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ObjectivesFirefighters are exposed to multiple cardiovascular hazards, but few epidemiological studies have addressed their cardiovascular morbidity. The objective of this study was therefore to examine the incidence of cardiovascular diseases (CVD) in Danish firefighters.MethodsWe used individual historical employment records on 11.691 male Danish firefighters supplied by trade unions and fire agencies. The Supplementary Pension Fund Register was used to establish two occupational reference groups (a random sample from the male employed population and military employees). Information on CVD incidence was retrieved from the nationwide Danish National Patient Registry. SIRs and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs.ResultsIn comparison with the population sample, the age-adjusted and calendar time-adjusted SIR for all CVDs combined was increased in firefighters (SIR=1.10, 95% CI 1.05 to 1.15). The risk was also elevated for the most frequent outcomes, including angina pectoris (SIR=1.16, 95% CI 1.08 to 1.24), acute myocardial infarction (SIR=1.16, 95% CI 1.06 to 1.26), chronic ischaemic heart disease (SIR=1.15, 95% CI 1.06 to 1.24) and atrial fibrillation/flutter (SIR=1.25, 95% CI 1.14 to 1.36). This analysis showed the most elevated SIRs for CVD in full-time firefighters compared with part-time/volunteer firefighters. Both types of firefighters employed <15 years had an increased risk of CVD. Similar risk patterns appeared in comparisons with the military. Internal analysis supported external findings.ConclusionThe risk of overall CVD, including the most frequent subtypes was modestly increased in Danish firefighters and was most elevated in full-time firefighters compared with other male employees.

ObjectiveFirefighters are exposed to numerous respiratory hazards, but large studies on the risk of pulmonary disease are scarce. The objective of this study was to examine incidence of asthma and chronic obstructive pulmonary disease (COPD) in a nationwide cohort of Danish firefighters.MethodsWe used individual historical employment records on 11 968 Danish male firefighters primarily supplied by trade unions and fire agencies. Furthermore, we used the Supplementary Pension Fund Register to form an occupational reference group consisting of military employees. Information on respiratory incidence was retrieved from the nationwide Danish National Patient Registry. Age and calendar time standardised incidence ratio (SIR) and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs.ResultsCompared with military employees, the overall age and calendar-time adjusted risk for asthma was significantly increased among full-time firefighters (SIR=1.58, 95% CI 1.32 to 1.88), but not among part-time/volunteer firefighters. Full-time firefighters’ risk for asthma did not vary by duration of employment. No consistent evidence of an increased risk for chronic obstructive pulmonary disease was detected.ConclusionDanish firefighters have an increased risk of asthma, but the causes, whether occupational or not, remain to be established.

The focus on hand hygiene during the pandemic has been reported to increase the hand eczema (HE) prevalence in healthcare workers (HCWs), however, detailed prospective data is missing.

Background:The study was intended to evaluate the possible impact of poison center advice on physicians' treatment and referral of nondrug exposures.Methods:Doctors seeking advice on nondrug poisoning were asked for their management plan before any recommendations were given. The proportions of cases in different treatment and referral categories were compared to the poison center recommendations. Rate ratios were used as effect measure.Results:A total of 175 cases were included in the study. For 90% of these, the exposure was estimated by the poison center to be of no or minor risk. The inquiring physicians had intended to treat 43 more cases than the poison center recommended, rate ratios: 1.6 (95% CI: 1.3–2.0). The most marked difference was for treatment by gastrointestinal decontamination, rate ratios: 5.0 (95% CI: 2.5–9.8). For referral, 42 more cases would have been observed in a stationary hospital unit, rate ratios: 2.3 (95% CI: 1.6–3.3) and 28 excess cases would have been observed in an outpatient facility, rate ratios: 2.0 (95% CI: 1.3–1.6). A more active attitude for treatment and referral by the inquirers was independently associated with patients ≤ 14 years of age, lack of symptoms at presentation, and insignificant exposures. Conclusions:Doctors seeking advice on the management of nondrug poisoning intended to treat and refer to health care facilities more actively than recommended by the poison center. The tendency was most pronounced for children exposed to substances of minor toxicological significance and treatment with gastrointestinal decontamination.

A randomized parallel-group comparative trial with a 1-year follow-up period was performed.

Pancreatic tissue pressure (PTP) was measured peroperatively by the needle technique in 14 patients with chronic pancreatitis undergoing drainage operations for pseudocysts (six patients) or dilated ducts (eight patients). All patients suffered from severe abdominal pain before the operation, and a pain evaluation was made at discharge and after 8–18 months of observation. PTP was increased in all patients and was not different in the two groups. PTP decreased significantly in both groups after drainage. Pain relief at discharge was good or fair in 12 patients and poor in one (one patient died postoperatively). During observation, pain returned in four patients. Long-term pain relief was not related to PTP decrease, PTP after operation, type of operation, or patency of anastomosis as seen by endoscopic retrograde pancreaticography.

ObjectiveProlonged seated immobility during long-distance flights is related to an increased risk of venous thromboembolism (VTE) but little is known on the risk, if any, related to sedentary work. The objective of this paper was to examine the risk of VTE according to sitting posture at work.MethodsA total of 88 077 participants from the Copenhagen City Heart Study and the Copenhagen General Population Study were included in the study cohort, all without previous thromboembolic events and aged below 65 years. Activity level at work was obtained at baseline through self-administered questionnaires. VTEs were identified through national patient registries with complete coverage. Survival analyses were performed to determine the risk of VTE according to activity level at work with adjustment for a range of known determinants including lifestyle and coagulation factors.ResultsDuring the follow-up period of 5 79 116 person years (mean follow-up, 7 years) 805 participants experienced their first venous thromboembolic event. 42% of the population categorised themselves as sedentary workers. Multivariable adjusted analyses showed no difference in risk of VTE between sedentary and walking work [hazard ratio (HR) 0.95 (95% confidence interval (CI), 0.80–1.14)]. Likewise, when considering activity level at work on a continuous scale, defined by Metabolic equivalents (METs), multivariable adjusted HR for 1 MET increase was 1.04 (95% CI 0.96–1.13).ConclusionSedentary work defined by a wide-range group of occupations, is not a risk factor for VTE. Whether certain occupations with particularly high exposure to immobilised sitting positions are associated with thromboembolic events is not addressed.

ObjectiveFirefighters are exposed occupationally to a complex range of potential health threats including toxic chemicals, shift work, excessive heat, physical and emotional strain. The aim of this study is to examine the resulting pattern of mortality among Danish firefighters.MethodPast and present male Danish firefighters were identified through systematic collection of personnel and membership records from employers and trade unions from the entire country (n=11,529). Using the unique Danish personal identification number, information on additional employment, vital status and cause of death was linked to each member of the cohort from the Supplementary Pension Fund Register, the Danish Civil Registration System and the Danish Register of Causes of Death. Standardised mortality ratios (SMRs) were calculated for specific causes of death using rates for two selected reference groups, a sample of the working population and military employees respectively.ResultsCompared to both the sample of the working population and the military, overall mortality was significantly reduced among the firefighters (SMR 0.74, 95% CI 0.69–0.78 and SMR 0.87, 95% CI 0.82–0.93). In addition, the SMRs for mental disorders, endocrine disorders, suicides, accidents and other external causes were significantly reduced against both reference groups.ConclusionDespite possible exposure to numerous occupational hazards, male Danish firefighters have a significantly lower mortality compared to both a sample of the Danish working population and the military.

ObjectivesTo explore the incidence of selected diagnoses of cardiovascular diseases (CVD) among 11.691 male Danish firefighters, including the relative risk among different exposure groups.MethodsTrade unions, with firefighter membership records, Danish municipalities and private companies covering firefighting assignments supplied historical employment records to this study. The Supplementary Pension Fund Register, with information on all employees in Denmark, was used to establish two occupational reference groups: a) a random sample from the employed male population and b) the military. Information on CVD, 1977–2014, was retrieved from the Danish National Patient Registry. Age and calendar standardised incidence rates (SIR) were estimated using reference group rates.ResultsThe number of observed cases significantly exceeded the expected number for all cardiovascular diseases combined when firefighters were compared with both references. Significantly increased SIRs were also observed for angina pectoris (1.16, 95% CI=1.08–1.24), acute myocardial infarction (1.16, 95% CI=1.06–1.26), chronic ischaemic heart disease (1.15, 95% CI=1.06–1.24) and atrial fibrillation/flutter (1.25, 95% CI=1.14–1.36) compared with the general working population sample. When comparing the firefighters with the military, results reflected the same pattern. In subgroup analyses, the risk of CVD was elevated for full-time employed firefighters, but decreased with increasing duration of employment.ConclusionOur study indicates a modest elevated CVD incidence among Danish firefighters. This study is the first large cohort study exploring the association between firefighting and CVD incidence, and more studies including more detailed information on ”dose” of firefighting and potential confounding factors are warranted.

IntroductionDisturbed indoor climate may in some cases be associated with illness. In the present paper, we report the results from a thorough investigation of office workers in Greenland, who developed skin and/or airway problems after moving into renewed offices.Material and methodsIn 2009 the office of the Bank of Greenland had a total renovation of the building, including new furniture and carpets. Symptoms developed within the first year after moving back into the renewed buildings. After removal of carpets in the building, symptoms significantly improved. Workers were examined in 2009 and re-examined in 2013, including clinical examination, patch test and when relevant also skin prick tests and histamine release test. Isothiazolinones and fumarates, both able to cause airway as well as skin symptoms, were isolated from carpets before testing, and included in the test series.ResultsIn total, 32 out of 80 workers (40%) developed symptoms; 27 reported eczema, 20 rhinitis and 4 urticaria. Eczema was located on the hands and/or lower arms in 18 workers, on the face in 10 workers and on legs/trunk in 12 workers. After intervention in the office, 22 workers with eczema reported significant improvement, all cases of hand eczema cleared and 16 workers with rhinitis also improved. Positive patch tests to carpet extracts were found significantly more frequent in the worker cohort than in a control group comprising 47 dermatitis patients (p<0.001). Only few workers reacted with a positive response to skin prick test or in the HR test, no obvious pattern in reactions was found, and no conclusions can be made from these reactions.ConclusionThe results indicate that the reported symptoms are related to exposures from the building after renovation in 2009. A specific triggering exposure could not be identified, although chemicals from the glued carpets are suspected. The study is an example of a work place investigation, and illustrates the diversity of symptoms and exposures involved in “Sick Building” cases.