OBJECTIVE: To estimate the hazard ratio for disability pension associated with shift work. METHODS: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. RESULTS: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. CONCLUSION: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.
Musculoskeletal disorders (MSDs) are the main reason for morbidity during military training. MSDs commonly result in functional impairment leading to premature discharge from military service and disabilities requiring long-term rehabilitation. The purpose of the study was to examine associations between various risk factors and MSDs with special attention to the physical fitness of the conscripts.
Two successive cohorts of 18 to 28-year-old male conscripts (N = 944, median age 19) were followed for six months. MSDs, including overuse and acute injuries, treated at the garrison clinic were identified and analysed. Associations between MSDs and risk factors were examined by multivariate Cox's proportional hazard models.
During the six-month follow-up of two successive cohorts there were 1629 MSDs and 2879 health clinic visits due to MSDs in 944 persons. The event-based incidence rate for MSD was 10.5 (95% confidence interval (CI): 10.0-11.1) per 1000 person-days. Most MSDs were in the lower extremities (65%) followed by the back (18%). The strongest baseline factors associated with MSDs were poor result in the combined outcome of a 12-minute running test and back lift test (hazard ratio (HR) 2.9; 95% CI: 1.9-4.6), high waist circumference (HR 1.7; 95% CI: 1.3-2.2), high body mass index (HR 1.8; 95% CI: 1.3-2.4), poor result in a 12-minute running test (HR 1.6; 95% CI: 1.2-2.2), earlier musculoskeletal symptoms (HR 1.7; 95% CI: 1.3-2.1) and poor school success (educational level and grades combined; HR 2.0; 95% CI: 1.3-3.0). In addition, risk factors of long-term MSDs (>or=10 service days lost due to one or several MSDs) were analysed: poor result in a 12-minute running test, earlier musculoskeletal symptoms, high waist circumference, high body mass index, not belonging to a sports club and poor result in the combined outcome of the 12-minute running test and standing long jump test were strongly associated with long-term MSDs.
The majority of the observed risk factors are modifiable and favourable for future interventions. An appropriate intervention based on the present study would improve both aerobic and muscular fitness prior to conscript training. Attention to appropriate waist circumference and body mass index would strengthen the intervention. Effective results from well-planned randomised controlled studies are needed before initiating large-scale prevention programmes in a military environment.
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Occupational exposure to combustion products rich in polycyclic aromatic hydrocarbons and particles is associated with an increased risk of lung cancer. This study aimed to evaluate whether the risk depended on the age at which the individuals were exposed.
Data from 1042 lung cancer cases and 2364 frequency-matched population controls selected from all men aged 40-75 years residing in Stockholm County, Sweden, at any time between 1985 and 1990, included detailed questionnaire information on occupational, residential, and smoking history. Occupational exposures were assessed by an occupational hygienist, and exposure to air pollution from road traffic was estimated based on dispersion models.
We found that individuals exposed to combustion products in their twenties were at higher risk than those never exposed (adjusted OR = 1.46; 95% CI 1.02, 2.10). The association was still evident after adjusting for a number of potential confounders, including lifetime cumulative exposure and latency. No clear association was found in those exposed at older ages.
Exposure to combustion products at a young age was associated with elevated risk of lung cancer. Exposure-reduction programs should be aware of the susceptibility of the younger employees.
The article is devoted to analysis of the problem of lung diseases due to industrial dust exposure in Kursk region and to studying the clinical features of the most widespread occupational respiratory disease--occupational chronic obstructive pulmonary disease, among patients of various age groups. It is shown that the development of dust-induced bronchoobstructive diseases provokes infringement of physiological lungs aging and in clinical course of the disease in elderly and senile age has its features.
BACKGROUND: The reasons for the increasing incidence of and strong male predominance in patients with oesophageal and cardia adenocarcinoma remain unclear. The authors hypothesised that airborne occupational exposures in male dominated industries might contribute. METHODS: In a nationwide Swedish population based case control study, 189 and 262 cases of oesophageal and cardia adenocarcinoma respectively, 167 cases of oesophageal squamous cell carcinoma, and 820 frequency matched controls underwent personal interviews. Based on each study participant's lifetime occupational history the authors assessed cumulative airborne occupational exposure for 10 agents, analysed individually and combined, by a deterministic additive model including probability, frequency, and intensity. Furthermore, occupations and industries of longest duration were analysed. Relative risks were estimated by odds ratios (OR), with 95% confidence intervals (CI), using conditional logistic regression, adjusted for potential confounders. RESULTS: Tendencies of positive associations were found between high exposure to pesticides and risk of oesophageal (OR 2.3 (95% CI 0.9 to 5.7)) and cardia adenocarcinoma (OR 2.1 (95% CI 1.0 to 4.6)). Among workers highly exposed to particular agents, a tendency of an increased risk of oesophageal squamous cell carcinoma was found. There was a twofold increased risk of oesophageal squamous cell carcinoma among concrete and construction workers (OR 2.2 (95% CI 1.1 to 4.2)) and a nearly fourfold increased risk of cardia adenocarcinoma among workers within the motor vehicle industry (OR 3.9 (95% CI 1.5 to 10.4)). An increased risk of oesophageal squamous cell carcinoma (OR 3.9 (95% CI 1.2 to 12.5)), and a tendency of an increased risk of cardia adenocarcinoma (OR 2.8 (95% CI 0.9 to 8.5)), were identified among hotel and restaurant workers. CONCLUSIONS: Specific airborne occupational exposures do not seem to be of major importance in the aetiology of oesophageal or cardia adenocarcinoma and are unlikely to contribute to the increasing incidence or the male predominance.
A study of 206 machine builders in dynamics (up to 15 years) with dust-induced bronchitis showed that the disease has a tendency to advancing within the first three years, especially in those with a combination of noxious professional factors (dust, heat, hard physical work). Negative risk factors: working conditions, preceding unspecific respiratory infections, smoking.
Work-related asthma in aluminium potroom workers, is reviewed and discussed, mainly on the basis of own investigations. The occurrence of work-related asthma has been shown to be associated with the duration of potroom employment, although the prevalence of asthmatic symptoms is not significantly different from that of the general population. Typical manifestations of occupational asthma are described in potroom workers, and a close relationship between the levels of fluoride exposure and work-related asthmatic symptoms has been observed. The existence of occupational asthma in aluminium potroom workers has been confirmed by characteristic patterns of repeated peak flow measurements, supported by changes in methacholine responsiveness in workers with suspected work-related asthma. However, no immunological test is available to establish the diagnosis. Methacholine challenge appears to be inappropriate for screening aluminium potroom workers in order to detect work-related asthma. Current smoking, but not self-reported allergy, is a risk factor for potroom asthma. A family history of asthma and previous occupational exposure may have some effect on the risk of developing symptoms. The prognosis of potroom asthma seems to depend on early replacement to unexposed work. The pathogenetic mechanisms are unknown, although some studies indirectly imply a hypersensitivity reaction. Future studies involving specific bronchial challenge appear to be necessary to find the causal agent(s) of aluminium potroom asthma.
The necessity of studying the impact of electromagnetic fields (EMF) on the health status of the operation staff from power enterprises has stemmed from the improper prior significance being attached to this matter. The subjects of the investigations were operators' premises, work environment system, and operation staff. The intensity of the electrical and magnetic constituents of a 50-Hz EMF in the operation staff's workplaces, in the areas adjacent to 500- and 110-kVsubstation grounding systems, and in the flats of the approximate apartment houses where the workers lived was measured. Then their permissible cumulative daily exposure was calculated. Working arrangement was also assessed. The examinees' behavior was predicted in stress situations. This permitted a scientific rationale to be provided for protective measures against exposure to electromagnetic irradiations in productive and nonproductive conditions.