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Staples, B; Howse, M L P; Mason, H; Bell, G M
doi: 10.1136/oem.60.7.463pmid: 12819278
Aims: To determine the prevalence of proteinuira and enzymuria among a cohort of subjects exposed to hexachlorobutadiene (HCBD) in their homes and to determine whether there was a change in observed effects when exposure ceased. Methods: Residents underwent a health check, which included a panel of urinary markers of both glomerular and tubular origin, within two months of cessation of long term exposure to HCBD and again at least 10 months after exposure ceased. Analysis of the results was performed to determine if there was any early evidence of renal effects, and to ascertain whether changes in these parameters occurred after exposure to HCBD ceased. Results: Tubular proteinuria and enzymuria were increased in the initial health check and significantly decreased after the residents had left their homes for about 10 months. As the early renal tubular markers improved when exposure ceased it is anticipated that the long term nephrotoxic risk will be minimal, but the carcinogenic risk remains unknown. Conclusions: Results show there was a renal effect which improved when subjects left their homes. This suggests there was a local environmental factor responsible for the observations. This is consistent with the predicted toxicological effects of HCBD from animal studies.
Wager, N; Fieldman, G; Hussey, T
doi: 10.1136/oem.60.7.468pmid: 12819279
Aims: To investigate the role played by employees’ perceptions of their supervisors’ interactional styles as a possible source of workplace stress that may be associated with increased morbidity and mortality rates from cardiovascular disorders in workers in the lower strata of organisational hierarchies. Methods: A controlled, quasi-experimental, field study of female healthcare assistants. Allocation to the experimental and control groups was based on participants’ responses to a supervisor interactional style questionnaire. Experimental participants (n = 13) reported working under two divergently perceived supervisors at the same workplace, on different days. The control group (n = 15) worked either under one supervisor, or two similarly perceived supervisors. Ambulatory blood pressure was recorded every 30 minutes, over a 12 hour period for three days. Results: The control group showed a 3 mm Hg difference in systolic blood pressure (SBP) and a non-significant difference in diastolic blood pressure (DBP; mean difference 1 mm Hg) between the two supervisor conditions. The experimental group showed significantly higher SBP (15 mm Hg) and DBP (7 mm Hg) when working under a less favoured compared to a favoured supervisor. The degree of divergence in perceptions of supervisors shows a significant positive relation with the difference in blood pressure between the two workdays. Divergence in perceptions of interpersonal fairness is the strongest predictor of difference in blood pressure. Conclusion: An unfavourably perceived supervisor is a potent workplace stressor, which might have a clinically significant impact on supervisees’ cardiovascular functioning.
Korhonen, T; Ketola, R; Toivonen, R; Luukkonen, R; Häkkänen, M; Viikari-Juntura, E
doi: 10.1136/oem.60.7.475pmid: 12819280
Aims: To investigate work related and individual factors as predictors for incident neck pain among office employees working with video display units (VDUs). Methods: Employees in three administrative units of a medium sized city in Finland (n = 515) received mailed questionnaires in the baseline survey in 1998 and in the follow up survey in 1999. Response rate for the baseline was 81% (n = 416); respondents who reported neck pain for less than eight days during the preceding 12 months were included into the study cohort as healthy subjects (n = 232). The follow up questionnaire 12 months later was completed by 78% (n = 180). Incident neck cases were those reporting neck pain for at least eight days during the preceding 12 months. Results: The annual incidence of neck pain was 34.4% (95% CI 25.5 to 41.3). Poor physical work environment and poor placement of the keyboard increased the risk of neck pain. Among the individual factors, female sex was a strong predictor. Smoking showed a tendency for an increased risk of neck pain. There was an interaction between mental stress and physical exercise, those with higher mental stress and less physical exercise having especially high risk. Conclusion: In the prevention of neck disorders in office work with a high frequency of VDU tasks, attention should be given to the work environment in general and to the more specific aspects of VDU workstation layout. Physical exercise may prevent neck disorders among sedentary employees.
Letzel, S; Göen, Th; Bader, M; Angerer, J; Kraus, T
doi: 10.1136/oem.60.7.483pmid: 12819281
Aims: To investigate the exposure to dinitrotoluene (DNT) and trinitrotoluene (TNT) and the resulting effects in workers which occur during the disposal of military waste. Methods: Eighty two employees from a mechanical plant in Germany were studied, of whom 51 were regularly exposed to ammunition containing TNT and DNT, 19 occasionally, and 12 not at all. Results: Air analyses yielded maximum concentrations of 20 μg/m3 for 2,4-DNT and 3250 μg/m3 for 2,4,6-TNT, respectively. The maximum concentrations in the urine of workers regularly exposed amounted to 5.0 μg/l of 2,4,6-TNT, 1464.0 μg/l of 2-amino-4,6-dinitrotoluene, 6693.0 of μg/l 4-amino-2,6-dinitrotoluene, 2.1 μg/l of 2,4-DNT, 95.0 μg/l of 2,4-dinitrobenzoic acid, and 3.6 μg/l of 2,6-DNT. There was a highly significant linear correlation between the urinary concentrations of the two main metabolites of TNT, 2-amino-4,6-dinitrotoluene and 4-amino-2,6-dinitrotoluene. In 63 persons TNT or DNT or metabolite concentrations above the analytical detection limit were found in urine. These persons reported more frequently symptoms like bitter taste, burning eyes, and discoloration of the skin and hair than persons (n = 19) without detectable TNT and/or DNT exposure. Conclusion: During the disposal of military waste containing relevant TNT and DNT, exposure can occur of occupational-medical relevance. Biological monitoring is suitable for the early detection of possible adverse effects at workplaces exposed to TNT. Protective measures should be improved, together with adequate occupational-medical surveillance of persons exposed to nitroaromatic explosives. Further studies are necessary to exclude possible long term effects.
doi: 10.1136/oem.60.7.489pmid: 12819282
Background: Psychiatric epidemiology has revealed a number of associations between gender, socioeconomic status, and psychiatric disorders. Aims: To examine psychosocial conditions on and off the job in relation to psychological ill health. Methods: Longitudinal design with 24 year follow up of employed persons (190 women, 177 men). Interview and questionnaire data on work and leisure conditions were collected in 1969 and 1993. Risk analyses were performed in relation to three outcomes in 1993: depression within the preceding 12 months, impaired psychological wellbeing, and heavy alcohol use. Results: Thirteen per cent of the women and 11% of the men showed symptoms of depression, 21% and 22% had impaired psychological wellbeing, and 7% and 15% respectively were heavy alcohol users. Dissatisfaction with the quality (women) or quantity (men) of social contacts 24 years earlier was a significant risk factor for depression. Dissatisfaction with the quality of social contacts was also associated with impaired psychological wellbeing (among women), and dissatisfaction with leisure time activities was associated with heavy alcohol use (among men). Frequent overtime work 24 years earlier was associated with heavy alcohol use among women. Cross sectional analyses also showed associations between psychological ill health and some work related factors (mentally demanding work and lack of job pride). Conclusions: Perceived inadequacies in social contacts, and practical obstacles to social relationships are viewed as risk factors for depression. In this longitudinal study, work related factors, including mental demands and time pressure, do not appear sufficiently associated with psychological ill health.
Maul, I; Läubli, T; Klipstein, A; Krueger, H
doi: 10.1136/oem.60.7.497pmid: 12819283
Aims: To describe the course of low back pain (LBP) among nurses across eight years. Methods: A longitudinal study was performed with a follow up at 1 and 8 years among nurses employed by a large university hospital in Switzerland. A modified version of the Nordic Questionnaire was distributed to obtain information about demographic data, occupational activities, and various aspects of LBP. A clinical examination and several functional tests were used to overcome the problems associated with subjective pain reporting. Nurses having answered the questionnaire on all three occasions (n = 269) were classified into subgroups according to their pain intensity. For each subgroup the course of LBP was recorded. Results: LBP was highly prevalent with an annual prevalence varying from 73% to 76%. A large percentage (38%) indicated the same intensity of LBP on all three occasions. The proportion of nurses reporting repeated increase of LBP (19%) was approximately as large as the proportion who complained about repeated decrease of LBP (17%). Conclusion: It became evident that LBP poses a persistent problem among nurses. Over an eight year period almost half of the nurses indicated the same intensity of LBP, thus supporting a recurrent rather than a progressive nature of LBP.
López-Abente, G; Pollán, M; Ardanaz, E; Errezola, M
doi: 10.1136/oem.60.7.504pmid: 12819284
Background: The study of the distribution of brain cancer mortality in Spain shows a grouping of highest risk provinces corresponding to the autonomous regions of Navarre and the Basque Country. Aim: To explore the possible existence of geographical patterns in these areas. Methods: Municipal maps of brain cancer incidence were drawn up and the influence of land use related variables on the distribution of the disease duly analysed. Autoregressive conditional models were used to plot smoothed municipal maps. The influence of explanatory land use variables, ascertained by remote sensing, was assessed. Results: The maps revealed that certain towns situated in the “Media” and “Cantábrica-Baja Montaña” districts of Navarre were areas of highest risk. Among the towns in question, those in the “Media” district lie very close to the city of Pamplona. However, the pattern of brain cancer incidence in Navarre and the Basque Country could not be conclusively said to be determined by any specific type of land cover and/or crop. Conclusions: Results suggest a possible increase of risk linked to areas devoted to a high percentage of non-irrigated arable land.
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