Job Exposure Matrix Research Articles

Surgery for subacromial impingement syndrome and occupational biomechanical risk factors in a 16-year prospective study among male construction workers.

The aim of this study was to assess the association between occupational biomechanical exposures and the occurrence of surgical treatment for subacromial impingement syndrome (SIS). A cohort of 220 295 male constructions workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively over a 16-year follow-up period (2001-2016) for surgically treated SIS. Worker job title, smoking status, height, weight, and age were registered on health examination. Job titles were mapped to 21 occupational groups based on tasks and training. A job exposure matrix (JEM) was developed with exposure estimates for each occupational group. Surgical cases were determined through linkage with the Swedish national in- and outpatient registers. Poisson regression was used to assess the relative risks (RR) for each biomechanical exposure. The total incidence rate of surgically treated SIS over the 16-year observation period was 201.1 cases per 100 000 person-years. Increased risk was evident for workers exposed to upper-extremity loading (push/pull/lift) (RR 1.45-2.30), high hand grip force (RR 1.47-2.23), using handheld tools (RR 1.52-2.09), frequent work with hands above shoulders (RR 1.62-2.11), static work (RR 1.77-2.26), and hand-arm vibration (RR 1.78-2.13). There was an increased risk for SIS surgery for all occupational groups (construction trades) compared with white-collar workers (RR 1.56-2.61). Occupational upper-extremity load and posture exposures were associated with increased risk for surgical treatment of SIS, which underlines the need for reducing workplace exposures and early symptom detection in highly exposed occupational groups.

Occupational inhalable agents constitute major risk factors for rheumatoid arthritis, particularly in the context of genetic predisposition and smoking

ObjectivesTo assess the effects of occupational inhalable exposures on rheumatoid arthritis (RA) development and their interactions with smoking and RA-risk genes, stratifying by presence of anticitrullinated protein antibodies (ACPA).MethodsData came...

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.

Agreement between an expert-rated mini job exposure matrix of occupational biomechanical exposures to the lower body and technical measurements or observation: a method comparison study

ObjectivesInvestigating the agreement between an expert-rated mini job exposure matrix (JEM) of lower body exposures and technical measurements of worktime spent standing/walking and observation-based estimates of time spent kneeling/squatting and...

Application of the New Asthma-Specific Job Exposure Matrix: A Study in Quebec Apprentice Cohort Exposed to Isocyanates

Background: Recently, the first asthma-specific Job Exposure Matrix (JEM) was updated to occupational asthma-specific JEM (OAsJEM). Our study aimed to evaluate the association between continued exposure to isocyanates and incident work-related chest symptoms in former car-painting apprentices and to compare the associations using the first and new OAsJEMs.Methods: We used data from an inception cohort of male car-painting apprentices. Post-apprenticeship exposure to isocyanate during follow-up was evaluated using the first asthma-specific JEM (“exposed”=1 or “not exposed”=0) and the new OAsJEM (high=2, medium=1, and none=0). Association between occupation exposure to isocyanate and incidence of work-related rhinoconjunctival and chest symptoms were evaluated through cox regression models, adjusted for age, smoking, wheezing, and non-specific bronchial hyperresponsiveness. Results: The agreement between the two JEMs (exposed vs non-exposed to isocyanate) was perfect (kappa coefficient=0.946, p<0.001). There were only five subjects who were classified as non-exposed based on the first JEM, but had a medium exposure to isocyanate based on the new OAsJEM. Exposure to isocyanate increased the risk of occupational chest symptoms in the high-exposure category (hazard ratio [HR] 2.7, 95% CI 1.1 – 6.6) and the medium category (HR 2.9, 95% CI 0.3 – 30.0) compared to the reference group based on the new OAsJEM, whereas an HR of 2.5 (95% CI 1.0-6.2) was observed from the first JEM. Both JEMs yielded an inconclusive association between exposure to isocyanates and the risk for work-related rhino-conjunctivitis. Conclusion: The asthma-specific JEM and OAsJEM consistently showed that isocyanate exposure increased the risk of incident work-related chest symptoms.

Quantitative levels of noise exposure and 20-year hearing decline: findings from a prospective cohort study (the HUNT Study)

Objective We aimed to assess the association between occupational noise exposure and long-term hearing decline. Design This prospective cohort study used linear regression to investigate the association between occupational noise exposure and 20-year hearing decline, adjusted for important confounders. Study sample The Norwegian cohort (N = 4,448) participated in two population-based health studies with pure-tone audiometry; HUNT2 1996–1998 and HUNT4 2017–2019. Exposure assessments included a quantitative job exposure matrix (JEM) and questionnaires. Results The participants (40.2% men, 20–39 years at baseline) had a mean 20-year decline (3–6 kHz) of 11.3 ± 9.8 decibels (dB). There was a positive association between 20-year logarithmic average noise level (JEM-based, LEX,20y) and 20-year hearing decline among men. Compared with no exposure ≥80 dB during follow-up, minimum 5 years of exposure ≥85 dB (JEM-based) predicted 2.6 dB (95% CI: 0.2–5.0) larger 20-year decline for workers aged 30–39 years at baseline, and −0.2 dB (95% CI: −2.2 to 1.7) for workers aged 20–29 years. Combining JEM information with self-reported noise exposure data resulted in stronger associations. Conclusion This large longitudinal study shows an association between JEM-based noise exposure level and increased 20-year hearing decline among men. Contrary to expectations, the associations were weaker among younger workers, which might reflect a latency period.

Fine particulate matter and incident coronary heart disease events up to 10 years of follow-up among Deepwater Horizon oil spill workers

BackgroundDuring the 2010 Deepwater Horizon (DWH) disaster, in-situ burning and flaring were conducted to remove oil from the water. Workers near combustion sites were potentially exposed to burning-related fine particulate matter (PM2.5). Exposure to PM2.5 has been linked to increased risk of coronary heart disease (CHD), but no study has examined the relationship among oil spill workers. ObjectivesTo investigate the association between estimated PM2.5 from burning/flaring of oil/gas and CHD risk among the DWH oil spill workers. MethodsWe included workers who participated in response and cleanup activities on the water during the DWH disaster (N = 9091). PM2.5 exposures were estimated using a job-exposure matrix that linked modelled PM2.5 concentrations to detailed DWH spill work histories provided by participants. We ascertained CHD events as the first self-reported physician-diagnosed CHD or a fatal CHD event that occurred after each worker's last day of burning exposure. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for the associations between categories of average or cumulative daily maximum PM2.5 exposure (versus a referent category of water workers not near controlled burning) and subsequent CHD. We assessed exposure-response trends by examining continuous exposure parameters in models. ResultsWe observed increased CHD hazard among workers with higher levels of average daily maximum exposure (low vs. referent: HR = 1.26, 95% CI: 0.93, 1.70; high vs. referent: HR = 2.11, 95% CI: 1.08, 4.12; per 10 μg/m3 increase: HR = 1.10, 95% CI: 1.02, 1.19). We also observed suggestively elevated HRs among workers with higher cumulative daily maximum exposure (low vs. referent: HR = 1.19, 95% CI: 0.68, 2.08; medium vs. referent: HR = 1.38, 95% CI: 0.88, 2.16; high vs. referent: HR = 1.44, 95% CI: 0.96, 2.14; per 100 μg/m3-d increase: HR = 1.03, 95% CI: 1.00, 1.05). ConclusionsAmong oil spill workers, exposure to PM2.5 from flaring/burning of oil/gas was associated with increased risk of CHD.

Comparison of agreement in asthmagen exposure assessments between rule-based automatic algorithms and a job exposure matrix in healthcare workers in Australia and Bhutan

Background:Assessment of occupational exposures is an integral component of population-based studies investigating the epidemiology of occupational diseases. However, all the available methods for exposure assessment have been developed, tested and used in high-income countries. Except for a few studies examining pesticide exposures, there is limited research on whether these methods are appropriate for assessing exposure in LMICs. The aim of this study is to compare a task-specific algorithm-based method (OccIDEAS) to a job-specific matrix method (OAsJEM) in the assessment of asthmagen exposures among healthcare workers in a high-income country and a low- and middle- income country (LMIC) to determine an appropriate assessment method for use in LMICs for future research.Methods:Data were obtained from a national cross-sectional survey of occupational asthmagens exposure in Australia and a cross-sectional survey of occupational chemical exposure among Bhutanese healthcare workers. Exposure was assessed using OccIDEAS and the OAsJEM. Prevalence of exposure to asthmagens and inter-rater agreement were calculated.Results:In Australia, the prevalence was higher for a majority of agents when assessed by OccIDEAS than by the OAsJEM (13 versus 3). OccIDEAS identified exposures to a greater number of agents (16 versus 7). The agreement as indicated by κ (Cohen’s Kappa coefficient) for six of the seven agents assessed was poor to fair (0.02 to 0.37). In Bhutan, the prevalence of exposure assessed by OccIDEAS was higher for four of the seven agents and κ was poor for all the four agents assessed (-0.06 to 0.13). The OAsJEM overestimated exposures to high-level disinfectants by assigning exposures to all participants from 10 (Bhutan) and 12 (Australia) ISCO-88 codes; whereas OccIDEAS assigned exposures to varying proportions of participants from these ISCO-codes.Conclusion:There was poor to fair agreement in the assessment of asthmagen exposure in healthcare workers between the two methods. The OAsJEM overestimated the prevalence of certain exposures. As compared to the OAsJEM, OccIDEAS appeared to be more appropriate for evaluating cross-country exposures to asthmagens in healthcare workers due to its inherent quality of assessing task-based determinants and its versatility in being adaptable for use in different countries with different exposure circumstances.

Occupation, Worker Vulnerability, and COVID-19 Vaccination Uptake: Analysis of the Virus Watch prospective cohort study

BackgroundOccupational disparities in COVID-19 vaccine uptake can impact the effectiveness of vaccination programmes and introduce particular risk for vulnerable workers and those with high workplace exposure. This study aimed to investigate COVID-19 vaccine uptake by occupation, including for vulnerable groups and by occupational exposure status. MethodsWe used data from employed or self-employed adults who provided occupational information as part of the Virus Watch prospective cohort study (n = 19,595) and linked this to study-obtained information about vulnerability-relevant characteristics (age, medical conditions, obesity status) and work-related COVID-19 exposure based on the Job Exposure Matrix. Participant vaccination status for the first, second, and third dose of any COVID-19 vaccine was obtained based on linkage to national records and study records. We calculated proportions and Sison-Glaz multinomial 95% confidence intervals for vaccine uptake by occupation overall, by vulnerability-relevant characteristics, and by job exposure. FindingsVaccination uptake across occupations ranged from 89-96% for the first dose, 87–94% for the second dose, and 75–86% for the third dose, with transport, trade, service and sales workers persistently demonstrating the lowest uptake. Vulnerable workers tended to demonstrate fewer between-occupational differences in uptake than non-vulnerable workers, although clinically vulnerable transport workers (76%-89% across doses) had lower uptake than several other occupational groups (maximum across doses 86%–96%). Workers with low SARS-CoV-2 exposure risk had higher vaccine uptake (86%-96% across doses) than those with elevated or high risk (81–94% across doses). InterpretationDifferential vaccination uptake by occupation, particularly amongst vulnerable and highly-exposed workers, is likely to worsen occupational and related socioeconomic inequalities in infection outcomes. Further investigation into occupational and non-occupational factors influencing differential uptake is required to inform relevant interventions for future COVID-19 booster rollouts and similar vaccination programmes.

Occupational heat exposure and prostate cancer risk: A pooled analysis of case-control studies

BackgroundHeat exposures occur in many occupations. Heat has been linked to key carcinogenic processes, however, evidence for associations with cancer risk is sparse. We examined potential associations between occupational heat exposure and prostate cancer risk in a multi-country study. MethodsWe analysed a large, pooled dataset of 3142 histologically confirmed prostate cancer cases and 3512 frequency-matched controls from three countries: Canada, France, and Spain. Three exposure indices: ever exposure, lifetime cumulative exposure and duration of exposure, were developed using the Finnish Job-Exposure Matrix, FINJEM, applied to the lifetime occupational history of participants. We estimated odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression models stratified by 5-year age groups and study, adjusting for potential confounders. Potential interactions with exposure to other occupational agents were also explored. ResultsOverall, we found no association for ever occupational heat exposure (OR 0.97; 95% CI 0.87, 1.09), nor in the highest categories of lifetime cumulative exposure (OR 1.04; 95% CI 0.89, 1.23) or duration (OR 1.03; 95% CI 0.88, 1.22). When using only the Spanish case-control study and a Spanish Job Exposure Matrix (JEM), some weakly elevated ORs were observed. ConclusionsFindings from this study provide no clear evidence for an association between occupational heat exposure and prostate cancer risk.

Occupational demands associated with rotator cuff disease surgery in the UK Biobank.

Physically-demanding occupations may increase rotator cuff disease (RCD) risk and need for surgery. We linked a job-exposure matrix (JEM) to the UK Biobank cohort study to measure physical occupational exposures and estimate associations with RCD surgery. Jobs and UK Standard Occupational Classification (SOC) codes were recorded during the UK Biobank verbal interview. Lifetime job histories were captured through a web-based survey. UK SOC codes were linked to a JEM based on the US O*NET database. O*NET-based scores [static strength, dynamic strength, general physical activities, handling/moving objects (range=1-7), time spent using hands, whole body vibration, and cramped/awkward positions (range=1-5)] were assigned to jobs. RCD surgeries were identified through linked national hospital inpatient records. Multivariable Cox regression was used to calculate hazard ratios (HR) as estimates of associations with RCD surgery. Among those with lifetime job histories, associations were estimated for duration of time with greatest exposure (top quartile of exposure). Of 277 808 people reporting jobs, 1997 (0.7%) had an inpatient RCD surgery. After adjusting for age, sex, race, education, area deprivation, and body mass index, all O*NET variables considered were associated with RCD surgery (HR per point increase range=1.10-1.45, all P<0.005). A total of 100 929 people reported lifetime job histories, in which greater exposures were significantly associated with RCD surgery after >10 years of work (eg, HR for 11-20 versus 0 years with static strength score ≥4 = 2.06, 95% confidence interval 1.39-3.04). Workplace physical demands are an important risk factor for RCD surgery, particularly for workers with more than a decade of exposure.

Occupational risk of COVID-19 related hospital admission in Denmark 2020-2021: a follow-up study.

Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021. The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression. During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk. Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.

Occupational characteristics associated with SARS-CoV-2 infection in the UK Biobank during August–November 2020: a cohort study

BackgroundOccupational exposures may play a key role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection risk. We used a job-exposure matrix linked to the UK Biobank to measure occupational characteristics and estimate associations with a positive SARS-CoV-2 test.MethodsPeople reporting job titles at their baseline interview in England who were < 65 years of age in 2020 were included. Healthcare workers were excluded because of differential access to testing. Jobs were linked to the US Occupational Information Network (O*NET) job exposure matrix. O*NET-based scores were examined for occupational physical proximity, exposure to diseases/infection, working outdoors exposed to weather, and working outdoors under cover (score range = 1–5). Jobs were classified as remote work using two algorithms. SARS-CoV-2 test results were evaluated between August 5th-November 10th, 2020, when the UK was released from lockdown. Cox regression was used to calculate adjusted hazard ratios (aHRs), accounting for age, sex, race, education, neighborhood deprivation, assessment center, household size, and income.ResultsWe included 115,451 people with job titles, of whom 1746 tested positive for SARS-CoV-2. A one-point increase in physical proximity score was associated with 1.14 times higher risk of SARS-CoV-2 (95%CI = 1.05–1.24). A one-point increase in the exposure to diseases/infections score was associated with 1.09 times higher risk of SARS-CoV-2 (95%CI = 1.02–1.16). People reporting jobs that could not be done remotely had higher risk of SARS-CoV-2 regardless of the classification algorithm used (aHRs = 1.17 and 1.20). Outdoors work showed an association with SARS-CoV-2 (exposed to weather aHR = 1.06, 95%CI = 1.01–1.11; under cover aHR = 1.08, 95%CI = 1.00–1.17), but these associations were not significant after accounting for whether work could be done remotely.ConclusionPeople in occupations that were not amenable to remote work, required closer physical proximity, and required more general exposure to diseases/infection had higher risk of a positive SARS-CoV-2 test. These findings provide additional evidence that coronavirus disease 2019 (COVID-19) is an occupational disease, even outside of the healthcare setting, and indicate that strategies for mitigating transmission in in-person work settings will remain important.

Paternal Occupational Exposure to Heavy Metals and Welding Fumes and Testicular Germ Cell Tumours in Sons in France.

Simple SummaryTesticular cancer is the most common cancer among men below 40 years old, and its causes remain largely unknown. Marked geographic differences in the occurrence along with the relatively young age at diagnosis suggest a possible role of environmental and occupational exposures that occur early in life, probably already during embryonic development. Using data from a French case–control study, we investigated associations between paternal occupational exposure to five heavy metals and welding fumes before and at birth and testicular cancer risk in sons. We estimated exposures from job titles and considered other potential risk factors in the statistical analyses. We found no association. Thus, further research is necessary to identify potentially modifiable risk factors.Testicular cancer is the most common cancer in young men. Its causes are largely unknown, although prenatal occupational and environmental exposures have been suggested. We investigated paternal occupational exposure to heavy metals and welding fumes and the risk of testicular germ cell tumors (TGCT) in their offspring. A total of 454 cases and 670 controls were included from a French nationwide case–control study. The INTEROCC job exposure matrix was used to assign occupational exposures (cadmium, chromium, iron, nickel, lead, and welding fumes) to the fathers’ jobs. Odds ratios (ORs) for TGCT were estimated using conditional logistic regression models for frequency-matched sets. Three complementary analytical approaches were used: (1) single-agent analysis, (2) analysis by groups, and (3) principal component analysis (PCA). The proportion of paternal exposure to different heavy metals and welding fumes ranged from 0.7% (cadmium) to 11.3% (lead). Based on PCA, three principal components explained 93.5% of the cumulative variance. No associations were found between heavy metals or welding fumes and TGCT. In this study, paternal occupational exposure to heavy metals or welding fumes was not associated with TGCT development in their sons.

Flour exposure, sensitization and respiratory health among Alberta trainee bakers.

Sensitization to allergens encountered in baking, and allergic disease including asthma and rhinitis, is recognized. Attempts to reduce this risk have been instituted in some workplaces, but awareness remains low. This study aimed to quantify the current risk among Alberta bakers. To estimate the onset of sensitization to bakery allergens and allergic disease among trainee bakers at the outset of their career. Trainees attending one of the two bakery programmes were recruited between 2015 and 2018. At entry, an interview was held and spirometry and skin prick tests were performed. Participants were contacted every 6 months by telephone or online interview for 3 years to update work and health information. An exit interview was completed between 2018 and 2019 for all who could be contacted. Exposure was estimated using collected work history and a job exposure matrix was prepared for this study. A total of 220 individuals participated in the entry interview, 204 completed one or more periodic interviews and 113 completed the exit interview. Six who completed exit testing developed new sensitization to bakery antigens, an incidence of 2.49/100 person-years. Positive skin prick tests for bakery antigens were associated with bread making. Rhinitis symptoms were associated with total flour dust and new-onset rhinitis to months in trade. New-onset asthma was related to cumulative exposure to flour improvers. Trainee bakers in Alberta remain at risk of sensitization and occupational respiratory disease.

Association between COVID-19 infection and work exposure assessed by the Mat-O-Covid job exposure matrix in the CONSTANCES cohort

ObjectivesThe COVID-19 pandemic has brought to light a new occupational health threat. We aimed to evaluate the association between COVID-19 infection and work exposure to SARS-CoV-2 assessed by a job-exposure...

Is the mental health of older adults receiving care from their children related to their children’s dual burden of caregiving and work stress? A linked lives perspective

Objectives Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents’ mental health is related to their children’s dual burden of informal caregiving and job strain. Methods Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported ‘mild’ or ‘severe’ anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child’s occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334. Results After adjusting for covariates, caregiving children’s lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children’s job demands and their older parents’ mental health (OR 1.08, p = 0.799). Conclusion In line with the linked lives perspective, results highlight that the work–life balance of informal caregiving adult children may play a role in their older parent’s mental health.

Occupational heat exposure and prostate cancer risk: a pooled analysis of case-control studies

Background and aim: Heat exposures occur frequently in many indoor and outdoor occupations. In our previous work, we observed some evidence for a positive association of occupational heat exposure and breast cancer risk. Here we seek to examine potential associations with prostate cancer risk in a large multi-country study. Methods: We performed a pooled analysis of data from 3,175 histologically confirmed prostate cancer cases and 3,529 frequency-matched controls from studies in three different countries, Spain, France, and Canada. The Finnish job exposure matrix, FINJEM, was used to apply estimates of occupational heat exposure to the lifetime occupational history of participants. Three main exposure indices were used: ever vs. never exposed, lifetime cumulative exposure (heat stress years) and duration of exposure (years) with a lag period of 5 years. We estimated odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression models stratified by 5-year age groups and study and adjusted for potential confounders. Results: A total of 32% of cases and 33% of controls were classified as being ever occupationally exposed to heat. Highest heat exposed occupations included ore and metal furnace operators, firefighters, and bakers. We found no evidence for an association of ever occupational heat exposure and prostate cancer risk (OR 0.92; 95% CI 0.83, 1.03). There were also no associations observed in the highest categories of lifetime cumulative exposure or duration, and there was no evidence for a trend. Results did not change when stratifying by Gleason scores. When analysing the Spanish case-control study separately using a Spanish job exposure matrix developed for local working conditions, some odds ratios were elevated, though results were imprecise. Conclusions: Findings from this pooled study have provided no strong evidence for an association between occupational heat exposure and prostate cancer risk. Keywords: prostate cancer, occupational exposures, heat, pooled analysis

Personal exposure to radiofrequency electromagnetic fields in various occupations in Spain

Background: A Job-Exposure Matrix (JEM) for radiofrequency electromagnetic fields (RF-EMF) was previously created based on measurements collected from the literature and individualized EMF source-based information. In the context of an international study aimed at enhancing this preliminary JEM, personal measurements of occupational exposure to RF-EMF were conducted among various occupations in Spain. Methods: Identification and prioritization of occupations to be measured were based on the levels and prevalence of exposure to RF fields in the preliminary RF-JEM and expert judgements. A screening questionnaire developed within our project was used to identify potential participants, based on job titles, tasks, and reported sources of RF exposure. Personal full-shift measurements were conducted using 10 Narda RadMan 2XT personal measurement devices. Results: Personal full-shift measurements were collected for 285 workers of various occupations in Spain. Exposures to electric (E) and magnetic (H) fields were low (99.74% of (E-fields) measurements &amp;#x3c;1% ICNIRP standards). Results exceeded the ICNIRP limits for only 3% of the workers, though these exceedances lasted a few seconds. Overall, almost 50% of workers had values above 1% of the ICNIRP standards (exposure duration between 1 second and 27.13 minutes). Electric and magnetic fields peaks exceeding 100% of the standards were observed among 8% of the physiotherapists (N=59) and 7% of the nursing auxiliaries (N=28), with exposure durations ranging from 1 to 13 seconds (E-fields) and 2 to 36 seconds (H-fields) of exposure above the limits, respectively. Conclusion: We performed the first phase of data collection of personal RF-EMF measurements among various occupations in Spain in the framework of an international study. The initial results in Spain showed low prevalence and low overall levels of exposure to RF fields, despite some short-term peaks. Additional measurements will be conducted in France and the Netherlands. Keywords: Radiofrequency electromagnetic fields, occupational exposure assessment, job-exposure-matrix

Towards the Exposome Project for Health and Occupational Research (EPHOR) Mega Cohort

BACKGROUND AND AIM: Existing cohort studies in Europe capturing occupational information enrol millions of persons. They are invaluable resources for understanding relationships between occupation and health. Within the Exposome Project for Health and Occupational Research (EPHOR) we aim to systematically construct a mega cohort combining data from multiple individual cohort studies to study the working life exposome and health. METHODS: Participating cohorts are registered in an open online inventory containing cohort meta-data. A set of harmonised variables is being prepared, including occupational as well as non-occupational factors (personal, lifestyle, sociodemographic, other), and a framework for de-centralized large-scale pooling of data for epidemiological analyses is being implemented. Lifetime occupational histories are being coded and harmonised across coding systems and will be linked with a European Job-Exposure Matrix (JEM) being developed. A range of harmonised outcome data including cancer, as well as respiratory, metabolic and cardiovascular, neurodegenerative, and musculoskeletal diseases, mental disorders, and work participation will be defined based on registry, record, or other follow-up methods. RESULTS: The EPHOR mega cohort currently includes participation of 28 cohorts from eight European countries, as well as multi-country studies, containing data on over 20 million participants. Initial cohorts were selected from the inventory with cancer diagnoses, respiratory outcomes, and/or information on working time prioritised in this first phase. Additional cohorts will be invited to participate here. The mega cohort will be used for a range of exposome analyses including 1) systematic and agnostic exploration of multiple risk factors in relation to health outcomes, 2) to identify vulnerable life stages and population subgroups, 3) to study rare exposures/outcomes. CONCLUSIONS: We expect collaboration to be useful to explore relationships between occupations, multiple work-related exposures and health. The mega cohort is intended to be a long-term resource for occupational health researchers. KEYWORDS: cohorts, data pooling, exposome, harmonisation, occupation