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Home care is a rapidly growing industry. Violence towards home care workers is common, while also likely underreported. This violence adversely affects the physical and mental health of both workers and care recipients. The current study aims to identify and appraise recent evidence on the determinants of violence towards care workers working in the home setting.Six electronic databases: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Informit, Medline, PsycINFO, and Web of Science, were systematically searched. A systematic review was conducted in accordance with the Joanna Briggs Institute manual for evidence synthesis.A total of 18 papers met the inclusion criteria. All were cross-sectional surveys. The majority of studies were from the United States. The most commonly investigated associations were those between the medical history of clients, workers' apprehension of violence, worker-client relationship, or care plans, and any form of violence or verbal abuse.Violence was common in clients with cognitive disorders, substance abuse disorder, and limited mobility; toward workers who feared that violence might happen; toward those who had very close or very distant worker-client relationships; and when care plans were not inclusive of clients' needs. The current review highlights a gap in evidence on determinants of violence towards care workers working in the home setting, and suggests potential areas to be addressed to reduce such violence.

BACKGROUND The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT-detected interstitial lung abnormalities (ILA). METHODS The Asbestos Review Program offers annual LDCT, health assessments, and pulmonary function tests to an asbestos-exposed cohort. Asbestosis was defined using the Helsinki Consensus statement and the presence of ILA defined using a protocol for occupational CT reports. At least two of three pulmonary function tests: forced expiratory volume in 1 s (FEV1 );​ forced vital capacity (FVC); and diffusion capacity for carbon monoxide (DLco) were required for analysis of physiological decline. RESULTS From 1513 cases, radiological ILA was present in 485 (32%). The cohort was 83.5% male with a median age of 68.3 years and a median (IQR) asbestos exposure of 0.7 (0.09-2.32) fiber/ml-year. A mixed occupation, mixed asbestos fiber cohort comprised the majority of the cohort (65.8%). Of those with ILA, 40 (8.2%) had an FVC decline of ≥10% and 30 (6.2%) had a DLco decline of ≥15% per year. Time since first exposure, increasing tobacco exposure and reported dyspnea were independently associated with the presence of ILA. CONCLUSIONS In this population with relatively low asbestos exposure, LDCT-detected ILA that fits criteria for asbestosis is common, but physiological decline is not. This mild chronic stable phenotype of asbestos-associated ILA contrasts with the traditionally accepted views that asbestosis requires high exposures.

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.

Background Metastatic germ cell tumor (mGCT) patients receiving chemotherapy have increased risk of life‐threatening venous thromboembolism (VTE). Identifying VTE risk factors may guide thromboprophylaxis in this highly curable population. Methods Data were collected from mGCT patients receiving first‐line platinum‐based chemotherapy at 22 centers. Predefined variables included International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification, long‐axis diameter of largest retroperitoneal lymph node (RPLN), Khorana score, and use of indwelling vascular access device (VAD). VTE occurring at baseline, during chemotherapy and within 90 days, was analyzed. Results Data from 1135 patients were collected. Median age was 31 years (range 10‐74). IGCCCG risk was 64% good, 20% intermediate, and 16% poor. VTE occurred in 150 (13%) patients. RPLN >3.5 cm demonstrated highest discriminatory accuracy for VTE (AUC 0.632, P, Venous thromboembolism can cause morbidity in germ cell tumor patients receiving chemotherapy; large retroperitoneal lymphadenopathy (RPLN) and indwelling vascular access devices (VAD) are significant VTE risk factors. VAD insertion should be avoided and thromboprophylaxis can be considered for large RPLN.

BACKGROUND Limited information is available on exposure to high molecular weight (HMW) asthmagens derived from plants and on the main occupations and tasks that result in such exposure among workers. METHODS Data were collected as part of the Australian Work Exposures Study-Asthma. We estimated adjusted prevalence ratios (aPR) using modified Poisson regression models to determine which factors were associated with exposure. RESULTS A 12.8% of 4878 workers were exposed to HMW asthmagens derived from plants. The highest prevalence of exposure was found among farmers/animal workers, education workers, and food processing workers. The main circumstances of exposure were through handling flour, freesias, or through raising livestock. Exposure was more common among female workers (aPR = 1.26, 1.10-1.43) than males, while it was lower among workers born overseas (aPR = 0.70, 0.57-0.86) than those born in Australia. CONCLUSION Prevention of exposure to HMW asthmagens derived from plants requires a broad strategy targeting different tasks and occupations.

Background HIV notifications among people born in sub-Saharan Africa and South-East Asia have increased in Australia in the last decade. People born in these regions have the highest rates of HIV diagnosis by region of birth and are overrepresented in late or advanced presentation of HIV infection. Methods This study developed and tested a questionnaire for reliability through test-retest. A cross-sectional survey using intercept and online recruitment of HIV knowledge and use of health services was then undertaken among people born in sub-Saharan Africa and South-East Asia, who had arrived in Australia less than 10 years ago and were living in Western Australia (n = 209). Results were reported on by gender and length of time in Australia. Results Participants had a reasonable knowledge of HIV transmission, but held a number of incorrect beliefs. Two-thirds (65%) of participants reported a barrier to accessing health services in Australia. Just over a third (34%) of participants had ever tested for HIV, despite indicating that they believed HIV testing was important. Conclusions This project indicates a very low rate of HIV testing among this priority population. Further action is required to improve early diagnosis of HIV and reduce onward transmission of HIV infection within these communities. SO WHAT?: We need targeted interventions that extend beyond knowledge to increase HIV testing rates among this population.

OBJECTIVES Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5-10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. METHODS Cases with no known asbestos exposure were selected from the WA Mesothelioma Register (WAMR). Matched controls were selected from hospital patients admitted for conditions unrelated to asbestos. Occupational histories were coded by an industrial hygienist. Data were analyzed using conditional logistic regression. RESULTS Thirty-eight MM participants and 134 controls were recruited. Risk of MM was increased (OR = 3.1, 95%CI 1.0-9.6) after no known, but likely, exposure to asbestos at work. CONCLUSIONS Because of its extensive use, few people in WA have never been exposed to asbestos. Unrecognized exposure may cause most MM cases initially regarded as "no exposure." Am. J. Ind. Med. 60:432-436, 2017. © 2017 Wiley Periodicals, Inc.

OBJECTIVE: Farm work is labor-intensive, physically demanding, and incurs a high risk of injury. The aim of this study was to identify characteristics of farmworkers at increased risk of adverse health outcomes to focus targeted interventions. METHODS: The National Agricultural Workers Survey for 2008-2012 was used to compare characteristics associated with adverse health and safety conditions among US-born and Mexican and Central American-born Latino and Indigenous, documented and undocumented farmworkers, separately for males and females. RESULTS: US-born farmworkers had more secure work, worked less onerous tasks, and earned more per hour than other categories of farmworkers. Undocumented Indigenous workers had more precarious work, worked more onerous tasks, and were more likely to do piece work, than undocumented Latino workers. DISCUSSION: We highlight disparities in modifiable occupational health risk factors across groups of farmworkers that are associated with increased risks of work-related injury and poor health. Am. J. Ind. Med. 59:644-655, 2016. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc. Language: en

Background and objective Computed tomography (CT)-based studies of asbestos-exposed individuals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of asbestos-exposed subjects in Western Australia. Methods A total of 906 subjects from the Western Australian Asbestos Review Programme underwent LDCT of the chest as part of regular annual review. An indeterminate (solid) nodule was defined as >50 mm3 and part-solid/non-solid nodules >5 mm. The presence of asbestos-related diseases was recorded with a standardized report. Results Subjects were mostly (81%) men with a median age of 70 years. Fifty-eight (6.5%) participants were current smokers, 511 (56.4%) ex-smokers and 325 (36.4%) never-smokers. One hundred and four indeterminate nodules were detected in 77 subjects (8.5%); of these, eight cases had confirmed lung cancer (0.88%). Eighty-seven subjects (9.6%) had incidental findings that required further investigation, 42 (4.6%) from lower airways inflammation. The majority of nodules were solid, 4–6 mm and more common with age. Five hundred and eighty (64%) subjects had pleural plaques, and 364 (40.2%) had evidence of interstitial lung disease. Conclusion The prevalence of LDCT-detected indeterminate lung nodules in 906 individuals with significant asbestos exposure was 8.5%, lower than many other CT studies. Clinically important incidental findings were found in 9.4%, predominantly related to lower respiratory tract inflammation. LDCT appears to effectively describe asbestos-related diseases and is likely to be an acceptable modality to monitor asbestos-exposed individuals.

Background Road transport workers (RTWs) are at high risk of exposure to several occupational carcinogens. However, there are gaps in knowledge regarding the extent and the circumstances of exposure. As a sub-study of the Australian Work Exposures Study, this study investigated the prevalence of occupational exposure in Australian RTWs. Methods A random sample of Australian working population was invited to a telephone interview regarding their current jobs. An automated expert-assessment procedure was applied to self-reported job-related tasks using a web-based application. 162 RTWs were included in this study. Results RTWs were exposed to diesel exhaust (97%), solar ultraviolet radiation (78%), environmental tobacco smoke (55%), benzene (29%), silica (15%), and asbestos (10%) at work. Besides driving on roads, vehicle maintenance-related tasks were the major source of carcinogen exposures among RTWs. Discussion Most RTWs are exposed to at least one carcinogen at work. We have identified tasks where the use of control measures could potentially reduce exposures. Am. J. Ind. Med. 59:31–41, 2016. © 2015 Wiley Periodicals, Inc.

Background and objective Many of the pathological consequences in the lung following inhalation of asbestos fibres arise as a consequence of persistent oxidative stress and inflammation. Inflammatory responses can be observed in asymptomatic asbestos-exposed individuals. There are currently no interventions to reduce inflammatory or oxidative responses to asbestos before disease develops. We investigated the effects of oral N-acetylcysteine (NAC) on indicators of inflammation or oxidative stress in asymptomatic people previously exposed to asbestos. Methods A double-blind, randomized, placebo-controlled study was conducted to assess the effectiveness and safety of 1800 mg of NAC given orally over a period of 4 months. This was a proof of principle study. Effectiveness was assessed using indicators of inflammation or oxidation as primary end–points. Serum levels of total combined thiols (cysteine, cysteinylglycine, glutathione and homocysteine) were used to monitor the NAC supplementation. Results Thirty-four subjects were randomly allocated to NAC and 32 to placebo. Serum levels of total combined thiols were similar between the groups after intervention. There were no differences in levels of inflammatory or oxidative stress end–points between the groups. No adverse effects were identified. Conclusions No evidence was found that NAC supplementation replenishes total combined thiols in the blood of healthy subjects with a history of asbestos exposure. There was also no evidence of reduced indicators of inflammation or oxidative stress. Further studies should determine the conditions required to increase levels of total anti-oxidant capacity in the blood and in the lungs of subjects with either asbestos-related diseases or subclinical lung inflammation.

Background Although job-related diseases result in more deaths per year than job-related injuries, most research concerning ethnic minority workers has concerned accidents and injuries rather than disease-causing exposures such as carcinogens. Methods We conducted a telephone-based cross-sectional survey to estimate the prevalence of occupational exposure to carcinogens among a sample of ethnic minority workers in Australia, and compared their exposure prevalence to that of a sample of the general Australian-born working population (‘Australian workers’). Results One-third of the ethnic minority workers were exposed to at least one carcinogen at work. The likelihood of exposure to carcinogens was not significantly different from that of Australian workers, although the likelihood of exposure to individual carcinogens varied by ethnicity. Conclusion Knowing the prevalence of exposure to carcinogens in the workplace in different ethnic groups will allow better targeted and informed occupational health and safety measures to be implemented where necessary. Am. J. Ind. Med. 58:923–932, 2015. © 2015 Wiley Periodicals, Inc.

Introduction Occupational exposure to bauxite is common in the aluminium industry but little is known about the associated health effects. This study investigates respiratory health in relation to respirable bauxite dust exposure longitudinally over a 13 year period. Methods An inception cohort study recruited 91 male bauxite miners and 363 male alumina refinery workers. Annual measurements of respiratory symptoms and lung function were made. Cumulative exposure to bauxite was derived from job histories and air monitoring data. Mixed-effects modeling was used. Results No associations were found between cumulative bauxite exposure and respiratory symptoms or lung function. However, when analysis was restricted to the first three rounds, FEV1 was significantly lower in all exposure groups than in those unexposed but with no significant trend. Conclusion Increasing exposure to bauxite dust in the aluminum industry was not associated with respiratory symptoms or consistent decrements in lung function. Am. J. Ind. Med. 58:897–904, 2015. © 2015 Wiley Periodicals, Inc.

Aim The aim of this study was to undertake a retrospective review of admissions and discharges to the neonatal unit at the National Hospital Guido Valadares Dili in order to gain insight into the epidemiology of hospitalised neonates in East Timor as the information cannot be obtained from the hospital health management information system. Method Data were sourced from unit registers for 3 years 2008-2010 inclusive. Demographic characteristics and diagnoses were related to the risk of dying using stepwise multivariate logistic regression and adjusting for potential confounders of age sex and weight. Results Two thousand eighty-eight babies were admitted to the unit over the study period. Over a quarter of babies weighed

Childhood brain tumors (CBT) are the leading cause of cancer death in children; their risk factors are still largely unknown. Since most CBTs are diagnosed before five years of age, prenatal exposure and early postnatal factors may be involved in their etiology. We investigated the association between CBT and parental occupational exposure to engine exhausts in an Australian population-based case-control study. Parents of 306 cases and 950 controls completed detailed occupational histories. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for both maternal and paternal exposure in key time periods. Increased risks were observed for maternal exposure to diesel exhaust any time before the child's birth (OR 2.03, 95% CI 1.09-3.81) and paternal exposure around the time of the child's conception (OR 1.62, 95% CI 1.12-2.34). No clear associations with other engine exhausts were found. Our results suggest that parental occupational exposure to diesel exhaust may increase the risk of CBT.

Background There are few data on the long-term health outcomes of exposure to asbestos in childhood. This study investigated cancer and mortality of adults exposed to blue asbestos as children. Methods Data linkage to relevant health registries was used to identify cancers and mortality in a cohort of adults (n = 2,460) that had lived in an asbestos mining town during their childhood (

Objective: Since the mid-1990s Australia's immigration program has focused on encouraging skilled migration. This study investigated skill usage in three longitudinal studies of immigrants to Australia and examined if there is an association with mental health status. Methods: Three Longitudinal Surveys of Immigrants to Australia (LSIA), with multiple data collection waves, were conducted between 1994 and 2006. Some 5,192 primary applicants participated in LSIA1, 3,124 in LSIA2 and 9,865 in LSIA3. Data collected included demographics and employment history in all surveys as well as mental health in LSIA1 and 2. Results: Among migrants in LSIA 1, 49% reported working in jobs in which they used their skills sometimes, rarely or never, 3½ years after immigrating. This was not solely explained by English language proficiency as 47% of migrants who reported speaking English well or very well did not use their qualifications in their job. Migrants who did not use their job qualifications at wave three had a worse GHQ-12 score at wave three after adjusting for age, sex, country of birth and highest educational qualification. There was no difference in wave one or wave two GHQ-12 score between those who did or did not use their job qualifications at wave three. The pattern was similar for those migrants in LSIA 2. Conclusions and Implications: There is a large under-utilisation of employment skills in the migrant population in Australia up to 3½ years after immigrating. This is associated with poorer mental health.

INTRODUCTION New in vitro models of castration-resistant prostate cancer (CRPC) are urgently required. METHODS Trans-rectal needle biopsies (TRBP) of the prostate were performed for research purposes on progressing CRPC patients who had not received prior treatment to the prostate. Biopsies were immediately digested with collagenase and plated onto collagen-coated flasks with a feeder layer of 3T6 cells and cultured in cytokine-supplemented keratinocyte serum-free medium. RESULTS Biopsies from 25 patients were collected and one of these, following an initial period of crisis, spontaneously immortalized. A series of cell lines called Bob were then established from a clone that survived CD133-selection followed by 4 weeks under adhesion-independent conditions in methylcellulose. Gains and losses previously described in clinical prostate tumors, most notably loss of 8(p) and gain of 8(q), were identified on comparative genomic hybridization and long-term growth in culture, survival in methylcellulose and invasion through matrigel confirmed the malignant phenotype of Bob. Furthermore, Bob expressed high levels of p53 and markers of early differentiation, including K8, prostatic acid phosphatase and prostate stem cell antigen. There was, however, no in vivo growth and ERG and ETV1 were not rearranged. Growth in serum permitted some differentiation. CONCLUSION This is the first spontaneously immortalized prostate cancer cell line to be established from a TRBP of a patient with CRPC. Bob is a novel pre-clinical model for functional studies in CRPC and especially for studying the CRPC “basal” phenotype. Prostate 69: 1507–1520, 2009. © 2009 Wiley-Liss, Inc.

Aim: To determine the influence of perinatal and childhood exposures on lung function in a cohort of Australian Aboriginal children. Methods: This was a cross-sectional study of 547 Northern Territory Aboriginal children, aged 8–14 years, belonging to a birth cohort. Assessment included physical examination and spirometry as well as retrospective review of centralised hospital records. The effect of select perinatal and childhood exposures on lung function outcomes (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory flow between 25 and 75 s (FEF25–75)) adjusted for age, sex, height and other measures of size was examined using multiple regression. Results: Non-urban residence (FEV1 −5% (95% confidence interval, CI 0.91–0.99), FVC −9% (95% CI 0.87–0.95)), current cough (FEV1 −6% (95% CI 0.91–0.97), FVC −4% (95% CI 0.93–0.97), FEF25–75 −8% (95% CI 0.86–0.98)) and hospitalisations for respiratory disease (FEV1 −10% (95% CI 0.86–0.95), FEF25–75 −12% (95% CI 0.70–0.87)) all had significant negative effects on adjusted lung function measures. Children with a non-Aboriginal ancestor had significantly better lung function. No perinatal exposure other than neonatal lung disease had any significant effect on adjusted lung function. Conclusions: For Northern Territory Aboriginal children factors related to the childhood environment are more important than perinatal factors in determining childhood lung function.

This work describes the preparation of approximately 13,000 compounds for rapid identification of hits in high-throughput screening (HTS). These compounds were designed as potential serine/threonine or tyrosine kinase inhibitors. The library consists of various scaffolds, e.g., purines, oxindoles, and imidazoles, whereby each core scaffold generally includes the hydrogen bond acceptor/donor properties known to be important for kinase binding. Several of these are based upon literature kinase templates, or adaptations of them to provide novelty. The routes to their preparation are outlined. A variety of automation techniques were used to prepare >500 compounds per scaffold. Where applicable, scavenger resins were employed to remove excess reagents and when necessary, preparative high performance liquid chromatography (HPLC) was used for purification. These compounds were screened against an 'in-house' kinase panel. The success rate in HTS was significantly higher than the corporate compound collection.