Occupational Disease Surveillance Research Articles

Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada.

Previous Canadian epidemiologic studies have identified associations between occupations and prostate cancer risk, though evidence is limited. However, there are no well-established preventable risk factors for prostate cancer, which warrants the need for further investigation into occupational factors to strengthen existing evidence. This study uses occupation and prostate cancer information from a large surveillance cohort in Ontario that linked workers' compensation claim data to administrative health databases. Occupations were examined using the Occupational Disease Surveillance System (ODSS). ODSS included 1 231 177 male workers for the 1983 to 2015 period, whose records were linked to the Ontario Cancer Registry (OCR) in order to identify and follow up on prostate cancer diagnoses. Cox proportional hazard models were used to calculate age-adjusted hazard ratios and 95% CI to estimate the risk of prostate cancer by occupation group. A total of 34 997 prostate cancer cases were diagnosed among workers in ODSS. Overall, elevated prostate cancer risk was observed for men employed in management/ administration (HR 2.17, 95% CI = 1.98-2.38), teaching (HR 1.99, 95% CI = 1.79-2.21), transportation (HR 1.20, 95% CI = 1.16-1.24), construction (HR 1.09, 95% CI = 1.06-1.12), firefighting (HR 1.62, 95% CI = 1.47-1.78), and police work (HR 1.20, 95% CI = 1.10-1.32). Inconsistent findings were observed for clerical and farming occupations. Associations observed in white collar, construction, transportation, and protective services occupations were consistent with previous Canadian studies. Findings emphasize the need to assess job-specific exposures, sedentary behaviour, psychological stress, and shift work. Understanding specific occupational risk factors can lead to better understanding of prostate cancer etiology and improve prevention strategies.

Breast cancer risk by occupation and industry in women and men: Results from the Occupational Disease Surveillance System (ODSS).

The recently established Occupational Disease Surveillance System (ODSS) was used to examine breast cancer risk in women and men by occupation and industry. Ontario workers in the ODSS cohort (1983-2016) were followed up for breast cancer diagnosis through the Ontario Cancer Registry. Cox-proportional hazard models were used to calculate age-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 17 865 and 492 cases were identified in working women (W) and men (M), respectively. Elevated risks were observed in management (W: HR = 1.54, 95% CI = 1.40-1.70; M: HR = 2.79, 95% CI = 1.44-5.39), administrative/clerical (W: HR = 1.16, 95% CI = 1.11-1.21; M: HR = 1.45, 95% CI = 1.06-1.99), and teaching (W: HR = 1.54, 95% CI = 1.44-1.63; M: HR = 3.00, 95% CI = 1.49-6.03). Other elevated risks were observed in nursing/health, social sciences, and janitor/cleaning services for both genders. Common occupational associations in both genders warrant investigation into job-related risk factors, such as sedentary behavior, shift work, ionizing radiation, and chemical exposures.

Epidemiology of silicosis: reports from the SWORD scheme in the UK from 1996 to 2017

ObjectiveTo document the demographic risk factors of workers reported to have silicosis in the UK.MethodsAll cases of silicosis reported to the Surveillance of Work-related and Occupational Respiratory Disease (SWORD) scheme...

Work-related laryngeal cancer: Trends in France from 2001 to 2016

ObjectivesAs part of the 2014–2019 cancer plan and in order to improve our knowledge of work-related cancers, we analysed the work-related laryngeal cancer risk situations identified in the French national occupational disease surveillance and prevention network (rnv3p) from 2001 to 2016. Material and methodsThis study focused on cases of work-related laryngeal cancer, which the expert physician considered to be directly related to exposure (intermediate or strong causal relationship). Demographic data, occupational exposure circumstances (hazards, occupation, business sector), non-occupational risk factors and the occupational physician's opinion concerning notification as an occupational disease were analysed. ResultsTwo hundred forty-four cases of laryngeal cancer were registered between 2001 and 2016. One hundred and forty seven cases were considered to be work-related, with an intermediate or strong causal relationship in 87 cases. This exclusively male population had a median age of 59 years. Ninety-seven different forms of exposure were identified, including asbestos in 78 cases. The main business sectors concerned were specialized construction (14 cases) and metallurgy (7 cases). Occupational disease notification was recommended in 60 patients, corresponding to asbestos exposure in 80% of cases. ConclusionsAsbestos is the laryngeal cancer risk factor most commonly reported in the network from 2001 to 2016. This study confirms the role of asbestos in laryngeal carcinogenesis. Laryngeal cancer may therefore need to be compensated as an occupational disease in France, as in other European countries.

Breast Cancer Risk by Occupation in Females and Males in Ontario, Canada: Results from the Occupational Disease Surveillance System (ODSS), 1983-2016

Background: While breast cancer is one of the most commonly diagnosed cancers among women, it accounts for fewer than 1% of cancer cases in men worldwide. Few prior studies have been able to study breast cancer in working men. This study uses data from the recently established Occupational Disease Surveillance System (ODSS) to examine risk of breast cancer in both women and men across different occupation groups.Methods: The ODSS was established through the linkage of existing administrative data and contains information on 2,190,246 Ontario workers (1983-2016). Workers were followed up for breast cancer diagnosis in the Ontario Cancer Registry (OCR). Cox-proportional hazard models were used to calculate age-adjusted hazard ratios (HR) and 95% confidence intervals (CI).Results: A total of 17, 865 and 492 breast cancer cases were identified in working women and men, respectively. Across both sexes, statistically significant (p<0.05) elevated risks were observed in management (w: HR 1.57, 95% CI 1.42-1.73; m: HR 2.41, 95% CI 1.24-4.66), administrative and clerical (w: HR 1.16, 95% CI 1.11-1.21; m: HR 1.56, 95% CI 1.13-2.13), and teaching occupations (w: HR 1.49, 95% CI 1.41-1.59; m: HR 2.82, 95% CI 1.40-5.66). Other statistically significant elevated risks were observed in social sciences, nursing and other health, transport and equipment operating, and sales commodity occupations for both sexes.Conclusions: Similar findings were found in women and men that warrant further investigation into job-related factors, such as sedentary behaviour, stress, shift work, and for some occupations, radiation exposure. The findings from this study, if validated in other study samples, may help focus breast cancer prevention and education efforts for both females and males.

Establishing the Occupational Disease Surveillance System (ODSS) for Ontario: a linkage of administrative data

IntroductionWorkplace conditions and exposures are important determinants of health. However, identifying and monitoring population-level trends in work-related disease is challenged by existing data limitations. Administrative health databases capture timely and accurate information about disease diagnoses among the Ontario population, but these data do not include work history.
 Objectives and ApproachThe Occupational Disease Surveillance System (ODSS), launched in 2017, captures and reports trends in work-related disease in Ontario. A cohort of 2+ million workers was identified from compensation claims (1983-2014). Records were linked through probabilistic and deterministic methods to the Registered Persons Database (1990-2015), and administrative health databases including the Ontario Cancer Registry (1964-2016), hospitalization (2006-2016), ambulatory care (2006-2016) and provincial health insurance plan billing data (1999-2016). Preliminary applications of ODSS have examined risks of 28 cancer sites and 11 non-cancer health conditions. Risks are estimated with Cox proportional hazards models for thousands of industry and occupation groups.
 ResultsLinkage of existing administrative databases is an efficient approach for examining risk factors for work-related disease at the population level. ODSS can identify groups of workers by industry or occupation that are at increased risk of disease due to known or suspected workplace conditions and risk factors. For example, ODSS detected elevated risk of lung cancer among known at-risk workers employed in mining and quarrying (HR 1.47, 95% CI 1.33-1.61), transport equipment operating (HR 1.39, 95% CI 1.34-1.44), and construction (HR 1.09, 95% CI 1.06-1.13). Exploratory analyses can also detect previously unknown associations between work-related risk factors and disease. For example, although dermatitis and asthma are common occupational diseases, many causative exposures remain unclear. ODSS is currently being used to further explore potential risk factors.
 Conclusion/ImplicationsTimely information about work-related disease is crucial to support prevention initiatives to protect workers. This novel linkage identifies existing and emerging trends in occupational disease in Ontario. By capturing work-related risk factors, ODSS serves as a model for other provinces to overcome existing gaps in disease surveillance.

Occupational cancer surveillance in China

Abstract Occupational cancer causes a large number of deaths every year, posing a great threat to public health in China and abroad. Occupational cancer surveillance can help to dynamically monitor and predict the trend of cancer occurrence and provide basic reference for the formulation of occupational cancer prevention and treatment measures. Occupational cancer surveillance started late in China relative to developed western countries, but formed its own characteristics through years of development of legislation and institutional reform, and large-scale epidemiological investigations and laboratory research. Occupational cancer surveillance is currently a part of cancer surveillance system of the National Cancer Center, as well as an integral part of occupational disease surveillance in China. It generally includes not only cancer incidence surveillance, but also cancer-related occupational risk factor surveillance, and surveillance of effects of occupational cancer prevention, treatment, and intervention. The methods of occupational cancer surveillance in China include passive monitoring, active monitoring, and sentinel monitoring. These methods have their respective advantages and disadvantages and would be best to be combined in practice. The rapid development of economy and technology, and continuous advancement of hospital informatization, especially the establishment and application of big data on occupational cancer, may point out directions for the development of occupational cancer surveillance in the future. Occupational cancer prevention and control in China still has a long way to go and the destination is to achieve primary prevention for occupational cancer.

Results analysis of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou City

Objective: To analyze the results of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou, to provide basis for occupational health supervise. Methods: The data were derived from "occupational disease and health information surveillance system" and the summary data reported by all the occupational physical examination agencies, and analyzed by descriptive epidemiology method. Results: 77506 data from 21 agencies of 12 district were collected, and 63 suspected occupational disease were detected, which including 1 silicosis, 8 benzene poisoning, 54 noise deafness. Conclusion: Noise exposure was distributed widely, noise deafness had to be focused on, occupational chronic benzene poisoning and silicosis should be monitored continuously. Small, foreign economy and manufacturing industry should be supervised firstly.

Chest CT scan findings in World Trade Center workers

ABSTRACTWe examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6.8 years after 9/11/2001. Pleural abnormalities were the most frequent (21.1%) across all occupational groups In multivariable analyses, significant pre-WTC occupational asbestos exposure, and work as laborer/cleaner were predictive of pleural abnormalities, with prevalence being highest for the Polish subgroup (n = 237) of our population. Continued occupational lung disease surveillance is warranted in this cohort.

Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System

BackgroundThe Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative...

The spectrosome of occupational health problems.

Given the increased prevalence of cancer, respiratory diseases, and reproductive disorders, for which multifactorial origins are strongly suspected, the impact of the environment on the population represents a substantial public health challenge. Surveillance systems have become an essential public health decision-making tool. Networks have been constructed to facilitate the development of analyses of the multifactorial aspects of the relationships between occupational contexts and health. The aim of this study is to develop and present an approach for the optimal exploitation of observational databases to describe and improve the understanding of the (occupational) environment–health relationships, taking into account key multifactorial aspects. We have developed a spectral analysis (SA) approach that takes into account both the multi-exposure and dynamic natures of occupational health problems (OHPs) and related associations. The main results of this paper are to present the construction method of the “spectrum” and “spectrosome” of OHPs (range and structured list of occupational exposures) and describe the information contained therein with an illustrative example. The approach is illustrated using the case of non-Hodgkin lymphoma (NHL) from the French National Occupational Diseases Surveillance and Prevention Network database as a working example of an occupational disease. We found that the NHL spectrum includes 40 sets of occupational exposures characterized by important multi-exposures, especially solvent combinations or pesticide combinations, but also specific exposures such as polycyclic aromatic hydrocarbons, formaldehyde and ionizing radiation. These findings may be useful for surveillance and the assessment of occupational exposure related to health risks.

Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015

BackgroundPesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China.MethodsThe pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated.ResultsDuring the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%).ConclusionsThis study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

Contribution of job-exposure matrices for exposure assessment in occupational safety and health monitoring systems: application from the French national occupational disease surveillance and prevention network.

To detect new hazards ("signals"), occupational health monitoring systems mostly rest on the description of exposures in the jobs held and on reports by medical doctors; these are subject to declarative bias. Our study aims to assess whether job-exposure matrices (JEMs) could be useful tools for signal detection by improving exposure reporting. Using the French national occupational disease surveillance and prevention network (RNV3P) data from 2001 to 2011, we explored the associations between disease and exposure prevalence for 3 well-known pathology/exposure couples and for one debatable couple. We compared the associations measured when using physicians' reports or applying the JEMs, respectively, for these selected diseases and across non-selected RNV3P population or for cases with musculoskeletal disorders, used as two reference groups; the ratio of exposure prevalences according to the two sources of information were computed for each disease category. Our population contained 58,188 subjects referred with pathologies related to work. Mean age at diagnosis was 45.8 years (95% CI 45.7; 45.9), and 57.2% were men. For experts, exposure ratios increase with knowledge on exposure causality. As expected, JEMs retrieved more exposed cases than experts (exposure ratios between 12 and 194), except for the couple silica/silicosis, but not for the MSD control group (ratio between 0.2 and 0.8). JEMs enhanced the number of exposures possibly linked with some conditions, compared to experts' assessment, relative to the whole database or to a reference group; they are less likely to suffer from declarative bias than reports by occupational health professionals.

Occupational contact dermatitis from protein in sea products: who is the most affected, the fisherman or the chef?

BackgroundProtein contact dermatitis has frequently been reported in case studies (usually in cases involving contact with seafood products), but there are very few descriptive series.The objectives of this present study were firstly to determine the incidence of protein contact dermatitis among fishermen in France and compare it with data from onshore work involving seafood exposure. Second, to discover what factors could explain any differences.In order to answer these questions we analysed data from the French national occupational disease surveillance and prevention network (RNV3P) and occupational diseases declared to the French National Network for Monitoring and Prevention of Occupational Disease. This retrospective study was done for a 13 year period.Case presentationBetween 2000 and 2012, we only found eight cases of protein contact dermatitis in the French network. There were no cases of protein contact dermatitis in the seafaring population. The eight cases from the French network are essentially allergies to different fish and chefs are the professionals most affected. Atopy is present in half of these cases.In the seafaring population we found several cases of allergic delayed-time contact dermatitis due to bryozoans and to gloves but no protein contact dermatitis.ConclusionsChefs who have to cook seafood are more at risk of occupational protein contact dermatitis than fishermen. We think that skin protection (that is to say glove wearing) is better implemented in the fishing sector than in the catering profession on shore in France.

What causes occupational asthma in cleaners?

Epidemiological studies have consistently found cleaners to be at increased risk of new-onset asthma,1 ,2 the risk seems to be particularly high in domestic cleaners using spray bleaches.2 Due to...

Geographic dimensions of a health network dedicated to occupational and work related diseases.

BackgroundAlthough introduced nearly 40 years ago, Geographic Information Systems (GISs) have never been used to study Occupational Health information regarding the different types, scale or sources of data. The geographic distribution of occupational diseases and underlying work activities were always analyzed independently. Our aim was to consider the French Network of Occupational Disease (OD) clinics, namely the “French National OD Surveillance and Prevention Network” (rnv3p) as a spatial object in order to describe its catchment.MethodsWe mapped rnv3p observations at the workplace level. We initially analyzed rnv3p capture with reference to its own data, then to the underlying workforce (INSEE “Employment Areas”), and finally compared its capture of one emblematic occupational disease (mesothelioma) to an external dataset provided by a surveillance system thought to be exhaustive (PNSM).ResultsWhile the whole country is covered by the network, the density of observations decreases with increase in the distance from the 31 OD clinics (located within the main French cities). Taking into account the underlying workforce, we show that the probability to capture and investigation of OD (assessed by rates of OD per 10,000 workers) also presents large discrepancies between OD clinics. This capture rate might also show differences according to the disease, as exemplified by mesothelioma.ConclusionThe geographic approach to this network, enhanced by the possibilities provided by the GIS tool, allow a better understanding of the coverage of this network at a national level, as well as the visualization of capture rates for all OD clinics. Highlighting geographic and thematic shading zones bring new perspectives to the analysis of occupational health data, and should improve occupational health vigilance and surveillance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12942-016-0063-7) contains supplementary material, which is available to authorized users.

Specific Allergen Immunotherapy for the Treatment of Atopic Eczema: A Cochrane Systematic Review

Pierrick Cros, MD, Brice Lodde, MD, Anne-Marie RoguedasContios, MD, Jd Dewitte, MD, PhD, Laurent Misery, MD, PhD; Service de p ediatrie CHRU Morvan, Brest, France, Service de Dermatov en er eologie, CHRU Morvan, Brest, France, Service de Sant e au Travail et Maladies Li ees a l’Environnement, CHRU Morvan, Brest, France, Universit e Europ eenne de Bretagne, Universit e de Brest, EA 4686, CS 93837, Brest Cedex 3, France, Service de Dermato-v en er eologie, Brest, France, and Service de Sant e au Travail et Maladies Li ees a l’Environnement, CHRUMorvan, Brest, France, Universit e Europ eenne de Bretagne, Universit e de Brest, EA 4686, CS 93837, Brest, France. RATIONALE: Although there are a number of case reports of contact dermatitis caused by seafood products, few case series have been published. The primary objective of the present study was to determine and compare the incidences of protein contact dermatitis among professional seafaring fishermen in France and in onshore workers exposed to seafood. The secondary objective was to identify explanatory factors for any observed differences between these two populations. METHODS: We retrospectively analyzed data collected over a 12-year period by the French National Occupational Disease Surveillance and Prevention Network and the French National Network for the Monitoring and Prevention of Occupational Disease RESULTS: Between 2000 and 2012, we identified eight cases of seafoodrelated protein contact dermatitis in onshore workers (primarily fish allergies, and mainly affecting chefs). Atopy was frequent. In the seafaring population, we found several cases of eczema (due to bryozoans and gloves) but no cases of protein contact dermatitis. CONCLUSIONS: Chefs who prepare and cook seafood are at a greater risk of occupational protein contact dermatitis than fishermen. We suggest that skin protection (i.e. use of gloves, primarily) is better in the fishing sector than in the catering profession and other onshore activities. Atopy appears to be a risk factor for sensitivity to fish proteins in chefs but is rare among professional fishermen in France. Asthma may prevent atopic individuals from going to sea.

The surveillance of occupational diseases in Italy: the MALPROF system.

Occupational diseases data can guide efforts to improve worker's health and safety. To describe MALPROF, the Italian system for surveillance of work-related diseases collected by the subregional Department of Prevention. The MALPROF system started in 1999 with contributions from Lombardy and Tuscany and spread in the following years to collect contributions from 14 out of the 20 Italian regions. MALPROF data were explored to follow-up work-related diseases and to detect emerging occupational health risks by calculating proportional reporting ratio (PRR), as in pharmacosurveillance. It classified work-related diseases according to economic sector and job activity in which the exposure occurred. Occupational physicians of the Italian National Health Service evaluate the possible causal relationship with occupational exposures and store the data in a centralized database. From 1999 to 2012, the MALPROF system collected about 112000 cases of workers' diseases. In 2010, more than 13000 cases of occupational diseases were reported. The most frequently reported diseases were hearing loss (n = 4378, 32%), spine disorders (n = 2394, 17%) and carpal tunnel syndrome (n = 1560, 11%). The PRR calculated for cervical disc herniation, a disease whose occupational origin has to be studied, in 1999-2010 was 2.47 [95% confidence interval (CI) 1.76-3.47] for drivers and 36.64 (95% CI 22.03-60.93) for air transport workers. MALPROF is a sensitive system for identifying possible associations between occupational risks and diseases, it can contribute to the development of preventive measures, to evaluate the effectiveness of preventive interventions and to stimulate research on new occupational risks and diseases.

The utility of information collected by occupational disease surveillance systems.

The Health and Occupation Research (THOR) network in the UK and the Republic of Ireland (ROI) is an integrated system of surveillance schemes collecting work-related ill-health (WRIH) data since 1989. In addition to providing information about disease incidence, trends in incidence and the identification of new hazards, THOR also operates an ad hoc data enquiry service enabling interested parties to request information about cases of WRIH reported to THOR. To examine requests for information made to a network of surveillance schemes for WRIH in the UK. Analysis via SPSS of data requests received by THOR between 2002 and 2014. A total of 631 requests were received by THOR between 2002 and 2014. Requests were predominantly submitted by participating THOR physicians (34%) and the main THOR funder-the UK Health & Safety Executive (HSE) (31%). The majority (67%) of requests were for information about work-related respiratory or skin disease with relatively few requests for other diagnoses, such as musculoskeletal or mental ill-health. Requests frequently related to a specific industry and/or occupation (42%) and/or a specific causal agent (58%). Data collected by occupational disease surveillance systems such as THOR are an extremely useful source of information, the use of which extends beyond informing government on disease incidence and trends in incidence. The data collected provide a framework that can assist a wide range of enquirers with clinical diagnoses, identification of suspected causative agents/exposures and to highlight growing risks in particular industrial and occupational sectors.

A review of occupational disease surveillance systems in Modernet countries.

To improve occupational health public policies and to facilitate coordinated research within the European Union to reduce the incidence of occupational diseases (ODs), it is important to know what OD surveillance systems exist and how they compare. Monitoring trends in occupational diseases and tracing new and emerging risks in a network (Modernet) participants are well placed to provide this information as most either contribute data to and/or are involved in the management of OD systems. To identify and describe OD surveillance systems in Modernet countries with the longer-term objective of identifying a core template to be used on a large scale. A questionnaire sent to Modernet participants, seeking structured information about the OD surveillance system(s) in their country. Overall 14 countries (70%) provided information for 33 OD systems, among them 11 compensation-based (CB) systems. Six countries provided information for non-CB systems reporting for any type of OD. The other systems reported either only ODs from a prescribed list, or specific diagnoses or diagnostic groups, with reports to most schemes being physician-based. Data collected varied but all systems collected diagnosis, age, gender, date reported and occupation (and/or industry) and most collected information on exposure. This review provides information beneficial to both policy makers and researchers by identifying data sources useable to measure OD trends in European countries and opening the way to future work, both on trend comparisons within Europe and on the definition of a core template to extend OD surveillance on a larger scale.