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As social issues like climate change become increasingly salient, digital traces left by scholarly documents can be used to assess their reach outside of academia. Our research examine who shared climate change research papers on Twitter by looking at the expressions used in profile descriptions. We categorized users in eight categories (academia, communication, political, professional, personal, organization, bots and publishers) associated to specific expressions. Results indicate how diverse publics may be represented in the communication of scholarly documents on Twitter. Supplementing our word detection analysis with qualitative assessments of the results, we highlight how the presence of unique or multiple categorizations in textual Twitter descriptions provides evidence of the publics of research in specific contexts. Our results show a more substantial communication by academics and organizations for papers published in 2016, whereas the general public comparatively participated more in 2015. Overall, there is significant participation of publics outside of academia in the communication of climate change research articles on Twitter, although the extent to which these publics participate varies between individual papers. This means that papers circulate in specific communities which need to be assessed to understand the reach of research on social media. Furthermore, the flexibility of our method provide means for research assessment that consider the contextuality and plurality of publics involved on Twitter.

Purpose In thermal paper, Bisphenol S (BPS) is one of the alternatives for bisphenol A (BPA). Due to its structural similarity to BPA, concern has been raised about the safety of BPS. Indeed, handling thermal paper receipts could be a source of occupational exposure to BPS among cashiers, as it was previously described for BPA. In this study, we investigated whether frequent contacts with thermal paper are associated with an increase in urinary BPS levels in cashiers. Method Total (unconjugated and conjugated forms) and free (unconjugated) BPS were measured in urine samples from 17 cashiers and 15 controls, using LC–MS/MS. Spot urine samples, including pre-shift and post-sift samples and first morning void were collected from each volunteer. BPS concentration in thermal paper was determined and the number of receipts handled by cashiers was estimated as well. Results The median urinary total BPS concentration was 0.67 μg/L (0.52 μg/g creatinine) for controls and 2.53 μg/L (2.07 μg/g creatinine) for cashiers. Total BPS concentration was significantly higher in cashiers than in controls. Free BPS was detected in less than 20% of urine samples collected from controls and in less than 50% of urine samples collected from cashiers. Conclusion The detectable levels of BPS in urine of controls suggest an exposure to BPS of the general population. In addition, frequent contact with thermal paper could be responsible for an increase in urinary concentration of total BPS in cashiers.

A cost-efficient approach for assessing working postures could be to build statistical models for predicting results of direct measurements from cheaper data, and apply these models to samples in which only the latter data are available. The present study aimed to build and assess the performance of statistical models predicting inclinometer-assessed trunk and arm posture among paper mill workers. Separate models were built using administrative data, workers' ratings of their exposure, and observations of the work from video recordings as predictors.Trunk and upper arm postures were measured using inclinometry on 28 paper mill workers during three work shifts each. Simultaneously, the workers were video filmed, and their postures were assessed by observation of the videos afterwards. Workers' ratings of exposure, and administrative data on staff and production during the shifts were also collected. Linear mixed models were fitted for predicting inclinometer-assessed exposure variables (median trunk and upper arm angle, proportion of time with neutral trunk and upper arm posture, and frequency of periods in neutral trunk and upper arm inclination) from administrative data, workers' ratings, and observations, respectively. Performance was evaluated in terms of Akaike information criterion, proportion of variance explained (R2), and standard error (SE) of the model estimate. For models performing well, validity was assessed by bootstrap resampling.Models based on administrative data performed poorly (R2 ≤ 15%) and would not be useful for assessing posture in this population. Models using workers' ratings of exposure performed slightly better (8% ≤ R2 ≤ 27% for trunk posture; 14% ≤ R2 ≤ 36% for arm posture). The best model was obtained when using observational data for predicting frequency of periods with neutral arm inclination. It explained 56% of the variance in the postural exposure, and its SE was 5.6. Bootstrap validation of this model showed similar expected performance in other samples (5th-95th percentile: R2 = 45-63%; SE = 5.1-6.2).Observational data had a better ability to predict inclinometer-assessed upper arm exposures than workers' ratings or administrative data. However, observational measurements are typically more expensive to obtain. The results encourage analyses of the cost-efficiency of modeling based on administrative data, workers' ratings, and observation, compared to the performance and cost of measuring exposure directly.

International audience; Purpose: As an essential component of polycarbonate plastics and epoxy resins, Bisphenol A (BPA) is found in numerous industrial and consumer products. BPA may cause adverse health effects because of its endocrine activity. General population exposure to this compound mainly through diet is well documented. Thermal paper was also identified as a source of BPA through dermal intake. In this study, we investigated whether frequent contact with thermal paper is associated with an increase in urinary BPA excretion.Methods: We evaluated the exposure to BPA in cashiers and in non-occupationally exposed workers from several workplaces. Urinary BPA was quantified in free (unconjugated) and total (unconjugated plus conjugated) forms in 24-h and spot urine samples using LC–MS/MS. BPA concentration in thermal paper was also measured from each workplace. In addition, participants provided information on job, food and drink, tobacco consumption and hands wash during the sampling period through a questionnaire.Results: Urine samples were collected from 90 cashiers and 44 controls. Free and total BPA were detected in all samples. The median urinary total BPA concentration was 3.54 µg/L (2.89 µg/g creatinine) for controls and 8.92 µg/L (6.76 µg/g creatinine) for cashiers. For the free BPA, the median urinary concentration was 0.20 µg/L (0.21 µg/g creatinine) for controls and 0.28 µg/L (0.22 µg/g creatinine) for cashiers. Any correlation was found between the urinary concentration levels and the number of thermal receipts handled. Hand washes frequency, age, job length of service and tobacco consumption had also no effect on the BPA excretions.Conclusion:A significant increase in urinary total BPA concentration was observed for cashiers handling daily thermal paper receipts. However, no significant increase was observed in urinary free BPA concentration. These findings are particularly interesting for risk assessment since all available data on occupational exposure to BPA through thermal paper were obtained from models or from simulated experiments.

The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98-1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90-0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12-1.32) and SMR 1.11 (95% CI 1.02-1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07-1.54), paper production (SMR 1.26, 95% CI 1.06-1.49), and maintenance (SMR 1.16, 95% CI 1.02-1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).

Objectives This study investigated whether previous findings of an increased risk of gliomas among workers in some pulp and paper mills could be confirmed for all Swedish pulp and paper mill workers and whether the increase could be attributed to certain occupational groups. Methods The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer from 1971 to 1990 and the 1960 and 1970 census data on codes of occupation and industry for the whole population. Standardized incidence ratios (SIR) were used to estimate the risks for men in different occupations in pulp (N=28 142) and paper (N=39 169) mills in 1960, 1970 or both years as compared with those of all gainfully employed men in Sweden. Results Maintenance workers employed in pulp or paper mills in 1960, 1970 or both years, as well as pulp workers, showed an increased incidence of gliomas in 1971-1990 [SIR 1.5, 95% confidence interval (95% CI) 1.1-2.1 and SIR 1.5, 95% CI 1.0-2.2, respectively], whereas the incidence among process workers in paper mills was lower than expected (SIR 0.6, 95% CI 0.3-0.9). Taken together, all employed men in the pulp mill industry had an increased incidence of gliomas (SIR 1.3, 95% CI 1.0-1.7). Conclusions Pulp mill workers, but not paper mill workers, were found to have more gliomas in 1971-1990 than expected. There was an increased risk of gliomas among maintenance workers in both pulp and paper mills. Few risk factors for brain tumors are recognized, and the causes of the increase are not obvious.

To assess possible health risks associated with the manufacture of paper, we carried out a retrospective analysis of mortality among 4,242 men and women employed at a Scottish paper mill between 1955 and 1992. During follow-up to 1994, 959 subjects had died giving an SMR of 0.85 (95% CI 0.80-0.90) in comparison with the national population. Mortality from all cancer (SMR 0.77, 95% CI 0.68-0.88) and particularly from lung cancer (SMR 0.64, 95% CI 0.50-0.81) was lower than expected. An excess of lymphatic and hematopoietic cancer (11 deaths, SMR 2.17) was observed in the making department. These findings do not support an occupational hazard of lung cancer as suggested by several earlier studies. The excess of lymphatic and hematopoietic cancer in the making department was unexpected, and may be a chance occurrence.

The risk to workers of exposure to HIV or other blood-borne infectious diseases on the job is dependent upon the likelihood of exposure to blood, body fluids, or tissues while performing the tasks required by the job. Three categories of workplace-associated risk of HIV exposure have been defined. These categories can be summarized as follows. Category I--Regular or Frequent Exposure Potential. Applies primarily to health-care workers, including emergency medical workers. These workers are at greatest risk of occupationally acquired HIV disease. Category II--Intermittent Exposure Potential. Applies to persons such as police officers, fire fighters, and correctional facility personnel. Category III--Rare or No Exposure Potential. Applies to most jobs in the service and manufacturing industries, including office personnel. These workers are at no greater risk than the general public for exposure to HIV. As there is definite risk to Category I and II workers of becoming infected with HIV while performing duties required by their jobs (their risk of acquiring HBV is much greater), it is important for employers in these workplaces to establish procedures to prevent the exposures that may lead to infections. The first step in this process is to analyze carefully tasks performed within the workplace to identify Category I and II tasks, as described in the DOL/DHHS Joint Advisory Notice. Once this has been done, the DOL/DHHS document and pertinent CDC recommendations should be used to develop specific procedures for those workers at risk.

Three hundred and ninety one male employees aged 35-65 in a Swedish pulp and paper company were followed up for 22 years; 151 deaths were recorded by 31 December 1983. On the basis of data from 1961, indices for job decision latitude, job support, and other work related psychosocial factors were constructed as were five indices for non-work related social network factors. All indices were checked by life table analysis in respect of mortality. Job decision latitude and a combined index for job decision latitude and job support showed significant associations with mortality. These two indices were investigated by multivariate analysis with scale for evaluation of neuroticism and known somatic risk factors such as smoking, cholesterol, and systolic and diastolic blood pressure. Age, educational level, occupational status, physically heavy work, and general health state were also included in the multivariate analysis. Age, systolic blood pressure, the combined index for job decision latitude and job support, smoking, and neuroticism were shown to be independent predictors of mortality.

Systems thinking approaches can benefit the occupational vocal health of vocally reliant workers. This paper explores community faith leaders as an example of a highly vocally reliant occupation, who may benefit from systems thinking being used to support their vocal occupational health and safety. A scoping review of the current literature regarding faith leaders' occupational voice use and vocal health is detailed, including recognised occupational hazards. This article then discusses the unique and potential use of systems thinking for facilitating faith leaders' vocal occupational health and safety. Rather than using a solely clinical perspective, the sociotechnical systems approach and the biopsychosocial-spiritual approach are noted as particularly pertinent for this occupational group.

Background UK Biobank (UKB) is a large prospective cohort capturing numerous health outcomes, but limited occupational information (job title, self-reported manual work and occupational walking/standing). Aims To create and evaluate validity of a linkage between UKB and a job exposure matrix for physical work exposures based on the US Occupational Information Network (O*NET) database. Methods Job titles and UK Standard Occupational Classification (SOC) codes were collected during UKB baseline assessment visits. Using existing crosswalks, UK SOC codes were mapped to US SOC codes allowing linkage to O*NET variables capturing numerous dimensions of physical work. Job titles with the highest O*NET scores were assessed to evaluate face validity. Spearman’s correlation coefficients were calculated to compare O*NET scores to self-reported UKB measures. Results Among 324 114 participants reporting job titles, 323 936 were linked to O*NET. Expected relationships between scores and self-reported measures were observed. For static strength (0–7 scale), the median O*NET score was 1.0 (e.g. audiologists), with a highest score of 4.88 for stone masons and a positive correlation with self-reported heavy manual work (Spearman’s coefficient = 0.50). For time spent standing (1–5 scale), the median O*NET score was 2.72 with a highest score of 5 for cooks and a positive correlation with self-reported occupational walking/standing (Spearman’s coefficient = 0.56). Conclusions While most jobs were not physically demanding, a wide range of physical work values were assigned to a diverse set of jobs. This novel linkage of a job exposure matrix to UKB provides a potentially valuable tool for understanding relationships between occupational exposures and disease.

Purpose Suicide among hospitality workers has recently attracted attention in the media. To date, little is known about suicide among hospitality workers in Australia. Methods Suicide data were obtained from the National Coronial Information System (NCIS). Occupational suicide rates were calculated using the Australian Bureau of Statistics population-level data from the 2011 census. Negative binomial regression, univariate logistic regression, and multivariate logistic regression were used to estimate the association between suicide and employment as a hospitality worker over the period 2006–2017, compared to all other occupations. Results Suicide rates for chefs was significantly higher than for persons in non-hospitality occupations [incidence rate ratio (IRR), 3.93; 95% CI 2.53–5.79; P

This study investigated the characteristics of transmission routes of COVID-19 cluster infections (⩾10 linked cases within a short period) in Gangwon Province between 22 February 2020 and 31 May 2021. Transmission routes were divided into five major categories and 35 sub-categories according to the relationship between the infector and the infectee and the location of transmission. A total of 61 clusters occurred during the study period, including 1741 confirmed cases (55.7% of all confirmed cases (n = 3125)). The the five major routes of transmission were as follows: ‘using (staying in) the same facility (50.7%), ‘cohabiting family members’ (23.3%), ‘social gatherings with acquaintances’ (10.8%), ‘other transmission routes’ (7.0%), and ‘social gatherings with non-cohabiting family members/relatives’ (5.5%). For transmission caused by using (staying in) the same facility, the highest number of confirmed cases was associated with churches, followed by medical institutions (inpatient), sports facilities, military bases, offices, nightlife businesses, schools, restaurants, day-care centres and kindergarten, and service businesses. Our analysis highlights specific locations with frequent transmission of infections, and transmission routes that should be targeted in situations where adherence to disease control rules is difficult.

Background Patients are increasingly recognized as playing important roles in improving health services. Little is known about the mechanisms by which patients develop and diffuse local innovations in a complex health-care system. Objective To ascertain how diffusion of an innovation, My Medication Passport, occurred and roles played by patients in it. Design Case study: quantitative mapping of innovation's diffusion and analysis of the routes and occupations of those through whom the innovation spread; documentary analysis; reflective assessment of patient's roles. Setting and participants NHS Trusts, third sector organizations, patients and health-care professionals. Interventions studied Co-produced action to raise awareness and influence use of the innovation; order database which enabled ease of access to the innovation. Main outcome measures Geographical spread of innovation; occupations of individuals; types of organizations using the innovation. Results The innovation spread from initial development and use in Northwest London across the UK and beyond. Key roles played by patients were as follows: co-producer; advocate; relationship builder; relationship broker; planner; presenter; awareness raiser; trainer; networker. Patients identified and introduced potential audiences and users to MMP, using social, organizational, sectoral, lay and professional networks to do so. They organized a range of awareness-raising and communication activities, monitored feedback, evaluated the impact and responded to new interest. Discussion and conclusions The roles of patients in diffusing innovations are under-recognized. Collaborative working between patients, carers and health-care professionals in planning and progressing the use and supporting diffusion of the innovation was important. Principles described in this study are relevant to progressing other patient-led ideas for innovative changes relating to health service development.

Background There are widespread concerns that workers in precarious employment have suffered the most in the COVID-19 pandemic and merit special attention. The aim of this rapid scoping umbrella review was to examine what evidence exists about how COVID-19 has affected the health of this highly vulnerable group, and what gaps remain to be investigated. Methods Five databases were searched for systematic or scoping reviews from January 2020 to May 2021. The quality of the included reviews was determined using A MeaSurement Tool to Assess systematic Reviews. Results We identified 6 reviews that reported 30 unique relevant primary studies. The included studies indicate that essential (non-health) workers are at greater risk of COVID-19 infection and case fatality than others in their surrounding community. The occupational risk of exposure to COVID-19 also seems to be greater among more precarious categories of workers, including younger workers and workers in low-income and low-skilled occupations. Further, hazardous working conditions faced by many essential workers appear to have amplified the pandemic, as several occupational sites became ‘super-spreaders’, due to an inability to socially distance at work and high contact rates among workers. Finally, employment and financial insecurity generated by the pandemic appears to be associated with negative mental health outcomes. The quality of the included reviews however, and their primary studies, were generally weak and many gaps remain in the evidence base. Conclusions Our study highlights that COVID-19 is creating new health risks for precarious workers as well as exacerbating the pre-existing health risks of precarious employment.

Absenteeism is an important feature of the labour market, imposing significant costs on employers and the economy as a whole. This paper is the first to use a large labour force survey sample to investigate how different physical and mental health conditions affect absence rates among prime age workers in the UK. A pooled time series/cross-section analysis reveals that people with a chronic health condition are more likely to be absent from work, and mental health has a significantly larger effect than physical health. From a longitudinal perspective, we find that a change in mental health has an effect on absenteeism more than three times greater than a change in physical health. These findings imply that the prevention and alleviation of chronic health conditions, particularly common mental disorders such as depression and anxiety that are highly prevalent in prime age workers, will deliver significant benefits to the UK economy due to reduced absenteeism. Further, there is significant heterogeneity between different health conditions, with some having no effect at all on absenteeism having controlled for other factors.

Background Comparative long-term trends in fatal accident rates in the UK’s most hazardous occupations have not been reported. Aims To compare trends in fatal accident rates in six of the most hazardous occupations (the three armed forces, merchant shipping, sea fishing and coal mining) and the general British workforce during peacetime years since 1900. Methods Examinations of annual mortality reports, returns, inquiry files and statistics. The main outcome measure was the fatal accident rate per 100 000 population employed. Results These six occupations accounted for ~40% of all fatal accidents in the British workforce. Fatal accident rates were highest in merchant shipping to 1914 (400–600 per 100 000) and in the Royal Air Force and sea fishing by the early 1920s (around 300 per 100 000). Since the 1950s sea fishing has remained the most hazardous occupation (50–200). Widespread reductions in fatal accident rates for each occupation have been greatest in recent years in the three armed forces and merchant shipping. Compared with the general workforce, relative risks of fatalities have increased in recent decades in all these occupations except shipping. Conclusions All six occupations still have high fatal accident rates. The greatly increased fatalities in sea fishing generally and in the Royal Air Force during its early years reflect, for different reasons, cultures of extreme risk-taking in these two sectors. Reductions in fatality rates in the armed forces over the last 20 years are due largely to decreases in land transport accidents.

The aim of the study was to assess occupational exposure to bisphenol A in Finland. Five companies took part in the research project: two paint factories (liquid and powder paints), a composite product factory, a thermal paper factory, and a tractor factory. Exposure was assessed by measuring total bisphenol A excretion (free and conjugated) from urine samples, and its concentrations in the air. The results revealed the specific work tasks in two of five companies in which significant occupational exposure to bisphenol A may occur. In the manufacturing of liquid paint hardener, urine samples collected after the working day showed bisphenol A levels of up to 100-170 µg l-1. Workers in thermal paper manufacturing were also exposed to bisphenol A, especially those working in the manufacture of coating material and operating coating machines. Median concentrations of the post-shift urine samples of coating machine workers were in the range of 130-250 µg l-1. The highest bisphenol A concentrations were in the range of 1000-1500 µg l-1. Recommendations for more effective personal protection resulted in decreased exposure, particularly among coating machine operators. In the rest of the companies, urinary bisphenol A levels were typically in the range of those of the general population. Bisphenol A concentrations in air samples were typically low (

Background COVID-19 resulted in considerable mental health burden in the Chinese general population and among health care workers at the beginning and peak of the pandemic. However, little is known about potentially vulnerable groups during the final stage of the lockdown. Objective The aim of this survey study was to assess the mental health burden of different professions in China in order to find vulnerable groups, possible influencing factors, and successful ways of coping during the last 4 weeks of the lockdown in Hubei Province. Methods A cross-sectional online survey asked participants about current residence, daily working hours, exposure to COVID-19 at work, and media preferences. We used a shortened version of the Depression, Anxiety and Stress Scale (DASS-21) to assess mental health. Further assessments included perceived stress (Simplified Chinese version of the 14-item Perceived Stress Scale), coping strategies for all participants, and specific stressors for health care workers. We followed the reporting guidelines of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement for observational studies. Results The sample (N=687) consisted of 158 doctors, 221 nurses, 24 other medical staff, 43 students, 60 teachers/government staff, 135 economy staff, 26 workers/farmers, and 20 professions designated under the “other” category. We found increased depression (n=123, 17.9%), anxiety (n=208, 30.3%), and stress (n=94, 13.7%) in our sample. Professions that were vulnerable to depression were other medical staff and students. Doctors, nurses, and students were vulnerable to anxiety; and other medical staff, students, and economy staff were vulnerable to stress. Coping strategies were reduced to three factors: active, mental, and emotional. Being female and emotional coping were independently associated with depression, anxiety, or stress. Applying active coping strategies showed lower odds for anxiety while mental coping strategies showed lower odds for depression, anxiety, and stress. Age, being inside a lockdown area, exposure to COVID-19 at work, and having a high workload (8-12 hours per day) were not associated with depression, anxiety, or stress. WeChat was the preferred way of staying informed across all groups. Conclusions By the end of the lockdown, a considerable part of the Chinese population showed increased levels of depression and anxiety. Students and other medical staff were the most affected, while economy staff were highly stressed. Doctors and nurses need support regarding potential anxiety disorders. Future work should focus on longitudinal results of the pandemic and develop targeted preventive measures.

In recent years there have been major shifts in how the role of science-and scientists-are understood. The critical examination of scientific expertise within the field of Science and Technology Studies (STS) are increasingly eroding notions of the "otherness" of scientists. It would seem to suggest that anyone can be a scientist-when provided with the appropriate training and access to data. In contrast, however, ethnographic evidence from the scientific community tells a different story. Scientists are quick to recognize that not everyone can-or should-be a scientist. Appealing to notions such as "good hands" or "gut feelings", scientists narrate a distinction between good and bad scientists that cannot be reduced to education, access, or opportunity. The key to good science requires scientists to express an intuitive feeling for their discipline, but also that individuals derive considerable personal satisfaction from their work. Discussing this personal joy in-and "fittingness" of-scientific occupations using the fields of STS, ethics and science policy is highly problematic. In this paper we turn to theology discourse to analyze the notion of "callings" as a means of understanding this issue. Callings highlight the identification and examination of individual talents to determine fit occupations for specific persons. Framing science as a calling represents a novel view of research that places the talents and dispositions of individuals and their relationship to the community at the center of flourishing practices.

Unprecedented measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic in China. People's adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Chinese residents' KAP towards COVID-19 during the rapid rise period of the outbreak. An online sample of Chinese residents was successfully recruited via the authors' networks with residents and popular media in Hubei, China. A self-developed online KAP questionnaire was completed by the participants. The knowledge questionnaire consisted of 12 questions regarding the clinical characteristics and prevention of COVID-19. Assessments on residents' attitudes and practices towards COVID-19 included questions on confidence in winning the battle against COVID-19 and wearing masks when going out in recent days. Among the survey completers (n=6910), 65.7% were women, 63.5% held a bachelor degree or above, and 56.2% engaged in mental labor. The overall correct rate of the knowledge questionnaire was 90%. The majority of the respondents (97.1%) had confidence that China can win the battle against COVID-19. Nearly all of the participants (98.0%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score (OR: 0.75-0.90, P

Background Workers are exposed to physical, chemical and other hazards in the workplace, which may impact their respiratory health. Aims To examine the healthy worker effect in the Canadian working population and to identify the association between occupation and respiratory health. Methods Data from four cycles of the Canadian Health Measures Survey were utilized. The current occupation of employed participants was classified into 10 broad categories based on National Occupation Category 2011 codes. Data relating to 15 400 subjects were analysed. Results A significantly lower proportion of those in current employment than those not in current employment reported respiratory symptoms or diseases or had airway obstruction. Similarly, those currently employed reported better general health and had greater mean values for percent-predicted forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of FVC (FEF25–75%) and FEV1/FVC ratio. Among males, females and older age groups, significant differences were observed for almost all the respiratory outcomes for those in current employment. Those in ‘Occupations unique to primary industry’ had a significantly greater likelihood of regular cough with sputum and ever asthma and had lower mean values of percent-predicted FEV1/FVC and FEF25–75% than those in ‘Management occupations’. Those in ‘Health occupations’ had the highest proportion of current asthma. Conclusions Participants in current employment were healthier than those not in current employment providing further support for the healthy worker effect. Those in ‘Occupations unique to primary industry’ had an increased risk of adverse respiratory outcomes and reducing workplace exposures in these occupations has the potential to improve their respiratory health.

Purpose Working on the hypothesis that the social and economic factors associated with onset of late-life depression operate differently for men and women, we investigated the impact of current social relationships and lifetime occupational attainment on incident major depressive disorder (MDD) assessed in three follow-up waves over a period of 5 years. Methods Participants were part of a household multistage probability sample of 2149 Nigerians who were aged 65 years and above. The presence of current and lifetime MDD was assessed using the World Health Organization (WHO) Composite International Diagnostic Interview. Participants’ highest occupational attainment was categorised based on the International Standard Classification of Occupations, while socio-economic positions were estimated using asset-based measures relevant to low-income settings. Current social contacts and participation were assessed using items from the WHO Disability Assessment Schedule. Results We found an incidence rate of 120.9 per 1000 persons years (95% CI = 110.4–132.5) among 1394 persons who were free of lifetime MDD and dementia at baseline. Incidence rates were 94.7 (95% CI = 82.5–108.7) and 153.8 (136.3–173.6) per 1000 person years, in men and women respectively. In analyses comparing gender and adjusting for the effect of age, we found that while a lifetime of unskilled occupation (trade: HR = 1.4, 95% CI = 1.0–2.0, and elementary occupations: HR = 1.5, 95% CI = 1.1–2.1) was significantly associated with incident MDD in men (but not in women), living in a rural location (HR = 1.3, 95% CI = 1.0–1.7) and having no regular contact with family (HR = 2.2, 95% CI = 1.0–4.7) at baseline significantly predicted subsequent onset of MDD in women. Conclusion There was a gender differential in the association of social and economic factors with incident MDD in this sample. These findings have implications for the design of early prevention strategies for late-life depression in sub-Saharan Africa. Electronic supplementary material The online version of this article (10.1007/s00127-018-1500-7) contains supplementary material, which is available to authorized users.

Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 A degrees C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 A degrees C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 A degrees C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate. Originally included in thesis in manuscript form with title: "Socio-environmental factors associated with heat and cold related mortality in Vadu HDSS, western India: A Population based case-crossover study design".

There are significant gender differences in both play behavior and occupational interests. Play has been regarded as an important medium for development of skills and personal characteristics. Play may also influence subsequent preferences through social and cognitive processes involved in gender development. The present study investigated the association between gender-typed play behavior in early childhood and gender-typed occupational interests in early adolescence. Participants were drawn from a British longitudinal population study, the Avon Longitudinal Study of Parents and Children. Participants were recruited based on their parent-reported gender-typed play behavior assessed at age 3.5 years. There were 66 masculine boys and 61 masculine girls, 82 feminine boys and 69 feminine girls, and 55 randomly selected control boys and 67 randomly selected control girls. At age 13 years, the participants were administered a questionnaire assessing their interest in gender-typed occupations. It was found that masculine children showed significantly more interest in male-typical occupations than did control or feminine children. Compared with control children, feminine children had marginally significantly lower interest in male-typical jobs. Masculine children also had significantly lower interest in female-typical jobs than did control or feminine children. The associations were not moderated by gender and were observed after taking into account sociodemographic background, parental occupations, and academic performance. The degree of gender-typed play shown by preschoolers can predict their occupational interests 10 years later following transition into adolescence. Childhood gender-typed play has occupational implications that transcend developmental stages.

This paper investigates associations between hazardous jobs, mental health and wellbeing among Thai adults. In 2005, 87 134 distance-learning students from Sukhothai Thammathirat Open University completed a self-administered questionnaire; at the 2009 follow-up 60 569 again participated. Job characteristics were reported in 2005, psychological distress and life satisfaction were reported in both 2005 and 2009. We derived two composite variables grading psychologically and physically hazardous jobs and reported adjusted odds ratios (AOR) from multivariate logistic regressions. Analyses focused on cohort members in paid work: the total was 62 332 at 2005 baseline and 41 671 at 2009 follow-up. Cross-sectional AORs linking psychologically hazardous jobs to psychological distress ranged from 1.52 (one hazard) to 4.48 (four hazards) for males and a corresponding 1.34–3.76 for females. Similarly AORs for physically hazardous jobs were 1.75 (one hazard) to 2.76 (four or more hazards) for males and 1.70–3.19 for females. A similar magnitude of associations was found between psychologically adverse jobs and low life satisfaction (AORs of 1.34–4.34 among males and 1.18–3.63 among females). Longitudinal analyses confirm these cross-sectional relationships. Thus, significant dose–response associations were found linking hazardous job exposures in 2005 to mental health and wellbeing in 2009. The health impacts of psychologically and physically hazardous jobs in developed, Western countries are equally evident in transitioning Southeast Asian countries such as Thailand. Regulation and monitoring of work conditions will become increasingly important to the health and wellbeing of the Thai workforce.

Background When searching for health information, many people use the internet as their first source of information. In online health forums, for example, users post their questions and exchange health advice. In recent years, information givers from various professions have begun to use positive language (indicated by the frequent use of positively valenced adjectives) to communicate their information and persuade their audiences. Objective The goal of the current study was to answer the following research questions: (1) How does positive language, in comparison to neutral language, influence the trustworthiness of a person arguing in an online health forum and the credibility of their health claims; (2) How does working for a university, compared to working for a lobbying organization, influence the trustworthiness of a person arguing in an online health forum and the credibility of their health claims; and (3) Do the two factors of language style and professional affiliation interact with each other to influence trustworthiness and credibility judgments? Methods In a 2 × 2 between-subject experiment, 242 participants read a post from an online health forum and subsequently rated the trustworthiness of the forum post author and the credibility of their information. Within the post, the professional affiliation (scientist vs lobbyist) and language style (neutral vs positive) of the forum post author was varied. Results When the forum post author used a positive language style, they were perceived as less trustworthy (high Machiavellianism [P Conclusions When searching for health information, information seekers evaluate the language style of forum posts to decide whether forum post authors are trustworthy and their information is credible.

Objective To update the data on food consumption and practices in children under 3 years of age in metropolitan France. Design The Nutri-Bébé 2013 cross-sectional study selected a random sample, according to the quota sampling method. After giving their informed consent, parents had to record the food consumption during three non-consecutive days framed by two face-to-face interviews, using for quantitative information different portion size measurement aids. Results One thousand one hundred and eighty-four children were enrolled. Mothers’ mean age was 30·8 (sd 5·4) years; 38 % were primiparous; 89 % lived with a partner; 60 % had an occupation. Of the infants younger than 4 months, 31 % were breast-fed. One thousand and thirty-five children consumed infant formula followed by growing-up milk in 63 % of them; solid foods were introduced at a mean age of 5·4 (sd 2·13) months. From 8 months onwards, 25 % of children consumed the same foods as their parents on a more or less regular basis; 29 % ate in front of a screen, with a daily average screen time of 43·0 (sd 40·4) min. Conclusions This robust survey highlights the low prevalence and duration of breast-feeding in France and shows a modest improvement since the previous survey of 2005 in the observance of recommendations concerning other feeding practices. The frequent consumption of adult foods and the screen time are of concern.

SUMMARYHelicobacter pylori imparts a considerable burden to public health. Infections are mainly acquired in childhood and can lead to chronic diseases, including gastric ulcers and cancer. The bacterium subsists in water, but the environment's role in transmission remains poorly understood. The nationally representative National Health and Nutrition Examination Survey (NHANES) was examined for environmental risk factors associated with H. pylori seroprevalence. Data from 1999–2000 were examined and weighted to represent the US population. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations with seropositivity. Self-reported general health condition was inversely associated with seropositivity. Of participants aged H. pylori transmission. A disproportionate burden of infection is associated with poor health and crowded living conditions, but risks vary by age and race/ethnicity. These findings could help inform interventions to reduce the burden of infections in the United States.

Objective: To study the health status and explore the putative risk factors of chronic diseases among a Chinese rural population. Subjects and Methods: Face-to-face interviews were carried out to collect the information of social characteristics, health status and related risk factors of 11,909 families comprised of 49,383 subjects in the rural area of Liuyang, Hunan province during 2007. Chronic disease was diagnosed according to the diagnosis certification from the town clinic or superior level hospital. Results: The morbidity rate of chronic disease among Liuyang rural residents in 2007 was 19.22%. The prevalence of the top 10 chronic disorders was as follows: hypertension: 3.65%; urolithiasis: 1.03%; chronic obstructive pulmonary disease: 0.92%; ischemic heart disease: 0.92%; chronic gastritis: 0.91%; cerebrovascular disease: 0.71%; lumbar disk disease: 0.61%; chronic viral hepatitis: 0.55%; gallstones: 0.54%, and diabetes: 0.54%. Age, gender, educational level, occupation, marital status, type of housing, source of drinking water, smoking, underweight and overweight were factors associated with chronic disease. We also noticed that 14.2% of the residents were underweight and 29.7% are still using unsafe sources of drinking water. Conclusions: The prevalence of chronic disease in Liuyang area was severe both in communicable and noncommunicable chronic disease. Unhealthy lifestyles such as tobacco usage and overweight partially contributed to the high prevalence of chronic disease.

BACKGROUND: Depression is a common psychological problem that decreases life satisfaction and quality of life in people with spinal cord injury (SCI). OBJECTIVE: The aim of this study was to investigate the prevalence of depression after SCI and its association with pathophysiological, demographic, and socioeconomic factors, including sex, age, level of injury, financial status, and suicidal thoughts. METHODS: This was a cross-sectional study of 134 adults (≥18 years old) with SCI who were referred to the Brain and Spinal Cord Injury Research Center (BASIR) clinic, Tehran University of Medical Sciences, for outpatient rehabilitation. The Beck Depression Inventory (BDI-II Persian), a 21-question multiple-choice inventory, was used to measure the presence and severity of depression. Data were collected by interview. RESULTS: Sixty-six (49.3%) participants had mild to severe depression. There was a higher probability of depression in individuals with SCI who were female, had tetraplegia, had suicidal thoughts, had a history of suicide attempt, had a low education level, or were taken cared for by a family member other than a spouse or parents. CONCLUSIONS: Depression was highly prevalent in individuals with SCI and was related to some demographic, pathophysiological, and socioeconomic indicators. The primary predictive indicators and the factors influencing depression should be determined to provide early detection and timely treatment to prevent more complications and improve quality of life for individuals with SCI. Language: en

Objectives To measure the prevalence of common mental disorder (CMD) by occupation in a representative sample of Great Britain and to identify occupations with increased and decreased risk of CMD. Methods A cross-sectional interview-based survey was carried out including 5,497 working male and female respondents, 16–64 years from a stratified random survey of private households in Britain. Occupations were classified by the Standard Occupational Classification (SOC) into four groups: major, sub-major, minor and constituent unit groups. Common Mental Disorder was measured by the Revised Clinical Interview Schedule. Results Major SOC groups with higher prevalence of common mental disorder included clerical and secretarial, sales, and personal and protective services whereas craft and related, ‘other’ professional occupations and plant and machine operatives had lower prevalence compared to 13% overall prevalence in all adults. In sub-major SOC groups managers and administrators, teaching professionals, clerical and secretarial, ‘other’ sales and personal service occupations had higher prevalence whereas many professional and skilled occupations had lower prevalence. Specific SOC unit groups with higher prevalence included primary and secondary teachers, welfare community, youth workers, security staff, waiters, bar staff, nurse auxiliaries and care assistants. General managers in government and large organizations (OR = 2.79, 95% CI 1.41–5.54), managers in transport and storing (OR = 2.44, 95% CI 1.18–5.03), buyers and mobile sales persons (OR = 2.48, 95% CI 1.09–5.60), sales occupations (NES) (OR = 2.78, 95% CI 1.25–6.19) and clerks (NES) (OR = 2.71, 95% CI 1.59–4.61) had increased risk of common mental disorder relative to specialist managers adjusting for social and financial factors and physical ill-health. Conclusions Occupations with higher risk of common mental disorder may be typified by high levels of job demands, especially emotional demands and lack of job security. The reasons why occupations have low rates of common mental disorder are varied and may include high levels of job discretion, good job training and clearly defined job tasks.

OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.

A total of 51 patients who underwent the second open discectomy by fenestration from January 1988 through December 1994, were followed for an average of 146.8 months. The long-term follow-up results were evaluated through direct examinations and questionnaires. At the final follow-up, according to the Macnab classification an excellent and good outcome was achieved in 70.6% of the cases, and 78.4% were satisfied with their results. The failure rate was 15.7% (8 patients). Excluding those 8 failed cases who needed another reoperation, the average improvement calculated by Japanese Orthopaedic Association (JOA) scores was 64.6%. Factors that were associated with a fair and bad outcome included smoking, isolated trauma or injury, fibrosis and the duration of the remaining or recurrent primary postoperative symptoms. We noted that psychosociological signs were probably negative predictors of lumbar disc surgery outcome. Because the revision operation is typically associated with a higher complexity, selection of suitable surgical candidates and determination of valid indications for operative treatment are very important.

A survey of size-fractionated dust exposure was carried out in 10 wood processing plants across the United States as part of a 5-year longitudinal respiratory health study. The facilities included a sawmill, plywood assembly plants, secondary wood milling operations, and factories producing finished wood products such as wood furniture and cabinets. Size-fractionated dust exposures were determined using the RespiCon Personal Particle Sampler. There were 2430 valid sets of respirable, thoracic, and inhalable dust samples collected. Overall, geometric mean (geometric standard deviation) exposure levels were found to be 1.44 (2.67), 0.35 (2.65), and 0.18 (2.54) mg/m, for the inhalable, thoracic, and respirable fractions, respectively. Averaged across all samples, the respirable fraction accounted for 16.7% of the inhalable dust mass, whereas the corresponding figure for thoracic fraction as a percentage of the inhalable fraction was 28.7%. Exposures in the furniture manufacturing plants were significantly higher than those in sawmill and plywood assembly plants, wood milling plants, and cabinet manufacturing plants, whereas the sawmill and plywood assembly plants exhibited significantly lower dust levels than the other industry segments. Among work activities, cleaning with compressed air and sanding processes produced the highest size-fractionated dust exposures, whereas forklift drivers demonstrated the lowest respirable and inhalable dust fractions and shipping processes produced the lowest thoracic dust fraction. Other common work activities such as sawing, milling, and clamping exhibited intermediate exposure levels, but there were significant differences in relative ranking of these across the various industry segments. Processing of hardwood and mixed woods generally were associated with higher exposures than were softwood and plywood, although these results were confounded with industry segment also.

In a previous study of older pulp and paper workers in Berlin, New Hampshire, decrements in spirometry results associated with accidental exposures to high levels of irritant gases depended on cumulative levels of pulp mill exposure and cigarette smoking. Many of those subjects were older and retired. A new study was initiated to assess whether gassing events were a problem among current workers. Three hundred white male pulp and paper workers from the mill in Berlin, New Hampshire, were surveyed in 1992. Testing included spirometry and questionnaires. The mean age was 40.4 yr, and the mean tenure with the company was 18.5 yr. A total of 105 of the 300 subjects (35%) reported ever having an episode of high exposure to chlorine gases (i.e., being gassed). The percentage gassed was 51% for pulp mill workers and only 13% for other employees. For subjects with no more than 26 pack-years of cigarette smoking, obstruction (i.e., abnormally low FEV1 and FEV1/FVC) was observed only among those with a history of gassing. Also, the combination of high cigarette smoking (i.e., > 26 pack-years) and gassing had a greater than additive effect on obstruction. These findings suggest that additional controls are needed to minimize the number of gassing events in this and other chemical pulp mills.

SUMMARYThis paper considers the reported attack ratio arising from outbreaks of influenza in enclosed societies. These societies are isolated from the wider community and have greater opportunities for contact between members which would aid the spread of disease. While the particular kind of society (prison, care home, school, barracks, etc.) was not a significant factor in an adjusted model of attack ratio, a person's occupation within the society was. In particular, children and military personnel suffer a greater attack ratio than other occupational types (staff, prisoners, etc.). There was no temporal trend in final attack ratio nor, with the exception of 1918, do pandemic years show abnormal attack ratios. We also observed that as community size increases, the attack ratio undergoes steep nonlinear decline. This statistical analysis draws attention to how the organization of such societies, their size and the occupations of individuals within them affect the final attack ratio.

BACKGROUND: The 2004 edition of the National Standard for Health Assessment of Rail Safety Workers (the standard) used the Epworth Sleepiness Scale (ESS) to screen for excessive daytime sleepiness related to obstructive sleep apnoea (OSA). The 2012 edition of the standard expanded the OSA screening matrix to include body mass index, comorbid hypertension and type 2 diabetes as triggers requiring a sleep study to be undertaken irrespective of the ESS. AIMS: To assess the impact of the new standard on the estimated prevalence of OSA in railway workers. METHODS: An analysis of data on safety critical employees referred for rail safety health assessment during the 2013 calendar year and meeting the criteria for sleep study referral. Sleep study outcomes were used to assess the predictive value of screening under the new standard. RESULTS: A total of 200/4311 workers were investigated with a sleep study. One hundred and ninety-three met the new risk factor criteria and 182 (91%) were newly diagnosed with OSA. The prevalence of OSA in the study population was 7%, compared with 2% in 2009. No worker reported an elevated ESS. The false positive to true positive ratio was 0.1 (95% CI 0.06-0.16). CONCLUSIONS: The new medical standard has resulted in an increased estimate of the prevalence of OSA in rail workers. This study supports the use of objective clinical risk factors to select workers for further investigation, aiming to minimize the risk of accidents associated with excessive daytime sleepiness and other comorbid conditions of OSA. Language: en

Socio-economic gradients in diet quality are well established. However, the influence of material socio-economic conditions particularly in childhood, and the use of multiple disaggregated socio-economic measures on diet quality have been little studied in the elderly. In the present study, we examined childhood and adult socio-economic measures, and social relationships, as determinants of diet quality cross-sectionally in 4252 older British men (aged 60–79 years). A FFQ provided data on daily fruit and vegetable consumption and the Elderly Dietary Index (EDI), with higher scores indicating better diet quality. Adult and childhood socio-economic measures included occupation/father's occupation, education and household amenities, which combined to create composite scores. Social relationships included social contact, living arrangements and marital status. Both childhood and adult socio-economic factors were independently associated with diet quality. Compared with non-manual social class, men of childhood manual social class were less likely to consume fruit and vegetables daily (OR 0·80, 95 % CI 0·66, 0·97), as were men of adult manual social class (OR 0·65, 95 % CI 0·54, 0·79), and less likely to be in the top EDI quartile (OR 0·73, 95 % CI 0·61, 0·88), similar to men of adult manual social class (OR 0·66, 95 % CI 0·55, 0·79). Diet quality decreased with increasing adverse adult socio-economic scores; however, the association with adverse childhood socio-economic scores diminished with adult social class adjustment. A combined adverse childhood and adulthood socio-economic score was associated with poor diet quality. Diet quality was most favourable in married men and those not living alone, but was not associated with social contact. Diet quality in older men is influenced by childhood and adulthood socio-economic factors, marital status and living arrangements.

SUMMARYTai'an, a famous cultural tourist district, is a new endemic foci of scrub typhus in northern China. Frequent reports of travel-acquired cases and absence of effective vaccine indicated a significant health problem of scrub typhus in Tai'an. Thus, descriptive epidemiological methods and spatial-temporal scan statistics were used to describe the epidemic characteristics and detect the significant clusters of the high incidence of scrub typhus at the town level in Tai'an. Results of descriptive epidemiological analysis showed a total of 490 cases were reported in Tai'an with the annual average incidence ranging from 0·48 to 2·27/100 000 during 2006–2013. Females, the elderly and farmers are the high-risk groups. Monthly changes of scrub typhus cases indicated an obvious epidemic period in autumn. Spatial-temporal distribution analysis, showed significant clusters of high incidence mainly located in eastern and northern Tai'an. Our study suggests that more effective, targeted measures for local residents should be implemented in the eastern and northern areas of Tai'an in autumn. Meanwhile, it may prove beneficial for health policy makers to advise travellers to take preventive measures in order to minimize the risk of infection of scrub typhus in Tai'an.

Aims: To develop a job-exposure matrix (JEM) from personal and static respirable crystalline silica (RCS) measurements in UK industrial silica sand workers. Methods: A total of 2429 personal and 583 static RCS dust samples were collected using cyclone samplers at seven UK quarries between 1978 and 2000. These data were combined, and analysis of variance using general linear models was used to evaluate the effect of quarry, job, and year on RCS concentrations, and facilitate the creation of five quarry and three time categories with similar exposure levels by comparing the least-square GM RCS concentrations. Results: The overall geometric mean (GM) RCS concentration was 0.09 mg/m3 (geometric standard deviation 3.9). Silica flour and dry job categories tended to have the highest RCS exposure and 13.3% of all samples exceeded the UK maximum exposure level of 0.3 mg/m3. RCS levels generally decreased over time. Conclusions: Data have been collected and used to develop a JEM for UK industrial silica sand workers between 1978 and 2000. Although there were some limitations in the data and certain assumptions were made, the use of available data to estimate exposure quantitatively is an improvement over the use of qualitative and surrogate measures of exposure. The continual collection of dust measurements in the industry is essential to facilitate the exploration of exposure-response relations that may exist between silica and silicosis, lung cancer, and other diseases.

Men and women may be affected differently by the transition from central planning to a market economy and especially by the privatization and restructuring of state-owned enterprises. After briefly reviewing the international evidence on this issue, the author looks at the recent experience of Vietnam and the prospects of its new reform program. During the massive downsizing in Vietnam in the early 1990s, many more women than men were laid off. Women withdrew from the labor force in larger numbers than men after separation, but the difference nearly vanished after a year. Economic reforms were associated with a considerable decline in the gender gap in earnings, both in the state sector and outside it. Women are less likely to be retrenched in large numbers in the downsizing in the early part of this decade. Labor redundancies are concentrated in male-dominated sectors, such as mining, transport, and construction; redundancies are smaller in female-dominated sectors, such as footwear, textiles, and garments. Moreover, temporary and short-term contracts are more prevalent in female-dominated sectors, suggesting demand for women's work. Assistance programs for redundant workers have potential gender biases. The authors shows that separation packages defined as a multiple of earnings favor men more, while lump-sum packages favor women more. Packages based on seniority are roughly gender neutral, but require a substantially higher expenditure to reach the same acceptance rate as the other two.

OBJECTIVES—To assess the role of potential (occupational) risk factors for fragrance contact allergy (FCA). Most studies assessing the range of contact sensitisation in various clinical populations found the fragrance mix, a good screening tool for the detection of FCA in general, to be one of the leading allergens. The role of occupational exposure to fragrances is, however, yet unclear. METHODS—Firstly, crude analyses of the prevalence of FCA in various occupational fields including all 57 779 patients patch tested in the participating centres of the Information Network of Departments of Dermatology (IVDK) between January 1992 and December 1998. Secondly, a multifactorial Poisson regression analysis of these patients, including several potential risk factors. RESULTS—(a) The proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, (b) the highest occupational risk of FCA was associated with work as a masseur or physiotherapist, metal furnace operator, potter or glass maker etc, or geriatric nurse, (c) non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and increasing age. CONCLUSIONS—Occupations with a high risk of FCA were identified as targets of preventive action—that is, the substitution of scented products with fragrance free materials with which to work (skin disinfectants, cleaning solutions, personal care products) wherever possible. Keywords: contact allergy; occupational risk factors; fragrances

Background: little is known about the prevalence of at-risk drinking in older adults. Objective: to compare rates of at-risk drinking in 75-year-olds examined in 1976–77 and in 2005–06. Design: cross-sectional survey. Setting: two samples representative of the general population in Gothenburg, Sweden. Participants: 75-year-olds born in 1901–02 (n = 303) and in 1930 (n = 753). Methods: participants took part in a multidisciplinary study on health and ageing. Protocols regarding alcohol consumption were identical for both cohorts. Total weekly alcohol intake was estimated and at-risk drinking was defined as ≥100 g alcohol/week. Results: the proportion abstaining differed significantly between birth cohorts (18% in 1976–77 versus 9% in 2005, P < 0.001). Frequencies of drinking beer and liquor were similar in the two cohorts for men, but were lower for women in the later-born cohort. Proportions drinking wine were higher in the later-born cohort for both sexes. Total weekly alcohol intake was higher for both men and women. At-risk drinking was observed in 19.3% of the men in the earlier-born cohort, and in 27.4% in the later-born cohort (P = 0.117). Corresponding figures for women were 0.6 and 10.4% (P < 0.001). At-risk drinking was significantly associated with birth cohort in women (OR: 13.77, CI: 1.82–104.0, P = 0.011) and the occupational group in men (OR: 1.60, CI: 1.13–2.26, P = 0.008). Conclusions: alcohol consumption in 75-year-olds has changed markedly, especially in women. Studies need to be carried out in varied settings in order to evaluate the clinical and public health implications of changing trends in alcohol consumption.

OBJECTIVES—To examine trends in estimated population based incidence of occupational asthma by age, sex, occupation, geographical region, and causal agents based on 9 years of the Surveillance of Work Related and Occupational Respiratory Disease (SWORD) data. METHODS—In January 1989 the SWORD scheme for the surveillance of occupational respiratory disease was established in the United Kingdom to make good the lack of epidemiological information on the incidence of these diseases in the United Kingdom. Between 80% and 90% of chest and occupational physicians report voluntarily all new cases they see, on a monthly or random sampling basis. During the 9 years 1989-97, an estimated 25 674 new cases of occupational respiratory disease, including 7387 of occupational asthma, were reported. Suspected causal agents were classified into 44 categories and estimated annual incidences of asthma were calculated with denominators from the labour force survey. RESULTS—Overall, a third of the suspected causes of asthma were organic, a third chemical, 6% metallic, and the rest miscellaneous, or in 8%, unknown. There was evidence of an increase since 1989 in cases due to latex, and possibly glutaraldehyde, and an apparent drop since 1991 in the proportion of cases attributed to isocyanates. Incidences were higher in men than women and the disparity was especially marked in the population aged 45 years or more in which rates for men were at least twice those for women. Average annual rates per million workers for 1992-7 ranged from 7 (95% confidence interval (95% CI) 5 to 9) for the lowest risk group of professional, clerical, and service workers to 1464 (95% CI 968 to 2173) for coach and other spray painters. Except for laboratory technicians, all other occupations with rates over 100 were concerned with manufacturing and processing that used chemicals, metals, and organic materials. Incidences were two to three times higher in the north and midlands than in East Anglia and the south. The introduction of a sampling scheme in 1992 doubled estimates of reported incidence of occupational asthma, but there was little evidence of other temporal changes. CONCLUSIONS—The SWORD scheme has produced consistent estimates of the causes and incidence of occupational asthma as seen by chest and occupational physicians. It has allowed the epidemiology of occupational asthma in the population to be studied and high risk occupations to be identified. There is certainly more occupational asthma in the population than that which reaches specialists in occupational and chest medicine; therefore the incidence rates presented here are underestimates, but by how much remains unknown. Keywords: occupational asthma; incidence; regional differences

OBJECTIVE—To establish a detailed pattern of the nature and extent of illnesses and injuries among construction workers in Ireland which cause temporary absence from work, and to identify diseases and disabilities which lead to premature retirement from the industry on health grounds. METHODS—The population base for the study consisted of construction workers who were members of the Construction Federation operatives pension and sick pay scheme. Records of sickness absence since 1981, stored on computer disks, and records of early retirement on health grounds since 1972, stored on microfiche film, were examined. Pertinent data were extracted and transferred to a database; after cleaning and the exclusion of unvalidated data, records of 28 792 absences and 3098 records of early retirement were available for analysis. Data were analysed with Access 97 and Epi Info. RESULTS—Over the period of the study the mean annual absences were 7.8/100 workers. Three quarters of absences were among younger workers; however, the rate of absence increased with age, as did the mean duration of absence. Injury was the most frequent reason for absence, followed by infectious disease, then musculoskeletal disorders. The mean annual rate of early retirement on health grounds was 5.3/1000 workers. The median age at retirement was 58 years. Cardiovascular disease and musculoskeletal disorders each accounted for nearly one third of the conditions leading to permanent disability on the grounds of which early retirement was granted. During the period of the study, over 677 000 working days were lost due to sickness absence, and over 24 000 potential years of working lives were lost due to early retirement on health grounds. CONCLUSIONS—The study has shown patterns of sickness absence and early retirement on health grounds in the Irish construction industry which will contribute to the further development of health promotion strategies for construction workers. Keywords: construction industry; sickness absence; early retirement