Burden Of Occupational Disease Research Articles

Essential Occupational Safety and Health Interventions for Low- and Middle-income Countries: An Overview of the Evidence

There is still a considerable burden of occupational diseases and injuries in the world. It is not well known which interventions can effectively reduce the exposures at work that cause this burden. The objective of this article is to summarize evidence from systematic reviews of interventions to prevent occupational diseases and injuries. We included systematic reviews of interventions to reduce the incidence of work-related cancer, dust-related diseases, occupational asthma, chronic obstructive pulmonary disease, noiseinduced hearing loss, back pain, and occupational injuries. We searched Medline and Embase with predefined search strategies to locate systematic reviews of these interventions. We found 23 systematic reviews of which the results are also applicable to low- and middle income countries. Effective measures to reduce exposure leading to work-related cancer, dust-related diseases, asthma, chronic obstructive pulmonary disease, noise, and injuries are available. However, better implementation of these measures is needed. Regulation, enforcement of regulation, and incentives for employers are effective interventions to achieve this goal. There is evidence that feedback and rewards for workers help in reducing occupational injuries. There is no evidence in many studies that back pain can be prevented. Personal protective equipment technically has the potential to reduce exposure but this is difficult to put into effect. There is no evidence in the studies regarding the effectiveness of education and training, preventive drugs, or health examinations. There is evidence that the implementation of technical measures enforced by regulation can prevent occupational diseases and injuries. For other interventions such as education or health examinations, there is no evidence that supports their effectiveness. More systematic reviews are needed in the area of injury prevention.

Empleo, condiciones de trabajo y salud

Work is an essential component of human life. It represents the relationship between human beings and nature, as well as how humans produce goods and shape their social interactions, providing the foundations for economic production reflected in social and political life. Work is also a concept central to an understanding of the way in which society distributes wealth and power and integrates or excludes certain groups, giving rise to a more or less fair distribution of goods and access to resources. This is the origin of the socioeconomic stratification that influences not only consumption patterns, but also lifestyles and behavior (1,2,3). Work’s centrality becomes evident when we use occupation as a proxy for socioeconomic status or as a component in measuring social class. Nonetheless, working conditions around the world have historically deteriorated and become a determining factor in health, disability, and sickness (4). In a comparative study assessing worldwide occupational risk factors carried out for the WHO, Driscoll et al. (2004)(5) reported that 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease and 2% of leukemia were related to the carcinogens, airborne particulates, injury hazards, ergonomic stressors and noise present in the workplace. Overall, occupational exposures resulted in approximately 800,000 deaths and the loss of over 22 million years of healthy life. The factors influencing this deterioration in workers’ health are complex, and understanding them requires a consideration of the macroeconomic, political, and social determinants conducive to biological, chemical, physical and ergonomic risks, as well as the presence of psychosocial stressors in the workplace. The economic burden of occupational diseases and injuries has been estimated at 4% of Gross National Product in developed countries, and up to 11% in poorer countries (6). However, much of this burden, particularly the emotional pain experienced by workers and their families resulting from disability and loss of life, cannot be measured. The way in which a society effectively regulates the relations between employers and employees, mobilizing resources to maintain healthy and safe workplaces and adequate occupational health and safety systems, is crucial for worker wellbeing.

Estimated burden of disease attributable to selected occupational exposures in the United Arab Emirates

As part of an effort to strengthen occupational safety and health programs, the United Arab Emirates (UAE) commissioned a study to estimate the burden of disease attributable to occupational exposure to carcinogens, particulate matter, and noise. We developed an innovative simulation model to estimate the occupational disease burden and facilitate future assessments as more field-based quantitative data become available. We determined that, in 2008, an estimated 46 deaths (95% CI: 27-71) and 17,000 health-care facility visits (95% CI: 16,000-18,000), along with 4,500 cases of noise-induced hearing loss, were attributable to the occupational risk factors covered in this study. Lung cancer and leukemia were associated with the highest number of deaths (38), whereas asthma and chronic obstructive pulmonary disease contributed most to the health-care facility visits (nearly 16,900). The highest estimated occupational disease burden is in construction. These results will help the UAE to institute new policies for environment, health, and safety management.

What is the best strategy to reduce the burden of occupational asthma and allergy in bakers?

RationaleInsight into the effectiveness of intervention strategies will help realise a decrease in the occupational disease burden from (allergic) respiratory diseases in the bakery population.ObjectivesTo use a simulation model to...

Pesticide Poisoning and Respiratory Disorders in Colorado Farm Residents

Respiratory hazards significantly contribute to the burden of occupational disease among farmers. Pesticide exposure has been linked to an increased prevalence of respiratory symptoms in several farming populations. The purpose of this study was to evaluate the association between respiratory symptoms and pesticide poisoning in a cross-sectional survey of farm residents. A total of 761 farm operators and their spouses, representing 479 farms in northeastern Colorado, were recruited from 1993 to 1997. A personal interview asked whether the resident had experienced a pesticide poisoning and several respiratory conditions including cough, allergy, wheeze, and organic dust toxic syndrome (ODTS). Spirometry testing was performed on 196 individuals. Logistic regression was used to model the association of pesticide poisoning with respiratory conditions, and linear regression was used to model the relationship of pesticide poisoning and forced vital capacity (FVC) and forced expiratory volume (FEV1). In unadjusted models, pesticide poisoning was associated with all four respiratory conditions, and stayed significant in adjusted models of allergies and cough in non-smokers. In age- and gender-adjusted models, pesticide poisoning was significantly associated with lower FVC and FEV1 in current smokers and in those who were not heavy drinkers. Although this study should be reproduced in a larger sample, it suggests that further evaluation of the respiratory effects of pesticide exposure is warranted.

The burden of occupational cancer

In this issue of the journal ( see p 789 ), Rushton and colleagues1 report the first detailed estimate of the burden of occupational cancer in the UK. Estimates for...

Estimating reduction in occupational disease burden following reduction in exposure

Background/objective:Many occupational exposures causing disease cannot feasibly be eliminated entirely, but policies that reduce the exposures may be under consideration. This paper sets out to clarify how to estimate the...

Occupational health and safety: Role of academic institutions

The occupational disease burden is growing at an unprecedented rate. The profile of occupational diseases has also changed over the period of time as a result of modernization, market liberalization and globalization which now encompasses minor allergy and injuries, systemic infections and diseases as well as the life-threatening leukemia and cancers. Trained human resources in the field of occupational health and safety are far below the requirement. Training in the area of occupational health and industrial medicine is not keeping pace with the changing industrial growth and technologies. There is an urgent need for strengthening skills, developing newer competencies and broadening our knowledge in occupational health and safety and disaster management. Traditional training in occupational health, needs to be supplemented with techniques of environmental epidemiology, environmental impact assessment and environmental risk assessment. The academic community should take the first step in demonstrating its leadership to address the long neglected concerns of occupational health and safety.

Costs of Work-Related Musculoskeletal Disorders (MSDs) in Developing Countries: Colombia Case

The real burden of occupational diseases, specifically work-related musculoskeletal disorders (MSDs), and its impact on workers’ productivity is not known. The situation is critical in developing countries where only cases that cause workers’ disability are recorded. In this study, the incidence of MSDs in Colombia was estimated by using the age and gender specific double incidence rate of repetitive strain injuries diseases in Finland for 2002. The results showed that the estimated number of MSDs recorded in Colombia during 2005 was 23,477 cases at the rate of 11.6 cases per 10,000 workers. The estimated total cost of these MSD cases relative to workers’ productivity was US $171.7 million, representing around 0.2% of Colombia’s Gross Domestic Product for 2005. The systematic appraisal of the incidence of MSDs and their associated cost on workers’ productivity are necessary in developing countries to reduce the costly impact on productivity and to increase workers’ well-being.

Characterizing the Burden of Occupational Injury and Disease

To review the literature on the burden of occupational disease and injury and to provide a comprehensive characterization of the burden. The scientific and governmental literature from 1990 to the present was searched and evaluated. Thirty-eight studies illustrative of the burden of occupational disease were reviewed for findings, methodology, strengths, and limitations. Recent U.S. estimates of occupational mortality and morbidity include approximately 55,000 deaths (eighth leading cause) and 3.8 million disabling injuries per year, respectively. Comprehensive estimates of U.S. costs related to these burdens range between dollar 128 billion and dollar 155 billion per year. Despite these significant indicators, occupational morbidity, mortality, and risks are not well characterized in comparative burden assessments. The magnitude of occupational disease and injury burden is significant but underestimated. There is a need for an integrated approach to address these underestimates.

Disease outcome in workers with occupational skin disease

Occupational contact dermatitis (OCD) contributes significantly to the burden of occupational disease, but there is little known about prognostic factors. The study was designed to determine the health status of workers with OCD at least 2 years after diagnosis and to identify risk factors related to prognosis. A questionnaire study was conducted of workers with a diagnosis of work-related skin disease. Of the 201 workers with OCD, 76% noted improvement and 40% reported that they were currently free of any eruption. Approximately one third noted that their skin disease interfered with household, work, or recreational activities. The key prognostic factor appeared to be sex because women reported a better outcome. Diagnosis and atopic status tended to be related to some outcomes, whereas age was not. Examination of other possible factors, some of which may be associated with sex, that might affect outcome should be undertaken to gain a better understanding of possible management strategies. A retrospective study has methodologic limitations and a prospective intervention trial should yield more information.

Hazard Surveillance: A Proposal

HE Occupational Safety and Health Administration has suffered for almost zo years from a lack of information > T ~ about the workplaces or types of workplaces in which ~ j ~workers are experiencing exposures to specific health hazards. To remedy this situation we are proposing to cL4t expand hazard surveillance. Hazard surveillance is the assessment of the status and trends in worker exposure to toxic agents in the workplace (i). The concept upon which hazard surveillance is based is that the identification of workers exposed to high levels of specific agents will permit timely public health intervention to prevent occupational disease and mortality. There are two primary objectives: to identify areas where intervention strategies need to be initiated, and to target OSHA inspections. Secondary objectives are to provide information on the magnitude of the occupational disease burden associated with hazardous chemicals, and to evaluate the effectiveness of interventions and inspections. Hazard surveillance is an important complement to surveillance of occupational disease or "health surveillance." As with health surveillance, data on industry demographics, patterns of chemical use and workplace exposures are routinely collected and analyzed. Unfortunately, for illnesses with long latent periods, health surveillance techniques fail to provide the opportunity for preventive interventions. Hazard surveillance has the advantage, however, of being timely. It can be completed before the onset of disease, while prevention will work. Identification of workers at risk may result in a substantially reduced occupational disease burden through early intervention and control.