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Keil A, Haber G, Graubard B, Stewart PA, Silverman D, Koutros S. Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula. Occup Environ Med 2024; 81:225-231. [PMID: 38769004 DOI: 10.1136/oemed-2024-109532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES To inform the potential human carcinogenicity of acrylonitrile, we estimate associations between acrylonitrile exposures and lung cancer mortality in US workers with the objectives of (1) assessing potential for healthy worker survivor bias and (2) adjusting for this bias while assessing the expected lung cancer mortality under different hypothetical occupational exposure limits on acrylonitrile exposure using the parametric g-formula. METHODS We used data from a cohort of 25 460 workers at facilities making or using acrylonitrile in the USA. We estimated HRs to quantify associations between employment and lung cancer mortality, and exposure and leaving employment. Using the parametric g-formula, we estimated cumulative lung cancer mortality at hypothetical limits on acrylonitrile exposure. RESULTS Recent and current employment was associated with lung cancer, and exposure was associated with leaving employment, indicating potential for healthy worker survivor bias. Relative to no intervention, reducing the historical exposure under limits of 2.0, 1.0 and 0.45 parts per million would have been expected to reduce lung cancer mortality by age 90 by 4.46 (95% CI 0.78 to 8.15), 5.03 (95% CI 0.96 to 9.11) and 6.45 (95% CI 2.35 to 10.58) deaths per 1000 workers, respectively. A larger lung cancer mortality reduction would be expected under elimination of exposure: 7.21 (95% CI 2.72 to 11.70) deaths per 1000 workers. CONCLUSIONS Healthy worker survivor bias likely led to underestimation of excess risk. Our results corroborate previous study findings of an excess hazard of lung cancer among the highest exposed workers.
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Affiliation(s)
- Alexander Keil
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Gregory Haber
- Information Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Barry Graubard
- Biostatistics Branch, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Debra Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Stella Koutros
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Ko Y, Howard SC, Golden AP, French B. Adjustment for duration of employment in occupational epidemiology. Ann Epidemiol 2024; 94:33-41. [PMID: 38631438 DOI: 10.1016/j.annepidem.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/12/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE In occupational epidemiology, the healthy worker survivor effect can manifest as a time-dependent confounder because healthier workers can accrue greater amounts of exposure over longer periods of employment. For example, in occupational studies of radiation exposure that focus on cumulative annualized radiation dose, workers can accrue greater amounts of cumulative radiation exposure over longer periods of employment, while workers with longer periods of employment can transition into jobs with a reduced potential for annualized radiation exposure. The extent to which confounding arising from the healthy worker survivor effect impacts radiation risk estimates is unknown. METHODS We assessed the impact of the healthy worker survivor effect on estimates of radiation risk among nuclear workers in a Million Person Study cohort. In simulation studies, we contrasted the ability of marginal structural Cox models with inverse probability weighting and Cox proportional hazards models to account for time-dependent confounding arising from the healthy worker survivor effect. RESULTS Marginal structural Cox models and Cox proportional hazards models with flexible functional forms for duration of employment provided reliable results. CONCLUSIONS It is crucial to flexibly adjust for duration of employment to account for confounding arising from the healthy worker survivor effect in occupational epidemiology.
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Affiliation(s)
- Yeji Ko
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Avenue Suite 1100, Nashville, TN 37203, USA
| | - Sara C Howard
- Oak Ridge Associated Universities, 100 Orau Way, Oak Ridge, TN 37830, USA
| | - Ashley P Golden
- Oak Ridge Associated Universities, 100 Orau Way, Oak Ridge, TN 37830, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Avenue Suite 1100, Nashville, TN 37203, USA.
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Park RM. Risk assessment for conventional diesel exhaust (before 1990) and lung cancer in a cohort of miners. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1413-1429. [PMID: 37876044 DOI: 10.1111/risa.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/22/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023]
Abstract
Diesel exhaust in the latter half of the 20th century has been found to be a lung carcinogen. Conventional diesel emissions continue in the transportation, mining, construction, and farming industries. From the Diesel Exhaust in Miners Study, a public-use dataset was used to calculate the excess lifetime risk of lung cancer associated with diesel exposure (1947-1997). Excess rates of lung cancer mortality associated with respirable elemental carbon (REC) and possible other mining exposures (e.g., oil mists, explosives emissions) were investigated using Poisson regression methods. Lung cancer mortality declined with increasing employment duration while increasing with cumulative REC and non-diesel exposures, suggesting a strong worker survivor effect. Attenuation of the REC effect was observed with increasing cumulative exposure. After adjustment for employment duration, the excess rate ratio for lung cancer mortality was 0.67 (95% CI = 0.35-0.99) for a 10-year lagged exposure to 200 μg/m3 REC, a typical below-ground exposure in the study mines. At exposures of 200, 10, and 1 μg/m3 REC, the estimated excess lifetime risks, respectively, were 119, 43, and 8.7 per thousand. Analysis of an inception cohort hired after dieselization commenced produced smaller and less certain estimates of lifetime risk. From exposures to conventional diesel engine exhaust common in occupational groups in the past, the excess lifetime risk of lung cancer was more than 5%. Ambient REC exposures in the general population were estimated to confer lifetime risks of 0.14 to 14 per thousand, depending on assumptions made.
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Diz JC, Rodríguez I, Iglesias-Sueiro S, Diz Ferreira E, Sanchez-Lastra MA, Ayán C. Mortality of Spanish soccer referees and coaches: a retrospective cohort study. SCI MED FOOTBALL 2024; 8:112-118. [PMID: 36862076 DOI: 10.1080/24733938.2023.2184485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/03/2023]
Abstract
There is evidence that elite soccer players live longer than general population, but there is no information on soccer coaches and referees. We aimed to analyze the longevity of both professionals, comparing them with soccer players and with general population. In this retrospective cohort study, a total of 328 male Spanish soccer coaches, 287 referees, and 1230 soccer players, all born before 1950, were divided in two cohorts, matched 2:1 with coaches and referees. We compared the survival of the cohorts with the Kaplan-Meier estimator and significance with the log-rank test. We calculated hazard ratios of death for coaches and referees compared with male Spanish general population of the same period. Differences in survival among cohorts were found, but they did not reach statistical significance. The estimated median survival time was 80.1 years (95% CI 77.7-82.4) for referees, 78 years (95% CI 76.6-79.3) for coaches, 78.8 years (95% CI 77.6-80) for referees matched with players, and 76.6 years (95% CI 75.3-77.9) for coaches matched with players. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age. We found no differences in longevity among Spanish elite soccer referees, coaches and players born before 1950. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age.
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Affiliation(s)
- José Carlos Diz
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, España
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur). SERGAS-UVIGO, Vigo, Spain
| | - Iván Rodríguez
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, España
| | | | - Eva Diz Ferreira
- Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel A Sanchez-Lastra
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, España
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur). SERGAS-UVIGO, Vigo, Spain
| | - Carlos Ayán
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, España
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur). SERGAS-UVIGO, Vigo, Spain
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Gédor M, Bourgkard È, Dziurla M, Ribet C, Goldberg M, Grzebyk M, Hédelin G, Boini S. Relationship between night work and health-related quality of life: an analysis based on profiles and cumulative duration of exposure to night work among French workers in the CONSTANCES cohort. Int Arch Occup Environ Health 2024; 97:377-386. [PMID: 38466419 DOI: 10.1007/s00420-024-02053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/29/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The aim of this study is to estimate the association between night work and health-related quality of life (HRQoL) among French workers. The association between cumulative duration of night work and HRQoL was also investigated. METHODS Three career-long night work exposure groups were defined at inclusion in the CONSTANCES cohort: permanent night workers, rotating night workers and former night workers. Day workers with no experience of night work were the reference group. HRQoL was assessed using the Short Form Health Survey (SF-12), in particular the physical component summary (PCS) and mental component summary (MCS) scores, with a higher score indicating better HRQoL. Several linear regression models were built to test the association between night work exposure and HRQoL. The relationship between cumulative duration of night work and HRQoL scores was analyzed using generalised additive models. RESULTS The sample consisted of 10,372 participants. Former night workers had a significantly lower PCS score than day workers (β [95% CI]: - 1.09 [- 1.73; - 0.45], p = 0.001), whereas permanent night workers had a significantly higher MCS score (β [95% CI]: 1.19 [0.009; 2.36], p = 0.048). A significant decrease in PCS score from 5 to 20 years of cumulative night work was observed among former night workers. CONCLUSIONS Former night workers had poorer physical HRQoL in contrast to permanent and rotating night workers who had similar or even better HRQoL than day workers, suggesting the well-known healthy worker survivor effect. Consequently, both current and former night workers require regular and specific follow-up focused on the physical components of their health.
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Affiliation(s)
- Maud Gédor
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France.
| | - Ève Bourgkard
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Mathieu Dziurla
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Céline Ribet
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 11, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Villejuif, France
| | - Marcel Goldberg
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 11, Université Paris Cité, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Villejuif, France
| | - Michel Grzebyk
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Guy Hédelin
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
| | - Stéphanie Boini
- Department of Occupational Epidemiology, French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1, Rue du Morvan, CS 60027 54519, Vandœuvre-Lès-Nancy, France
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Min G, Shin J, Kim D, Choe Y, Woo J, Choi KY, Lee J, Cho M, Lee J, Ra JS, Yang W. Potential health risks to disinfection workers from exposure to active substances in COVID-19 biocidal products. Heliyon 2024; 10:e28249. [PMID: 38596037 PMCID: PMC11002044 DOI: 10.1016/j.heliyon.2024.e28249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
The importance of disinfection has recently been emphasized due to the increasing risk of the spread of infections such as coronavirus disease-2019 (COVID-19). In addition, disinfection for preventing the spread of COVID-19 is highly recommended. The increased use of biocidal products raises concerns regarding the potential health risks from exposure among disinfection workers. This study aimed to assess these exposure and health risks using questionnaires targeting disinfection workers who were exposed to the active substances in biocidal products used for disinfection during the COVID-19 pandemic. A follow-up survey was conducted among 271 disinfection workers for 10 working days within two weeks, and exposure factors with reference to disinfection were evaluated through interview-administered questionnaires. An exposure algorithm was used to evaluate the exposure of disinfection workers during disinfection. The hazard index (HI) was calculated by dividing the inhalation concentration obtained using the exposure algorithm and the dermal dose according to occupational exposure limits (OEL). A sensitivity analysis was conducted to identify the exposure factors with the greatest impact on the inhalation and dermal exposure algorithms. A logistic regression analysis was performed to verify the relationship with health effects and sociodemographic and exposure characteristics. The average number of disinfections performed during 10 working days was 17.5 ± 12.3 times. The type of disinfection work was divided into 2806 cases of COVID-19 prevention and disinfection and 1956 cases of regular pesticide application to prevent and remove any pests. The HI was ≥1, indicating a potential health risk, with the use of ethanol (6.50E+00), quaternary ammonium compounds (QACs; 1.49E+01), and benzalkonium chloride (BKC; 1.73E+00). Dermal exposure was more hazardous than inhalation exposure for 6 of the 11 active substances in biocidal products. The weight fraction and exposure time were the factors that most significantly influenced the inhalation and dermal exposure algorithms in the sensitivity analysis. Higher exposure concentrations were more likely to affect health (AOR: 3.239, 95% CI: 1.155-9.082). This study provides valuable information regarding the exposure and risk of disinfection workers to 11 biocidal active substances included in common disinfectants. Our results suggest that the use of ethanol, BKC, and QACs has potential health risks to disinfection workers, with a higher possibility of negative health impacts with increasing exposure concentration.
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Affiliation(s)
- Gihong Min
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Jihun Shin
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Dongjun Kim
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Youngtae Choe
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Jaemin Woo
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Kil Yong Choi
- Department of Environmental Energy Engineering, Anyang University, Anyang, South Korea
| | - Jangwoo Lee
- Convergence Research Center for Big-data, Cheminet Ltd, Seoul, South Korea
| | - Mansu Cho
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
| | - Jongdae Lee
- Department of Environmental Health Science, Soonchunhyang University, Chungnam, South Korea
| | - Jin-Sung Ra
- Eco-testing & Risk Assessment Center, Korea Institute of Industrial Technology, Ansan, South Korea
| | - Wonho Yang
- Department of Health and Safety, Daegu Catholic University, Gyeongbuk, South Korea
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Freund R, Sauvain JJ, Suarez G, Wild P, Charreau T, Debatisse A, Sakthithasan K, Jouannique V, Pralong JA, Guseva Canu I. Discriminative potential of exhaled breath condensate biomarkers with respect to chronic obstructive pulmonary disease. J Occup Med Toxicol 2024; 19:10. [PMID: 38576000 PMCID: PMC10993619 DOI: 10.1186/s12995-024-00409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) affecting 334 million people in the world remains a major cause of morbidity and mortality. Proper diagnosis of COPD is still a challenge and largely solely based on spirometric criteria. We aimed to investigate the potential of nitrosative/oxidative stress and related metabolic biomarkers in exhaled breath condensate (EBC) to discriminate COPD patients. METHODS Three hundred three participants were randomly selected from a 15,000-transit worker cohort within the Respiratory disease Occupational Biomonitoring Collaborative Project (ROBoCoP). COPD was defined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as post-bronchodilator ratio of Forced Expiratory Volume in 1st second to Forced Vital Capacity < 0.7 in spirometry validated by an experienced pulmonologist. Discriminative power of biomarker profiles in EBC was analyzed using linear discriminant analyses. RESULTS Amongst 300 participants with validated spirometry, 50.3% were female, 52.3 years old in average, 36.0% were current smokers, 12.7% ex-smokers with mean tobacco exposure of 15.4 pack-years. Twenty-one participants (7.0%) were diagnosed as COPD, including 19 new diagnoses, 12 of which with a mild COPD stage (GOLD 1). Amongst 8 biomarkers measured in EBC, combination of 2 biomarkers, Lactate and Malondialdehyde (MDA) significantly discriminated COPD subjects from non-COPD, with a 71%-accuracy, area under the receiver curve of 0.78 (p-value < 0.001), and a negative predictive value of 96%. CONCLUSIONS These findings support the potential of biomarkers in EBC, in particular lactate and MDA, to discriminate COPD patients even at a mild or moderate stage. These EBC biomarkers present a non-invasive and drugless technique, which can improve COPD diagnosis in the future.
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Affiliation(s)
- Romain Freund
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Jean-Jacques Sauvain
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Guillaume Suarez
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pascal Wild
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Thomas Charreau
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Jacques A Pralong
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- SwissMedPro Health Services, Geneva, Switzerland
- Hôpital de La Tour, Geneva, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Guseva Canu I, Wild P, Charreau T, Freund R, Toto A, Pralong J, Sakthithasan K, Jouannique V, Debatisse A, Suarez G. Long-term exposure to PM 10 and respiratory health among Parisian subway workers. Int J Hyg Environ Health 2024; 256:114316. [PMID: 38159498 DOI: 10.1016/j.ijheh.2023.114316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Exposure to ambient PM10 may increase the risk of chronic obstructive pulmonary disease (COPD) and lung function decline. We evaluated the long-term exposure to PM10 and its relationship with COPD prevalence and lung function in Parisian subway workers. Participants were randomly selected from a 15,000-subway worker cohort. Individual annual external exposure to PM10 (ePM10) was estimated using a company-specific job-exposure-matrix based on PM10 measurements conducted between 2004 and 2019 in the Parisian subway network. Mean annual inhaled PM10 exposure (iPM10) was modeled as function of ePM10 exposure, inhalation rate, and filtration efficiency of the respiratory protection used. COPD diagnosis was performed in March-May 2021 based on post-bronchodilator spirometry. The relationship between iPM10 and outcomes was assessed using logistic and linear regression models, adjusted for exposure duration and potential confounders. Amongst 254 participants with complete data, 17 were diagnosed as COPD. The mean employment duration was 23.2 ± 7.3years, with annual mean ePM10 of 71.8 ± 33.7 μg/m3 and iPM10 of 0.59 ± 0.27 μg/shift, respectively. A positive but statistically non-significant association was found for COPD prevalence with iPM10 (OR = 1.034, 95%-CI = 0.781; 1.369, per 100 ng/shift) and ePM10 (OR = 1.029, 95%-CI = 0.879; 1.207, per 10 μg/m3). No decline in lung function was associated with PM10 exposure. However, forced expiratory volume during the first second and forced vital capacity lower than normal were positively associated with exposure duration (OR = 1.125, 95%-CI = 1.004; 1.260 and OR = 1.171, 95%-CI = 0.989; 1.386 per year, respectively). Current smoking was strongly associated with COPD prevalence (OR = 6.85, 95%-CI = 1.87; 25.10) and most lung function parameters. This is the first study assessing the relationship between long-term exposure to subway PM10 and respiratory health in subway workers. The risk estimates related with subway PM10 exposure are compatible with those related to outdoor PM10 exposure in the large recent studies. Large cohorts of subway workers are necessary to confirm these findings.
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Affiliation(s)
- Irina Guseva Canu
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland.
| | - Pascal Wild
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Thomas Charreau
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Romain Freund
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Antonio Toto
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Jacques Pralong
- Faculty of Medicine, University of Geneva, Switzerland; SwissMedPro Health Services, Switzerland; Hôpital de la Tour, Geneva, Switzerland
| | | | | | | | - Guillaume Suarez
- Center from Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
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Landau Prat D, Kapelushnik N, Zloto O, Leshno A, Klang E, Sina S, Segev S, Arazi M, Soudry S, Ben Simon GJ. Prevalence of common and rare ophthalmic findings in adults attending a medical survey institute. Int Ophthalmol 2024; 44:43. [PMID: 38334834 PMCID: PMC10857980 DOI: 10.1007/s10792-024-03026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To examine the ophthalmic data from a large database of people attending a general medical survey institute, and to investigate ophthalmic findings of the eye and its adnexa, including differences in age and sex. METHODS Retrospective analysis including medical data of all consecutive individuals whose ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects examined at a single general medical survey institute. RESULTS Data were derived from 184,589 visits of 3676 patients (mean age 52 years, 68% males). The prevalence of the following eye pathologies were extracted. Eyelids: blepharitis (n = 4885, 13.3%), dermatochalasis (n = 4666, 12.7%), ptosis (n = 677, 1.8%), ectropion (n = 73, 0.2%), and xanthelasma (n = 160, 0.4%). Anterior segment: pinguecula (n = 3368, 9.2%), pterygium (n = 852, 2.3%), and cataract or pseudophakia (n = 9381, 27.1%). Cataract type (percentage of all phakic patients): nuclear sclerosis (n = 8908, 24.2%), posterior subcapsular (n = 846, 2.3%), and capsular anterior (n = 781, 2.1%). Pseudophakia was recorded for 697 patients (4.6%), and posterior subcapsular opacification for 229 (0.6%) patients. Optic nerve head (ONH): peripapillary atrophy (n = 4947, 13.5%), tilted disc (n = 3344, 9.1%), temporal slope (n = 410, 1.1%), ONH notch (n = 61, 0.2%), myelinated nerve fiber layer (n = 94, 0.3%), ONH drusen (n = 37, 0.1%), optic pit (n = 3, 0.0%), and ON coloboma (n = 4, 0.0%). Most pathologies were more common in males except for ONH, and most pathologies demonstrated a higher prevalence with increasing age. CONCLUSIONS Normal ophthalmic data and the prevalences of ocular pathologies were extracted from a very large database of subjects seen at a single medical survey institute.
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Affiliation(s)
- Daphna Landau Prat
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel.
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
| | - Noa Kapelushnik
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Ofira Zloto
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Ari Leshno
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Eyal Klang
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
- The Sami Sagol AI Hub, ARC Innovation Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Sigal Sina
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | - Shlomo Segev
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
- Institute for Medical Screening, Sheba Medical Center, Tel Hashomer, Israel
| | - Mattan Arazi
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
| | | | - Guy J Ben Simon
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
- Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
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Calderwood CJ, Marambire E, Nzvere FP, Larsson LS, Chingono RMS, Kavenga F, Redzo N, Bandason T, Rusakaniko S, Mujuru HA, Simms V, Khan P, Gregson CL, Ndhlovu CE, Ferrand RA, Fielding K, Kranzer K. Prevalence of chronic conditions and multimorbidity among healthcare workers in Zimbabwe: Results from a screening intervention. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002630. [PMID: 38261562 PMCID: PMC10805297 DOI: 10.1371/journal.pgph.0002630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/27/2023] [Indexed: 01/25/2024]
Abstract
The burden of non-communicable diseases (NCDs) in southern Africa is expanding and is superimposed on high HIV prevalence. Healthcare workers are a scarce resource; yet are vital to health systems. There are very limited studies on the burden of chronic conditions among healthcare workers in Africa, and none exploring multimorbidity (≥2 chronic conditions). We describe the epidemiology of infectious (HIV) and non-communicable chronic conditions, and multimorbidity, among Zimbabwean healthcare workers. Healthcare workers (≥18 years) in eight Zimbabwean provinces were invited to a voluntary, cross-sectional health-check, including HIV, diabetes, hypertension and mental health screening. Statistical analyses described the prevalence and risk factors for multimorbidity (two or more of HIV, diabetes, hypertension or common mental disorder) and each condition. Missing data were handled using multiple imputation. Among 6598 healthcare workers (July 2020-July 2022) participating in the health-check, median age was 37 years (interquartile range 29-44), 79% were women and 10% knew they were living with HIV. Half had at least one chronic condition: 11% were living with HIV, 36% had elevated blood pressure, 12% had elevated HbA1c and 11% had symptoms of common mental disorder. The overall prevalence of multimorbidity was 15% (95% CI: 13-17%); 39% (95% CI: 36-43%) among people aged 50 and older. Whilst most HIV was diagnosed and treated, other chronic conditions were usually undiagnosed or uncontrolled. Limiting our definition of multimorbidity to two or more screened conditions sought to reduce bias due to access to diagnosis, however, may have led to a lower reported prevalence than that found using a wider definition. Half of healthcare workers screened were living with a chronic condition; one in seven had multimorbidity. Other than HIV, most conditions were undiagnosed or untreated. Multisectoral action to implement contextually relevant, chronic disease services in Africa is urgently needed. Specific attention on health workers is required to protect and retain this critical workforce.
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Affiliation(s)
- Claire Jacqueline Calderwood
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Edson Marambire
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Farirai Peter Nzvere
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Leyla Sophie Larsson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
| | - Rudo M. S. Chingono
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Fungai Kavenga
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- AIDS & TB Control Programme, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Nicole Redzo
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Hilda A. Mujuru
- Faculty of Medicine and Health Sciences, Child and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Victoria Simms
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Data Science Unit, Africa Health Research Institute, Durban, South Africa
| | - Palwasha Khan
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Data Science Unit, Africa Health Research Institute, Durban, South Africa
| | - Celia Louise Gregson
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Global Health and Ageing Research Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chiratidzo E. Ndhlovu
- Internal Medicine Unit, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rashida Abbas Ferrand
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
| | - Katherine Fielding
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katharina Kranzer
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Health Research Unit Zimbabwe, Biomedical Research & Training Institute, Harare, Zimbabwe
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich, Munich, Germany
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11
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Babigumira R, Veierød MB, Hosgood HD, Samuelsen SO, Bråtveit M, Kirkeleit J, Rothman N, Lan Q, Silverman DT, Friesen MC, Shala NK, Grimsrud TK, Stenehjem JS. Benzene exposure and risk of lung cancer in the Norwegian Offshore Petroleum Worker cohort: a prospective case-cohort study. Occup Environ Med 2023:oemed-2023-109139. [PMID: 38154914 DOI: 10.1136/oemed-2023-109139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The objective of our study was to examine whether occupational exposure to benzene is associated with lung cancer among males in the Norwegian Offshore Petroleum Workers cohort. METHODS Among 25 347 male offshore workers employed during 1965-1998, we conducted a case-cohort study with 399 lung cancer cases diagnosed between 1999 and 2021, and 2035 non-cases sampled randomly by 5-year birth cohorts. Individual work histories were coupled to study-specific job-exposure matrices for benzene and other known lung carcinogens. Weighted Cox regression was used to estimate HRs and 95% CIs for the associations between benzene exposure and lung cancer, by major histological subtypes, adjusted for age, smoking and occupational exposure to welding fumes, asbestos and crystalline silica. Missing data were imputed. RESULTS For lung cancer (all subtypes combined), HRs (95% CIs) for the highest quartiles of benzene exposure versus unexposed were 1.15 (0.61 to 2.35) for cumulative exposure, 1.43 (0.76 to 2.69) for duration, and 1.22 (0.68 to 2.18) for average intensity (0.280≤P-trend≤0.741). For 152 adenocarcinoma cases, a positive trend was observed for exposure duration (P-trend=0.044). CONCLUSIONS In this cohort of offshore petroleum workers generally exposed to low average levels of benzene, we did not find an overall clear support for an association with lung cancer (all subtypes combined), although an association was suggested for duration of benzene exposure and adenocarcinoma. The limited evidence might be due to restricted statistical power.
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Affiliation(s)
- Ronnie Babigumira
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jorunn Kirkeleit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (NIOH), Oslo, Norway
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Nita Kaupang Shala
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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12
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Kyung M, Chin DL, Phelps S, Hong O. Testing the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap in career firefighters in the United States. Am J Ind Med 2023; 66:1101-1108. [PMID: 37717215 DOI: 10.1002/ajim.23536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Firefighters are routinely exposed to loud noise that put them at risk for hearing loss. A reliable and valid measure to assess firefighters' hearing function is important. This study aims to test the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap ((m)AIADH) in firefighters. METHOD A cross-sectional study was conducted using a convenience sample of 239 career firefighters from six partnered fire departments in Central Texas and Northern California. The internal consistency, convergent and criterion validity, and the ability to discriminate groups by measured hearing, perceived hearing, and a combination of measured and perceived hearing, were examined using the total score and score for each of the five subscales of the (m)AIADH. RESULTS The study participants were primarily men (93%). Satisfactory internal consistency was revealed for the (m)AIADH with Cronbach's alpha above 0.80 for all five subscales. Criterion analysis presented a moderate correlation between the (m)AIADH and the average of hearing threshold at high frequencies (4, 6, and 8 kHz). For convergent validity, the (m)AIADH was moderately to highly related with perceived hearing. There were statistically significant differences in the total (m)AIADH score and the five subscales for measured hearing thresholds except for "intelligibility in quiet." The (m)AIADH also showed a discriminative ability to distinguish between the group with good perceived hearing and the group with bad perceived hearing. CONCLUSION The (m)AIADH is a reliable and valid measure to assess various dimensions of hearing function among firefighters.
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Affiliation(s)
- Minjung Kyung
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Dal Lae Chin
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Stephanie Phelps
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - OiSaeng Hong
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, USA
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13
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Araujo-Chaveron L, Sicsic J, Moffroid H, Díaz Luévano C, Blondel S, Langot F, Mueller JE. Impact of a COVID-19 certificate requirement on vaccine uptake pattern and intention for future vaccination. A cross-sectional study among French adults. Vaccine 2023; 41:5412-5423. [PMID: 37481404 DOI: 10.1016/j.vaccine.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/22/2023] [Accepted: 07/02/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND In August 2021, France enacted a COVID-19 certificate requirement (vaccination/recovery/test) to access specific services, with mandates for professional groups. We evaluated the impact of this incentive-coercive policy in terms of vaccine uptake equality, future vaccine intention and confidence in authorities' crisis management. METHODS In late August 2021, a representative sample of adults (18-75 years) completed an internet-based questionnaire. We classified vaccinated participants by stated reasons for vaccination and estimated adjusted prevalence ratios (aPR) using multivariable Poisson regression. Counterfactual vaccine status assumed non-vaccination of those vaccinated for the certificate. We analysed the association of free-text testimonial themes with level of confidence in authorities. RESULTS Among 972 participants, 85.7% were vaccinated or intended vaccination: 3.6% only for certificate/mandate, 17.7% mainly for certificate/mandate plus other reasons, and 64.4% mainly for other reasons. In the counterfactual situation, vaccine uptake would have been significantly more likely among older vs. younger participants (aPR = 1.35) and among those with moderate-high vs. low levels of confidence in authorities for COVID-19 crisis management (aPR = 2.04). In the observed situation, confidence was the only significant determinant of vaccine status (moderate-high vs. low, aPR = 1.39). Among those without genuine motivation for vaccination, professionally active persons were more likely to have ceded to the certificate requirement (aPR = 3.76). Those vaccinated only for the certificate were more likely to express future COVID-19 vaccine intention than unvaccinated persons (aPR = 6.41). Themes significantly associated with lower confidence were criticism of morality (aPR = 1.76) and poor communication by the authorities (aPR = 1.66). CONCLUSION The incentive-coercive policy has reduced the negative association of vaccine status with younger age and low confidence in authorities, but may have reinforced isolation of professionally inactive persons. The requirement did not negatively impact future COVID-19 vaccine intention. Future vaccine-incentive policies should pay special attention to populations with low levels of confidence in authorities.
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Affiliation(s)
- Lucia Araujo-Chaveron
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France
| | | | - Hadrien Moffroid
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; University of Melbourne, Australia
| | | | - Serge Blondel
- Université Paris Cité, LIRAES, F-75006 Paris, France; GRANEM - Groupe de Recherche Angevin en Economie et Management, Paris, France
| | - François Langot
- Le Mans Université (Gains-TEPP, IRA), Le Mans, France; IUF - Institut Universitaire de France, Paris, France; PSE - Paris School of Economics, Paris, France; CEPREMAP - Centre pour la recherche économique et ses applications, Paris, France; IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics, Bonn, Germany
| | - Judith E Mueller
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France.
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14
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Richardson DB, Leuraud K, Laurier D, Gillies M, Haylock R, Kelly-Reif K, Bertke S, Daniels RD, Thierry-Chef I, Moissonnier M, Kesminiene A, Schubauer-Berigan MK. Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study. BMJ 2023; 382:e074520. [PMID: 37586731 PMCID: PMC10427997 DOI: 10.1136/bmj-2022-074520] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To evaluate the effect of protracted low dose, low dose rate exposure to ionising radiation on the risk of cancer. DESIGN Multinational cohort study. SETTING Cohorts of workers in the nuclear industry in France, the UK, and the US included in a major update to the International Nuclear Workers Study (INWORKS). PARTICIPANTS 309 932 workers with individual monitoring data for external exposure to ionising radiation and a total follow-up of 10.7 million person years. MAIN OUTCOME MEASURES Estimates of excess relative rate per gray (Gy) of radiation dose for mortality from cancer. RESULTS The study included 103 553 deaths, of which 28 089 were due to solid cancers. The estimated rate of mortality due to solid cancer increased with cumulative dose by 52% (90% confidence interval 27% to 77%) per Gy, lagged by 10 years. Restricting the analysis to the low cumulative dose range (0-100 mGy) approximately doubled the estimate of association (and increased the width of its confidence interval), as did restricting the analysis to workers hired in the more recent years of operations when estimates of occupational external penetrating radiation dose were recorded more accurately. Exclusion of deaths from lung cancer and pleural cancer had a modest effect on the estimated magnitude of association, providing indirect evidence that the association was not substantially confounded by smoking or occupational exposure to asbestos. CONCLUSIONS This major update to INWORKS provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality based on some of the world's most informative cohorts of radiation workers. The summary estimate of excess relative rate solid cancer mortality per Gy is larger than estimates currently informing radiation protection, and some evidence suggests a steeper slope for the dose-response association in the low dose range than over the full dose range. These results can help to strengthen radiation protection, especially for low dose exposures that are of primary interest in contemporary medical, occupational, and environmental settings.
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Affiliation(s)
- David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | | | | | - Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Stephen Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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15
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Singh A, Zeig-Owens R, Cannon M, Webber MP, Goldfarb DG, Daniels RD, Prezant DJ, Boffetta P, Hall CB. All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters. Occup Environ Med 2023; 80:297-303. [PMID: 36972975 PMCID: PMC10523283 DOI: 10.1136/oemed-2022-108703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population. METHODS 10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race. RESULTS Between 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. CONCLUSION Both firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.
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Affiliation(s)
- Ankura Singh
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Madeline Cannon
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Mayris P Webber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David G Goldfarb
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Robert D Daniels
- Division of Science integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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16
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Sato K, Noguchi H, Inoue K, Kawachi I, Kondo N. Retirement and cardiovascular disease: a longitudinal study in 35 countries. Int J Epidemiol 2023:7157039. [PMID: 37155837 PMCID: PMC10396426 DOI: 10.1093/ije/dyad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Many countries have been increasing their state pension age (SPA); nonetheless, there is little consensus on whether retirement affects the risk of cardiovascular disease (CVD). This study examined the associations of retirement with CVD and risk factors. METHODS We used harmonized longitudinal datasets from the Health and Retirement Study and its sister surveys in 35 countries. Data comprised 396 904 observations from 106 927 unique individuals aged 50-70 years, with a mean follow-up period of 6.7 years. Fixed-effects instrumental variable regressions were performed using the SPA as an instrument. RESULTS We found a 2.2%-point decrease in the risk of heart disease [coefficient = -0.022 (95% confidence interval: -0.031 to -0.012)] and a 3.0%-point decrease in physical inactivity [-0.030 (-0.049 to -0.010)] among retirees, compared with workers. In both sexes, retirement was associated with a decreased heart disease risk, whereas decreased smoking was observed only among women. People with high educational levels showed associations between retirement and decreased risks of stroke, obesity and physical inactivity. People who retired from non-physical labour exhibited reduced risks of heart disease, obesity and physical inactivity, whereas those who retired from physical labour indicated an increased risk of obesity. CONCLUSIONS Retirement was associated with a reduced risk of heart disease on average. Some associations of retirement with CVD and risk factors appeared heterogeneous by individual characteristics.
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Affiliation(s)
- Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Graduate School of Economics, Waseda University, Tokyo, Japan
| | - Haruko Noguchi
- Graduate School of Economics, Waseda University, Tokyo, Japan
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
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17
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Wang S, Xue Y, Zhang J, Meng H, Zhang J, Li X, Zhang Z, Li H, Pan B, Lu X, Zhang Q, Niu Q. Interaction between aluminum exposure and ApoEε4 gene on cognitive function of in-service workers. CHEMOSPHERE 2023; 323:138282. [PMID: 36868418 DOI: 10.1016/j.chemosphere.2023.138282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/28/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The occurrence and development of cognitive impairment, the early stage of AD, may be affected both by factors of environmental (aluminum exposure) and genetic (ApoEε4 gene). But whether there is an interaction between the two factors on cognitive function is still unknown. To explore the interaction between the two factors on cognitive function of in-service workers. A total of 1121 in-service workers in a large aluminum factory were investigated in Shanxi Province. Cognitive function was assessed by the Mini-mental State Examination (MMSE), the clock-drawing test (CDT), the Digit Span Test (DST, including DSFT and DSBT), the fuld object memory evaluation (FOM), and the verbal fluency task (VFT). The plasma-Al (p-Al) concentrations were measured by inductively coupled plasma-mass spectrometry (ICP-MS) as an internal exposure indicator, and the participants were divided into four Al exposure groups according to the quartile of p-Al concentrations, namely Q1, Q2, Q3, and Q4. ApoE genotype was determined by Ligase Detection Reaction (LDR). The multiplicative model was fitted using non-conditional logistic regression and additive model was fitted using crossover analysis to analyze the interaction between p-Al concentrations and the ApoEε4 gene. Finally, a dose-response relationship between p-Al concentrations and cognitive impairment was observed, with the p-Al concentrations increased, cognitive function performance gradually becomes worse (Ptrend<0.05), and the risk of cognitive impairment gradually increases (Ptrend<0.05), mainly in executive/visuospatial impairment, auditory memory impairment (particularly the working memory impairment). And ApoEε4 gene may be a risk factor for cognitive impairment, while no association between the ApoEε2 gene and cognitive impairment is observed. Additionally, an additive but no multiplicative interaction between p-Al concentrations and ApoEε4 gene is observed, and when the two factors work together, the risk of cognitive impairment further increased, of which 44.2% can be attributed to the interaction effect.
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Affiliation(s)
- Shanshan Wang
- Section of Occupational Medicine, Department of Special Medicine, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Yingjun Xue
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Jintao Zhang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Huaxing Meng
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Department of Neurology, First Hospital, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Jingsi Zhang
- Section of Occupational Medicine, Department of Special Medicine, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Xiaoyan Li
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Zhuoran Zhang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Huan Li
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Department of Occupational Health, School of Public Health, Jining Medical University, Jining, Shandong, 272000, China
| | - Baolong Pan
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Sixth Hospital of Shanxi Medical University (General Hospital of Tisco), Taiyuan, Shanxi, 030001, China
| | - Xiaoting Lu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Key Lab of Environmental Hazards and Health Damage of Shanxi Province, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Qinli Zhang
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Key Lab of Environmental Hazards and Health Damage of Shanxi Province, Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Qiao Niu
- Department of Occupational Health, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Key Lab of Environmental Hazards and Health Damage of Shanxi Province, Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
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18
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Rathod AM, Verpaele S, Kelvin M, Sullivan KV, Leybourne MI. Uranium: an overview of physicochemical properties, exposure assessment methodologies, and health effects of environmental and occupational exposure. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:1183-1200. [PMID: 35711076 DOI: 10.1007/s10653-022-01293-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
Uranium is chemo- and radiotoxic element which can cause multifactorial health hazards. Natural and anthropogenic uranium contamination raises concerns about potential public health problems. Natural contamination plays a significant role with regard to uranium exposure in the general population, whereas anthropogenic contamination leads to occupational uranium exposure, particularly in nuclear industry workers. In this review, we present a state-of-the-art status concerning uranium-induced health risks with a focus on epidemiological findings of uranium processing and enrichment plant workers. We provide a general overview of physicochemical properties of uranium and analytical methods for measuring or monitoring uranium, describe environmental and occupational exposure scenarios, and discuss the challenges for objectively investigating risks from uranium exposure.
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Affiliation(s)
- Abhisha M Rathod
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, 64 Bader Lane, Kingston, ON, K7L 3N6, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, T6G 2S2, Canada
| | - Steven Verpaele
- Nickel Institute, Health and Environment Public Policy, Brussels, Belgium
| | - Michelle Kelvin
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
| | - Kaj V Sullivan
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada
| | - Matthew I Leybourne
- Department of Geoscience and Geological Engineering, Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada.
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, 64 Bader Lane, Kingston, ON, K7L 3N6, Canada.
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19
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Re: Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health. 2022;48(2):86-98. doi:10.5271/sjweh.3993. Scand J Work Environ Health 2023; 49:231-244. [PMID: 37000459 PMCID: PMC10621902 DOI: 10.5271/sjweh.4090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 04/01/2023] Open
Abstract
Objectives Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. Methods A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. Results We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.84–1.12] and females (HR 0.97, 95% CI 0.82–1.15). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 9% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.09, 95% CI 0.82–1.43). Conclusions While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
| | | | | | | | | | | | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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20
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Pan Y, Pikhart H, Bobak M, Pikhartova J. Labour-Market Characteristics and Self-Rated Health: Evidence from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4748. [PMID: 36981656 PMCID: PMC10048592 DOI: 10.3390/ijerph20064748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
In the face of labour-force ageing, understanding labour-market characteristics and the health status of middle-aged and older workers is important for sustainable social and economic development. Self-rated health (SRH) is a widely-used instrument to detect health problems and predict mortality. This study investigated labour-market characteristics that may have an impact on the SRH among Chinese middle-aged and older workers, using data from the national baseline wave of the China Health and Retirement Longitudinal Study. The analytical sample included 3864 individuals who at the time held at least one non-agricultural job. Fourteen labour-market characteristics were clearly defined and investigated. Multiple logistic regression models of the associations of each labour-market characteristic with SRH were estimated. Seven labour-market characteristics were associated with higher odds of poor SRH when controlled for age and sex. Employment status and earned income remained significantly associated with poor SRH, when controlling for all the sociodemographic factors and health behaviours. Doing unpaid work in family businesses is associated with 2.07 (95% CI, 1.51-2.84) times probability of poor SRH, compared with employed individuals. Compared with more affluent individuals (highest quintile of earned income), people in the fourth and fifth quintiles had 1.92 (95% CI, 1.29-2.86) times and 2.72 (95% CI, 1.83-4.02) times higher chance, respectively, of poor SRH. In addition, residence type and region were important confounders. Measures improving adverse working conditions should be taken to prevent future risk of impaired health among the Chinese middle-aged and older workforce.
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21
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Harber P, Furlong M, Stern DA, Morgan WJ, Wright AL, Guerra S, Martinez FD. Association of Childhood Respiratory Status with Adult Occupational Exposures in a Birth Cohort. Ann Am Thorac Soc 2023; 20:390-396. [PMID: 36538681 PMCID: PMC9993150 DOI: 10.1513/annalsats.202204-293oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Rationale: People with better early-life respiratory health may be more likely to work in occupations with high workplace exposures in adult life compared with people with poor respiratory health. This may manifest as a healthy worker effect bias, potentially confounding the analysis of environmental exposure studies. Objectives: To evaluate associations between lung function in adolescence and occupational exposures at initial adult employment. Methods: The TCRS (Tucson Children's Respiratory Study) is a long-term prospective study of respiratory health beginning at birth. Associations between respiratory function at age 11 years and occupational exposures at first job at age 26 years were evaluated with logistic regression. We calculated percentage predicted values for forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1:FVC ratio, and forced expiratory flow from 25% to 75% of vital capacity at age 11. At the 26-year visit, participants self-reported occupational exposures to dust, smoke, and fumes/gas at first job in a standardized interview. Results: Forced expiratory flow from 25% to 75% of vital capacity and FEV1:FVC ratio at age 11 were positively associated with dust workplace exposures at the first job. Each 10% increase in percentage predicted prebronchodilator FEV1:FVC ratio was associated with 30% higher odds of workplace dust exposure (odds ratio for a 1% increase, 1.03 [95% confidence interval, 1.00-1.06; P = 0.045]). Similar associations were observed for FEV1 and FVC with workplace smoke exposures. We also observed modification by time at job: associations were stronger for those who remained in their jobs longer than 12 months. In addition, those with better function at age 11 were more likely to stay in their jobs longer than 12 months if their first jobs involved exposure to dust. Conclusions: Childhood lung function affects initial career choice. This study supports the premise of the healthy worker effect.
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Affiliation(s)
- Philip Harber
- Mel and Enid Zuckerman College of Public Health
- Asthma and Airway Disease Research Center, and
| | | | | | - Wayne J. Morgan
- Asthma and Airway Disease Research Center, and
- Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Anne L. Wright
- Asthma and Airway Disease Research Center, and
- Department of Pediatrics, University of Arizona, Tucson, Arizona
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22
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Takayama A, Takeshima T, Omae K, Yoshioka T, Nakagawa H, Ozaka A, Takahashi S, Naganuma T, Hamaguchi S, Fukuhara S. Association Between Paid Work and Health-Related Quality of Life Among Community-Dwelling Older Adults: The Sukagawa Study. J Appl Gerontol 2023; 42:1056-1067. [PMID: 36680311 DOI: 10.1177/07334648231152157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In this study, we aimed to determine whether paid work has an impact on health-related quality of life (HRQOL) among older adults. Over three years, we longitudinally collected data from 5,260 community-dwelling older adults aged 75 years or older from a city in Japan. We assessed HRQOL using the Short-Form-8. We estimated the mean difference between the physical component summary (PCS) and the mental component summary (MCS) scores, which were stratified based on gender using multivariate, generalized estimating equation models. We further conducted a subgroup analysis based on the participants' occupational backgrounds. Engagement in paid work was associated with increased MCS scores across both genders and with increased PCS scores among women. In the subgroup analysis, only women who had previously worked as managerial workers showed an inverse association with MCS scores. In this population, engagement in paid work may be a crucial factor associated with well-being.
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Affiliation(s)
- Atsushi Takayama
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, 38049Kyoto University, Japan
| | - Taro Takeshima
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of General Medicine, Shirakawa Satellite for Teaching And Research (STAR), 13251Fukushima Medical University, Japan
| | - Kenji Omae
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), 12775Fukushima Medical UniversityHospital, Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Hiroaki Nakagawa
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of General Internal Medicine, 12775Fukushima Medical University, Fukushima, Japan
| | - Akihiro Ozaka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
| | - Sei Takahashi
- Department of General Internal Medicine, 12775Fukushima Medical University, Fukushima, Japan
- Futaba Emergency and General Medicine Support Center, 12775Fukushima Medical University
| | - Toru Naganuma
- Department of General Internal Medicine, 12775Fukushima Medical University, Fukushima, Japan
- Futaba Emergency and General Medicine Support Center, 12775Fukushima Medical University
| | - Sugihiro Hamaguchi
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Department of General Internal Medicine, 12775Fukushima Medical University, Fukushima, Japan
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), 12775Fukushima Medical University, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, 38049Kyoto University, Kyoto, Japan
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, ML, USA
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23
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Kayyal-Tarabeia I, Blank M, Zick A, Agay-Shay K. Residence near industrial complex and cancer incidence: A registry-based cohort of 1,022,637 participants with a follow-up of 21 years, Israel. ENVIRONMENTAL RESEARCH 2023; 216:114471. [PMID: 36208787 DOI: 10.1016/j.envres.2022.114471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/12/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Industrial complex (IC) residence is associated with higher cancer incidence in adults and children. However, the effect on young adults and the residence duration are not well described. Since the beginning of the 20th century, the Haifa bay area (HBA) has a major IC area with petrochemical industry complex and many other industries. The objectives of the current study were to estimate the association between IC residence and cancer incidence and to evaluate the effect of the residence duration. METHODS This study is a registry-based cohort (N = 1,022,637) with a follow-up of 21 years. Cox regression models were used to evaluate the associations (hazards ratios (HR) and its 95% confidence intervals (CIs)) between HBA residence and incidence of all cancer sites (n = 62,049) and for site-specific cancer types including: lung cancer (n = 5398), bladder cancer (n = 3790), breast cancer (n = 11,310), prostate cancer (n = 6389) skin cancer (n = 4651), pancreatic cancer (n = 2144) and colorectal cancer (n = 8675). We evaluated the effect of the duration of exposure as categories of 7 years for those with 15 years of follow-up. RESULTS IC residence was associated with higher risk for all cancer sites (HR:1.09, 95% CI: 1.06-1.12), for site-specific cancer incidence including: lung cancer (HR:1.14, 95% CI: 1.04-1.23), bladder cancer (HR:1.11, 95% CI: 1.01-1.23), breast cancer (HR:1.04, 95% CI: 0.98-1.10), prostate cancer (HR:1.07, 95% CI: 0.99-1.16), skin cancer (HR:1.22, 95% CI: 1.12-1.33) and colorectal cancer (HR:1.10, 95%CI: 1.03-1.17). Similar risk was also observed among young adults (HR: 1.10, 95% CI: 1.00-1.20). In the analyses for the duration of exposure, IC residence was associated with higher risk for all cancer site for the longest residence duration (15-21 years: HR: 1.08, 95% CI: 1.04-1.13). CONCLUSIONS Harmful associations were found between IC residence and incidence of all cancer sites and site-specific cancers types. Our findings add to the limited evidence of associations between IC residence and cancer in young adults.
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Affiliation(s)
- Inass Kayyal-Tarabeia
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
| | - Michael Blank
- Laboratory of Molecular and Cellular Cancer Biology, Azrieli Faculty of Medicine, Bar Ilan University, Israel.
| | - Aviad Zick
- Department of Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Ein-Kerem, Jerusalem, Israel.
| | - Keren Agay-Shay
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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24
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Lindert L, Zeike S, Choi KE(A, Pfaff H. Transformational Leadership and Employees' Psychological Wellbeing: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:676. [PMID: 36612996 PMCID: PMC9819424 DOI: 10.3390/ijerph20010676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Managers play a key role in realizing a humane organization of work. Transformational leadership aims to identify and examine leadership behaviors that strengthen employees' awareness of the importance and values of task outcomes by articulating a vision for the future, providing a realistic action plan, and giving individualized support. Previous studies have revealed associations between transformational leadership and the psychological wellbeing of employees in different settings, while others did not find such associations. As research based on longitudinal data remains rare, this study builds on longitudinal data from two employee surveys conducted in 2015 and 2018 in a medium-sized German company. In this study, transformational leadershipt0 and gender had a significant impact on transformational leadershipt1, while psychological wellbeing∆, social capital∆, and age did not. Psychological wellbeingt0 and social capital∆ had a significant impact on psychological wellbeingt1, but transformational leadership∆, age, and gender did not. Therefore, it is worthwhile for companies to invest in social capital and focus on gender aspects at work. As underlying mechanisms regarding employees' psychological wellbeing may differ between companies, it is worthwhile for each organization to conduct mental risk assessments to identify "red flags" and implement suitable measures.
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Affiliation(s)
- Lara Lindert
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
| | - Sabrina Zeike
- vivalue Health Consulting GmbH, Friesenplatz 4, 50672 Cologne, Germany
| | - Kyung-Eun (Anna) Choi
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
- Health Services Research, MIAAI, Danube Private University (DPU) GmbH, Steiner Landstraße 124, 3500 Krems an der Donau, Austria
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
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Oh J, Min J, Kang C, Kim E, Lee JP, Kim H, Lee W. Excess mortality and the COVID-19 pandemic: causes of death and social inequalities. BMC Public Health 2022; 22:2293. [PMID: 36476143 PMCID: PMC9730675 DOI: 10.1186/s12889-022-14785-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the coronavirus diseases 2019 (COVID-19) pandemic, population's mortality has been affected not only by the risk of infection itself, but also through deferred care for other causes and changes in lifestyle. This study aims to investigate excess mortality by cause of death and socio-demographic context during the COVID-19 pandemic in South Korea. METHODS: Mortality data within the period 2015-2020 were obtained from Statistics Korea, and deaths from COVID-19 were excluded. We estimated 2020 daily excess deaths for all causes, the eight leading causes of death, and according to individual characteristics, using a two-stage interrupted time series design accounting for temporal trends and variations in other risk factors. RESULTS During the pandemic period (February 18 to December 31, 2020), an estimated 663 (95% empirical confidence interval [eCI]: -2356-3584) excess deaths occurred in South Korea. Mortality related to respiratory diseases decreased by 4371 (3452-5480), whereas deaths due to metabolic diseases and ill-defined causes increased by 808 (456-1080) and 2756 (2021-3378), respectively. The increase in all-cause deaths was prominent in those aged 65-79 years (941, 88-1795), with an elementary school education or below (1757, 371-3030), or who were single (785, 384-1174), while a decrease in deaths was pronounced in those with a college-level or higher educational attainment (1471, 589-2328). CONCLUSION No evidence of a substantial increase in all-cause mortality was found during the 2020 pandemic period in South Korea, as a result of a large decrease in deaths related to respiratory diseases that offset increased mortality from metabolic disease and diseases of ill-defined cause. The COVID-19 pandemic has disproportionately affected those of lower socioeconomic status and has exacerbated inequalities in mortality.
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Affiliation(s)
- Jieun Oh
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Jieun Min
- grid.255649.90000 0001 2171 7754Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea ,grid.255649.90000 0001 2171 7754Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Cinoo Kang
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Ejin Kim
- grid.31501.360000 0004 0470 5905Institute of Health and Environment and Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jung Pyo Lee
- grid.412479.dDepartment of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Ho Kim
- grid.31501.360000 0004 0470 5905Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826 Republic of Korea
| | - Whanhee Lee
- grid.262229.f0000 0001 0719 8572School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, 50612 Republic of Korea
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Park I, Kim S, Kim Y, Yun B, Yoon JH. Association between physical risk factors and sleep disturbance among workers in Korea: The 5th Korean Working Conditions Survey. Sleep Med 2022; 100:157-164. [PMID: 36063638 DOI: 10.1016/j.sleep.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Sleep disturbance is associated with negative effects to workers' health and productivity; hence, it is important to find which population of workers are associated with sleep disturbance. This study aimed to investigate the association between physical risk factors (vibration, noise, high, and low temperatures) and sleep disturbance in the Korean working population. METHODS We analyzed data on 29,213 paid workers from the 5th Korean Working Conditions Survey. Individual and occupational characteristics, physical risk factors exposure, and sleep disturbance were collected using self-reported questionnaires. To assess the association between physical risk factors and sleep disturbance, the chi-square test and multivariable logistic regression models were conducted. All statistical analyses were performed in sex-based subgroups. RESULTS We observed that all physical risk factors are associated with sleep disturbance. The adjusted odds ratios (95% confidence interval [CI]) of severe exposure to vibration, noise, high and low temperature were 1.69 (CI:1.47-1.94), 2.52 (CI:2.17-2.92), 3.09 (CI:2.69-3.56), and 1.96 (CI:1.68-2.28) in male workers and 2.27 (CI:1.89-2.72), 3.52 (CI:2.92-4.24), 3.30 (CI:2.81-3.87), and 2.87 (CI:2.44-3.38) in female workers, respectively. The prevalence of sleep disturbance increased with increased exposure to physical risk factors, indicating a dose-response relationship. CONCLUSIONS Physical risk factors exposure in the workplace was associated with sleep disturbance of workers, indicating a dose-response relationship. Given the impact of sleep disturbance on workers' health and efficiency, it may be important to control exposure to physical risk factors in the working environment with regards to sleep conditions.
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Affiliation(s)
- Inho Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seunghan Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yangwook Kim
- Department of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Byungyoon Yun
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea.
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27
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Spetz M, Lundberg L, Nwaru C, Li H, Santosa A, Ng N, Leach S, Gisslén M, Hammar N, Nyberg F, Rosvall M. An intersectional analysis of sociodemographic disparities in Covid-19 vaccination: A nationwide register-based study in Sweden. Vaccine 2022; 40:6640-6648. [PMID: 36210254 PMCID: PMC9515344 DOI: 10.1016/j.vaccine.2022.09.065] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Studies on sociodemographic disparities in Covid-19 vaccination uptake in the general population are still limited and mostly focused on older adults. This study examined sociodemographic differences in Covid-19 vaccination uptake in the total Swedish population aged 18-64 years. METHODS National Swedish register data within the SCIFI-PEARL project were used to cross-sectionally investigate sociodemographic differences in Covid-19 vaccination among Swedish adults aged 18-64 years (n = 5,987,189) by 12 October 2021. Using logistic regression models, analyses were adjusted for sociodemographic factors, region of residence, history of Covid-19, and comorbidities. An intersectional analysis approach including several cross-classified subgroups was used to further address the complexity of sociodemographic disparities in vaccination uptake. FINDINGS By 12 October 2021, 76·0% of the Swedish population 18-64 years old had received at least two doses of Covid-19 vaccine, an additional 5·5% had received only one dose, and 18·5% were non-vaccinated. Non-vaccinated individuals were, compared to vaccinated, more often younger, male, had a lower income, were not gainfully employed, and/or were born outside Sweden. The social patterning for vaccine dose two was similar, but weaker, than for dose one. After multivariable adjustments, findings remained but were attenuated indicating the need to consider different sociodemographic factors simultaneously. The intersectional analysis showed a large variation in vaccine uptake ranging from 32% to 96% in cross-classified subgroups, reflecting considerable sociodemographic heterogeneity in vaccination coverage. INTERPRETATION Our study, addressing the entire Swedish population aged 18-64 years, showed broad sociodemographic disparities in Covid-19 vaccine uptake but also wide heterogeneities in coverage. The intersectional analysis approach indicates that focusing on specific sociodemographic factors in isolation and group average risks without considering the heterogeneity within such groups will risk missing the full variability of vaccine coverage. FUNDING SciLifeLab / Knut & Alice Wallenberg Foundation, Swedish Research Council, Swedish government ALF agreement, FORMAS.
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Affiliation(s)
- M. Spetz
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden,Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Gotaland, Gothenburg, Sweden,Corresponding author at: School of Public health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Box 463, 405 30 Gothenburg, Sweden
| | - L. Lundberg
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Clinical Pharmacology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - C. Nwaru
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - H. Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - A. Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - N. Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - S. Leach
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Clinical Pharmacology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - M. Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Infectious Diseases, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - N. Hammar
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - F. Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - M. Rosvall
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden,Department of Social Medicine, Regionhälsan, Region Västra Götaland, Gothenburg, Sweden
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28
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Shoman Y, Rousson V, Bianchi R, Guseva Canu I. Holistic Assessment of Factors Associated with Exhaustion, the Main Symptom of Burnout: A Meta-Analysis of Longitudinal Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013037. [PMID: 36293607 PMCID: PMC9602979 DOI: 10.3390/ijerph192013037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND This meta-analysis summarized longitudinal findings pertaining to exhaustion's predictors. In so doing, our aim was ultimately to identify target factors for the prevention of burnout. METHODS We searched for studies that (a) examined predictors of exhaustion longitudinally and (b) reported correlation coefficients as an effect estimate. We conducted our literature search in three databases: MEDLINE, PsycINFO, and Embase. We focused on studies published between January 1990 and November 2020. Predictors were grouped into families, subfamilies, and subgroups. A meta-analysis of z-transformed correlation coefficients (rho) was performed. The results were scrutinized in relation to studies' follow-up length. RESULTS We included 65 studies assessing 242 predictors of different types captured across different occupations. Our findings highlighted mostly weak associations (rho < 0.30). For six predictors-Job control, Job resources, Interactions at work, Communication and leadership, Job attitudes, and Work-family interface-longer length of follow-up involved weaker associations with exhaustion. The quality of the evidence available was generally low. CONCLUSIONS The evidence available does not point to clear target factors for preventing burnout. The decrease in associations as the follow-up length increases may suggest a relatively short latency period, followed by recovery. Higher-quality cohorts should be conducted to better understand the etiology and course of burnout.
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Affiliation(s)
- Yara Shoman
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
- Correspondence: ; Tel.: +41-(21)-3147413
| | - Valentin Rousson
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
| | - Renzo Bianchi
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Irina Guseva Canu
- Center of Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Epalinges-Lausanne, Switzerland
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29
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Ervasti J, Peutere L, Virtanen M, Krutova O, Koskinen A, Härmä M, Kivimäki M, Ropponen A. Concurrent trajectories of self-rated health and working hour patterns in health care shift workers: A longitudinal analysis with 8-year follow-up. Front Public Health 2022; 10:926057. [PMID: 36148352 PMCID: PMC9485932 DOI: 10.3389/fpubh.2022.926057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/19/2022] [Indexed: 01/24/2023] Open
Abstract
Background The association between health and working hours is hypothesized to be reciprocal, but few longitudinal studies have examined changes in both health and working hour patterns over time. We examined combined trajectories of self-related health and two working hour patterns (working <35 h/week and working night shifts) and the extent to which these trajectories were predicted by employees' lifestyle and mental health. Methods Participants of this cohort study with a 8-year follow-up were 5,947 health care shift workers. We linked self-reports of health from three repeated surveys with objective pay-roll based data on working hours. Using group-based multi-trajectory analysis we identified concurrent trajectories for self-rated health and working hour patterns. We examined their associations with baseline lifestyle-related factors (smoking, at-risk alcohol use, obesity, and physical inactivity) and mental health (sleep problems and psychological distress) using multinomial regression analysis. Results Three combined trajectories of self-rated health and working <35 h/week and four combined trajectories of self-rated health and night work were identified. Unhealthy lifestyle and poor mental health were associated with trajectories of moderate and declining health. Sleep problems were linked with working <35 h/week. Younger age and good mental health were associated with a combined trajectory of good health and continued night shift work. Conclusion Trajectories of suboptimal and declining health are associated with trajectories of reducing working hours and leaving night work, and are more common in employees with unhealthy lifestyle, sleep problems, and psychological distress.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland,*Correspondence: Jenni Ervasti
| | - Laura Peutere
- Finnish Institute of Occupational Health, Helsinki, Finland,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Oxana Krutova
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland,Clinicum, University of Helsinki, Helsinki, Finland,Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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30
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Yang L, Luo Y, He L, Yin J, Li T, Liu S, Li D, Cheng X, Bai Y. Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank. J Am Heart Assoc 2022; 11:e025936. [PMID: 36036170 PMCID: PMC9496406 DOI: 10.1161/jaha.122.025936] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Although the association between shift work and individual cardiometabolic diseases has been well studied, its role in the progression to cardiometabolic multimorbidity (CMM) remains unclear. In this study, we investigate the association between shift work and the incidence of CMM in patients with hypertension. Methods and Results This study is a population-based and prospective cohort study on 36 939 UK Biobank participants. We used competing risk models to examine the association between shift work and the risk of CMM, which was defined as coexistence of hypertension and diabetes, coronary heart disease, or stroke in our study. We also investigated the association between the frequency and duration of shift work and CMM risks. In addition, we conducted a cross-classification analysis with the combination of frequency and duration of shift work, chronotype and sleep duration as the exposure metrics. During a median follow-up of 11.6 years, a total of 5935 participants developed CMM. We found that usually/always night shift workers were associated with a 16% higher risk of CMM compared with day workers (hazard ratio [HR], 1.16 [95% CI, 1.02-1.31]). We also found that a higher frequency of night shifts (>10/month) was associated with increased risk of CMM (HR, 1.19 [95% CI, 1.06-1.34]) that was more pronounced for >10/month in combination with a morning chronotype or <7 hours or >8 hours of sleep duration (HR, 1.26 [95% CI, 1.02-1.56]; HR, 1.43 [95% CI, 1.19-1.72], respectively). Conclusions We find that night shift work is associated with higher CMM risk in patients with hypertension.
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Affiliation(s)
- Liu Yang
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yi Luo
- Department of Cardiovascular Medicine The Third Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Tie Li
- Department of Cardiovascular Medicine Changsha County Second People's Hospital Changsha Hunan China
| | - Shuai Liu
- Department of General and Vascular Surgery Xiangya Hospital, Central South University Changsha Hunan China
| | - Dongjie Li
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
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Grahn K, Broberg K, Gustavsson P, Ljungman P, Lindfors P, Sjöström M, Wiebert P, Selander J. Occupational exposure to particles and biomarkers of cardiovascular disease-during work and after vacation. Int Arch Occup Environ Health 2022; 95:1537-1548. [PMID: 35819531 PMCID: PMC9424160 DOI: 10.1007/s00420-022-01900-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/12/2022] [Indexed: 11/30/2022]
Abstract
Objective Ambient particle matter is a risk factor for cardiovascular disease (CVD). However, little is known about associations between particles in occupational settings and risk of CVD. We investigated associations between occupational dust exposure and biomarkers of CVD, and potential recovery effects after vacation. Methods Personal dust exposure measurements (respirable silica, respirable dust < 4 µm, and particles of 0.1–10 µm (PM 0.1–10) were conducted once, and biological sampling were performed twice on non-smoking, male construction workers in Stockholm county, Sweden; during work and immediately after summer vacation. Linear regressions with adjustments for confounders and covariates were performed evaluating associations between occupational dust exposure and biomarkers. Paired t tests were performed evaluating changes before and after vacation. Results Sixty-five workers participated. Homocysteine concentrations were significantly higher with increasing concentrations (mg/m3) of respirable silica, respirable dust, and PM 0.1–10, and pulse rate with higher levels of respirable dust and dust of PM 0.1–10. Homocysteine levels were also positively correlated to number of years of dust exposure, as were low-density lipoprotein (LDL) levels. A clear recovery effect was present for LDL after vacation, but not for homocysteine. Conclusions Occupational dust exposure was associated with some CVD risk markers, even at mean exposure concentrations below the Swedish occupational exposure limits for respirable silica and respirable dust, respectively. Vacation resulted in recovery for some risk markers. However, the change of the homocysteine and LDL levels suggest a long-term effect. Reduction of occupational exposure to dust may decrease the risk of CVD among exposed workers. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-022-01900-5.
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Affiliation(s)
- Karin Grahn
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Danderyd University Hospital, Danderyd, Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mattias Sjöström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Pernilla Wiebert
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jenny Selander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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32
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Adedoyin AR, Mbada CE, Ajayi OK, Idowu OA, Oghumu SN, Oke KI, Moda HM, Fatoye F. Prevalence and pattern of work-related musculoskeletal disorders among Nigerian bricklayers. Work 2022; 72:627-635. [DOI: 10.3233/wor-205240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Typically, bricklayers in developing countries’ contexts manually lay bricks, concrete blocks and other similar materials to construct walls and buildings which make them susceptible to work-related musculoskeletal disorders (WRMSDs). The burden of WRMSDs among this high-risk group seems has not been well documented. OBJECTIVES: This study examined the prevalence of WRMSDs among bricklayers in Nigeria. METHODS: A cross-sectional survey of 118 consenting bricklayers from a Nigerian setting was carried out. The standardized Nordic musculoskeletal disorder questionnaire and a proforma were used to profile the prevalence of WRMSDs and socio-demographic information of the respondents. Data was analyzed using descriptive and inferential statistics. Alpha level was set at p < 0.05. RESULTS: The 12-months and 7-days prevalence of WRMSDs were 87.3% and 67.4%. Shoulder (61.0%) and the low-back (59.3%) were the two most affected anatomical sites based on 12-month prevalence. WRMSDs affecting the knees (6.8%) was the most disabling in carrying normal work routines. Working for less than 10 years was significantly associated with high prevalence of WRMSDs in the shoulder (odd ratio (OR) = 0.27, 95% confidence interval (CI) = 0.09 to 0.87) and wrist region (OR = 0.24, 95% CI 0.08 to 0.73). Having neck pain led to higher odds (OR = 0.29, 95% CI 0.13 to 0.68) of taking a break from work among the bricklayers. CONCLUSIONS: WRMSDs were high among Nigerian bricklayers. Years of work experience was associated with high prevalence of WRMSDs in the shoulder and wrist. In addition, taking work breaks was associated with neck pain.
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Affiliation(s)
- Adesoji R. Adedoyin
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Chidozie E. Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Oladotun K. Ajayi
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Opeyemi A. Idowu
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, Nigeria
| | - Saturday N. Oghumu
- Department of Physiotherapy, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Kayode I. Oke
- Department of Physiotherapy, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, Nigeria
| | - Haruna M. Moda
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Francis Fatoye
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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33
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Mbada CE, Adebayo OS, Olaogun MO, Johnson OE, Ogundele AO, Ojukwu CP, Akinwande OA, Makinde MO. Infant-carrying techniques: Which is a preferred mother-friendly method? Health Care Women Int 2022; 43:535-548. [DOI: 10.1080/07399332.2019.1615915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Chidozie Emmanuel Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Owanike Shakirat Adebayo
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Matthew Olatokunbo Olaogun
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olubusola Esther Johnson
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Abiola Ogundele Ogundele
- Department of Medical Rehabilitation, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Chidiebele Petronilla Ojukwu
- Department of Medical Rehabilitation, College of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | | | - Moses Oluwatosin Makinde
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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34
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Lee HJ, Kim HK, Han KD, Lee KN, Park JB, Lee H, Lee SP, Kim YJ. Age-dependent associations of body mass index with myocardial infarction, heart failure, and mortality in over 9 million Koreans. Eur J Prev Cardiol 2022; 29:1479-1488. [PMID: 35580584 DOI: 10.1093/eurjpc/zwac094] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND While obesity is a well-known cardiovascular risk factor, little is known whether age has a modifying effect. AIM To determine the age-dependent associations of BMI with cardiovascular outcomes. METHODS A population-based cohort of 9,278,433 Koreans without prior cardiovascular disease were followed up for the incidence of myocardial infarction (MI), heart failure (HF), and all-cause death. The effect of BMI with optimal normal weight (18.5-22.9 kg/m2) as reference was analyzed according to age groups [young (20-39 years), middle-aged (40-64 years), and elderly (≥65 years)] and age decades. RESULTS During 8.2 years, MI, HF, and all-cause death occurred in 65,607 (0.71%), 131,903 (1.42%), and 306,065 (3.30%), respectively. Associations between BMI and all outcomes were significantly modified by age (p-for-interaction < 0.001). There was a proportional increase in incident MI according to BMI in young subjects; this relationship became U-shaped in middle-aged subjects, and inversely proportional/plateauing in elderly subjects. A U-shaped relationship between BMI and incident HF was observed, but the impact of obesity was stronger in young subjects while the impact of underweight was stronger in middle-aged and elderly subjects. Meanwhile, lower BMI was associated with higher all-cause mortality in all ages, although this association was attenuated at young age, and pre-obesity was associated with the greatest survival benefit. These associations were independent of sex, smoking, physical activity, and comorbidities. CONCLUSIONS The impact of BMI on cardiovascular risk differs according to age. Weight loss may be recommended for younger overweight subjects, while being mildly overweight may be beneficial at old age.
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Affiliation(s)
- Hyun-Jung Lee
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
| | - Hyung-Kwan Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Kyu-Na Lee
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Jun-Bean Park
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
| | - Heesun Lee
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
| | - Seung-Pyo Lee
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
| | - Yong-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Korea
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35
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Shakir M, Willems AE, van Harten PN, van Lutterveld R, Tenback DE. The effect on relapse rate and psychiatric symptomatology: Switching a combination of first- and second-generation antipsychotic polypharmacy to antipsychotic monotherapy in long-term inpatients with schizophrenia and related disorders. A pragmatic randomized open-label trial (SwAP trial). Schizophr Res 2022; 243:187-194. [PMID: 35397249 DOI: 10.1016/j.schres.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/30/2022] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is little evidence to support the use of antipsychotic polypharmacy, and there are concerns about safety and side effects. Nonetheless, it is commonly used in the treatment of long-term inpatients with schizophrenia. This study investigated the effects of switching from a combination of first- and second-generation antipsychotics (FGA and SGA) to monotherapy (FGA or SGA) on relapse rates and psychiatric symptomatology. METHODS Institutionalized patients with chronic psychotic disorders using a combination of SGA and FGA (n = 136) participated in a randomized open-label trial. The SWITCH group discontinued either FGA or SGA, the STAY group continued combination treatment. Relapse and psychotic symptoms were measured at baseline and during follow-up at 3, 6, and 9 months. Psychiatric symptomatology was measured using the Brief Psychiatric Rating Scale (BPRS). Relapse was defined as (i) an increase in BPRS score of at least 2 points on any item, or (ii) an increase of at least 4 points in total BPRS score and an adjustment of antipsychotics. RESULTS A logistic regression model, corrected for sex, showed that the probability of relapse was significantly lower in the SWITCH group: 0.29 (95% CI 0.13-0.62). The protective effect of switching to monotherapy was attributable to patients continuing clozapine as monotherapy. For patients who did not experience a relapse nor dropped out, BPRS total scores decreased significantly more in the SWITCH group (p = 0.0001). CONCLUSION Switching from a combination of FGA and SGA to monotherapy in long-term inpatients does not increase the relapse rate and may even reduce it.
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Affiliation(s)
- Mushde Shakir
- Veldzicht Center for Transcultural Psychiatry, Custodial Institutions Agency (DJI), Ministry of Justice and Security, Balkbrug, the Netherlands; i-psy Haaglanden, Parnassia Group Mental Health Service, Den Haag, the Netherlands; Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht, the Netherlands.
| | - Anne E Willems
- Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht, the Netherlands; Psychiatric Center GGz Centraal, Amersfoort, the Netherlands
| | - Peter N van Harten
- Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht, the Netherlands; Psychiatric Center GGz Centraal, Amersfoort, the Netherlands
| | - Remko van Lutterveld
- Brain Research and Innovation Center, Ministry of Defence, Utrecht, the Netherlands; University Medical Center Utrecht, Department of Psychiatry, Utrecht, the Netherlands
| | - Diederik E Tenback
- Veldzicht Center for Transcultural Psychiatry, Custodial Institutions Agency (DJI), Ministry of Justice and Security, Balkbrug, the Netherlands; FPC de Oostvaarderskliniek, Custodial Institutions Agency (DJI), Ministry of Justice and Security, Almere, the Netherlands
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36
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Tomida M, Nishita Y, Tange C, Nakagawa T, Otsuka R, Ando F, Shimokata H. Typology of Work-Family Balance Among Middle-Aged and Older Japanese Adults. Front Psychol 2022; 13:751879. [PMID: 35369186 PMCID: PMC8967286 DOI: 10.3389/fpsyg.2022.751879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
This study explores the clusters of work-family balance (WFB) among Japanese middle-aged and older adults and clarifies the characteristics of the derived clusters. Data on working adults (N = 1,351; age range = 40-85 years) were drawn from a pool of participants in the National Institute for Longevity Sciences-Longitudinal Study of Aging. The WFB scale consists of subscales assessing work-family conflict (WFC) and work-family facilitation (WFF). First, a cluster analysis was performed using the WFB scale, and four clusters were extracted. Second, we examined associations between the four clusters and related variables such as demographic characteristics, work, family, and lifestyle factors, social support, and mental health. Our findings showed that the clusters included high-WFC/high-WFF, high-WFC/low-WFF, low-WFC/high-WFF, and low-WFC/low-WFF. Differences were found in related variables among the clusters. Specifically, those in the Low-WFC/High-WFF cluster had a good lifestyle, received the highest levels of social support, and had the fewest mental health issues. Our findings have implications for maintaining sufficient WFB and promoting positive mental health among workers.
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Affiliation(s)
- Makiko Tomida
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takeshi Nakagawa
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Fujiko Ando
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan.,Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Japan
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Osuka Y, Okubo Y, Nofuji Y, Sasai H, Seino S, Maruo K, Fujiwara Y, Oka H, Shinkai S, Lord SR, Kim H. Modifiable intrinsic factors related to occupational falls in older workers. Geriatr Gerontol Int 2022; 22:338-343. [PMID: 35266260 DOI: 10.1111/ggi.14370] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/21/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
AIM Identification of modifiable intrinsic factors for occupational falls is required for initiating effective fall prevention strategies for older workers. This study aimed to identify modifiable intrinsic factors related to falls during occupational activities among older workers. METHODS This retrospective study involved 1164 older workers (aged ≥60 years, workdays ≥4/month) sampled from 18 public employment agencies for seniors in Saitama, Japan. Participants were assessed regarding the following 10 modifiable intrinsic factors: multimorbidity, polypharmacy, fall-risk-increasing medication use, self-rated vision and hearing, functional strength, bilateral stepping, standing balance, executive function and visuospatial ability. The number of falls during occupational activities in the past year was also recorded. RESULTS In total, 111 falls occurred in 73 of the 1164 participants during occupational activities in the past year. A negative binomial regression model showed that use of fall-risk-increasing medications (incidence rate ratio [IRR]: 2.23, 95% confidence interval [CI]: 1.08, 4.60, P = 0.031), reduced functional strength (IRR: 1.81, 95% CI: 1.02, 3.21, P = 0.042), poor standing balance (IRR: 1.83, 95% CI: 1.09, 3.09, P = 0.023) and poor visuospatial ability (IRR: 1.56, 95% CI: 1.03, 2.36, P = 0.034) were independently associated with occupational falls. CONCLUSIONS Our findings suggest that the assessment of medication use, functional strength, standing balance and visuospatial ability in regular health checks in the workplace may be useful for screening older workers at risk of occupational falls. Geriatr Gerontol Int 2022; 22: 338-343.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Japan
| | - Shoji Shinkai
- Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Sakado-shi, Japan
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
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Keil AP. Real and Illusory Precision Gains in Meta-Analysis to Speed Action on Carcinogens. Cancer Epidemiol Biomarkers Prev 2022; 31:695-697. [PMID: 35373265 PMCID: PMC10116503 DOI: 10.1158/1055-9965.epi-21-1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
One should avoid benzene exposure, all other things being equal. Risk assessment can help inform human health outcomes when all other things are not equal, as when competing legal or economic interests arise. In sparse literatures where exposures may be highly deleterious and yet understudied, there is a dire need for evidence synthesis, such as meta-analysis, to maximally inform risk assessment. Here, using the analysis and approach of Scholten and colleagues from the current issue as a touch point, I describe how meta-analysis could ideally meet this aim and how it often fails to do so. Some of the current literature on transportability of causal effects is illustrative, and I describe how some of the lessons from this literature could be applied within the innovative framework of Scholten and colleagues to leverage meta-analysis within the broader decision-making framework of risk-assessment. See related article by Scholten et al., p. 751.
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Hinksman CA, Haylock RGE, Gillies M. Cerebrovascular Disease Mortality after occupational Radiation Exposure among the UK National Registry for Radiation Workers Cohort. Radiat Res 2022; 197:459-470. [PMID: 35139226 DOI: 10.1667/rade-20-00204.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/21/2021] [Indexed: 11/03/2022]
Abstract
Exposure to ionizing radiation can damage the cerebrovascular system, however there is uncertainty regarding the effects after chronic exposure to low doses of radiation, such as that experienced by the public and those occupationally exposed. This study uses data from the UK National Registry for Radiation Workers cohort to assess the association between low-dose exposure to external radiation and cerebrovascular disease (CeVD) mortality. Poisson regression was used to estimate the Excess Relative Risk of CeVD mortality per Sievert (ERR/Sv) of radiation exposure. Estimates were obtained for all CeVD combined, ischemic stroke, hemorrhagic stroke and other/ill-defined CeVD. Results were adjusted for attained age, calendar period, sex, employer, industrial category and employment length. 166,812 nuclear workers (3,665,413 person-years) were included. By the end of 2011, 23% were dead including 3,219 deaths with an underlying cause of CeVD. The ERR/Sv for all CeVD deaths was 0.57 (95% CI: 0.00, 1.31; p = 0.05). Increased CeVD mortality rates were observed after doses as low as 10-20 mSv. However, a linear-exponential model fit the data significantly better than a linear model (p = 0.02). In the sub-type analyses, no evidence of linear associations were observed, however the patterns of response appeared to differ and there was some suggestion of an increased risk of hemorrhagic stroke at lower doses. These results are broadly consistent with other occupational cohort studies and suggest external radiation exposure may increase CeVD risk at lower doses than current ICRP protection guidelines suggest. Exploration of factors driving the observed dose-response shape, the potential impact of the healthy worker survivor effect, and further studies of cohorts with data on other potential confounders would be valuable.
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Affiliation(s)
- Catherine A Hinksman
- UK Health Security Agency, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, United Kingdom
| | - Richard G E Haylock
- UK Health Security Agency, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, United Kingdom
| | - Michael Gillies
- UK Health Security Agency, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxfordshire, OX11 0RQ, United Kingdom
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Association between physical hazardous agent exposure and mental health in the Korean working population: the 5th Korean Working Conditions Survey. Ann Occup Environ Med 2022; 33:e33. [PMID: 35024150 PMCID: PMC8668812 DOI: 10.35371/aoem.2021.33.e33] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/21/2021] [Indexed: 01/22/2023] Open
Abstract
Background Mental health problems are emerging issues in occupational safety and health, whereas the findings on the relationship between physical hazards and mental health are not consistent. The aim of our study was to investigate the association between physical hazard exposure and mental health outcomes including depression and anxiety. Methods We included 48,476 participants from the fifth Korean Working Conditions Survey (KWCS) in this study. The χ2 test and logistic regression analyses were conducted to assess the association between physical hazard exposures and mental health. All statistical analyses were performed sex-specifically. Results In logistic regression analysis, the odds ratios (ORs) of depression were significantly increased in male workers who were exposed to vibration (severe OR: 1.54, 95% confidence interval [CI]: 1.21–1.95) and noise (severe OR: 1.93, 95% CI: 1.49–2.48) whereas the ORs of depression were not significant in female workers from vibration (severe OR: 0.86, 95% CI: 0.50–1.38) or noise exposure (severe OR: 1.39, 95% CI: 0.84–2.17). The ORs of anxiety were significantly increased in male workers with vibration (severe OR: 1.76, 95% CI: 1.43–2.15) and noise exposure (severe OR: 2.12, 95% CI: 1.69–2.63) whereas the OR between vibration and anxiety (severe OR: 1.45, 95% CI: 0.91–2.21) was not significant in female workers. High or low temperature exposure had significant associations with depression and anxiety in both male and female subjects. Conclusions Results of our study suggest that physical hazard exposures may be associated with increased risk of mental health problems including depression and anxiety. These associations are more prominent in male workers in comparison with female workers.
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Elser H, Chen KT, Arteaga D, Reimer R, Picciotto S, Costello S, Eisen EA. Metalworking Fluid Exposure and Stroke Mortality Among US Autoworkers. Am J Epidemiol 2022; 191:1040-1049. [PMID: 35029630 PMCID: PMC9393063 DOI: 10.1093/aje/kwac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/26/2021] [Accepted: 01/05/2022] [Indexed: 01/16/2023] Open
Abstract
Although air pollution is an important risk factor for stroke, few studies have considered the impact of workplace exposure to particulate matter (PM). We examined implications of exposure to PM composed of metalworking fluids (MWFs) for stroke mortality in the United Autoworkers-General Motors cohort. Cox proportional hazards models with age as the timescale were used to estimate the association of cumulative straight, soluble, and synthetic MWF exposure with stroke mortality, controlling for sex, race, plant, calendar year, and hire year. Among 38,553 autoworkers followed during 1941-1995, we identified 114 ischemic stroke deaths and 113 hemorrhagic stroke deaths. Overall stroke mortality risk was increased among workers in the middle exposure category for straight MWF (hazard ratio (HR) = 1.31, 95% confidence interval (CI): 0.87, 1.98) and workers in the highest exposure category for synthetic MWF (HR = 1.94, 95% CI: 1.13, 3.16) compared with workers who had no direct exposure. Ischemic stroke mortality risk was increased among workers in the highest exposure categories for straight MWF (HR = 1.45, 95% CI: 0.83, 2.52) and synthetic MWF (HR = 2.39, 95% CI: 1.39, 4.50). We observed no clear relationship between MWF exposure and hemorrhagic stroke mortality. Our results support a potentially important role for occupational PM exposures in stroke mortality and indicate the need for further studies of PM exposure and stroke in varied occupational settings.
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Affiliation(s)
- Holly Elser
- Correspondence to Dr. Holly Elser, Department of Neurology, 3 Gates, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (e-mail: )
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Harris MA, Kim J, Demers P. Metabolic health measurements of shift workers in a national cross-sectional study: Results from the Canadian Health Measures Survey. Am J Ind Med 2021; 64:895-904. [PMID: 34346078 DOI: 10.1002/ajim.23283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/21/2021] [Accepted: 07/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Shift work exposure may be a concern for a range of health effects, including metabolic health outcomes such as insulin resistance, high body weight, and abdominal obesity. METHODS We analyzed shift work and indicators of metabolic health (overweight/obesity defined by body mass index, self-reported changes in body mass index (BMI) in previous 1 and 10 years, waist circumference, waist-to-hip ratio, and insulin resistance assessed by the homeostasis model assessment 2 (HOMA-2-IR)) in the cross-sectional Canadian Health Measures Survey (CHMS). We analyzed descriptive characteristics of shift workers (regular night, evening, and rotating shift) and used multivariable linear regression to examine the association between two definitions of shift work exposure and measures of metabolic health, adjusted for age, sex, daily energy expenditure, sleep, and poor dietary quality. RESULTS 5470 anthropometry (2637 fasting) participants in CHMS Cycles 1 and 2 were included, of whom 16.5% worked regular evening, night, or rotating shifts. Shift workers were younger and slept longer hours than non-shift workers. Bivariate associations showed inverse relationships between shift work and BMI, waist circumference, waist-to-hip ratio, and HOMA-2-IR. In adjusted analyses, BMI was inversely related to shift work, and other metabolic health outcomes showed no significant associations. CONCLUSIONS Healthy worker effects (including self-selection of exposure) could explain inverse relationships, particularly as the cross-sectional design only allowed assessment of current exposure. Key strengths include the population-based design and measurement of metabolic health indicators. Results underscore the importance of consideration of the health of shift workers following departure from the exposed population.
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Affiliation(s)
- M. Anne Harris
- School of Occupational and Public Health Ryerson University Toronto Ontario Canada
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
| | - Joanne Kim
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada
| | - Paul Demers
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
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Peckham E, Allgar V, Crosland S, Heron P, Johnston G, Newbronner E, Spanakis P, Wadman R, Walker L, Gilbody S. Health risk behaviours among people with severe mental ill health during the COVID-19 pandemic: Analysis of linked cohort data. PLoS One 2021; 16:e0258349. [PMID: 34648548 PMCID: PMC8516268 DOI: 10.1371/journal.pone.0258349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND People with severe mental ill health (SMI) experience a mortality gap of 15-20 years. COVID-19 has amplified population health inequalities, and there is concern that people with SMI will be disproportionately affected. Understanding how health risk behaviours have changed during the pandemic is important when developing strategies to mitigate future increases in health inequalities. METHODS We sampled from an existing cohort of people with SMI. Researchers contacted participants by phone or post to invite them to take part in a survey about how the pandemic had affected them. We asked people about their health risk behaviours and how these had changed during the pandemic. We created an index of changed behaviours, comprising dietary factors, smoking, lack of exercise, and drinking patterns. By creating data linkages, we compared their responses during pandemic restrictions to responses they gave prior to the pandemic. OUTCOMES 367 people provided health risk data. The mean age of the participants was 50.5 (range = 20 to 86, SD ± 15.69) with 51.0% male and 77.4% white British. 47.5% of participants reported taking less physical activity during the pandemic and of those who smoke 54.5% reported smoking more heavily. Self-reported deterioration in physical health was significantly associated with an increase in health risk behaviours (adjusted OR for physical health 1.59, 95%CI 1.22-2.07; adjusted OR for Age 0.99, 95%CI 0.98-1.00). INTERPRETATION COVID-19 is likely to amplify health inequalities for people with SMI. Health services should target health risk behaviours for people with SMI to mitigate the immediate and long lasting impacts of the COVID-19 pandemic.
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Affiliation(s)
- Emily Peckham
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | | | - Suzanne Crosland
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | - Paul Heron
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | | | - Elizabeth Newbronner
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | - Panagiotis Spanakis
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | - Ruth Wadman
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | - Lauren Walker
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
| | - Simon Gilbody
- Mental Health and Addiction Research Group, University of York, Heslington, United Kingdom
- Hull York Medical School, Heslington, United Kingdom
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Zettermark S, Khalaf K, Perez-Vicente R, Leckie G, Mulinari D, Merlo J. Population heterogeneity in associations between hormonal contraception and antidepressant use in Sweden: a prospective cohort study applying intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). BMJ Open 2021; 11:e049553. [PMID: 34598985 PMCID: PMC8488727 DOI: 10.1136/bmjopen-2021-049553] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES From a reproductive justice framework, we aimed to investigate how a possible association between hormonal contraceptive (HC) and antidepressants use (as a proxy for depression) is distributed across intersectional strata in the population. We aimed to visualise how intersecting power dynamics may operate in combination with HC use to increase or decrease subsequent use of antidepressants. Our main hypothesis was that the previously observed association between HC and antidepressants use would vary between strata, being more pronounced in more oppressed intersectional contexts. For this purpose, we applied an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy approach. DESIGN Observational prospective cohort study using record linkage of national Swedish registers. SETTING The population of Sweden. PARTICIPANTS All 915 954 women aged 12-30 residing in Sweden 2010, without a recent pregnancy and alive during the individual 1-year follow-up. PRIMARY OUTCOME MEASURE Use of any antidepressant, meaning being dispensed at least one antidepressant (ATC: N06A) during follow-up. RESULTS Previously mentally healthy HC users had an OR of 1.79 for use of antidepressants compared with non-users, whereas this number was 1.28 for women with previous mental health issues. The highest antidepressant use were uniformly found in strata with previous mental health issues, with highest usage in women aged 24-30 with no immigrant background, low income and HC use (51.4%). The largest difference in antidepressant use between HC users and non-users was found in teenagers, and in adult women of immigrant background with low income. Of the total individual variance in the latent propensity of using antidepressant 9.01% (healthy) and 8.16% (with previous mental health issues) was found at the intersectional stratum level. CONCLUSIONS Our study suggests teenagers and women with immigrant background and low income could be more sensitive to mood effects of HC, a heterogeneity important to consider moving forward.
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Affiliation(s)
- Sofia Zettermark
- Unit for Social Epidemiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kani Khalaf
- Unit for Social Epidemiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Raquel Perez-Vicente
- Unit for Social Epidemiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - George Leckie
- Unit for Social Epidemiology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Center for Multilevel Modelling, School of Education, University of Bristol, Bristol, UK
| | - Diana Mulinari
- Department of Gender Studies, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Juan Merlo
- Unit for Social Epidemiology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Center for Primary Health Care Research, Region Skåne, Region Skane Health Care, Malmö, Sweden
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Bertke SJ, Keil AP, Daniels RD. Lung Cancer Mortality and Styrene Exposure in the Reinforced-Plastics Boatbuilding Industry: Evaluation of Healthy Worker Survivor Bias. Am J Epidemiol 2021; 190:1784-1792. [PMID: 33847736 DOI: 10.1093/aje/kwab108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022] Open
Abstract
The evidence for styrene's being a human lung carcinogen has been inconclusive. Occupational cohorts within the reinforced-plastics industry are an ideal population in which to study this association because of their relatively high levels of exposure to styrene and lack of concomitant exposures to other known carcinogens. However, healthy worker survivor bias (HWSB), where healthier workers stay employed longer and thus have higher exposure potential, is a likely source of confounding bias for exposure-response associations, in part due to styrene's acute effects. Through December 31, 2016, we studied a cohort of 5,163 boatbuilders exposed to styrene in Washington State who were employed between 1959 and 1978; prior regression analyses had demonstrated little evidence for an exposure-response relationship between styrene exposure and lung cancer mortality. Based on estimates of necessary components of HWSB, we found evidence for a potentially large HWSB. Using g-estimation of a structural nested model to account for HWSB, we estimated that 1 year of styrene exposure at more than 30 parts per million accelerated time to lung cancer death by 2.29 years (95% confidence interval: 1.53, 2.94). Our results suggest possibly strong HWSB in our small cohort and indicate that large, influential studies of styrene-exposed workers may suffer from similar biases, warranting a reassessment of the evidence of long-term health effects of styrene exposure.
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Relationship Between Emotional Labor and Perceived Health Status Among Service and Sales Workers: Findings From the Korea National Health and Nutrition Examination Survey 2007 to 2009. J Occup Environ Med 2021; 63:e86-e91. [PMID: 33298755 DOI: 10.1097/jom.0000000000002105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study examined the relationship between emotional labor and general health status in a nationally representative sample of South Korean service and sales workers. METHODS Data were obtained from the 2007 to 2009 Korea National Health and Nutrition Examination Survey. A total of 1907 subjects were included in the analysis. Multiple logistic regression was performed to determine the relationship between emotional labor and perceived health status (PHS). RESULTS The adjusted odds ratio (95% confidence interval) of poor PHS was 1.869 (1.464 to 2.391) among high emotional labor group, compared with the low emotional labor group as the reference. Perceived stress accounted for 35.57% of the variance in the relationship between high emotional labor and poor PHS. CONCLUSIONS Emotional labor was associated with increased risk of poor PHS.
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Richardson DB, Rage E, Demers PA, Do MT, DeBono N, Fenske N, Deffner V, Kreuzer M, Samet J, Wiggins C, Schubauer-Berigan MK, Kelly-Reif K, Tomasek L, Zablotska LB, Laurier D. Mortality among uranium miners in North America and Europe: the Pooled Uranium Miners Analysis (PUMA). Int J Epidemiol 2021; 50:633-643. [PMID: 33232447 DOI: 10.1093/ije/dyaa195] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany and the USA. METHODS Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. RESULTS There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16 633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). CONCLUSIONS Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.
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Affiliation(s)
| | - E Rage
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE, SESANE, Fontenay-aux-Roses, France
| | - P A Demers
- Occupational Cancer Research Centre, Toronto, Canada
| | - M T Do
- Occupational Cancer Research Centre, Toronto, Canada
| | - N DeBono
- Occupational Cancer Research Centre, Toronto, Canada
| | - N Fenske
- Federal Office for Radiation Protection, Neuherberg, Germany
| | - V Deffner
- Federal Office for Radiation Protection, Neuherberg, Germany
| | - M Kreuzer
- Federal Office for Radiation Protection, Neuherberg, Germany
| | - J Samet
- Colorado School of Public Health, Aurora, CO, USA
| | - C Wiggins
- University of New Mexico, Albuquerque, NM, USA
- New Mexico Tumor Registry, Albuquerque, NM, USA
| | - M K Schubauer-Berigan
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
- International Agency for Research on Cancer, Lyon, France
| | - K Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - L Tomasek
- Radiation Protection Institute, Prague, Czech Republic
| | - L B Zablotska
- University of California, San Francisco, San Francisco, CA, USA
| | - D Laurier
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE, SESANE, Fontenay-aux-Roses, France
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Burks SV, Anderson JE, Panda B, Haider R, Ginader T, Sandback N, Pokutnaya D, Toso D, Hughes N, Haider HS, Brockman R, Toll A, Solberg N, Eklund J, Cagle M, Hickman JS, Mabry E, Berger M, Czeisler CA, Kales SN. Employer-mandated obstructive sleep apnea treatment and healthcare cost savings among truckers. Sleep 2021; 43:5606928. [PMID: 31648298 DOI: 10.1093/sleep/zsz262] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/01/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effect of an employer-mandated obstructive sleep apnea (OSA) diagnosis and treatment program on non-OSA-program trucker medical insurance claim costs. METHODS Retrospective cohort analysis; cohorts constructed by matching (randomly, with replacement) Screen-positive Controls (drivers with insurance screened as likely to have OSA, but not yet diagnosed) with Diagnosed drivers (n = 1,516; cases = 1,224, OSA Negatives = 292), on two factors affecting exposure to medical claims: experience level at hire and weeks of job tenure at the Diagnosed driver's polysomnogram (PSG) date (the "matching date"). All cases received auto-adjusting positive airway pressure (APAP) treatment and were grouped by objective treatment adherence data: any "Positive Adherence" (n = 932) versus "No Adherence" (n = 292). Bootstrap resampling produced a difference-in-differences estimate of aggregate non-OSA-program medical insurance claim cost savings for 100 Diagnosed drivers as compared to 100 Screen-positive Controls before and after the PSG/matching date, over an 18-month period. A two-part multivariate statistical model was used to set exposures and demographics/anthropometrics equal across sub-groups, and to generate a difference-in-differences comparison across periods that identified the effect of OSA treatment on per-member per-month (PMPM) costs of an individual driver, separately from cost differences associated with adherence choice. RESULTS Eighteen-month non-OSA-program medical claim costs savings from diagnosing (and treating as required) 100 Screen-positive Controls: $153,042 (95% CI: -$5,352, $330,525). Model-estimated effect of treatment on those adhering to APAP: -$441 PMPM (95% CI: -$861, -$21). CONCLUSIONS Results suggest a carrier-based mandatory OSA program generates substantial savings in non-OSA-program medical insurance claim costs.
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Affiliation(s)
- Stephen V Burks
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN.,Behavioral and Personnel Economics Program, Institute of Labor Economics (IZA), Bonn, Germany.,Roadway Safety Institute, Region 5 University Transportation Center, Minneapolis, MN
| | - Jon E Anderson
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Bibhudutta Panda
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Rebecca Haider
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Tim Ginader
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Nicole Sandback
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Darya Pokutnaya
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Derek Toso
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Natalie Hughes
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Humza S Haider
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Resa Brockman
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Alice Toll
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Nicholas Solberg
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Jesse Eklund
- Division of Social Science, University of Minnesota Morris (UMN Morris), Morris, MN
| | - Michael Cagle
- Division of Science and Math, University of Minnesota Morris (UMN Morris), Morris, MN
| | | | - Erin Mabry
- Virginia Tech Transportation Institute, Blacksburg, VA
| | - Mark Berger
- Precision Pulmonary Diagnostics, Houston, TX
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Stefanos N Kales
- Division of Sleep Medicine, Harvard Medical School, Boston, MA.,Department of Environmental & Occupational Medicine & Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.,Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
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49
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Zhu XB, Yang MC, Wang YX, Qian W, Yan YN, Yang JY, Wu SL, Chen SH, Dong L, Wei WB, Jonas JB. Prevalence and Risk Factors of Epiretinal Membranes in a Chinese Population: The Kailuan Eye Study. Invest Ophthalmol Vis Sci 2021; 61:37. [PMID: 32955561 PMCID: PMC7509757 DOI: 10.1167/iovs.61.11.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the prevalence of epiretinal membranes (ERMs) and their risk factors in a Chinese population. Methods The community-based Kailuan Eye Study included 14,440 participants (9835 male, 4605 female) with a mean age of 54.0 ± 13.3 years (range, 20-110 years). They underwent a systemic and ophthalmologic examination. ERMs were diagnosed on fundus photographs. Results Retinal photographs assessable for the presence of ERMs were available for 13,295 (92.0%) individuals (9094 male) with a mean age of 53.6 ± 13.3 years (range, 20-110 years). ERMs were found in 1013 participants (1489 eyes) with a prevalence of 7.6% (95% confidence interval [CI], 7.1%-8.1%). Secondary ERMs caused by intraocular reasons were found 46 (4.5%) individuals (69 [4.6%] eyes). A higher prevalence of any ERMs (and of primary ERMs) was associated with older age (odds ratio [OR]: 1.08; 95% CI:1.07-1.10), higher body mass index (OR: 1.05; 95% CI: 1.00-1.11), higher prevalence of smoking (OR:1.43; 95% CI: 1.01-2.03), higher serum concentration of glucose (OR: 1.08; 95% CI: 1.04-1.13), and lower serum concentration of uric acid (OR: 0.99; 95% CI: 0.99-1.00). Visual acuity was significantly (P = 0.002) lower in eyes with premacular fibroses than in eyes with cellophane macular reflexes. Conclusions In our cross-sectional community-based study, the prevalence of all ERMs was 7.6%. Among the group of participants with ERMs, secondary ERMs caused by intraocular reasons were detected in 46 (4.5%) individuals (69 [4.6%] eyes). A higher prevalence of any ERM and of primary ERMs was associated with older age, higher body mass index, higher prevalence of smoking, a higher serum concentration of glucose, and a lower serum concentration of uric acid.
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Affiliation(s)
- Xiao Bo Zhu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Dongfang Hospital Beijing University of Chinese Medicine
| | - Mo Chi Yang
- General Hospital of Ningxia Medical University
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wang Qian
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan Ni Yan
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Yan Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shou Ling Wu
- Health Care Center, Kailuan Group, Tangshan, China
| | - Shuo Hua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jost B Jonas
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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50
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Diz JC, Sueiro SI, Ferreira ED, Sanchez-Lastra MA, Ayán C. Mortality of Spanish Former Elite Soccer Players and Coaches. Int J Sports Med 2021; 42:662-668. [PMID: 33524999 DOI: 10.1055/a-1308-3116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37-85.19) for players and 81.8 years (IQR 74.55-86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits.
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Affiliation(s)
- José Carlos Diz
- Department of Functional Biology and Health Sciences, Well-Move Research Group, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - Santiago Iglesias Sueiro
- Department of Special Didactics, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - Eva Diz Ferreira
- Department of Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Carlos Ayán
- Department of Special Didactics, Well-Move Research Group, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
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