Occupational Surveillance Research Articles

Occupational Tuberculosis Among Laboratory Workers in South Africa: Applying a Surveillance System to Strengthen Prevention and Control.

Background: Tuberculosis (TB) is recognized as an important health risk for health workers, however, the absence of occupational health surveillance has created knowledge gaps regarding occupational infection rates and contributing factors. This study aimed to determine the rates and contributing factors of active TB cases in laboratory healthcare employees at the National Health Laboratory Service (NHLS) in South Africa, as identified from an occupational surveillance system. Methods: TB cases were reported on the Occupational Health and Safety Information System (OHASIS), which recorded data on occupation type and activities and factors leading to confirmed TB. Data collected from 2012 to 2019 were used to calculate and compare TB risks within NHLS occupational groups. Results: During the study period, there were 92 cases of TB identified in the OHASIS database. General workers, rather than skilled and unskilled laboratory workers and medical staff, had the highest incidence rate (422 per 100,000 person-years). OHASIS data revealed subgroups that seemed to be well protected, while pointing to exposure situations that beckoned policy development, as well as identified subgroups of workers for whom better training is warranted. Conclusions: Functional occupational health surveillance systems can identify subgroups most at risk as well as areas of programme success and areas where increased support is needed, helping to target and monitor policy and procedure modification and training needs.

Monitoring of major occupational diseases and analysis of occupational group's health status of Jining in 2018

Objective: To analyze the major occupational disease surveillance and the occupational health examination of Jining in 2018, provide the basis for the government department formulating occupational disease prevention measures. Methods: In January 2019, collecting data of the occupational disease and Occupational Health Information Surveillance Network in Jining from January 1 to December 31, 2018, 37295 workers were collected, and 37295 workers who were exposed to key occupational disease risk factors and underwent occupational health check-up during their working period. The contact of occupational Hazard Factors and occupational health examination were analyzed. SPSS 22.0 was used to set up the database for statistical analysis. Results: Workers exposed to major occupational hazards were more exposed to noise (56.34%, 39935/70883) , coal dust (15.65%, 11095/70883) , welding fume (10.25%, 7262/70883) , silicon dust (5.61%, 3975/70883) . In 2018, 24 cases (38.71%, 2462) of coal worker's pneumoconiosis, 21 cases (33.87%, 2162) of silicosis, 8 cases (12.90%, 82) of noise deafness and 8 cases (12.90%, 862) of brucellosis were the major occupational diseases reported. The abnormal rate of lung function examination was 14.87% (461/3100) , and the abnormal rate of high frequency hearing threshold examination was 4.56% (1492/32731) in workers exposed to coal dust (coal-silica dust) , the difference was statistically significant (P<0.01) . Conclusion: Jining should strengthen the supervision of enterprises with key occupational disease hazards, formulate classified supervision and management methods, and improve the occupational health inspection rate of workers.

Results analysis of occupational physical examination for major occupational hazards exposed laborer in 2018 in Guangzhou

Objective: To analyze the results of occupational physical examination for major occupational hazard exposed laborer in 2018 in Guangzhou, to provide scientific basis for occupational health supervise. Methods: In January 2019, descriptive epidemiological methods were used as the data sources of the Occupational Disease and Occupational Health Information Surveillance System and the report data of Guangzhou Occupational Health Inspection Agency, collecting 2733 employers from 28 Occupational Health Inspection Organizations in 11 administrative regions of Guangzhou from January to December 2018, as well as the occupational health examination data of 97688 workers exposed to the occupational-disease-risk factors, to analyze the inspection of suspected occupational diseases and contraindications during the period of work of the workers who were monitored for the occupational hazard factors (silicon dust, welding fume, benzene, lead, Ethylene Dichloride, N-hexane, high temperature and hand-transmitted vibration) . Results: Total 128 cases of suspected occupational disease were detected, including 3 suspected silicosis, 8 suspected welder＇s pneumoconiosis, 17 suspected other pneumoconiosis, 10 suspected benzene poisoning, 1 suspected lead poisoning and 89 suspected noise deafness. There were 2061 cases of occupational contraindication, among which 550 cases were contraindication of high temperature, 261 cases were benzene and 1089 cases were noise. Conclusion: The Occupational Health Inspection Institution of this city should continuously monitor the occupational health status of the harmful workers during their work, do a good job of prevention, and strengthen the labor protection.

Occupational Stress and Risk Factors Among Workers from Electronic Manufacturing Service Companies in China

What is already known about this topic? Occupational stress and workplace health have become issues of significant concern for both employees and employers. The workers from electronic manufacturing services (EMS) industry in China are exposed to increasing occupational hazards and injuries. Despite the fact that it is a known health risk for psychological and medical disorders, only few studies have investigate the prevalence of occupational stress and risk factors among EMS workers. What is added by this report? Analysis of data from the EMS industry of Occupational Stress Surveillance Program with a sample of 21,362 participants from 20 EMS companies. Results show that the prevalence of high strain and effort-reward imbalance were 19.5% and 15.8%, respectively, which are significantly differed by selected socio-demographic and job characteristics. Participants who are migrant, or working in the assembly-line position or in shift are exposed to higher stress level. What are the implications for public health practice? EMS workers are liable to be at risk for occupational stress and for developing psychological disorders and diseases. The findings of this study contribute to an evidence-base which inform the development and implementation of strategies aimed at reducing occupational stress of EMS workers should be at organizational and individual level.

Analysis on monitoring results of occupational hazards in Yangzhou city from 2014 to 2018

Objective: To undersand the monitor of occupational hazards in the enterprises in the past 5 years, as well as the distribution of occupational disease hazards and their dynamic changes in their respective jurisdictions, for providing scientific basis for prevention and control of occupational diseases in relevant departments. Methods: Taking the method of cluster sampling, select the monitoring results of the occupational disease hazard factors commissioned by the Municipal Center for Disease Control and Prevention from 2014 to 2018 and the annual monitoring data of the network of the occupational hazard declaration system of the Safety Supervision Bureau, using chi-square test, trend Statistical analysis was performed by chi-square test or Fisher exact probability method. Results: There were 461 testing companies in the past 5 years, with a total of 15, 186 monitoring points and 43428 samples. The pass rate was 94.32% (14324/15186) . The pass rate was increasing year by year from 2014 to 2017 (P<0.05) ; The pass rate of various occupational disease hazards surveillance were greater than 90% except the rate of physical factors. In 2014, the qualified rate of physical factors was the lowest, which was 86.99% (1558/1791) ; the production rate of different production scale enterprises in 2018 was higher than that of 2014. From 2014 to 2018, the number of inspection enterprises and the number of inspection points of the joint-stock economy and state-owned economic enterprises are both high, 58 (10091 points) and 71 (1830 points) respectively; The qualified rate of state-owned economy and collective economy monitoring is high, 98.36% (1800/1830) and 100% (74/74) respectively. It had reached more than 95%; The enterprises tested mainly from the economic development zone and Guangling, respectively accounting for 34.27% (158/461) and 33.84% (156/461) of the total number of enterprises. Which followed by the Hanjiang, accounting for 23.21% of the total number of enterprises (107/461) ; The monitoring enterprises were mainly distributed in the manufacturing and power industries, which accounted for 85.25% (393/461) and 6.07% (28/461) of the total number of enterprises, respectively. Conclusion: The monitoring rate of enterprises had been increasing year by year from 2014 to 2018. Noise was the main disease prevention and controlling factor in the area.In addition, micro-enterprises, individual economy and foreign-invested economy were the key targets for occupational health.

Integrated Transcriptomics, Metabolomics, and Lipidomics Profiling in Rat Lung, Blood, and Serum for Assessment of Laser Printer-Emitted Nanoparticle Inhalation Exposure-Induced Disease Risks.

Laser printer-emitted nanoparticles (PEPs) generated from toners during printing represent one of the most common types of life cycle released particulate matter from nano-enabled products. Toxicological assessment of PEPs is therefore important for occupational and consumer health protection. Our group recently reported exposure to PEPs induces adverse cardiovascular responses including hypertension and arrythmia via monitoring left ventricular pressure and electrocardiogram in rats. This study employed genome-wide mRNA and miRNA profiling in rat lung and blood integrated with metabolomics and lipidomics profiling in rat serum to identify biomarkers for assessing PEPs-induced disease risks. Whole-body inhalation of PEPs perturbed transcriptional activities associated with cardiovascular dysfunction, metabolic syndrome, and neural disorders at every observed time point in both rat lung and blood during the 21 days of exposure. Furthermore, the systematic analysis revealed PEPs-induced transcriptomic changes linking to other disease risks in rats, including diabetes, congenital defects, auto-recessive disorders, physical deformation, and carcinogenesis. The results were also confirmed with global metabolomics profiling in rat serum. Among the validated metabolites and lipids, linoleic acid, arachidonic acid, docosahexanoic acid, and histidine showed significant variation in PEPs-exposed rat serum. Overall, the identified PEPs-induced dysregulated genes, molecular pathways and functions, and miRNA-mediated transcriptional activities provide important insights into the disease mechanisms. The discovered important mRNAs, miRNAs, lipids and metabolites may serve as candidate biomarkers for future occupational and medical surveillance studies. To the best of our knowledge, this is the first study systematically integrating in vivo, transcriptomics, metabolomics, and lipidomics to assess PEPs inhalation exposure-induced disease risks using a rat model.

Occupational injury surveillance pyramid description and association of medical care utilization with low income among work-related injuries.

A more comprehensive characterization of total work-related injury burden would ideally include all levels of medical care. Additionally, studies have suggested differential utilization of medical care among various socioeconomic groups, and it is unclear how this translates to work-related injuries. The 2004-2016 National Health Interview Survey data were used to estimate all levels of care utilized by the individual for each injury episode. A multivariable logistic regression model based on 2004-2014 data was developed to investigate the relationship of low income and level of medical care used by the injured worker. Around 53.1% of occupational injury were exclusively treated outside of a hospital setting and never captured by hospital/emergency department data systems, which comprises 40% (3.0 million) of total missed days of work and 44% ($452 million) of total cost of lost productivity among full-time workers. Patients with work-related injuries are less likely to stay overnight in hospital compared with those with nonwork-related injuries (adjusted odds ration [aOR]: 0.6, 95% confidence interval [CI]: 0.5-0.7), however among work-related injuries, low-income patients are more likely to use medical care in a hospital setting compared with patients with income higher than poverty threshold (hospitalization: aOR: 1.9, 95% CI: 1.1-3.3; emergency room: aOR: 1.5, 95% CI: 1.1-2.0). These "minor work-related injuries" exclusively treated outside hospital tend to be ignored when defining national injury prevention priorities, but this analysis indicates that such an approach fails to capture a large portion of injuries significant enough to result in missed days of work and cost of lost productivity.

Dermatitis among workers in Ontario: results from the Occupational Disease Surveillance System

ObjectivesDermatitis is the most common occupational skin disease, and further evidence is needed regarding preventable risk factors. The Occupational Disease Surveillance System (ODSS) derived from administrative data was used to...

Hepatitis B vaccination coverage among medical residents from Catania University Hospital, Italy.

Medical residents (MRs) are healthcare workers (HCWs) who are likely to be exposed to blood-borne pathogens such as hepatitis B virus (HBV). A total of 220 (100%) MRs from Catania University Hospital (Italy) were enrolled for a seroprevalence study in the framework of occupational surveillance in order to evaluate HBV vaccination coverage. For each MR,Hepatitis B surface antigen (HbsAg), Hepatitis B surface antibody (HBsAb), Hepatitis B core antiboy (HbcAb), Hepatitis C antibody (HCV-Ab) and HIV antibody (HIV-Ab) were assessed. No one was found to be positive for: HbsAg, HbcAb, HCV-Ab or HIV-Ab. HBV vaccination coverage was found in 80% of those tested. A total of 45MRs showed a nonprotective antibody titer; in eight, complete vaccination had never been carried out; in 37, the vaccination had been carried out, but the antibody titer was not protective. This research showed high adherence to HBV vaccination; however, the vaccine coverage of HCWs is still suboptimal. Vaccinations for HCWs should be made mandatory.

Multi-Walled Carbon Nanotube-Induced Gene Expression Biomarkers for Medical and Occupational Surveillance.

As the demand for multi-walled carbon nanotube (MWCNT) incorporation into industrial and biomedical applications increases, so does the potential for unintentional pulmonary MWCNT exposure, particularly among workers during manufacturing. Pulmonary exposure to MWCNTs raises the potential for development of lung inflammation, fibrosis, and cancer among those exposed; however, there are currently no effective biomarkers for detecting lung fibrosis or predicting the risk of lung cancer resulting from MWCNT exposure. To uncover potential mRNAs and miRNAs that could be used as markers of exposure, this study compared in vivo mRNA and miRNA expression in lung tissue and blood of mice exposed to MWCNTs with in vitro mRNA and miRNA expression from a co-culture model of human lung epithelial and microvascular cells, a system previously shown to have a higher overall genome-scale correlation with mRNA expression in mouse lungs than either cell type grown separately. Concordant mRNAs and miRNAs identified by this study could be used to drive future studies confirming human biomarkers of MWCNT exposure. These potential biomarkers could be used to assess overall worker health and predict the occurrence of MWCNT-induced diseases.

High HOMA-IR Index in Healthcare Shift Workers.

Background and objectives: Evidence shows that shift work may be correlated with insulin resistance (IR). Therefore its estimation in clinical and prevention practice is of great significance. A cross-sectional study was performed to examine the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) Index among healthcare shift workers (HCSW). Materials and Methods: A total of 272 healthcare workers (HCWs) were invited to participate in the study within an occupational surveillance framework, 137 were HCSW while 135 were healthcare non-shift workers (HCNSW). Fasting glucose, insulin, and HOMA-IR Index were evaluated in each participant and correlated with shift workers. Results: Indicators of glucose metabolism were significantly higher in HCSW p < 0.001, and logistic regression analysis confirmed a significant positive association between increased values of HOMA-IR Index and shift workers (p < 0.05). Conclusions: Shift work could be a risk factor in developing insulin resistance and metabolic syndrome.

Occupational risks surveillance in informal vendors from Maputo: Experience of the use of direct observation for its monitoring

Over 90% of employment in Mozambique is informal. Given scarce resources and difficulties with monitoring informal employment, little is known about exposure to occupational hazards among informal workers in this country. Direct observation is a simple, easy, economical and rapid method for monitoring and obtaining data. We describe our experience with the use of direct observation of occupational hazards among informal street vendors in Maputo. Results reveal a high percentage of vendors are exposed to occupational hazards without any form of protection. Direct observation is a good method for monitoring occupational risks in exploratory phases of research or as a complementary method to quantitative data collection.

National occupational research agenda for hearing loss prevention

The National Institute for Occupational Safety and Health (NIOSH) has a mandate to conduct research on occupational safety and health. The research portfolio is organized by industrial sectors and cross-sectors for illnesses and injuries that are found in all sectors. The Hearing Loss Prevention research cross-sector council comprises representatives from government, labor organizations, academia, and industry representatives. The HLP council held several meetings throughout 2018 to determine research needs for occupational hearing loss prevention in the United States. Five topic areas were determined. (1) Provide input for policies and guidelines that will inform best practices for hearing loss-prevention efforts. (2) Develop effective, evidence-based education designed to improve hearing conservation program outcomes for exposed workers and management. (3) Develop, commercialize, and widely implement noise control solutions on jobsites in key industries. (4) Develop audiological tests for hearing loss prevention. (5) Improve occupational hearing loss surveillance. These topic areas will be discussed in detail to help motivate other researchers to join further our knowledge to prevent occupational hearing loss.

Occupational coccidioidomycosis surveillance and recent outbreaks in California.

Workers in Coccidioides-endemic areas performing soil-disturbing work or exposed to windy and dusty conditions are at increased risk for coccidioidomycosis. Four occupational coccidioidomycosis outbreaks from 2007 to 2014 in California are described, involving construction workers in a number of excavation projects and an outdoor filming event involving cast and crew. These outbreaks highlight the importance of identifying industries and occupations at high risk for coccidioidomycosis, conducting targeted occupational health surveillance to assess the burden of illness, developing and implementing prevention strategies, and setting research priorities.

Calls made to the Poisons Information Centre reveal need for improved risk management of cleaning agents in the workplace

Purpose. This study aimed to investigate chemical injuries caused by cleaning agents and disinfectants by reviewing poison control data. Methods. We performed a 5-year retrospective analysis of calls to the Swedish Poisons Information Centre (PIC) concerning occupational use of cleaning agents and disinfectants. In addition, callers for 17 new cases were interviewed. Results. Out of 8240 occupationally related cases handled by the PIC during 2010–2014, 24% concerned cleaning agents and disinfectants (N = 1983). Of these, one-third were classified as major risk cases, generally due to potential for corrosive eye and skin injuries. The most frequent type of workplace was restaurants and caterers. However, information about occupation was only identifiable for 30% of the cases. Follow-up interviews exemplify how limited awareness of safety data sheets and disregard of protective equipment may contribute to health-related outcomes such as absence at work. Conclusions. Management and prevention strategies for cleaning agents should be improved. PIC records hold relevant information both for designing interventions and for future research on occupational health and safety management. We suggest that systematic collection by the PIC of information on occupation and age would further improve the usefulness for occupational injury surveillance purposes.

Establishment and operation of a cooperative program to identify work-related acute myeloid leukemia in a general hospital.

BackgroundThe purpose of this report is to introduce the occupational cancer surveillance system, implemented in June 2018, and to share the results of our cooperative program.MethodsThe cooperative program begins when the patient is diagnosed with acute myeloid leukemia (AML). Newly diagnosed AML patients are admitted to the internal medicine hematology department, then attending hematology physician requests a consultation from the occupational and environmental medicine (OEM) department. The OEM doctor next visits the hospitalized patient and interviews them to take their occupational history, and preliminarily evaluates the likelihood that the condition is associated with occupation. If the patient wants to apply for compensation through the Korea Workers' Compensation & Welfare Service, the patient was informed to visits the outpatient clinic of the OEM department and requests a ‘work-relatedness evaluation report’ for use in applying for compensation.ResultsAmong the 103 patients, who received an OEM departmental work history evaluation, 18 patients were considered to have a work-related incidence and 12 patients were registered in the Industrial Accident Compensation Insurance system.ConclusionsThe present report provides data on a sustainable model for identifying occupational disease in a general hospital setting, while also informing patients about their occupational rights.

Silicosis: A former occupational disease with new occupational exposure scenarios

BackgroundRecent studies have shown an increase in the prevalence of silicosis due to the use of artificial quartz aggregates (AQA). The aim of this study was to assess the cases of silicosis in our area reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia to detect new agents of exposure to silica and working conditions that promote its onset. Material and methodA descriptive study was conducted of cases of silicosis reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia from January 2009 to September 2016. The data sources include epidemiological-occupational surveys and medical reports. ResultsNineteen cases of silicosis were reported, 74% of which were diagnosed using high-resolution computed tomography. Some 68.4% of the cases were related to the handling of AQA, as assemblers/cutters/sanders of countertops. The subgroup's mean age was 46.62±13.33 years, and the mean exposure was 11.00±3.58 years. The rest of the patients worked in companies with no AQA exposure, with a mean age of 62.33±16.22 years and a mean exposure of 27.16±8.44 years (p<0.05). Four cases presented complicated forms (3 exposed to AQA). ConclusionsThe work of assembling/cutting/sanding AQA countertops presents a high risk of developing the disease. The mean age at onset and the exposure time for this group is lower, and the percentage of complicated clinical forms is higher. Improvements need to be made in preventive planning for companies with exposure to these new agents.

PREVALENCE OF HBV AND HCV; AND THEIR ASSOCIATED RISK FACTORS AMONG PUBLIC HEALTH CENTER CLEANERS AT SELECTED PUBLIC HEALTH CENTERS IN SANA'A CITY-YEMEN

Occupational exposure of public health center cleaners (PHCCs) to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. In the industrialized world, occupational surveillance is performed to assess and monitor health hazards related to blood borne pathogens. In contrast, in developing countries as Yemen, exposure and health impacts are rarely monitored and much remains to be done to protect PHCCs. The objective of this study was to determine the prevalence of HBV and HCV and their potential risk factors among PHCCs. A cross sectional prospective study was conducted among 388 PHCCs. Data was collected using pre-tested and structured questions. Venous blood was collected and the sera were tested for HBV surface antigen and anti-hepatitis C antibodies using enzyme-linked immune sorbent assay technique. The data were analysis by EPI-Info. Chi square and Odds ratio tests were used to assess the association of risk factors with HBV and HCV positivity. Results revealed that among the total 388 PHCCs examined, HBV and HCV were detected in 32 (8.2%), and 4 (1.03%) of them respectively. There was significant risk factors of hepatitis viruses with age group 20-24 years (OR=2.8), exposure to patients blood (OR=3), accidental stick of used needles (OR=2.3), sharp injury (OR=5.6), history of blood transfusion (OR=2.5), and hospital admission (OR=2.7). Also significant protected roles for HBV vaccine was found with infection. In conclusion high prevalence rates of HBV and HCV occurred in PHCCs. Unfortunately; all workers did not take training on medical waste and few workers use protective measures consistently as vaccination. There is needed to make vaccination of health care workers against HBV infection a firm policy and ensure complete and consistent adherence to work standard safety measures.

Silicosis: una antigua enfermedad profesional con nuevos escenarios de exposición laboral

BackgroundRecent studies have shown an increase in the prevalence of silicosis due to the use of artificial quartz aggregates (AQA). The aim of this study was to assess the cases of silicosis in our area reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia to detect new agents of exposure to silica and working conditions that promote its onset. Material and methodA descriptive study was conducted of cases of silicosis reported to the Healthcare Information System for Occupational Epidemiological Surveillance of the Autonomous Community of Valencia from January 2009 to September 2016. The data sources include epidemiological-occupational surveys and medical reports. ResultsNineteen cases of silicosis were reported, 74% of which were diagnosed using high-resolution computed tomography. Some 68.4% of the cases were related to the handling of AQA, as assemblers/cutters/sanders of countertops. The subgroup's mean age was 46.62±13.33 years, and the mean exposure was 11.00±3.58 years. The rest of the patients worked in companies with no AQA exposure, with a mean age of 62.33±16.22 years and a mean exposure of 27.16±8.44 years (P<.05). Four cases presented complicated forms (3 exposed to AQA). ConclusionsThe work of assembling/cutting/sanding AQA countertops presents a high risk of developing the disease. The mean age at onset and the exposure time for this group is lower, and the percentage of complicated clinical forms is higher. Improvements need to be made in preventive planning for companies with exposure to these new agents.

Human nasal mucosal C-reactive protein responses after inhalation of ultrafine welding fume particles: positive correlation to systemic C-reactive protein responses

Exposures to occupationally relevant ultrafine, zinc- and copper-containing welding fumes cause inflammatory responses involving systemic IL-6, C-reactive protein (CRP) and serum amyloid A (SAA), all associated with elevated risk of cardiovascular events. We investigated whether the systemic response is preceded by nasal inflammatory reactions. Fifteen nonsmoking male subjects were exposed for 6 h under controlled conditions to zinc-/copper-containing welding fumes (at 2.5 mg/m3) or ambient air control in a randomized order. Nasal secretions were collected before and at 1, 3, 6, 10, and 29 h after exposure. Nasal levels of selected biomarkers were determined by electrochemiluminescent assays and related to their systemic levels. Nasal interferon-γ (IFN-γ) peaked significantly 1 h after start of exposure compared to baseline. Nasal CRP as well as SAA increased significantly at 10 and 29 h compared to baseline. Receiver operating characteristic (ROC) curve analysis for differentiating welding fume from control exposure was performed: The highest area under ROC curve (AUC) values were found for the CRP increases (10, 29 h versus 0 h): AUC = 0.83, and for IFN-γ increases (1 h versus 0 h): AUC = 0.92. Nasal and systemic changes of CRP at 29 h revealed a strong correlation (Spearman rank test: increases compared to baseline: r = 0.815, p = 0.0022; absolute levels: r = 0.9, p = 0.0002). In conclusion, short-term exposure to a zinc- and copper-containing welding fume causes significant increases of inflammatory mediators in nasal mucosal lining fluid. Therefore, measurement of nasal inflammatory mediators may provide a useful means for occupational surveillance of workers exposed to ultrafine metal fume particles.