Job-exposure Matrices Research Articles

Exposure to benzene and other hydrocarbons and risk of bladder cancer among male offshore petroleum workers

BackgroundOccupational exposures constitute the second leading cause of urinary bladder cancer after tobacco smoking. Increased risks have been found in the petroleum industry, but high-quality exposure data are needed to explain these observations.MethodsUsing a prospective case-cohort design, we analysed 189 bladder cancer cases (1999–2017) and 2065 randomly drawn non-cases from the Norwegian Offshore Petroleum Workers cohort. Cases were identified in the Cancer Registry of Norway, while work histories (1965–1998) and lifestyle factors were recorded by questionnaire at baseline (1998). Occupational petroleum-related hydrocarbon exposures were assessed by expert-developed job-exposure matrices. Hazard ratios were estimated by weighted Cox-regressions, adjusted for age, tobacco smoking, education, and year of first employment, and with lagged exposures.ResultsIncreased risks were found in benzene-exposed workers, either long-term exposure (≥18.8 years, HR = 1.89, 95% CI: 1.14–3.13; p-trend = 0.044) or high-level cumulative benzene exposure (HR = 1.60, 95% CI: 0.97–2.63; p-trend = 0.065), compared with the unexposed. Associations persisted with 20-year exposure lag. No associations were found with skin or inhalation exposure to crude oil, mineral oil (lubrication, hydraulics, turbines, drilling), or diesel exhaust.ConclusionsThe results suggest that exposures in the benzene fraction of the petroleum stream may be associated with increased bladder cancer risk.

Occupational risks associated with severe COVID-19 disease and SARS-CoV-2 infection - a Swedish national case-control study conducted from October 2020 to December 2021.

This study aimed to investigate whether workplace factors and occupations are associated with SARS-CoV-2 infection or severe COVID-19 in the later waves of the pandemic. We studied 552 562 cases with a positive test for SARS-CoV-2 in the Swedish registry of communicable diseases, and 5985 cases with severe COVID-19 based on hospital admissions from October 2020 to December 2021. Four population controls were assigned the index dates of their corresponding cases. We linked job histories to job-exposure matrices to assess the odds for different transmission dimensions and different occupations. We used adjusted conditional logistic analyses to estimate odds ratios (OR) for severe COVID-19 and SARS-CoV-2 with 95% confidence intervals (CI). The highest OR for severe COVID-19 were for: regular contact with infected patients, (OR 1.37, 95% CI 1.23-1.54), close physical proximity (OR 1.47, 95% CI 1.34-1.61), and high exposure to diseases or infections (OR 1.72, 95% CI 1.52-1.96). Mostly working outside had lower OR (OR 0.77, 95% CI 0.57-1.06). The odds for SARS-CoV-2 when mostly working outside were similar (OR 0.83, 95% CI 0.80-0.86). The occupation with the highest OR for severe COVID-19 (compared with low-exposure occupations) was certified specialist physician (OR 2.05, 95% CI 1.31-3.21) among women and bus and tram drivers (OR 2.04, 95% CI 1.49-2.79) among men. Contact with infected patients, close proximity and crowded workplaces increase the risks for severe COVID-19 and SARS-CoV-2 infection. Outdoor work is associated with decreased odds for SARS-CoV-2 infection and severe COVID-19.

Parental occupational exposure to solvents and risk of developing testicular germ cell tumors among sons: a French nationwide case-control study (TESTIS study).

The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. A French nationwide case-control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. Occupational exposure to at least one solvent during the year of their son's birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68-1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55-3.61), methylene chloride (OR 1.13, 95% CI 0.54-2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80-1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79-2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65-1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11-6.76). Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

Exploring the employment determinants of job insecurity in the French working population: Evidence from national survey data.

Studies are lacking on the employment determinants of job insecurity, that may be helpful to determine highly exposed groups and to assess the feasibility of constructing job-exposure matrices (JEMs) for this occupational exposure. The objectives were to explore the employment determinants of job insecurity in a nationally representative sample of the French working population. The study was based on the cross-sectional data of the 2013 national French working conditions survey including a sample of 28,293 employees, 12,283 men and 16,010 women. Job insecurity was assessed using one single item related to the fear of job loss in the next 12 months. Gender, age, and educational level were studied as well as the following employment variables: temporary/permanent work contract, full/part time work, job seniority, occupation, economic activity of the company, public/private sector, and company size. The associations with job insecurity were studied using bivariate and multivariate analyses. One quarter of the study sample was exposed to job insecurity, without any difference between genders. Lower age and lower educational levels were associated with job insecurity. Employees who had a temporary work contract, lower job seniority, who were working in low-skilled occupational groups, in manufacturing (for both genders) and construction (among men), and in the private sector had a higher prevalence of exposure to job insecurity. The two major employment variables associated with job insecurity were temporary work contract (prevalence ratios>2) and private sector (prevalence ratios>1.4) for the whole sample and for both men and women. Our findings suggested that intervention/prevention measures could be oriented towards specific highly exposed groups of the working population, especially those exposed to temporary work contract and/or working in the private sector. Our study also underlined that constructing JEMs for job insecurity may be possible and could be a useful tool for large-scale occupational health studies.

Job exposure matrices for occupational respiratory disease: a narrative review.

Job exposure matrices (JEMs) are epidemiological tools used to provide estimations of occupational exposures when it is not feasible to complete detailed individual occupational histories. To identify and summarize the characteristics of published general population JEMs (GPJEM) of inhalable occupational exposures applied in studies of respiratory disease. MEDLINE and EMBASE databases were searched using pre-defined search terms, with screening performed by two independent reviewers to identify studies reporting the use of a GPJEM. JEM creation papers were subsequently identified and reviewed for each individual GPJEM, noting its characteristics in terms of occupational classification system and exposure estimates. From 728 studies identified in initial searches, 33 GPJEMs of inhalable occupational exposures were identified. Versions of the International Standards Classification of Occupations were the most used occupational classification system. Binary, probability and intensity-based exposure estimates were most frequently reported in GPJEMs. Selection of a GPJEM to apply in epidemiological research should be based on the exposure(s) of interest, time period of occupations under review, geographical region for intended use, occupation classification system used and the exposure estimate outcome.

Combined exposure to heavy physical workload and low job control and the risk of disability pension: A cohort study of employed men and women in Sweden

ObjectiveTo investigate the separate and combined effects of overall heavy physical workload (PWL) and low decision authority on all-cause disability pension (DP) or musculoskeletal DP.MethodsThis study uses a sample of 1,804,242 Swedish workers aged 44–63 at the 2009 baseline. Job Exposure Matrices (JEMs) estimated exposure to PWL and decision authority. Mean JEM values were linked to occupational codes, then split into tertiles and combined. DP cases were taken from register data from 2010 to 2019. Cox regression models estimated sex-specific Hazard Ratios (HR) with 95% confidence intervals (95% CI). The Synergy Index (SI) estimated interaction effects.ResultsHeavy physical workload and low decision authority were associated with an increased risk of DP. Workers with combined exposure to heavy PWL and low decision authority often had greater risks of all-cause DP or musculoskeletal DP than when adding the effects of the single exposures. The results for the SI were above 1 for all-cause DP (men: SI 1.35 95%CI 1.18–1.55, women: SI 1.19 95%CI 1.05–1.35) and musculoskeletal disorder DP (men: SI 1.35 95%CI 1.08–1.69, women: 1.13 95%CI 0.85–1.49). After adjustment, the estimates for SI remained above 1 but were not statistically significant.ConclusionHeavy physical workload and low decision authority were separately associated with DP. The combination of heavy PWL and low decision authority was often associated with higher risks of DP than would be expected from adding the effects of the single exposures. Increasing decision authority among workers with heavy PWL could help reduce the risk of DP.

Occupational risks for infection with influenza A and B: a national case–control study covering 1 July 2006–31 December 2019

ObjectivesWe investigated whether crowded workplaces, sharing surfaces and exposure to infections were factors associated with a positive test for influenza virus.MethodsWe studied 11 300 cases with a positive test for...

Bladder cancer risk in relation to occupations held in a nationwide case-control study in Iran.

Globally, bladder cancer has been identified as one of the most frequent occupational cancers, but our understanding of occupational bladder cancer risk in Iran is less advanced. This study aimed to assess the risk of bladder cancer in relation to occupation in Iran. We used the IROPICAN case-control study data including 717 incident cases and 3477 controls. We assessed the risk of bladder cancer in relation to ever working in major groups of the International Standard Classification of Occupations (ISCO-68) while controlling for cigarette smoking, opium consumption. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). In men, decreased ORs for bladder cancer were observed in administrative and managerial workers (OR 0.4; CI: 0.2, 0.9), and clerks (OR 0.6; CI: 0.4, 0.9). Elevated ORs were observed in metal processors (OR 5.4; CI: 1.3, 23.4), and workers in occupations with likely exposure to aromatic amines (OR 2.2; CI: 1.2, 4.0). There was no evidence of interactions between working in aromatic amines-exposed occupations and tobacco smoking or opium use. Elevated risk of bladder cancer in men in metal processors and workers likely exposed to aromatic amines aligns with associations observed outside Iran. Other previously confirmed associations between high-risk occupations and bladder cancer were not observed, possibly due to small numbers or lack of details on exposure. Future epidemiological studies in Iran would benefit from the development of exposure assessment tools such as job exposure matrices, generally applicable for retrospective exposure assessment in epidemiological studies.

Parental occupational exposure to chemicals and risk of breast cancer in female offspring

ObjectivesParental exposure to chemicals at work has been hypothesized to be a potential predisposing factor for breast cancer in next generations. The objective of the present nationwide nested case-control study was to contribute with evidence to this area. MethodsWomen with primary breast cancer were identified using the Danish Cancer Registry and they were required to have information on either maternal or paternal employment history, which resulted in the inclusion of 5587 cases. For each case, 20 female cancer free controls were matched on year of birth using the Danish Civil Registration System. Employment history was linked to job exposure matrices to assess specific occupational chemical exposures. ResultsFor maternal exposures, we observed an association between ever exposure to diesel exhaust (OR = 1.13, 95% CI: 1.01–1.27) and exposure to bitumen fumes in the perinatal period (OR = 1.51, 95% CI: 1.00–2.26) and breast cancer in female offspring. Highest cumulative exposure to benzo(a)pyrene, diesel exhaust, gasoline and bitumen fumes was further indicated to increase the risk. Results further indicated a stronger association between diesel exhaust (OR = 1.23, 95% CI: 1.01–1.50) and benzo(a)pyrene exposure (OR = 1.23, 95% CI: 0.96–1.57) and estrogen receptor negative tumors than tumors with ER expression, while bitumen fumes seemed to elevate the risk of both hormonal subtypes. For paternal exposures, the main results did not indicate any associations with breast cancer in female offspring. ConclusionsOur study suggests an elevated breast cancer risk in daughters of women occupational exposed to some occupational pollutants, including diesel exhaust, benzo(a)pyrene and bitumen fumes. These findings need to be confirmed in future large-scale studies before any firm conclusions can be reached.

Application of a Mathematical Method to Assess Associations Between Work Exposures and Severe Back and Hand Pain Using Job Exposure Matrices in the CONSTANCES Cohort.

DELTREIL, GUILLAUME PhD*; TARDIVEL, PATRICK PhD; GRACZYK, PIOTR PhD; ESCOBAR-BACH, MIKAEL PhD; FADEL, MARC MD; DESCATHA, ALEXIS MD* Author Information

Psychosocial working conditions and sickness absence among younger employees in Denmark: a register-based cohort study using job exposure matrices.

Previous literature has established associations between psychosocial working conditions and sickness absence (SA), but only few studies have examined associations among younger employees. This study aimed to investigate associations between psychosocial working conditions and SA among employees, aged 15-30 years, who entered the labor market in Denmark between 2010 and 2018. We followed 301 185 younger employees in registers for on average 2.6 years. Using job exposure matrices, we assessed job insecurity, quantitative demands, decision authority, job strain, emotional demands, and work-related physical violence. Adjusted rate ratios of SA spells of any length were estimated for women and men separately with Poisson models. Among women, employment in occupations with high quantitative demands, low decision authority, high job strain, high emotional demands, or high work-related physical violence was associated with higher rates of SA. Being employed in occupations with high versus low emotional demands showed the strongest association with SA, with a rate ratio of 1.44 [95% confidence interval (CI) 1.41-1.47]. Among men, being employed in occupations with low decision authority showed the strongest association with SA (1.34, 95% CI 1.31-1.37), whereas occupations with high quantitative demands, high job strain, and high emotional demands were associated with lower rates of SA. We found that several psychosocial working conditions were associated with SA spells of any length. Associations with SA spells of any length resemble associations with long-term SA, suggesting that results from previous studies on long-term SA may be generalizable to all lengths of SA among younger employees.

Pleural Plaques and the Role of Exposure to Mineral Particles in the Asbestos Post-exposure Survey

Previous studies have inconsistently reported associations between refractory ceramic fibers (RCFs) or mineral wool fibers (MWFs) and the presence of pleural plaques. All these studies were based on chest radiographs, known to be associated with a poor sensitivity for the diagnosis of pleural plaques. Does the risk of pleural plaques increase with cumulative exposure to RCFs, MWFs, and silica? If the risk does increase, do these dose-response relationships depend on the co-exposure to asbestos or, conversely, are the dose-response relationships for asbestos modified by co-exposure to RCFs, MWFs, and silica? Volunteer workers were invited to participate in a CT scan screening program for asbestos-related diseases in France. Asbestos exposure was assessed by industrial hygienists, and exposure to RCFs, MWFs, and silica was determined by using job-exposure matrices. A cumulative exposure index (CEI) was then calculated for each subject and separately for each of the four mineral particle exposures. All available CT scans were submitted to randomized double reading by a panel of radiologists. In this cohort of 5,457 subjects, significant dose-response relationships were determined after adjustment for asbestos exposure between CEI to RCF or MWF and the risk of PPs (ORs of 1.29 [95%CI, 1.00-1.67] and 1.84 [95%CI, 1.49-2.27] for the highest CEI quartile, respectively). Significant interactions were found between asbestos on one hand and MWF or RCF on the other. This study suggests the existence of a significant association between exposure to RCFs and MWFs and the presence of pleural plaques in a large population previously exposed to asbestos and screened by using CT scans.

Constructing and validating an occupational job strain index based on five Norwegian nationwide surveys of living conditions on work environment

BackgroundIt has been claimed that Nordic register data are a “goldmine” for research. However, one limitation is the lack of information on working conditions. Job exposure matrices (JEMs) are one solution to this problem. Thus, the three aims of this study were (i) to investigate the reliability of an occupation-based psychosocial JEM, i.e., a Job Strain Index (job strain or JSI abbreviated), (ii) to examine the construct and criterion-related validity of this measure of job strain (iii) and assesses the concurrent and the predictive validity of an occupation-based Job Strain Index for use in analyses of Norwegian register data.MethodThe study utilized five waves of the nationwide Norway Survey of Living Conditions in the Work Environment with a total sample of 43,977 individuals and register data with a total sample of 1,589,535 individuals. Job strain was composed of items belonging to the two dimensions of Karasek’s DC model, job demands and job control (1979). The reliability of the JSI and its dimensions and components were investigated by measuring the degree of agreement (Cohen’s kappa), sensitivity, specificity, and internal consistency (Cronbach’s alpha). Construct validity was assessed by confirmatory factor analysis, and criterion-related validity was measured by concurrent validity and predictive validity. The selected concurrent criteria were self-reported survey information on long-term sick absence, anxiety, depression, and sleeping difficulty. The predictive criteria were register information on receipt of disability benefits, mortality, and long-term sick leave.ResultsAgreement between individual and occupation-based job strain and components was fair to poor. The sensitivity and specificity of occupation-based job strain and its components varied from acceptable to low. The consistency of the items comprising job demand and job control was clearly acceptable. Regarding concurrent validity, significant associations between (both individual and occupational) job strain, and long-term sick leave and sleeping difficulty were observed for both genders. Occupation-based job strain indicated an elevated risk for anxiety and depression among men, but not among women. As for predictive reliability, significant associations between occupation-based job strain and all three health outcomes were observed for both men and women.ConclusionOur occupation-based JSI serves as a reliable and valid indicator of psychosocial job exposure that can be used in analyses of Norwegian register data where individual information on such conditions is missing.

Maternal occupational exposure to organic solvents and intrauterine growth in the ELFE cohort

BackgroundIn developed countries, about 15% of women are occupationally exposed to solvents. Associations between this maternal occupational exposure and intrauterine fetal growth are inconsistent, but almost no existing study has investigated this relation by solvent family (oxygenated, petroleum, and chlorinated), although they may affect fetal growth differently. ObjectivesTo investigate the relations between maternal occupational solvent exposure, by solvent family, and the risk of neonates born small for gestational age (SGA), or with low birthweight, or with small head circumference (HC). MethodsAmong the 18,040 women enrolled in the Elfe rather than included in the Elfe birth cohort, we included 13,026 women who worked during pregnancy (72% of the cohort). Information about maternal occupations and industrial activities during pregnancy was collected by questionnaire at the maternity ward, and completed at 2-month when necessary. Using Matgéné job-exposure matrices, we assessed maternal occupational exposure to solvents. Logistic and multiple linear regressions were used to assess the association between maternal occupational solvent exposure and SGA status, birth weight, and HC. Analyses were conducted for exposure during pregnancy and also stratified by the trimester that pregnancy leave began. ResultsWe observed a higher risk of SGA newborns among mothers occupationally exposed during pregnancy to petroleum solvents (ORadjusted = 1.26; 95%CI: 1.01 to 1.57). Among women working until the third trimester of pregnancy, we observed a higher risk of SGA newborns to those occupationally exposed to oxygenated solvents (ORadjusted = 1.75; 95%CI: 1.11 to 2.75), a significantly lower birthweight for infants of mothers exposed to petroleum solvents (βadjusted = −47.37 g; −89.33 to −5.42), and a lower HC among newborns of those occupationally exposed to oxygenated solvents (βadjusted = −0.28; −0.49 to −0.07) and to chlorinated solvents (βadjusted = −0.29; −0.53 to −0.05). DiscussionOur results suggest that maternal occupational solvent exposure may influence fetal growth, especially exposure into the third trimester of pregnancy.

Night shift work and risk of aggressive prostate cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort.

Night shift work may acutely disrupt the circadian rhythm, with possible carcinogenic effects. Prostate cancer has few established risk factors though night shift work, a probable human carcinogen, may increase the risk. We aimed to study the association between night shift work and chlorinated degreasing agents (CDAs) as possible endocrine disrupters in relation to aggressive prostate cancer as verified malignancies. We conducted a case-cohort study on 299 aggressive prostate cancer cases and 2056 randomly drawn non-cases in the Norwegian Offshore Petroleum Workers cohort (1965-98) with linkage to the Cancer Registry of Norway (1953-2019). Work history was recorded as years with day, night, and rollover (rotating) shift work, and CDA exposure was assessed with expert-made job-exposure matrices. Weighted Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for aggressive prostate cancer, adjusted for education and year of first employment, stratified by 10-year birth cohorts, and with 10, 15, and 20 years of exposure lag periods. Compared with day work only, an increased hazard of aggressive prostate cancer (HR = 1.86, 95% CI 1.18-2.91; P-trend = 0.046) was found in workers exposed to ≥19.5 years of rollover shift work. This persisted with longer lag periods (HR = 1.90, 95% CI 0.92-3.95; P-trend = 0.007). The exposure-hazard curve for a non-linear model increased linearly (HRs ≥1.00) for 18-26 years of rollover shift work. No association was found with CDA exposure. Long-term exposure to rollover shift work may increase the hazard of aggressive prostate cancer in offshore petroleum workers.

Radon exposure and risk of neurodegenerative diseases among male miners in Ontario, Canada: A cohort study.

Environmental radon has been examined as a risk factor for neurodegenerative diseases in a small number of previous studies, but the findings have been inconsistent. This study aims to investigate the association between occupational radon exposure and neurodegenerative disease in a cohort of male miners with work experience in multiple ore types in Ontario, Canada. Radon exposure (1915-1988) was assessed using two job-exposure matrices (JEM) constructed from using historical records for 34,536 Ontario male miners. Neurodegenerative outcomes were ascertained between 1992 and 2018. Poisson regression models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between cumulative radon exposure in working level months (WLM) and each neurodegenerative outcome. Levels of cumulative radon exposure showed variability among cohort members with a mean of 7.5 WLM (standard deviation 24.4). Miners in uranium mines or underground jobs had higher levels and more variability in exposure than workers in non-uranium work or surface jobs. Compared to the reference group (radon < 1 WLM), increased rates of Alzheimer's (RR 1.23, 95% CI 1.05-1.45) and Parkinson's disease (RR 1.43, 95% CI 1.08-1.89) were observed among workers with >1-5 WLM and >5-10 WLM, respectively, but not among higher exposed workers (>10 WLM). This study did not observe a positive monotonic dose-response relationship between cumulative radon exposure and Alzheimer's or Parkinson's disease in Ontario mining workers. There was no association observed with motor neuron disease.

How to Use Biomechanical Job Exposure Matrices with Job History to Access Work Exposure for Musculoskeletal Disorders? Application of Mathematical Modeling in Severe Knee Pain in the Constances Cohort.

Musculoskeletal disorders related to work might be caused by the cumulative effect of occupational exposures during working life. We aimed to develop a new model which allows to compare the accuracy of duration of work and intensity/frequency associations in application to severe knee pain. From the CONSTANCES cohort, 62,620 subjects who were working at inclusion and coded were included in the study. The biomechanical job exposure matrix "JEM Constances" was used to assess the intensity/frequency of heavy lifting and kneeling/squatting at work together with work history to characterize the association between occupational exposure and severe knee pain. An innovative model G was developed and evaluated, allowing to compare the accuracy of duration of work and intensity/frequency associations. The mean age was 49 years at inception with 46 percent of women. The G model developed was slightly better than regular models. Among the men subgroup, odds ratios of the highest quartile for the duration and low intensity were not significant for both exposures, whereas intensity/duration were for every duration. Results in women were less interpretable. Though higher duration increased strength of association with severe knee pain, intensity/frequency were important predictors among men. Exposure estimation along working history should have emphasis on such parameters, though other outcomes should be studied and have a focus on women.

Transmission factors and exposure to infections at work and invasive pneumococcal disease.

Working in close contacts with coworkers or the general public may be associated with transmission of invasive pneumococcal disease (IPD). We investigated whether crowded workplaces, sharing surfaces, and exposure to infections were factors associated with IPD. We studied 3,968 cases of IPD, and selected six controls for each case from the Swedish population registry with each control being assigned the index date of their corresponding case. We linked job histories to job-exposure matrices to assess different transmission dimensions of pneumococci, as well as occupational exposure to fumes. We used adjusted conditional logistic analyses to estimate the odds ratios (ORs) for IPD with 95% confidence intervals (95% CI). ORs for IPD for the different transmission dimensions were increased moderately but were statistically significant. Compared to home-working or working alone, the highest odds was for Working mostly outside, or partly inside (OR 1.19, 95% CI 1.04-1.38). Estimates were higher in men for all dimensions, compared to women. The odds for IPD for Working mostly outside, or partly inside were 1.33 (95% CI 1.13-1.56) and 0.79 (95% CI 0.55-1.14) for men and women, respectively. Higher odds were seen for all transmission dimensions among those exposed to fumes, although CIs included unity. Contact with ill or infected patients did not increase the odds for IPD. IPD was associated with working in close contact with coworkers or the general public, and with outside work, especially for men. Contact with infected patients or persons was not associated with IPD.

Comparison of different estimators of SARS-CoV-2 pandemic activity on geographical and temporal levels.

BackgroundStudies began investigating occupational exposures as a source of contamination to SARS-CoV-2, yet few considered the variation in SARS-Cov2 pandemic activity for these exposures. Several indicators were built to assess SARS-Cov2 activity though they usually serve a specific purpose and have limitations. The aim was to compare qualitatively different estimators of the SARS-CoV-2 pandemic activity and to create an estimator of pandemic activity level based on daily hospital admissions for job-exposure matrices (JEM) usage.MethodsFrom publicly available French databases, we retrieved all data from March 19, 2020 (first day available) to March 25, 2021 (day of data collection) on four different estimators: percentage of intensive care bed occupied, reproductive number, tests' positive rate and number positive tests. An indicator based on new daily hospital admissions was created for a COVID JEM. Due to the heterogeneity of the estimators, a qualitative comparison was carried out.ResultsDuring the study period, three major outbreaks took place. Though the number of positive tests was the first indicator to worsen during the 2nd outbreak, it failed to identify variation during the outbreak. Though each indicators behaved differently during the study period, the indicator based on new daily hospital admissions and the positive rate seemed to be the closest to one another.ConclusionThis study highlights the heterogeneity of the indicators used during the first and second SARS-Cov2 outbreaks in France. An indicator based on new daily hospital admissions seems to be a good candidate for estimating SARS-CoV-2 epidemic activity for COVID JEMs and is easily available in countries where usual indicators are not commonly accessible.

Study of Parental Occupational Exposures to Solvents and Risk of Autism Spectrum Disorder in Offspring

BACKGROUND AND AIM: Solvents can accumulate in fat and later metabolize during pregnancy. Additionally, these toxicants could lead to germline mutations. We investigated associations between multiple parental occupational solvent exposures and odds of autism spectrum disorder (ASD) diagnosis in offspring. METHODS: Using population-based data from the Danish National Patient Registry, we identified a subset of ASD cases from 1982 to 2016 and 1:100 sex and birth-year matched controls obtained from the Central Population Register. We determined parental occupation history from age 16 years through 6 months post-childbirth from the Danish Pension Fund and estimated cumulative benzene, methylcyclohexane, toluene, trichloroethylene, perchloroethylene, and 1,1,1-trichloroethane exposure for mothers and fathers based on job exposure matrices (JEMs). Conditional logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for exposures one year prior to conception and during pregnancy. RESULTS: In analysis of data from 1898 people with ASD and 141,702 without ASD, there were no observed associations between maternal solvent exposures during pregnancy and risk of ASD in offspring. However, analysis for maternal benzene exposure one year prior to conception revealed higher adjusted odds for those with any exposure (aOR=1.55; 95% CI 1.02, 2.37). Additionally, although there were no significant associations between paternal solvent exposures during pregnancy and ASD risk, there were significantly increased odds of ASD in offspring whose fathers were exposed to benzene (aOR=3.07; 95% CI 1.72, 5.46) and toluene (aOR=1.66; 95% CI 1.05, 2.62) one year before conception. CONCLUSIONS: Although previous studies have suggested parental solvent exposure during pregnancy can contribute to pathogenesis of ASD, our findings suggest that risk may be increased through exposures prior to conception. However, unavoidable non-differential misclassification from the use of JEMs may have masked truly increased risk during pregnancy.