Occupational Circumstances Research Articles

105 Pooled analysis of two case-control studies of polycyclic aromatic hydrocarbons and risk of lung cancer

PAHs are ubiquitous compounds formed during incomplete combustion of organic material. IARC recently classified benzo (a)pyrene and several occupational circumstances involving PAH exposure as carcinogenic, though human evidence remains limited.ObjectivesTo...

A comparison of fatal occupational injury event characteristics from the Census of Fatal Occupational Injuries and the Vital Statistics Mortality System

ObjectivesThe aim of this study was to examine utility of appending International Classification of Diseases (ICD) codes from Vital Statistics Mortality (VSM) data to Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), and compare occupational event characteristics based on ICD external cause and BLS Occupational Injury and Illness Classification System (OIICS) event codes. MethodsWe linked VSM records with CFOI records for 2003 and 2004. ResultsNinety-five percent of approximately 11,000 CFOI cases were linked to VSM cases. Linked data suggest that CFOI OIICS event and VSM ICD codes identified similar leading events. However, VSM data were generally less specific. ConclusionLack of detail inherent in ICD codes and death narratives limits specificity of injury characteristics in VSM data. Appending ICD codes to CFOI appears to offer little value. Research comparing work- and non-work-related events may be better served by having a defined framework to crosswalk both coding schemes to facilitate comparisons. Impact on industryOver the last two decades, both ICD and OIICS have been used to characterize occupational injury circumstances; however, this is the first study to use linked case comparisons of the OIICS and ICD codes at a detailed level. This study confirmed that multiple source data systems provide more detail surrounding an incident than a single source data system does. Our results suggest that OIICS-coded CFOI data are a better source for occupational injury research and prevention purposes. For future comparison studies requiring ICD, it would be advantageous to have a defined framework that could easily be used to map both coding schemes (OIICS and ICD).

A Comparison of Dysphonia Severity Index in Female Teachers With and Without Voice Complaints in Elementary Schools of Tehran, Iran

Background: Teachers are the greatest group of professional voice users. Prolonged, continuous speaking in a loud voice at school may entail a bad vocal health. It seems that their occupational circumstances make them more likely to develop voice disorders in comparison with other groups. Objectives: The purposes of this study are 1) to compare teachers with and without voice complaint on the Dysphonia Severity Index and 2) to compare component measures that establish Dysphonia Severity Index. Materials and Methods: This study included 40 female teachers with voice complaint and 40 female teachers without voice complaint between the ages of 30 and 50 years who were teaching in elementary schools of Tehran city. Simple non-random sampling was done for selected teachers in two groups. The examinees were asked to produce the vowel /a/ three times for calculating any variables, then measures of maximum phonation time, jitter, highest phonational frequency, and lowest intensity were obtained for each subject with Praat and Phonetogram softwares and incorporated into multivariate Dysphonia Severity Index formula. Kolmogoro- Smirnov one sample test and independent sample T-Test was used, the significance level was set at P < 0.05. Results: Results indicate that female teachers without voice complaint have significantly higher Dysphonia Severity Index scores than female teachers with voice complaint (mean Dysphonia Severity Index: 3.58 vs. 1.05, respectively), also significant differences are observed between groups of with and without complaint for four of components of the DSI (F0 high, I low, jitter and maximum phonation time) (P value = 0.001). Conclusions: The findings of this study indicate that there is a significant difference in Vocal Quality between teachers with and without voice complaint. This finding may indicate teachers with voice complaint have worse vocal quality that means they are at risk for voice problems. This information may be very important for voice professionals and, speech and language pathology to advice teachers with voice complaint and manage to advocate good vocal health”.

526 – Prevalence of depression among health care's of intensive care units

Introduction Depression is the most prevalent psychiatric disease that affects 15% of men and 25% of women in general population. It is reported that depression has higher tolls between the staff of the Intensive Care Units (ICUs) and Operation Rooms (ORs) due to their occupational circumstances. Objectives To evaluate the status of depression among health care's of intensive care units Aims The present study examines the prevalence of depression in the staff members of ICUs and ORs in the Ilam province of Iran. Methods In this cross-sectional study, 48 random staff members from hospitals’ ICUs and ORs in Ilam province (western Iran) were evaluated. The data was collected using the standard Beck questionnaire and analyzed by SPSS software (ver. 17.0). Results The mean age of samples was 31.86 with standard deviation of 7.95. More than half (52.1%) of participant's study were male. 50% of the them were married, 10.4% smoking, and 29.2% exercising regularly. The mean Depression score in the study was 33.6 with the standard deviation of 8.0. According to beck questionnaire, 66.7% of participants show signs of major depression. Prevalence of depression was higher in women, married, smoker, and those that having sedentary lifestyle. However, this difference was not significant (P>0.05). Conclusions The prevalence of depression among participants study is significantly higher than the general population. We expect that decreasing the agreed total number of work hours, providing educational resources to improve their lifestyle, as well as holding consulting therapy groups in the hospitals are recommended.

Monocytic Crisis of Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitor

A 47-year-old man was diagnosed with Philadelphia chromosome-positive chronic myeloid leukemia (CML) in October 2005. He could not receive treatment with imatinib mesylate due to his economic circumstances. He was consequently treated with hydroxyurea with partial hematological remission until June 2008. Although imatinib mesylate was started thereafter, the adherence to this treatment was poor because of his occupational circumstances. In September 2009, imatinib mesylate was switched to nilotinib, with a subsequent phase of acceleration of the disease, presumably due to his poor adherence to the treatment. Dasatinib was started in September 2010, with transient hematological response and final blastic crisis of the disease in January 2011, regardless of improved adherence. Blast cells showed immature monocytic morphology and were positive for α-naphtylbutyrate esterase staining. They also expressed surface CD14 and CD64 antigens. A diagnosis of rare monocytic crisis of CML was made. He was treated with low-dose nilotinib following cytoreduction with MEC (mitoxantrone, etoposide, and cytarabine) chemotherapy. Severe leucopenia without circulating leukemic cells continued for about 2 months with sustained hepatosplenomegaly, and he died of pneumonia in March 2012. Necropsy showed severe bone marrow hypoplasia with focal infiltration of mature leukemic cells and similar infiltration in the liver.

Intervening to Reduce the Future Burden of Occupational Cancer in Britain: What Could Work?

In Britain, 14 carcinogenic agents and occupational circumstances currently account for 86% of estimated occupation attributable cancer. The future burden associated with these carcinogens has been forecast, using attributable fractions for forecast scenarios representing patterns of past and predicted future exposure, and exposure levels representing the introduction of new occupational exposure limits, increased levels of compliance with these limits and other reductions in worker exposure. Without intervention, occupational attributable cancers are forecast to remain at more than 10,000 by 2060. With modest intervention over 2,600, or with stricter interventions more than 8,200 cancers could be avoided by 2060 although because of long latency no impact will be seen until at least 10 years after intervention. Effective interventions assessed in this study include reducing workplace exposure limits and improving compliance with these limits. Cancers associated with asbestos, diesel engine exhaust, polycyclic aromatic hydrocarbons, work as a painter, radon, and solar radiation are forecast to continue, with construction remaining the prime industry of concern. Although exposure levels to the established carcinogens are falling, workers are remaining exposed at low levels at which there is still a cancer risk, although the aging population also contributes to rising cancer numbers, These forecasts can be used to assess the relative costs to society of different occupational carcinogenic agents, and the relative merits and savings associated with alternative intervention strategies. The methods are adaptable for different data circumstances, other types of interventions and could be extended to environmental carcinogens and other chronic diseases.

Occupational cancer in Britain

To estimate the current occupational cancer burden due to past exposures in Britain, estimates of the number of exposed workers at different levels are required, as well as risk estimates of cancer due to the exposures. This paper describes the methods and results for estimating the historical exposures. All occupational carcinogens or exposure circumstances classified by the International Agency for Research on Cancer as definite or probable human carcinogens and potentially to be found in British workplaces over the past 20–40 years were included in this study. Estimates of the number of people exposed by industrial sector were based predominantly on two sources of data, the CARcinogen EXposure (CAREX) database and the UK Labour Force Survey. Where possible, multiple and overlapping exposures were taken into account. Dose–response risk estimates were generally not available in the epidemiological literature for the cancer–exposure pairs in this study, and none of the sources available for obtaining the numbers exposed provided data by different levels of exposure. Industrial sectors were therefore assigned using expert judgement to ‘higher’- and ‘lower’-exposure groups based on the similarity of exposure to the population in the key epidemiological studies from which risk estimates had been selected. Estimates of historical exposure prevalence were obtained for 41 carcinogens or occupational circumstances. These include exposures to chemicals and metals, combustion products, other mixtures or groups of chemicals, mineral and biological dusts, physical agents and work patterns, as well as occupations and industries that have been associated with increased risk of cancer, but for which the causative agents are unknown. There were more than half a million workers exposed to each of six carcinogens (radon, solar radiation, crystalline silica, mineral oils, non-arsenical insecticides and 2,3,7,8-tetrachlorodibenzo-p-dioxin); other agents to which a large number of workers are exposed included benzene, diesel engine exhaust and environmental tobacco smoke. The study has highlighted several industrial sectors with large proportions of workers potentially exposed to multiple carcinogens. The relevant available data have been used to generate estimates of the prevalence of past exposure to occupational carcinogens to enable the occupational cancer burden in Britain to be estimated. These data are considered adequate for the present purpose, but new data on the prevalence and intensity of current occupational exposure to carcinogens should be collected to ensure that future policy decisions be based on reliable evidence.

Occupational cancer burden in Great Britain

A sound knowledge base is required to target resources to reduce workplace exposure to carcinogens. This project aimed to provide an objective estimate of the burden of cancer in Britain due to occupation. This volume presents extensive analyses for all carcinogens and occupational circumstances defined as definite or probable human occupational carcinogens by the International Agency for Research on Cancer. This article outlines the structure of the supplement – two methodological papers (statistical approach and exposure assessment), eight papers presenting the cancer-specific results grouped by broad anatomical site, a paper giving industry sector results and one discussing work-related cancer-prevention strategies. A brief summary of the methods and an overview of the updated overall results are given in this introductory paper. A general discussion of the overall strengths and limitations of the study is also presented. Overall, 8010 (5.3%) total cancer deaths in Britain and 13, 598 cancer registrations were attributable to occupation in 2005 and 2004, respectively. The importance of cancer sites such as mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma and stomach cancers are highlighted, as are carcinogens such as asbestos, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists, as well as occupational circumstances such as shift work and occupation as a painter or welder. The methods developed for this project are being adapted by other countries and extended to include social and economic impact evaluation.

Occupational cancer in Britain. Industry sector results.

A key feature of this project is the estimation of broad industry sectors for each carcinogen, occupational circumstance and cancer site. This information is critical to prioritise interventions that aim to reduce workplace-related cancer. This paper presents results for the current burden of occupational cancer by industry sector on the basis of attributable cancer registrations for 2004, for all industries for which there are at least 10 attributable registrations.

A priority list of occupational carcinogenic agents for preventative action in Australia

To develop a list of carcinogens to guide decisions on priorities for preventive action in Australian workplaces. The following criteria provided the assessment framework to establish a list of priority carcinogens: evidence of carcinogenicity using International Agency for Research on Cancer (IARC) criteria; use in occupational circumstances; and use in Australia industry. Literature from national and international agencies relating to carcinogens and industrial practice informed the assessment. The final priority list contained 38 established or probable carcinogenic agents that are present in Australian workplaces. Agents were grouped into the following categories: combustion products, inorganic dusts, organic dusts, metals, radiation, other industrial chemicals and non-chemical agents. The priorities are based primarily on the potential for occupational exposure and evidence of use in Australian industry because there is limited information on the prevalence and level of exposure to occupational carcinogens in Australia. The priority list of agents can provide direction for future disease burden studies to establish the prevalence and levels of exposure to carcinogens amongst Australian workers. From a policy viewpoint, a priority list will allow regulators to focus on activities such as setting exposure standards and restricting importation and use.

The British occupational cancer burden study

ObjectivesPrioritising control of occupationally-related cancers should be evidence based. We have estimated the current burden of cancer in Great Britain attributable to occupation for IARC group 1 and 2A carcinogens.MethodsWe...

O2-5.5 Estimation of the burden of occupational cancer in Great Britain

<h3>Introduction</h3> Prioritising control of occupationally-related cancers should be evidence based. We have estimated the current burden of cancer in Great Britain attributable to occupation for IARC group 1 and 2A carcinogens. <h3>Methods</h3> We calculated attributable fractions and numbers for mortality/incidence using risk estimates from published literature and national data sources to estimate proportions exposed. <h3>Results</h3> Cancer deaths attributable to occupation in 2005 are 5.3% (8023) (men: 8.2% (6366); women 2.3% (1657)). Attributable incidence estimates are 13694 (4.0%) cancer registrations (men: 10074 (5.7%); women 3620 (2.1%)). Occupational attributable fractions are over 2% for mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin, bladder, oesophagus, soft tissue sarcoma and stomach cancers. Asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists each contribute 100+ registrations. Industries/occupations with over 200 cancer registrations include construction, women9s shift work, metal working, personal/household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors. <h3>Conclusions</h3> This study is the first detailed cancer burden study using all IARC 1 and 2A carcinogens and quantifying the contribution of individual industry sectors. Our methodology provides a basis for adaptation for use in other countries and global occupational burden estimation and for extension to include social and economic impact evaluation. The results highlight specific carcinogenic agents and the occupational circumstances and industrial areas where exposures to these agents occurs, facilitating prioritisation of risk reduction strategies.

Gamelan Performance Outside Indonesia “Setting Sail”: Babar Layar and Notions of “Bi-musicality”

Contemporary gamelan performance outside Indonesia—and more broadly speaking, the discipline of ethnomusicology—owes a largely unacknowledged debt to a group of Dutch teenagers, who formed the first long-term European gamelan group, Babar Layar, in the prohibitive circumstances of Nazi occupation. In this essay I discuss the establishment and subsequent activities of Babar Layar, also examining the group’s historical significance, particularly the impact it had—however unintentionally—on the incorporation of performance into the discipline of ethnomusicology.

Infectious Diseases Associated with Caves

In recent times, caving has become increasingly popular, with almost 2 million people visiting national park caves each year in the United States. Although the 2 million tourist visits are extremely low risk, smaller numbers of sport cavers are at risk for some high risk conditions, and expedition cavers are at risk for some obscure infections. Infectious diseases like histoplasmosis, rabies, leptospirosis, and tick-borne relapsing fever may be transmitted by the underground fauna. To reduce the risk of illness or injury while caving, knowledge of potential risks before engaging in this activity is important. Caving preparation needs to be carefully planned and executed, including vaccinations, prophylactic medications, and advice regarding safe conduct and behaviors.

Occupational Participation of Homeless People

The purpose of the study was to investigate the occupational participation of homeless people regarding their roles, habits, and contexts. The specific aims of the study were to examine homeless people with regard to their: (a) volition; (b) recurrent patterns, that is, roles and habits, in their everyday lives; (c) capacity in occupational performance areas; and, (d) physical and social environments. The Occupational Circumstances Assessment Interview and Rating Scale Version 4.0 is a semi-structured interview that gathers information about a client concerning various aspects of their lives. The Occupational Circumstances Assessment Interview and Rating Scale Version 4.0 was administered to a convenience sample of 15 adult male participants recruited from a homeless shelter. The scoring of the Occupational Circumstances Assessment Interview and Rating Scale Version 4.0 revealed that only 13.33% of the participants indicated that they were able to facilitate participation in occupation. Fifty percent allowed participation in occupation while 28.89% inhibited participation in occupation. The remainder 7.78% restricted participation in occupation. The results of this study provide information concerning the occupational participation of homeless people. Homeless people may have difficulty facilitating participation in occupations.

“Holding on” or “coming to terms” with educational underachievement: A longitudinal study of ambition and attainment

Given mounting aspirations to graduate from college and pervasive difficulties in obtaining a four-year degree, growing numbers of young people in the United States have become "underachievers." Using data from the ongoing Youth Development Study, the authors examine the prevalence of "holding on" and "letting go" of high aspirations and the precursors of these states as youth move from high school through their mid-twenties. They find that advantage stemming from the family of origin and changing occupational circumstances engender persistence or reappraisal of earlier educational goals.

Research recommendations for selected IARC-classified agents.

ObjectivesThere are some common occupational agents and exposure circumstances for which evidence of carcinogenicity is substantial but not yet conclusive for humans. Our objectives were to identify research gaps and needs for 20 agents prioritized for review based on evidence of widespread human exposures and potential carcinogenicity in animals or humans.Data sourcesFor each chemical agent (or category of agents), a systematic review was conducted of new data published since the most recent pertinent International Agency for Research on Cancer (IARC) Monograph meeting on that agent.Data extractionReviewers were charged with identifying data gaps and general and specific approaches to address them, focusing on research that would be important in resolving classification uncertainties. An expert meeting brought reviewers together to discuss each agent and the identified data gaps and approaches.Data synthesisSeveral overarching issues were identified that pertained to multiple agents; these included the importance of recognizing that carcinogenic agents can act through multiple toxicity pathways and mechanisms, including epigenetic mechanisms, oxidative stress, and immuno- and hormonal modulation.ConclusionsStudies in occupational populations provide important opportunities to understand the mechanisms through which exogenous agents cause cancer and intervene to prevent human exposure and/or prevent or detect cancer among those already exposed. Scientific developments are likely to increase the challenges and complexities of carcinogen testing and evaluation in the future, and epidemiologic studies will be particularly critical to inform carcinogen classification and risk assessment processes.

The Relative Resilience of Property: First Possession and Order Without Law in East Timor

Much of the recent literature on customary property relations in sub-Saharan Africa has highlighted underlying characteristics of negotiability and indeterminacy. Custom is prone to reinvention as resource claimants manipulate customary references across multiple forums for property legitimation and authority. This article focuses on the resilience of customary property relations in East Timor. Based on a study of customary authority in the village of Babulo, we conclude that traditional Timorese narratives of first possession, where land authority is claimed by groups that trace descent to a mythic first settler, have acted as adaptive and resilient focal points for the reproduction of customary property relations in historical circumstances of war, colonization, and occupation. While a finding of customary resilience is not new to postcolonial contexts, the relative novelty of our study lies in its structured explanation for resilience in circumstances of war and displacement, based on the social ordering capacity of first possession principles themselves. This explanation, which derives from focal point theories for cooperative property relations, also takes into account a number of limits on the ordering capacity of first possession principles, which support a conclusion of relative or constrained resilience, particularly in terms of contested interpretations of possessory authority in contemporary East Timor.

Occupation and cancer in Britain

Background:Prioritising control measures for occupationally related cancers should be evidence based. We estimated the current burden of cancer in Britain attributable to past occupational exposures for International Agency for Research on Cancer (IARC) group 1 (established) and 2A (probable) carcinogens.Methods:We calculated attributable fractions and numbers for cancer mortality and incidence using risk estimates from the literature and national data sources to estimate proportions exposed.Results:5.3% (8019) cancer deaths were attributable to occupation in 2005 (men, 8.2% (6362); women, 2.3% (1657)). Attributable incidence estimates are 13 679 (4.0%) cancer registrations (men, 10 063 (5.7%); women, 3616 (2.2%)). Occupational attributable fractions are over 2% for mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma, larynx and stomach cancers. Asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists each contribute 100 or more registrations. Industries and occupations with high cancer registrations include construction, metal working, personal and household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors. 56% of cancer registrations in men are attributable to work in the construction industry (mainly mesotheliomas, lung, stomach, bladder and non-melanoma skin cancers) and 54% of cancer registrations in women are attributable to shift work (breast cancer).Conclusion:This project is the first to quantify in detail the burden of cancer and mortality due to occupation specifically for Britain. It highlights the impact of occupational exposures, together with the occupational circumstances and industrial areas where exposures to carcinogenic agents occurred in the past, on population cancer morbidity and mortality; this can be compared with the impact of other causes of cancer. Risk reduction strategies should focus on those workplaces where such exposures are still occurring.

Measuring elementary teacher stress and coping in the classroom: Validity evidence for the Classroom Appraisal of Resources and Demands

AbstractThe Classroom Appraisal of Resources and Demands (CARD, elementary version) was used to investigate teacher stress among a sample of elementary teachers (n = 521). The CARD measures teacher stress by examining the subjective experience of both classroom demands and resources provided by the school, and thereby attempts to capture the situationally specific nature of teacher stress. This study attempted to examine whether the CARD can provide reliable and valid information that addresses the call by experts in the field of teacher stress research for measures that consider each teacher's specific occupational circumstances. Specifically, the factor structure of the CARD was supported empirically. Further evidence was offered for the construct and concurrent validity by correlations between CARD scales scores and other measures theoretically relevant to teacher well‐being: general health, teacher efficacy, self‐critical attitudes, and burnout symptoms. © 2009 Wiley Periodicals, Inc.