure occupational hazard. Only sexual harassment, the least common social hazard, was associated with elevated systolic blood pressure (SBP) among the women workers. By contrast, no statistically significant associations were detectable between the other additional highly prevalent social and occupational hazards and SBP; we did, however, find suggestive evidence of an association between SBP and response to unfair treatment, implying that in a context of high exposure, differential susceptibility to the exposure matters. These results interestingly contrast to our prior findings for this same cohort, in which we found associations between self-reported experiences of racial discrimination and two other health outcomes: psychological distress and cigarette smoking. Likely explanations for these contrasting findings include: (a) the differential etiologic periods and pathways involving somatic health, mental health, and health behaviors, and (b) the high prevalence of adverse exposures, limiting the ability to detect significant associations. As clarified by the "inverse hazard law," to understand health inequities, research is needed that contrasts exposures and health status population-wide, not just among those most inequitably exposed.