Job Codes Research Articles

128 Development of a job-exposure matrix (JEM) to describe pesticide exposure in Spanish workers (1996–2005)

ObjectivesPesticides are intensively used in Spain in a wide range of economic activities such as agriculture, farming, wood treatments or pest control, reaching in 2005 a consumption of more than...

Depression- and anxiety-related sick leave and the risk of permanent disability and mortality in the working population in Germany: a cohort study.

BackgroundAnxiety and depression are the most common psychiatric disorders and are the cause of a large and increasing amount of sick-leave in most developed countries. They are also implicated as an increasing mortality risk in community surveys. In this study we addressed, whether sick leave due to anxiety, depression or comorbid anxiety and depression was associated with increased risk of retirement due to permanent disability and increased mortality in a cohort of German workers.Methods128,001 German workers with statutory health insurance were followed for a mean of 6.4 years. We examined the associations between 1) depression/anxiety-related sick leave managed on an outpatient basis and 2) anxiety/depression-related psychiatric inpatient treatment, and later permanent disability/mortality using Cox proportional hazard regression models (stratified by sex and disorder) adjusted for age, education and job code classification.ResultsOutpatient-managed depression/anxiety-related sick leave was significantly associated with higher permanent disability (hazard ratio (95% confidence interval)) 1.48 (1.30, 1.69) for depression, 1.25 (1.07, 1.45) for anxiety, 1.91 (1.56, 2.35) for both). Among outpatients, comorbidly ill men (2.59 (1.97,3.41)) were more likely to retire early than women (1.42 (1.04,1.93)). Retirement rates were higher for depressive and comorbidly ill patients who needed inpatient treatment (depression 3.13 (2,51, 3,92), both 3.54 (2.80, 4.48)). Inpatient-treated depression was also associated with elevated mortality (2.50 (1.80, 3.48)). Anxiety (0.53 (0.38, 0.73)) and female outpatients with depression (0.61 (0.38, 0.97)) had reduced mortality compared to controls.ConclusionsDepression/anxiety diagnoses increase the risk of early retirement; comorbidity and severity further increase that risk, depression more strikingly than anxiety. Sickness-absence diagnoses of anxiety/depression identified a population at high risk of retiring early due to ill health, suggesting a target group for the development of interventions.

Alcohol use disorder-related sick leave and mortality: a cohort study

BackgroundAlcohol use disorders (AUDs) are associated with the highest all-cause mortality rates of all mental disorders. The majority of patients with AUDs never receive inpatient treatment for their AUD, and there is lack of data about their mortality risks despite their constituting the majority of those affected. Absenteeism from work (sick leave) due to an AUD likely signals worsening. In this study, we assessed whether AUD-related sick leave was associated with mortality in a cohort of workers in Germany.Methods128,001 workers with health insurance were followed for a mean of 6.4 years. We examined the associations between 1) AUD-related sick leave managed on an outpatient basis and 2) AUD-related psychiatric inpatient treatment, and mortality using survival analysis, and Cox proportional hazard regression models (separately by sex) adjusted for age, education, and job code classification. We also stratified analyses by sick leave related to three groups of alcohol-related conditions (all determined by International Classification of Diseases 9th ed. (ICD-9) codes): alcohol abuse and dependence; alcohol-induced mental disorder; and alcohol-induced medical conditions.ResultsOutpatient-managed AUD-related sick leave was significantly associated with higher mortality (hazard ratio (HR) 2.90 (95% Confidence interval (CI) 2.24-3.75) for men, HR 5.83 (CI 2.90-11.75) for women). The magnitude of the association was similar for receipt of AUD-related psychiatric inpatient treatment (HR 3.2 (CI 2.76-3.78) for men, HR 6.5 (CI 4.41-9.47) for women). Compared to those without the conditions, higher mortality was observed consistently for outpatients and inpatients across the three groups of alcohol-related conditions. Those with alcohol-related medical conditions who had AUD-related psychiatric inpatient treatment appeared to have the highest mortality.ConclusionsAlcohol use disorder-related sick leave as documented in health insurance records is associated with higher mortality. Such sick leave does not necessarily lead to any specific AUD treatment. Therefore, AUD-related sick leave might be used as a trigger for insurers to intervene by offering AUD treatment to patients to try to reduce their risk of death.

Electric shocks at work in Europe: development of a job exposure matrix

ObjectivesElectric shocks have been suggested as a potential risk factor for neurological disease, in particular for amyotrophic lateral sclerosis. While actual exposure to shocks is difficult to measure, occurrence and...

JEMs and Incompatible Occupational Coding Systems: Effect of Manual and Automatic Recoding of Job Codes on Exposure Assignment

In epidemiological studies, occupational exposure estimates are often assigned through linkage of job histories to job-exposure matrices (JEMs). However, available JEMs may have a coding system incompatible with the coding system used to code the job histories, necessitating a translation of the originally assigned job codes. Since manual recoding is usually not feasible in large studies, this is often done by use of automated crosswalks translating job codes from one system to another. We set out to investigate whether automatically translating job codes led to different exposure estimates compared with those resulting from manual recoding using the original job descriptions. One hundred job histories were randomly drawn from the Netherlands Cohort Study on diet and cancer (NLCS), using a sampling strategy designed to oversample potentially exposed jobs. This resulted in 220 job codes that were automatically translated from the original Dutch coding system to the International Standard Classification of Occupations (ISCO)-68 and ISCO-88 as well as manually recoded from the job descriptions in the original questionnaire by two coders. Exposure to several agents (i.e. chromium, asbestos, silica, pesticides, aromatic solvents, and extremely low-frequency magnetic fields) was assigned by JEMs based on job codes resulting from automatic and manual recodings. The agreement between occupational exposure estimates based on the crosswalk versus those based on manual recoding reached a Cohen's Kappa (κ) of 0.66 or higher and were similar to the agreements between the two coders. Results of this study indicate that using automated crosswalks to recode job codes from one occupational classification system to another results only in a limited loss in agreement in assigned occupational exposure estimates compared with direct manual recoding. Therefore, in this case, crosswalks provide an efficient alternative to the costly and time-consuming direct manual recoding from job history descriptions from questionnaires.

An asbestos exposure database for asbestos mine/mill workers (1976–1994)

ObjectivesAs part of the creation of the Baie Verte, Newfoundland Asbestos Miners' Registry, the results from asbestos air samples collected at the Baie Verte open pit asbestos mine and mill...

Development of a shock job exposure matrix based on reported electric accidents in Europe

ObjectivesElectric shocks has been raised as a potential risk factor for neurological disease and in particular for amyotrophic lateral sclerosis (ALS). While actual exposure to electric shocks cannot be measured,...

The feasibility of adapting a population‐based asthma‐specific job exposure matrix (JEM) to NHANES

To determine the feasibility of applying a job exposure matrix (JEM) for classifying exposures to 18 asthmagens in the National Health and Nutrition Examination Survey (NHANES), 1999-2004. We cross-referenced 490 National Center for Health Statistics job codes used to develop the 40 NHANES occupation groups with 506 JEM job titles and assessed homogeneity in asthmagen exposure across job codes within each occupation group. In total, 399 job codes corresponded to one JEM job title, 32 to more than one job title, and 59 were not in the JEM. Three occupation groups had the same asthmagen exposure across job codes, 11 had no asthmagen exposure, and 26 groups had heterogeneous exposures across jobs codes. The NHANES classification of occupations limits the use of the JEM to evaluate the association between workplace exposures and asthma and more refined occupational data are needed to enhance work-related injury/illness surveillance efforts.

Occupational exposure of UK adults to extremely low frequency magnetic fields

Background:Occupational exposure to extremely low frequency (ELF) magnetic fields (MF) in the UK general population is poorly documented.Aims:To assess levels of occupational exposure to ELF MF in the UK and...

Variability in Endotoxin Exposure Levels and Consequences for Exposure Assessment

Workers in many industries are exposed to endotoxins, which may cause adverse health effects. In exposure assessment, information about exposure variability is essential. However, variability in exposure has rarely been investigated for biological agents and more specifically for endotoxin. Therefore, variance components and determinants of exposure were studied in a large database with >2000 endotoxin measurements. Data from 10 individual studies were combined to create a database with 2010 personal inhalable dust and endotoxin measurements, of which 1650 were repeated measurements. Exposure groups were defined based on job codes. Between- and within-worker variance components were estimated for different grouping strategies, and determinants of exposure were studied using mixed effects models. Inhalable dust and endotoxin exposure levels are summarized for 46 industries and 4 broadly defined sectors. The between-worker variability exceeded the within-worker variability overall and within sectors and subsectors, and variance components were larger for endotoxin than for dust. Between-worker variability also exceeded within-worker variability in nearly half of the exposure groups based upon industries or job code within industries for endotoxin exposure and in 10% of the groups for dust exposure. Among other things, dustiness of the process, contact with animals, bulk production, presence of plant material or a cyclic process appeared as determinants of exposure, which largely explained the between-worker variability. Exposure groups were much less homogeneous for endotoxin exposure than for dust exposure. This is distinctly different than for chemical exposure. Large variability in measured exposure levels is inherent to endotoxin exposure, which is caused in part by determinants that influence growth of microorganisms. These findings have major consequences for the design of future occupational intervention and epidemiological studies. The measurement effort needs to be greater than exposure assessment for chemical agents which demonstrate lower exposure variability, especially when evaluating endotoxin exposure for compliance testing. The established determinants of exposure give direction for potential exposure control, although more information about determinants of day-to-day variability in exposure is still needed to be able to effectively control endotoxin exposure.

Scores of asthma and asthma severity reveal new regions of linkage in EGEA study families

There is ongoing debate as to how asthma should be defined in order to forward understanding of the underlying mechanisms. The aim of the present study was to build quantitative scores of asthma and asthma severity and to assess whether refinement of disease phenotypes can facilitate the identification of chromosomal regions harbouring susceptibility genes. A genome-wide linkage scan was conducted in 110 families with at least two asthmatic siblings (n = 508) from the French Epidemiological study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy (EGEA). The phenotypes studied were an asthma severity score (assessed among asthmatics by combining clinical data and treatment), forced expiratory volume in one second (FEV(1)) and an asthma score (including both asthmatics and nonasthmatics and representing the whole disease spectrum). This analysis showed genome-wide suggestive evidence of linkage of the asthma score to 18p11, a novel region undetected in a previous screen of dichotomous asthma. There was potential linkage of 2p23 to asthma severity score and of three regions (1p36, 2q36 and 6q14) to FEV(1). Moreover, FEV(1) appeared to have no genetic determinant in common with asthma severity and asthma scores. Asthma and asthma severity quantitative scores revealed new regions of linkage and thus provide support for considering these phenotypes in future genetic studies.

Verbal abuse from outsiders versus insiders: Comparing frequency, impact on emotional exhaustion, and the role of emotional labor.

Research on aggression from organizational outsiders (customers, clients or patients) has ignored insider-instigated aggression, and has been limited to employees in emotional labor jobs (e.g., social work and customer services). The authors argue that customer-employee interactions have distinct characteristics from organizational insider interactions, and provide two studies to compare the frequency and strain of verbal abuse from customers, supervisors and coworkers. Furthermore, they assess whether customer verbal abuse is only a critical issue for employees in jobs requiring emotional labor, measured with both O*NET job codes and self-reported display rules. With a national random sample of U.S. employees (n = 2446) and a convenience sample of U.S. employees who have customer contact (n = 121), the authors find that verbal abuse from outsiders (1) occurs more frequently than insider verbal abuse, particularly for those with higher emotional labor requirements, and (2) predicts emotional exhaustion over and above insider verbal abuse, regardless of emotional labor requirements. The authors conclude that better integration of customer aggression and insider aggression research is needed.

Assigning exposure to pesticides and solvents from self-reports collected by a computer assisted personal interview and expert assessment of job codes: the UK Adult Brain Tumour Study

Objectives: To compare assignment of occupational pesticide and solvent exposure using self-reported data collected by a computer assisted personal interview (CAPI) with exposure based on expert assessment of job codes....

Exposure Assessment for Retrospective Follow-Up Studies of Semiconductor- and Storage Device-Manufacturing Workers

This exposure assessment was conducted in the first large study of mortality and cancer incidence in semiconductor and storage device manufacturing. Unique combinations of division, department and job codes and names (DDJ) from work history records were assigned to work groups and exposure categories. Agent exposure matrices assessed differences in potential exposures between groups. Changes in exposure over time were tracked by dividing the production history into manufacturing eras. Nineteen work groups were developed to capture 310,351 unique DDJs from 1965-1999. Agent exposure matrices contrasted exposure potential to solvents, metals, and work in cleanrooms between groups, and three manufacturing eras were identified for each site. The work groups, manufacturing eras and agent matrices have been used to classify workers in the study of cancer incidence and mortality.

A prospective study of occupation and prostate cancer risk.

A wide variety of occupations has been associated with prostate cancer in previous retrospective studies. Most attention has been paid to farming, metal working, and the rubber industry. Today, these results cannot be affirmed with confidence, because many associations could be influenced by recall bias, have been inconsistent, or have not been confirmed satisfactory in subsequent studies. This study was conducted to investigate and confirm these important associations in a large prospective cohort study. The authors conducted a prospective cohort study among 58,279 men. In September 1986, the cohort members (55-69 years) completed a self-administered questionnaire on potential cancer risk factors, including job history. Related job codes were clustered in professional groups. These predefined clusters were investigated in 3 time windows: 1) profession ever performed, 2) longest profession ever held, and 3) last profession held at baseline. Follow up for incident prostate cancer was established by linkage to cancer registries until December 1993. A case-cohort approach was used based on 830 cases and 1525 subcohort members. To minimize false-positive results, 99% confidence intervals (99% CI) were calculated. Although moderately decreased prostate cancer risks were found for electricians, farmers, firefighters, woodworkers, textile workers, butchers, salesmen, teachers, and clerical workers, none of the relative risks (RR) were found to be statistically significant. For road transporters, metal workers, and managers, no association with prostate cancer risk was found. Although the RR for railway workers, mechanics, welders, chemists, painters, and cooks was moderately increased, these estimates were not statistically significant. For men who reported to have ever worked in the rubber industry, we found a substantially increased prostate cancer risk, but not statistically significant (RR, 4.18; 99% CI = 0.22-80.45). For policemen, we found a substantial and marginally statistically significant increased prostate cancer risk, especially for those who reported working as a policeman for most of their occupational life (RR, 3.91; 99% CI = 1.14-13.42) or as the last profession held at baseline (RR, 4.00; 99% CI = 1.19-13.37). Most of the previously investigated associations between occupation and prostate cancer risk could not be confirmed with confidence in this prospective study. The lack of statistical significance for rubber workers could be caused by the scarcity of rubber workers in this cohort and subsequent lack of power. The results for policemen were substantial and statistically significant, although a conservative value for significance level was used.

Association between Parkinson’s Disease and Exposure to Pesticides in Southwestern France

A case-control study was performed in southwestern France in order to assess the relationship between pesticide exposure and Parkinson’s disease (PD) in the elderly. During the period from 1997 to 1999, 84 cases were recruited together with 252 population-based controls. Experts in occupational health reviewed job codes and provided pesticide exposure levels, making it possible to calculate cumulated exposure lifelong for individuals. Environmental pesticide exposure was considered in relation to the place of residence. A positive association was found with occupational pesticide exposure (odds ratio = 2.2, 95% confidence interval 1.1–4.3) in conditional logistic multiple regression analysis taking into account age, sex, educational level and smoking; however, no clear dose relationship was found. Our results support the hypothesis of an association between occupational pesticide exposure and PD and point to the need to investigate the role of fungicides, for which toxicological hypotheses exist.

The Development of a Prototype Database for the Voluntary Reporting of Occupational Exposure Data on Chemicals

A prototype occupational exposure database was developed as part of a study to retrospectively collect chemical exposure data from U.K. industry. The data dictionary for the database was constructed using existing recommendations on core data elements developed by working groups from the ACGIH and the European Union. The study also made use of existing job and workplace coding schemes. The practicalities of gathering the data by voluntary donation, its storage in a database, and the transfer of suitably anonymised data to the U.K. Health and Safety Executive's National Exposure Database system were investigated and assessed. Prior to the development, several existing exposure database systems were evaluated for their suitability to store the data from the study. Though of high quality, these were found to be insufficiently flexible for the diversity of datasets encountered and so the prototype exposure database was constructed using a leading database development package. The database was successfully used to gather data and forward it in a suitable format to the U.K. Health and Safety Executive. The published recommendations on occupational exposure databases and the associated coding schemes provided a very useful foundation for designing and implementing the prototype database. However, as data collection proceeded it became clear that the existing recommendations often were poorly understood and misinterpreted, or at least interpreted differently, by different database designers, data collectors, and other users of occupational exposure data. It is suggested that several items in the ACGIH and European Union core recommendations are ambiguous and need to be clarified. Once agreed, the improved database design criteria need to be widely promoted to foster a common understanding and to encourage their use by all those involved in collecting occupational exposure data. Beyond this, recommendations for exposure databases should be augmented to facilitate easy exchange of data between organizations.

The development of a prototype database for the voluntary reporting of occupational exposure data on chemicals.

A prototype occupational exposure database was developed as part of a study to retrospectively collect chemical exposure data from U.K. industry. The data dictionary for the database was constructed using existing recommendations on core data elements developed by working groups from the ACGIH and the European Union. The study also made use of existing job and workplace coding schemes. The practicalities of gathering the data by voluntary donation, its storage in a database, and the transfer of suitably anonymised data to the U.K. Health and Safety Executive's National Exposure Database system were investigated and assessed. Prior to the development, several existing exposure database systems were evaluated for their suitability to store the data from the study. Though of high quality, these were found to be insufficiently flexible for the diversity of datasets encountered and so the prototype exposure database was constructed using a leading database development package. The database was successfully used to gather data and forward it in a suitable format to the U.K. Health and Safety Executive. The published recommendations on occupational exposure databases and the associated coding schemes provided a very useful foundation for designing and implementing the prototype database. However, as data collection proceeded it became clear that the existing recommendations often were poorly understood and misinterpreted, or at least interpreted differently, by different database designers, data collectors, and other users of occupational exposure data. It is suggested that several items in the ACGIH and European Union core recommendations are ambiguous and need to be clarified. Once agreed, the improved database design criteria need to be widely promoted to foster a common understanding and to encourage their use by all those involved in collecting occupational exposure data. Beyond this, recommendations for exposure databases should be augmented to facilitate easy exchange of data between organizations.

Career Development Patterns Among Professional Persons with Severe Psychiatric Disabilities: Implications for Practice

This study investigated career patterns among persons with serious psychiatric disabilities who had completed higher education. As part of a vocational program follow-up, 48 middle-aged, mostly white men and women consumers were interviewed about educational and employment histories. A computer program based on age of onset, job skill level, job and educational codes, and dates of employment was developed. Five different, mutually exclusive, career development patterns were identified: (a) career constant with postformal education disability onset, (b) career constant with preformal education completion disability onset, (c) career change with post-formal educational disability onset, (d) career change with pre-formal educational completion disability onset, and (e) early onset with no career. Results were related to current career development theories and the needs of counselors serving this population.

Standardizing Job Titles for Exposure Assessment in the Pulp and Paper Industry

Abstract Standard occupational coding systems in Canada and elsewhere do not adequately describe the pulp and paper industry for the purpose of assigning the worker's chemical exposures. Accordingly, a coded list of standard job titles in the pulp and paper industry was developed from two sources: industry-related job titles in pre-existing Canadian occupational coding systems, and mill-specific job tides listed on historical job descriptions from 14 mills in the province of British Columbia, Canada. The mill-specific titles were reviewed in the context of the existing process technology, engineering controls, and mill-specific work practices. Each job code was considered unique in terms of its chemical exposure potential. The newly formed classification system was applied to job titles listed on the employment records of a sample of workers employed at the mills between 1950 and 1992. Standardizing and coding the job titles within each mill streamlined the subsequent exposure assessment and data analysis...