German Social Accident Insurance Research Articles

Decline in work and commuting injuries during the first lockdown in the SARS-CoV-2 pandemic : Comparison to the time period 2015-2019

HintergrundZur Reduktion der SARS-CoV-2-Infektionszahlen wurden Maßnahmen wie z. B. Kontakt- und Ausgangsbeschränkungen getroffen, die schließlich im „1. Lockdown“ mündeten. Dies sollte Kapazitäten im Gesundheitssystem zur Bewältigung der Pandemie schaffen.Ziel der ArbeitEs wird analysiert, ob während des Lockdowns die Anzahl der Arbeits- und Wegeunfälle im Vergleich zum Zeitraum der Jahre 2015–2019 gesunken ist.Material und MethodenEs wurden retrospektiv alle Arbeits- und Wegeunfälle, die während des Beobachtungszeitraumes 16.03.–04.05.2020 im Klinikum rechts der Isar sowie in der Berufsgenossenschaftlichen Unfallklinik Murnau behandelt wurden, mit den Zahlen aus demselben Beobachtungszeitraum der Jahre 2015 bis 2019 verglichen. Die Daten über die Fallzahlen nach dem Durchgangsarztverfahren (DAV) wurden weitergehend nach dem Verletzungsartenverzeichnis der Deutschen Gesetzlichen Unfallversicherung (DGUV) in Fälle des Verletzungsartenverfahrens (VAV) und Schwerstverletzungsartenverfahrens (SAV) aufgeschlüsselt. Zudem wurden die erhobenen Daten mit Daten des Statistischen Bundesamtes zu den Zahlen der Verkehrsunfälle und Verkehrstoten verglichen.ErgebnisseEs wurden insgesamt 4313 Fälle berücksichtigt. Im Jahr 2020 sank die Zahl der Arbeits- und Wegeunfälle im Vergleich zum Beobachtungszeitraum 2015–2019 um 31 %. Die VAV-Fälle waren 2020 um 26 % verringert. Die SAV-Fälle sind im Jahr 2020 um 5 % gesunken. Die Zahl der Straßenverkehrsunfälle sank in den ersten 4 Monaten im Jahr 2020 im Vergleich zu den ersten 4 Monaten 2019 um 17 %; die Zahl der Verkehrstoten sank um 11 %.DiskussionEs zeigt sich ein Rückgang der Arbeits- und Wegeunfälle um 31 %. Dies hat zur Ressourcenreallokation im Rahmen der Pandemie beigetragen. Dennoch zeigen sich nahezu konstante Zahlen schwerstverletzter Patienten und Unfalltoter, was die Relevanz unfallchirurgischer Strukturen besonders in Krisenzeiten aufzeigt und in der Kalkulation der intensivmedizinischen Ressourcen unabdingbar macht.

Teilnahmebereitschaft für Maßnahmen der Sekundärprävention. Einflussfaktoren am Beispiel des BGW-Rückenkollegs

Willingness to participate in prevention programmes. Key factors based on the example of the BGW back school Objectives: Employees in nursing professions run a high risk of back-related disorders. The German Social Accident Insurance Institution for the health and welfare services (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege – BGW) has developed a multi-stage programme of secondary individual prevention (SIP) with a back clinic, back school and refresher course in order to counteract the cause of occupational diseases of the lumbar spine. The aim of the study was to identify what factors influence the willingness to participate in these programmes. Methods: The study is based on data from 1011 participants who attended the back clinic at the Hamburg regional office of the BGW between 2012 and 2019. They were collected by means of a standardised questionnaire and an orthopaedic examination. The evaluation was based on a t-test for independent samples and the Levene test, which was used to verify the homogeneity of variance. Results: It was found that increasing age and a higher number of years in the job results in a significant increase of willingness to participate. At the same time, a higher level of BMI and the number of non-back disorders both have a significant inhibitory impact on participation. Conclusions: The use of preventive programmes will increase in terms of relevance. General state of health is a key factor in whether or not programmes are used by potential participants. Finally, the overall objective should be to develop solutions that encourage the willingness to participate even in the early stages of working life. Keywords: lumbar spine – prevention – back clinic – back school

Dokumentierte Risiken beim Einsatz von Desinfektionsmitteln

Documented risks when using disinfectants Objectives: Description of the occurrence of diseases through the use of disinfectants based on the data of the occupational disease routine database (BK-DOK) of the German Social Accident Insurance Institution for the health and welfare services (BGW) for the period from 2010 to 2019. Methods: An evaluation was carried out of the available data from the BK-DOK of the BGW on various diseases caused by chemical substances (BK 13xx), obstructive respiratory diseases (BK 4301/02) and skin diseases (BK 5101), which are possibly related to disinfection activities. The data covers the period from 2010 to 2019. The analysis drew a distinction between the 15 sectors of the BGW, the type of decision and the triggers for an occupational disease. Only decided cases were considered. Results: In the 10-year period, 81,960 cases of the selected occupational diseases were decided. Of these decisions, 92.2 % concerned BK 5101, 6.6 % BK 4301/02 and 1.2 % BK 13xx. Disinfectants were not documented as job-related reasons for the development of systemic diseases and only marginally for obstructive respiratory diseases. Disinfectants and wet work were documented as decisive influencing factors on the development of skin diseases. Conclusions: Skin diseases in particular occurred when handling disinfectants. This is attributed, on the one hand, to influences from the disinfectants themselves and, on the other hand, to the wet work caused by them. This was not only a problem in the health care sectors but affected every sector of the BGW. Increased prevention work and diligent risk assessment for disinfection and wet work are decisive factors in the reduction of occupational disease cases. Keywords: documentation of occupational diseases – disinfectants – wet work – skin diseases

The Current Therapy of Asbestos-Associated Malignant Pleural Mesothelioma - An Expert Consensus Paper

ZusammenfassungAsbestverursachte maligne Mesotheliome gehören in Deutschland mit etwa 1000 jährlichen Neuerkrankungen zu den häufigen arbeitsbedingten Krebserkrankungen. Die Prognose ist oftmals schlecht, da die Erkrankung lange symptomlos bleibt und deshalb meist erst als Zufallsbefund in bereits fortgeschrittenen Stadien diagnostiziert wird.Die deutsche gesetzliche Unfallversicherung (DGUV) hat in den letzten Jahren erhebliche Anstrengungen unternommen, eine Vorverlagerung des Diagnosezeitpunkts zu erreichen, um die Erkrankung möglichst in Frühstadien zu detektieren. Die aus diesen Bestrebungen resultierenden neuen medizinisch-wissenschaftlichen Erkenntnisse zeigen, dass die Kombination der Biomarker Calretinin und Mesothelin in einer Hochrisikogruppe die Vorverlegung der Diagnose um bis zu 12 Monaten ermöglicht.Die Diagnose eines Mesothelioms im Frühstadium wird idealerweise von der individuell bestmöglichen Therapie gefolgt. Die Standardtherapie basiert auf operativer Entfernung des Tumors und Chemotherapie, ergänzt um Strahlentherapie und Psychoonkologie. In den letzten Jahren wurden einige neue Therapieansätze entwickelt. Die Übersicht stellt den aktuellen Stand der Therapie des Mesothelioms, basierend auf den internationalen Leitlinien und neuen Studien, dar.

Charge-separating processes by spraying water under high pressure

Spraying water under high pressure generates charge-separating processes. While cleaning tanks and vessels in which an explosive atmosphere is present, an explosion may occur in the event of a resulting discharge. Water forms electrical double layers at the phase boundaries. Mechanical separation processes dissolve the water into many drops. This leads to charge separation and the charging of the sprayed water. The mechanical separation processes include water exiting from the nozzle, hydrodynamic instability in the jet and impact with an obstacle. Given that water has many charge carriers, the charge is stronger than with solvents. Whether the charges and the resulting discharges are potentially capable of igniting an explosive atmosphere must be investigated. The aim of this research is to define the quantity and polarity of the electrostatic charges of sprayed water under high pressure. Different measurement techniques and methods are used to enable mutual validation and to generate verified measurement results of the electric field and the potential. Water of different electrical conductivity is sprayed in free space and into a grounded conductive 1 m3 vessel. Design changes to the vessel allow centric or oblique spraying. The result is intended to extend the scope of application of the German regulation TRGS 727 and the international IEC TS 60079-32-1, which refer to ignition hazards due to electrostatic charging. This project is funded by the DGUV (German Social Accident Insurance) and partners from industry.

Speech intelligibility tests for hearing impaired persons using hearing protectors

The combination of hearing impairment and the requirement to use hearing protection can create severe problems regarding situational awareness, signal audibility and communication ability. Nevertheless, for persons with a noise induced hearing loss a reliable protection against harmful noise is especially important. The German Social Accident Insurance (DGUV) founds a project that investigates a number of approaches to protect the vulnerable group of persons with a hearing loss at noisy workplaces, providing at the same time sufficient communication ability. In Germany, signal audibility with hearing protectors is addressed via a calculation using the sound attenuation of the hearing protector and a loudness model. But speech intelligibility, so far, cannot be quantified, neither by calculation nor standardized tests. The DGUV project investigates different types of speech tests respectively speech audiometry in the lab and the field. One aim is to quantify the effect of different types of hearing protectors (active and passive), another one to assess the feasibility of the different test approaches. We present results for simple, work-related messages in comparison to everyday sentences and a matrix sentence test. The effect of different hearing protectors is analysed in relation to the amount of hearing loss.

Occupationally acquired MRSA colonization and occupational dermatological assessments (BK-No. 3101 in the German list of Occupational Diseases) : Analysis of the DGUV documentation and expert opinion on acase with work-related MRSA-triggered atopic dermatitis

HintergrundVon Mensch zu Mensch übertragene Infektionskrankheiten können eine Berufskrankheit(BK)-Nr. 3101 bedingen, wenn sie bei Versicherten auftreten, die infolge der Ausübung ihrer Arbeitstätigkeit in bestimmten Bereichen einer gegenüber der allgemeinen Bevölkerung wesentlich erhöhten Infektionsgefahr ausgesetzt sind.Ziel der ArbeitEs erfolgt die Darstellung der besonderen medizinischen und versicherungsrechtlichen Aspekte einer beruflichen MRSA-Kolonisation am Beispiel eines Gutachtenfalles und Auswertung der BK-Verdachtsanzeigen (BK-Nr. 3101) der gewerblichen Berufsgenossenschaften und Unfallversicherungsträger.Patienten und MethodenDie Geschäftsergebnisse und BK-Dokumentation der gewerblichen Berufsgenossenschaften und Unfallversicherungsträger 2007 bis 2012 wurden zur BK-Nr. 3101 ausgewertet sowie das Patientenkollektiv berufsdermatologischer Begutachtungsfälle 2007 bis 2012 der Hautklinik Universitätsklinikum Erlangen zum Vorliegen von Mensch zu Mensch übertragener Infektionskrankheiten der Haut retrospektiv untersucht.ErgebnisseVon Mensch zu Mensch übertragene Infektionskrankheiten der Haut sind in der berufsdermatologischen Begutachtung selten. Von den 2007 bis 2012 erfassten BK-Verdachtsanzeigen waren 2,6 % BK-Nr. 3101-Verdachtsfälle; 4,2 % aller anerkannten BKen entfielen auf BK-Nr. 3101-Fälle, darunter 9 Fälle von MRSA (Methicillin-resistenter Staphylococcus aureus). Eine symptomlose MRSA-Besiedlung wird im Gegensatz zur manifesten Infektionskrankheit nicht als BK-Nr. 3101 anerkannt. Bakterielle Superantigene können eine atopische Dermatitis (AD) triggern. Im Einzelfall kann eine AD infolge einer beruflich erworbenen MRSA-Ansteckung auftreten und eine BK-Nr. 3101 begründen.DiskussionEin frühzeitiger Nachweis einer MRSA-Kolonisation und Eradikation sind notwendig für eine Rehabilitation. Der Umgang mit Hauterkrankungen als Folge einer Infektionskrankheit im Berufskrankheitenverfahren wird dargelegt.

Tuberculosis among Health Workers—A Secondary Data Analysis of German Social Accident Insurance Data from 2002–2017

Tuberculosis (TB) is the most common cause of fatal infections worldwide. Recent TB figures in Europe indicate that 30 people were infected with tuberculosis each hour in 2017. Healthcare workers are at particular risk of being infected through patient contact. TB is the second most common occupational infectious disease among German healthcare workers. Routine data from the German Social Accident Insurance were used to examine trends in occupational TB diseases. We analyzed annual cross-sectional data for the years 2002 to 2017. The data underwent descriptive analysis. A total of 4653 TB cases were recognized as occupational diseases (OD) in the period under study. In 2002, 60 TB cases were recognized as OD No. 3101, i.e., transmissions from person to person. Since 2013, the level has settled at around 500 recognized cases per year. This is around eight times the number of cases compared to 2002. The following three groups collectively accounted for the largest share of TB cases (88.5%): nurses (including geriatric nurses), other healthcare employees, and physicians. The upward trend in the number of TB cases recognized as occupational diseases is probably due to improvements in diagnostic tests used to diagnose TB infections. TB in health and welfare workers remains an important issue in the health and welfare sector in Germany, partly due to the long latency period between potential exposure to infectious patients or materials and the recognition of the latent tuberculosis infection (LTBI) or active TB as OD.

Estimating Respirable Dust Exposure from Inhalable Dust Exposure.

In the sector of occupational safety and health only a limited amount of studies are concerned with the conversion of inhalable to respirable dust. This conversion is of high importance for retrospective evaluations of exposure levels or of occupational diseases. For this reason a possibility to convert inhalable into respirable dust is discussed in this study. To determine conversion functions from inhalable to respirable dust fractions, 15 120 parallel measurements in the exposure database MEGA (maintained at the Institute for Occupational Safety and Health of the German Social Accident Insurance) are investigated by regression analysis. For this purpose, the whole data set is split into the influencing factors working activity and material. Inhalable dust is the most important predictor variable and shows an adjusted coefficient of determination of 0.585 (R2 adjusted to sample size). Further improvement of the model is gained, when the data set is split into six working activities and three material groups (e.g. high temperature processing, adj. R2 = 0.668). The combination of these two variables leads to a group of data concerned with high temperature processing with metal, which gives rise to a better description than the whole data set (adj. R2 = 0.706). Although it is not possible to refine these groups further systematically, seven improved groups are formed by trial and error, with adj. R2 between 0.733 and 0.835: soldering, casting (metalworking), welding, high temperature cutting, blasting, chiseling/embossing, and wire drawing. The conversion functions for the seven groups are appropriate candidates for data reconstruction and retrospective exposure assessment. However, this is restricted to a careful analysis of the working conditions. All conversion functions are power functions with exponents between 0.454 and 0.946. Thus, the present data do not support the assumption that respirable and inhalable dust are linearly correlated in general.

Piezoelectric Micro-dosing System for Spiking Quality Samples in Occupational Hygiene Laboratories

Quality control is crucially important in the arena of chemical analysis. Reference materials are essential for calibration and quality control processes, and for verification of the accuracy and reliability of the analytical results obtained. Owing to the complexity of their manufacture, reference materials for chemical agents occurring at workplaces are expensive and available only on a limited scale and for a small number of substances. Therefore, their cost-effective and fast production is an important aim. The Institute for Occupational Health and Safety (IFA) of the German Social Accident Insurance (DGUV) currently pursues different strategies for the production of reference materials. One strategy entails the use of a piezoelectric micro-dispensing system for non-contact spiking of extremely small quantities of substances with high reproducibility. The dispensing system is coupled to a semi-automated assembly unit for loading high numbers of samples. It is used for spiking phosphoric and sulphuric acid onto quartz fibre filters. Comparison of the results obtained on different days shows higher variability than results observed on the same day. However, after daily adjustment of the number of droplets to the current droplet volume, highly reproducible series with an adequate number of samples (>500) could be realized. The results of the internal quality control were verified in an interlaboratory comparison. Furthermore, storage stability was investigated systematically over a period of 2 years. The samples produced are suitable for use as reference materials for both inorganic acids.

Measurement of electric fields of charged spray clouds of conductive liquids in free space and in a conductive vessel

The process of spraying liquids generated electrical charges. The question therefore arises as to whether this electrostatic charge represent an ignition hazard when an explosive mixture is present. This hazard occurs when cleaning vessels, in which an explosive mixture is formed by residues of easily flammable liquids or the cleaning medium itself. Although measurement techniques and methods exist for detecting this electrostatic charging process, they have not been sufficiently scientifically proven. The Chilworth JCI 131 adverse conditions field meter is to be used to measure the electrostatic charging of sprayed liquids. It shall be validated by measuring the electric field strength of a flat spray water jet in low-pressure range (8 bar) charged by contact charging and accumulation of free electrons of a commercial, insulated arranged electrostatic spraying system (up to - 90 kV). A flat-jet nozzle is selected which atomizes the spray jet, which serves as the measuring surface, sufficiently large. This arrangement is further investigated in a 1 m3 stainless steel IBC. The investigations presented are part of a project aiming to extend the scope of the German Technical Rules for Hazardous Substances (TRGS) of TRGS 727, which regulate avoiding ignition hazards resulting from electrostatic charging. The aim is to reach an understanding that allows provisions for safe cleaning of “small” and “medium-sized” containers up to 50 m3. This project is funded by DGUV (German Social Accident Insurance) and partners from the industry.

Methoden zur objektiven Absicherung der Ergonomie in Fahrerkabinen

This paper introduces a method for assessing the design of operating systems as part of cognitive ergonomics, as well as a method for assessing operator movements and gripping areas as part of physical ergonomics. Both methods can be used in the development of a cab or for comparative analysis of cabs. The innovative character of the methods is to establish a non-subject based evaluation process that provides more objective and comparable results across different examinations. The method of evaluating operating systems builds on the ergonomic principles of expectation conformity and movement compatibility. The motion capturing method for analyzing and evaluating gripping areas and movements uses the comfort angle specifications of the German Social Accident Insurance (DGUV).

Sick leave and work-related accidents of social workers in Germany: an analysis of routine data

PurposeThe study aimed to explore the prevalence of sick leave and the risk of work-related accidents among German social workers and to describe causes and time trends in sick leave and accident claims.MethodsA retrospective analysis of routine data was carried out. Aggregated sick leave data of 195,100 social workers from four health insurance funds and 3037 accident claims of social workers from an accident insurance institution were analysed. Causes of accidents were examined by statistics of the German Social Accident Insurance (DGUV). Sick leave rates per 100 insured person-years were calculated. Relative risks (RR) of accidents were calculated in a multivariate analysis for three occupational groups (social workers and therapists, caregivers in sheltered workshops and teachers in residential institutions) and compared to other health and welfare service workers.ResultsMental disorders caused about one-fifth of the sick leave days of social workers. Sick leave due to mental disorders slightly increased in 2015 compared to 2012 (+ 3% and + 18%). Among the three subgroups of social workers, caregivers in sheltered workshops (RR 1.30; 95% CI 1.14–1.49) and teachers in residential institutions (RR 1.41; 95% CI 1.17–1.70) were at an increased risk of accidents at the workplace. Accidents were mostly caused by slipping (30%) and by violence (22%).ConclusionsThis study confirms that sick leave of social workers is frequently caused by mental disorders. Future studies could further examine differences between practice fields, long-term effects of work hazards and effective workplace interventions.

Proactive prevention in occupational safety and health: how to identify tomorrow's prevention priorities and preventive measures

Introduction. Global trends such as digitalization, globalization and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). Methods. The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. In total, 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Results. Work intensity, demographic aspects and digitalization play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. Outlook. For the DGUV, training and consulting have great potential for proactive prevention in these priority areas, e.g., by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces and data security require continued research.

The Relationship Between the Explosion Indices of Dispersed Dust and Particle Surface Area and the Heat of Combustion

The German Social Accident Insurance has been studying dust samples from trade and industry for many years with regard to their explosion indices, and makes these data available free of charge and accessible from around the globe in the GESTIS-DUST-Ex database. The dusts studied vary widely in their chemical composition and particle size distribution. The substantial data collective nevertheless permits study of the possible relationships between the various safety indices. The focus of this study lies upon the influence of the median upon the maximum explosion pressure Pmax and the rate of pressure rise dp/dt. The median reduces a complete particle size distribution to a single value and is therefore an imprecise measure of the active surface of the dusts. For this reason, precise BET surface analyses of 129 dusts were performed in a further study in order to determine possible correlations between Pmax and Kst. In addition, the heat of combustion of these dusts was determined calorimetrically in order for further information on the explosion reaction and the Kst value to be obtained.

Exposure of Pupils to Recreational Noise from Portable Listening Devices and Possible Preventive Measures

Background and Objectives: Exposure to recreational noise is becoming increasingly important due to a change in leisure behavior amongst children and adolescents. The aim of this pilot study was to assess exposure of 6th grade pupils to recreational noise from portable listening devices (PLD). Furthermore, preventive measures to reduce recreational noise exposure should be identified. Methods: In "Ohrkan Kids", 38 Bavarian pupils aged 11 to 14 were interviewed regarding their music listening behavior using a standardized questionnaire. In addition, measurements of commonly used volume settings on the children's portable listening devices were carried out. Furthermore, the German Social Accident Insurance (DGUV), health insurance companies as well as health and education ministries of the German federal states were surveyed regarding their activities in the prevention of recreational noise exposure. Results: Based on the questionnaire data for weekly usage, 10 out of 31 children (32.3%) exceeded the upper exposure value of 85 dB recommended by labor protection law. Taking actually measured values, 9 out of 31 children (29%) exceeded this level. The DGUV and some federal states carry out specific projects for the prevention of recreational noise exposure. Conclusion: The large number of children with hazardous music consumption indicates that measures for the prevention of noise-induced hearing loss are already required for 11 to 14 year olds. To maximize the number of children addressed, age-appropriate and target-group-specific preventive measures are needed. As there are only few studies which examined the effectiveness of awareness campaigns for the prevention of recreational noise, any future prevention projects should be evaluated with an increased focus on estimating their effectiveness.

Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603,838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528,908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5·1 million person-years (mean 8·5 years), in which 4768 events were recorded, and for stroke was 3·8 million person-years (mean 7·2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35-40 h per week), working long hours (≥55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1·13, 95% CI 1·02-1·26; p=0·02) and incident stroke (1·33, 1·11-1·61; p=0·002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1·30-1·42). We recorded a dose-response association for stroke, with RR estimates of 1·10 (95% CI 0·94-1·28; p=0·24) for 41-48 working hours, 1·27 (1·03-1·56; p=0·03) for 49-54 working hours, and 1·33 (1·11-1·61; p=0·002) for 55 working hours or more per week compared with standard working hours (ptrend<0·0001). Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours. Medical Research Council, Economic and Social Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working Environment, Academy of Finland, Ministry of Social Affairs and Employment (Netherlands), US National Institutes of Health, British Heart Foundation.

Assessment of occupational cancer: important facts to consider

Background | Persons suffering from malignant tumors who had been exposed to carcinogens at their workplace must be compensated if occupational exposure probably caused the disease. However, the assessment of the causes of cancers is particularly difficult.Method | For the evaluation the authors analyzed selectively researched literature and considered publications of the German Social Accident Insurance and legal regulations.Result | Often the quantification of the occupational exposure is not possible. Cumulative exposures neglect important factors, e.g. high peak concentrations. Even in the general population exposure to noxious agents occurs. This raises the question what amount of occupational exposure must be considered as sufficient for compensation and how non-occupational factors, such as genetic susceptibility, should influence the expert's opinion. Syncancerogenetic effects are currently not sufficiently considered in the legal ordinance on occupational diseases.Conclusion | At best, only a very rough estimate of the probability of causation can be stated. If there is insufficient scientific evidence then there is a need of "makeshift" recommendations within the social consensus, which occupational exposure is considered to be relevant for occupational disease. If there are no reliable data on occupational exposure due to failure of the employer, this should not be stacked against the insured.

Detection of Airborne Bacteria in a Duck Production Facility with Two Different Personal Air Sampling Devices for an Exposure Assessment

Prevalent airborne microorganisms are not well characterized in industrial animal production buildings with respect to their quantity or quality. To investigate the work-related microbial exposure, personal bioaerosol sampling during the whole working day is recommended. Therefore, bioaerosol sampling in a duck hatchery and a duck house with two personal air sampling devices, a filter-based PGP and a NIOSH particle size separator, was performed. Subsequent, quantitative and qualitative analyses were carried out with” culture independent methods. Total cell concentrations (TCC) determined via fluorescence microscopy showed no difference between the two devices. In average, 8 × 106 cells/m3 were determined in the air of the duck hatchery and 5 × 107 cells/m3 in the air of the duck house. A Generated Restriction Fragment Length Polymorphism (RFLP) pattern revealed deviant bacterial compositions comparing samples collected with both devices. Clone library analyses based on 16S rRNA gene sequence analysis from the hatchery's air showed 65% similarity between the two sampling devices. Detailed 16S rRNA gene sequence analyses showed the occurrence of bacterial species like Acinetobacter baumannii, Enterococcus faecalis, Escherichia sp., and Shigella sp.; and a group of Staphylococcus delphini, S. intermedius, and S. pseudintermedius that provided the evidence of potential exposure to risk group 2 bacteria at the hatchery workplace. Size fractionated sampling with the developed by the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) device revealed that pathogenic bacteria would deposit in the inhalable, the thorax, and possibly alveolar dust fraction according to EN481. TCC analysis showed the deposition of bacterial cells in the third stage (< 1μm) at the NIOSH device which implies that bacteria can reach deep into the lungs and contaminate the alveolus after inhalation. Nevertheless, both personal sampling devices could be recommended for exposure assessment at agricultural workplaces.

Glucoamylase: a current allergen in the baking industry.

Background:Over a 10 year period a decline in the rate of sensitizations to α-amylase (Aspergillus oryzae) was observed in bakers investigated for allergic obstructive airway disease. At the same time, glucoamylase (Aspergillus niger) was identified as the currently the most relevant allergen in sensitizations to enzymes in the baking industry. The aim of the present study was to investigate whether, over a period of 10 years and in the case of new-onset disease, there had been any change in sensitization and exposure rates to enzymes used in the baking industry.Methods:Total immunoglobulin-E (IgE) levels and specific IgE to baking enzymes were determined in 433 bakers investigated in the Baker‘s Asthma prevention program (Bäckerasthma Präventionsprogramm, BAP) of the German Social Accident Insurance Institution for the foodstuffs and catering industry (Berufsgenossenschaft Nahrungsmittel und Gastgewerbe, BGN). At the same time personal dust exposure, including assessment of the level of α-amylase exposure in the area of exposure, was recorded.Results and conclusions:Serological investigations revealed a significant decline in the rate of sensitization to α-amylase from 26 % to 13 %. At 28 %, the rate of sensitization to the baking enzyme glucoamylase was significantly higher than to cellulase (16 %) and α-amylase among subjects in 2010. Multiple sensitizations to all three baking agents are common. In total, 30 % of affected bakers are currently sensitized to at least one of the baking enzymes investigated. Data from individual dust measurements revealed a decline in α-amylase exposure while overall dust exposure remained almost unchanged. Today, 11 % fewer bakers are exposed to α-amylase compared with ten years previously and, at the same time, enzyme concentrations in exposed bakers have dropped significantly. The high sensitization rate to glucoamylase in affected bakers gives cause to investigate exposure levels in bakeries and to assess sensitizations in the context of occupational disease proceedings.