Internationales Archiv für Arbeitsmedizin

Musculoskeletal disorders are extremely frequent and account for an important part of the global burden of disease. Risk factors for musculoskeletal disorders include sustained occupational exposure to physically demanding jobs. The effects of sustained occupational physical exposures on knee and shoulder pain are known to persist after retirement; also, several studies have shown a socio-economic gradient in health and quality-of-life outcomes, including for musculoskeletal pain. It is thus possible that prolonged occupational exposures affect workers differently in the long-term along a socio-economic gradient. This study was conducted to investigate whether the impacts of severe shoulder/arm and knee/leg pain on the quality of life of retired workers follow a socio-economic gradient. Data from the French GAZEL cohort study (n = 14,249) were used to compare the impacts of severe shoulder/arm and knee/leg pain separately on the SF-36, Nottingham Health Profile and limitations in activities of daily living measured in 2006 and 2007, between four groups of social position (measured in 1989). Analyses were made in 2014 with multiple linear and logistic regressions and stratified by sex. For both pain sites, in men and women, there was a strong general tendency for the impacts of severe pain to be smaller among participants in higher social positions. Most important differences were related to pain and physical limitations. These results suggest inequalities in the impacts of severe joint pain by socio-economic status. The source of these inequalities is still speculative and merits the scientific attention.

Nghiên cứu này được thực hiện để điều tra sự phơi nhiễm các hydrocacbon thơm đa vòng (PAHs) tại khu vực xung quanh một nhà máy xi măng với các lò nung sử dụng rác thải, bao gồm cả nhiên liệu từ nhựa từ đồ bỏ. Các hạt lơ lửng tổng thể trong khí quyển (TSP) cho mỗi khu vực bị phơi nhiễm và không bị phơi nhiễm đã được thu thập. Tương tự, các mẫu nước tiểu cũng được thu thập từ 330 đối tượng ở khu vực bị phơi nhiễm và 126 đối tượng ở khu vực không bị phơi nhiễm. Phân tích gas chromatography với phổ khối đã được sử dụng để phân tích PAHs trong mẫu TSP thu thập được và các sản phẩm chuyển hóa PAHs, 2-naphthol (2-NAP) và 1-hydroxypyrene (1-OHP) từ cư dân. Nồng độ của 2-NAP và 1-OHP trong nước tiểu đã được điều chỉnh theo nồng độ creatinine. Nồng độ PAHs trong khí quyển, bao gồm naphthalene và pyrene, cao hơn ở khu vực bị phơi nhiễm so với khu vực không bị phơi nhiễm. Trung bình hình học (GMs) của nồng độ 2-NAP trong nước tiểu của nhóm bị phơi nhiễm và không bị phơi nhiễm mà không có kinh nghiệm làm việc lần lượt là 4.06 và 1.55 μg/g creatinine. GMs của nồng độ 1-OHP trong nước tiểu là 0.26 và 0.14 μg/g creatinine, tương ứng. Kết quả cho thấy nồng độ của các sản phẩm chuyển hóa PAH cao hơn đáng kể ở nhóm bị phơi nhiễm so với nhóm không bị phơi nhiễm (p < 0.001). Phân tích hồi quy tuyến tính đa biến với các nồng độ 2-NAP và 1-OHP trong nước tiểu đã chuyển đổi log và các biến khác cho thấy có mối tương quan mạnh giữa việc sinh sống tại khu vực bị phơi nhiễm và hút thuốc với sự gia tăng nồng độ 2-NAP và 1-OHP trong nước tiểu. Bên cạnh các yếu tố nguy cơ đã biết, nghiên cứu này cho thấy việc sống gần một nhà máy xi măng có lò nung cũng là một yếu tố nguy cơ cho sự phơi nhiễm PAH.

The screening and identification of occupational liver or other organ-system injury related to long-term, low-level solvent exposure are difficult in clinical practice. We studied the feasibility of the use of common laboratory tests combined with a detailed exposure history. The relationships between laboratory tests and exposure to organic solvents were studied in regression modelling adjusted to age, alcohol consumption, gender and body mass index (BMI). The subjects were 29 solvent-exposed workers and 19 referents. Laboratory tests included serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), carbohydrate-deficient transferrin (CDT), alkaline phosphatase (ALP), creatinine, cholesterol, HDL-cholesterol, triglycerides, blood glucose and total and conjugated bilirubin. Positive hepatitis serology, systemic diseases or medications with known hepatic effects and current pregnancy were exclusion criteria. The main exposures of each subject were identified. Current solvent exposure status, exposure during the past 3 months, exposure during the past 5 and 10 years, and total life-time exposure were recorded. AST (P=0.0031), ALT (P=0.0015) and cholesterol (P=0.0110) correlated positively with cumulative solvent exposure in the past 5 years, total bilirubin with current exposure (P=0.0380), and glucose with exposure in the past 5 (P<0.0001) and 10 (P=0.0003) years. Triglycerides correlated positively with exposure in the past 5 (P=0.0025) and 10 (P=0.0059) years and with life-time exposure (P=0.0005). Creatinine correlated negatively with exposure in the past 10 years (P=0.0300) and life-time exposure (P=0.0005). Most laboratory values were within the normal range. These results suggest a multi-system health effect of solvents. The laboratory data had some similarities with those in the metabolic syndrome. The screening and diagnostics of solvent-related conditions should be based on a thorough work history and a set of carefully selected laboratory tests. No single test seems sufficient for this purpose.

The results of single exposure studies with exposure to trichloroethylene, TRI, (Monster et al., 1976), to 1,1,1-trichloroethane, MC, (Monster et al., 1979b) and to tetrachloroethylene, PERC, (Monster et al., 1979c) were used to study the precision in estimating the individual uptake from measured biological parameters after exposure. With simple linear and multiple linear regression analysis the individual uptake of TRI, MC and PERC was estimated from the concentrations of solvents and metabolites in biological media (blood, urine, exhaled air) at 2 h and at 20 h after exposure. The best results are obtained by estimation from the concentrations in blood, particularly of the solvents themselves. Including results of simultaneously measured concentrations in exhaled air or urine did not improve the estimate.

This study intended to explore the effect of C-Jun N-terminal kinases 1 (JNK1) polymorphisms on the sensitivity of individual hearing loss. A total of 1333 subjects, including 683 NIHL workers and 650 normal-hearing workers from east China, were included in this cross-sectional study. Genotyping of three JNK1 single nucleotide polymorphisms (rs9284, rs8428, and rs11598320) was performed. The relationship between different genotypes and noise-induced hearing loss was analyzed. Results show that rs11598320 TT genotype was associated with a higher risk of NIHL (OR 1.57, 95% CI 0.91–2.70). Stratified analysis indicated that the rs11598320 AT + AA genotype was associated with a decreased risk of hearing loss in subjects exposed to noise ≤ 16 years or a noise level > 92 dB (OR 0.68, 95% CI 0.50–0.93 and OR 0.64, 95% CI 0.42–0.96, respectively). The rs8428 TT genotype was associated with an increased risk of noise-induced hearing loss when the noise level was > 92 dB (OR 1.73, 95% CI 1.11–2.70). Haplotype TCT (rs9284–rs8424–rs11598320) was associated with an increased risk of noise-induced hearing loss (OR 1.30, 95% CI 1.00–1.68). Single nucleotide polymorphisms (rs11598320 and rs8424) in JNK1 can be used as new biomarkers of susceptibility for noise-induced hearing loss in Chinese workers.

Cadmium in urine is positively associated with urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) concentrations, a sensitive marker of oxidative DNA damage. We determined whether kidney concentrations of cadmium, mercury, and lead, which may generate oxidative DNA damage, were associated with urinary 8-oxodG or not. 8-OxodG was measured in separate 24 h and overnight urine samples from Swedish healthy adult kidney donors (N = 152) using LC–MS/MS. Concentrations of metals were measured in kidney biopsies (N = 109) by ICP-MS. The median 8-oxodG concentrations (adjusted to specific gravity) in 24 h and overnight samples were 13.5 and 15.3 nmol/L; 8-oxodG excretion rates in 24 h and overnight samples were 0.93 and 0.86 nmol/h. In multivariable linear regression analyses, we did not find any association between 8-oxodG concentrations or rates and elements in the kidney. The 24-h 8-oxodG concentrations were positively associated with serum ferritin (β = 0.048, p < 0.0001), body weight (β = 0.13, p = 0.0019), and inversely with gender (β = −3.34, p = 0.0024). Similar associations with 8-oxodG excretion rates were stronger. Smoking was positively associated with 24-h 8-oxodG excretion rates (β = 0.26, p = 0.0090), but not with overnight samples. Neither cadmium, nor mercury or lead in the kidney contributed to urinary 8-oxodG concentrations in non-occupationally exposed subjects. The iron status was positively associated with urinary 8-oxodG, particularly in women.

The relationship between occupational physical activity (OPA) and mortality has mainly been studied among males and shows conflicting results. This study examines this relationship in a cohort of both male and female workers. OPA was determined by 4 self-reported questions in a representative sample of 5,839 Danish workers aged 18–59 years at baseline. A 19-year follow-up on mortality was assessed by linkage with the national death registry. Gender-stratified Cox regression models were used to determine the effect of high OPA on all-cause mortality while controlling for age, BMI, smoking, alcohol consumption, doctor-diagnosed disease, influence at work, and social class. Two hundred and sixty-two males (8.6%) and 174 females (6.2%) died during follow-up. Being in the highest quartile of OPA predicted an increased risk for all-cause mortality among male workers (HR: 1.79, CI: 1.19–2.70), but not among female workers (HR: 0.99, CI: 0.65–1.49) compared with workers in the lowest quartile of OPA. Among females, indications of a u-shaped relationship between occupational physical activity and all-cause mortality were found. The findings indicate that high occupational physical activity increases the risk for all-cause mortality among male workers. Future studies need to further examine gender differences in the effects of OPA on mortality.

Acute poisonings of workers handling shipping containers by fumigants and other harmful chemicals off-gassed from cargo have been reported but (sub)-chronic neuropsychological effects have not been well studied. This cross-sectional study assessed, using standardised questionnaires, current (past 3-months) neuropsychological symptoms in 274 container handlers, 38 retail workers, 35 fumigators, and 18 log workers, all potentially exposed to fumigants and off-gassed chemicals, and a reference group of 206 construction workers. Prevalence odds ratios (OR), adjusted for age, ethnicity, smoking, alcohol consumption, education, personality traits and BMI, were calculated to assess associations with the total number of symptoms (≥ 3, ≥ 5 or ≥ 10) and specific symptom domains (neurological, psychosomatic, mood, memory/concentration, fatigue, and sleep). Compared to the reference group, exposed workers were more likely to report ≥ 10 symptoms, statistically significant only for retail workers (OR 6.8, 95% CI 1.9–24.3) who also reported more fatigue (OR 10.7, 95% CI 2.7–42.7). Container handlers with the highest exposure-duration were more likely to report ≥ 10 symptoms, both when compared with reference workers (OR 4.0, 95% CI 1.4–11.7) and with container handlers with shorter exposure duration (OR 7.5, 95% CI 1.7–32.8). The duration of container handling was particularly associated with symptoms in the memory/concentration domain, again both when compared to reference workers (OR 8.8, 95% CI 2.5–31.4) and workers with the lowest exposure-duration (OR 6.8, 95% CI 1.5–30.3). Container handlers may have an increased risk of neuropsychological symptoms, especially in the memory/concentration domain. Retail workers may also be at risk, but this requires confirmation in a larger study.

For the period from 1973 to the end of 1986, 70656 data sets on occupational preventive medical examinations in employees exposed occupationally to asbestos dust (G 1.2) were made available to us by the Central Registry for Employees Exposed to Asbestos Dust (ZAS). On the basis of this data, an analysis of asbestosis risk was to be made in relation to specific areas of work, taking into consideration the beginning and duration of exposure. Proceedings for declaratory appraisal in accordance with occupational disease no. 4103 were instituted in 1760 cases in the report period. In accordance with the character of the available data, the X-ray findings in the lungs were available from the persons investigated as parameters of possible asbestosis risk on the basis of coding consistent with the International Pneumoconiosis Classification (ILO U/C 1971 and/or ILO 1980 West Germany). The major result of the statistical analyses on the mainframe macrocomputer of the University of Erlangen-Nuremberg was that the relatively highest risk of asbestosis was present in persons whose exposure began before 1955. On the other hand, with increasing duration of exposure, an unequivocal rise of the asbestosis risk could not be detected on the basis of the overall population. In relation to the individual fields of work, the relatively highest risk of asbestosis was shown to be in the asbestos textile and paper industry, as well as in the asbestos cement industry. No detectable risk of asbestosis was present in the fields of mining, traffic and health service and for women in the industrial sectors of building material, gas and water, catering trade, building, commerce as well as banking and insurance. Accordingly, it can be assumed that certain fields of work are or were exposed to such a small extent or not at all that a risk of asbestosis which is relevant in terms of occupational medicine is no longer to be assumed or was not to be assumed. This applies above all to certain work in the frictional coating (brake lining) and asbestos paper industry. Furthermore, the analysis of the data material did not provide any unequivocal indications that inhalative smoking habits have a negative effect on the risk of asbestosis. In prinicple, it can be stated that the occupational preventive medical investigations according to G 1.2 are effective. However, irrespective of this, the analysis has shown that a regular exchange of experience on the part of authorized physicians should be institutionalized and the second X-ray appraisal should be retained in order to ensure a high measure of reliability and diagnostic relevance of the available investigation data. Besides this, all expert appraisal results from patients with recognized occupational diseases according to subparagraphs, 4103, 4104 and 4105 BeKV (no. 4103: asbestosis, no. 4104: asbestosis in connection with lung cancer, no. 4105: mesothelioma of the pleura or peritoneum) should be centrally registered both in persons exposed to asbestos dust and in persons with asbestosis and accompanying malignant diseases, would then be possible.