Self-reported Occupational Exposure Research Articles

Occupational exposure and new-onset asthma in the population-based Telemark study: a 5-year follow-up

ObjectivesThis study aimed to estimate the incidence of asthma and assess the association between job exposure matrix (N-JEM) assigned occupational exposure, self-reported occupational exposure to vapour, gas, dust and fumes...

Magnitude and associated factors of occupational hazard exposures among sanitary workers: Propose RASM model for risk mitigation for the public hospitals, eastern Ethiopia

BackgroundHospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations.MethodsHospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported.ResultOut of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60–0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%.ConclusionsThe concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study’s findings predicted that dissatisfied with their environment, working more than 8 hr per a day, a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy.

Association of lifestyle and occupational exposure factors with human semen quality: a cross-sectional study of 1060 participants

The incidence of male infertility (MI) is rising annually. However, the lifestyle and occupational exposure factors contributing to MI remain incompletely understood. This study explored the effects of self-reported lifestyle and occupational exposure factors on semen quality. Among 1060 subjects invited to participate, 826 were eligible. The participants’ general characteristics, lifestyle, and occupational exposure factors were collected immediately before or after semen evaluation through an online questionnaire. Initially, univariate analysis was used to investigate the relationship between the abovementioned factors and semen quality. The results indicated significant associations between low semen quality and various factors, including age, BMI, infertility type and duration, abstinence time, semen and sperm parameters, smoking, alcohol consumption, irregular sleep habits, and frequent exposure to high temperatures and chemicals at work (p < 0.05). Then, multivariate analysis was conducted to identify factors independently associated with low semen quality. Adjustment for relevant confounders was achieved by including factors with a p-value < 0.25 from univariate analyses as covariates in the binomial and ordered logistic regression models. The results suggested that alcohol consumption was a positive factor for sperm concentration (odds ratio [OR] = 0.60; 95% confidence interval [CI] = 0.36–0.99; p = 0.045). The groups with a BMI ≥ 24 and <28 kg/m2 showed a significant decrease in sperm progressive motility when compared to the reference group (BMI < 24 kg/m2) (OR = 0.63; 95% CI = 0.46–0.87, p = 0.005). In addition, the groups that drank green tea <1 time/week (OR = 1.52, 95% CI = 1.05–2.2) and 1–4 times/week (OR = 1.61, 95% CI = 1.02–2.54) exhibited significantly increased sperm DFI values compared with the group that drank green tea 5–7 times/week. In conclusion, these findings underscore the importance of maintaining a normal weight and regularly consuming green tea for men.

Physical working conditions over time: a repeated cross-sectional study in German employees

BackgroundThis study aimed to examine time trends in physical working conditions across and within occupational groups in Germany between 2006 and 2018.MethodsLogistic regression analyses were conducted using data from the BIBB/BAuA Employment Surveys in 2006, 2012, and 2018, with a total sample size of 59,006 participants. The study investigated changes in various self-reported occupational exposure measures over time, along with demographic shifts in the workforce.ResultsThe results showed overall improvements in most occupational exposure measures during the study period, alongside an aging and upskilling workforce. However, exposure to awkward postures, microorganisms, and, to a lesser extent, noise increased. Substantial variation was observed between occupational groups, with more favourable trends among white-collar high-skilled and blue-collar low-skilled workers, and less favourable trends among white-collar low-skilled and blue-collar high-skilled workers.ConclusionsWhile trends in physical working conditions in Germany are partly promising, some exposures are worsening, and substantial inequalities between occupations persist. As occupational exposures remain common, there is still a need for targeted interventions to improve working conditions, particularly in higher-risk occupations.

Exposure to Endocrine-Disrupting Chemicals and Congenital Heart Diseases: The Pooled Results Based on the Current Evidence.

The relationships between maternal exposure to endocrine-disrupting chemicals (EDCs) and congenital heart diseases (CHD) are not elucidated yet. The exposure levels of EDCs are generally estimated based on self-reported questionnaires or occupational exposure evaluations in the literature. Therefore, a study based on epidemiological data from human biospecimens is required to provide stronger evidence between maternal exposure to EDC and CHD. Embase, Pubmed, Scopus, and the Cochrane Library databases were searched for related research which provided risk estimates regarding the relationships between maternal EDC exposure and CHD in human offspring. Baseline characteristics and outcomes of CHD were extracted from each included study. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to calculate the overall estimates of CHD. Subgroup and meta-regression analyses were performed to identify the sources of heterogeneity. Bootstrapping techniques were used in analyses where several studies originated from a similar population. A total of seventeen studies were involved in the meta-analyses. Maternal EDC exposure was significantly related to CHD in offspring (OR 2.15; 95%CI 1.64 to 2.83). EDC exposure was significantly associated with septal defects (OR 2.34; 95%CI 1.77 to 3.10), conotruncal defects (OR 2.54; 95%CI 1.89 to 3.43), right ventricular outflow tract obstruction (OR 2.65; 95%CI 1.73 to 4.07), left ventricular outflow tract obstruction (OR 3.58; 95%CI 2.67 to 4.79), anomalous pulmonary venous return (OR 2.31; 95%CI 1.34 to 4.00), and other heart defects (OR 2.49; 95%CI 1.75 to 3.54). In addition, maternal exposure to heavy metals, which included lead (OR 2.19; 95%CI 1.29 to 3.71), cadmium (OR 1.81; 95%CI 1.28 to 2.56), mercury (OR 2.23; 95%CI 1.13 to 4.44), and manganese (OR 2.65; 95%CI 1.48 to 4.74), increased risks for CHD significantly. In conclusion, based on the latest evidence, maternal EDC exposure may increase CHD risks in human offspring, especially in heavy metal exposure conditions.

Exploring occupational toxicant exposures in patients with metabolic dysfunction-associated steatotic liver disease: A prospective pilot study

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) has been traditionally associated with insulin resistance and obesity. Recently, pollutants have been shown to contribute to the development of MASLD. Given the global burden of MASLD, understanding whether pollutants are merely associated with steatosis or contribute to its progression to advanced chronic liver disease (ACLD) and hepatocellular carcinoma (HCC) is critical. Workers exposed to occupational toxicants represent an ideal population for assessing the potentially hazardous consequences of professional exposure. Confirming a link between occupational exposure and ACLD/HCC may not only provide further elements in understanding MASLD, but also contribute to preventive strategies for exposed workers. ObjectiveThis study aimed to assess the prevalence of self-reported occupational exposure to toxicants in patients with MASLD. MethodsThis hospital-based prospective pilot study included 201 patients with MASLD. Data on workplace toxicant exposure were collected systematically using a structured questionnaire. Subsequently, patients with ACLD and/or HCC (n = 55) were compared to controls (n = 146). Logistic regression analysis and propensity score models were used to investigate the associations between self-reported occupational exposure and ACLD and/or HCC. ResultsPatients with ACLD/HCC reported exposure to metals, halogenated refrigerants, pain/resins, and fuel emissions more often than the controls. After controlling for confounders, durations of 21–30 years and >30 years of occupational exposure to toxicants showed odds ratios (ORs) of 2.31 (95 % confidence interval [CI]: 1.09–4.88, p = 0.029) and 4.47 (95 % CI: 2.57–7.78, p<0.001), respectively. ConclusionsIn this pilot study, patients with MASLD complications were more likely to report workplace toxicant exposure. Our results warrant future multicentre confirmatory studies, as implementing prevention policies may reduce the risk of life-threatening diseases among exposed populations.

The intensity and duration of occupational noise exposure and cardiovascular disease in the United States: a nationally representative study, 2015 to 2020.

Occupational noise exposure may be associated with an increased risk of cardiovascular disease (CVD). Yet the findings are inconclusive. This study aimed to examine the association between self-reported occupational noise exposure and CVD (using a broad composite case definition and by each condition) and identify how these associations vary with the intensity and duration of noise exposure, and combinations thereof. This cross-sectional study included a nationally representative sample (n = 6,266) from the National Health and Nutrition Examination Survey (2015 to 2020), aged 20 and greater, in the United States. Survey-weighted logistic regression models were constructed from multiple imputed datasets. Relative to the unexposed, the adjusted odds ratio (95% confidence interval) of composite CVD was 1.33 (1.05 to 1.67) among the noise-exposed population, and ranged from 1.23 to 1.56 when examining CVD conditions separately. The odds ratios of composite CVD were 1.43 (1.06 to 1.93), 1.43 (1.04 to 1.95), and 1.51 (1.03 to 2.21) among those who had noise exposure with very loud intensity of any duration, with duration ≥10 years at any intensity, and with a combination of very loud noise ≥10 years, respectively, compared to those unexposed. Increased risk of CVD is associated with occupational noise exposure, particularly at higher intensities and longer durations. Policies and interventions for noise mitigation at workplaces are warranted, targeting individuals with chronic exposure to high-level noise.

Self-reported occupational exposure and its association with sperm DNA fragmentation in infertile men

Background/Aim: Sperm quality has experienced a decline in recent years, with this issue being particularly pronounced in industrialized nations, suggesting a potential link to occupational exposures. Evaluating sperm DNA fragmentation can yield valuable insights into male fertility, although its association with occupational exposures remains less well-established. Our study aimed to investigate the relationship between self-reported occupational exposures and sperm DNA fragmentation in infertile men. Methods: This retrospective cohort study involved 391 infertile men who sought fertility treatment at a university clinic between 2017 and 2020. A brief questionnaire was administered to collect data on patients’ demographic characteristics, medical history, occupation, and exposure types. In this comparative study, patients were categorized into two groups based on their occupational exposures (the unexposed and exposed groups). The exposed group was further sub-grouped according to their specific exposure types, which included cement, solvents, metals, pesticides, mechanical vibration, and heat. The primary outcome in this study was assessed using the terminal deoxynucleotidyl transferase-mediated nick end-labeling test (TUNEL), with results expressed as the sperm DNA fragmentation index (DFI). Results: Patients in the exposed group exhibited a significantly higher sperm DFI compared to those in the unexposed group (14 [17] vs. 8 [9], P&lt;0.001). After accounting for potential confounding factors, our results demonstrated that several occupational exposure factors significantly increased the risk of elevated sperm DFI (&gt;15%) levels, including solvents (odds ratio (OR)=8.2, 95% confidence interval (CI)=3.6–18.5, P&lt;0.001), metals (OR=2.2, 95% CI=1.0–4.7, P=0.048), pesticides (OR=14.6, 95% CI=1.6–130.7, P=0.016), mechanical vibration (OR=2.6, 95% CI=1.5–4.6, P&lt;0.001), and heat (OR=6.4, 95% CI=1.7–23.5, P=0.005). Conclusion: The findings of our study corroborate earlier research suggesting that occupational exposures may have adverse effects on sperm DNA fragmentation in men. The identification and management of such exposures as part of routine clinical practice could offer a complementary approach to enhancing infertility treatment outcomes.

Association between self-reported menstrual disorders and occupational exposures in female healthcare workers: a university hospital experience from Turkey

Objectives: This study aims to demonstrate the relationship between menstrual disorders and occupational exposures in female healthcare workers, and to contribute to the regulation and improvement of working conditions of female healthcare workers. Methods: A cross-sectional study among 503 female healthcare workers at university hospital in Turkey was conducted during December 2020-April 2021. The questionnaire prepared using the Google Forms program was sent electronically. Results: Prevalence of dysmenorrhea was 59%, abnormal amount of menstrual bleeding 48.7%, abnormal menstrual duration 32%, and abnormal menstrual cycle length 154 30.6% in 503 participants. Dysmenorrhea risk was 0.79-fold (95% CI = 0.64-0.83) lower in those with advanced age and 1.56-fold (95% CI = 1.02-2.37) higher in smokers; risk of abnormal amount of menstrual bleeding was 3.91-fold (95% CI = 1.24-12.30) higher in those with total employment time of ≥ 20 years and 1.56-fold (95% CI = 1.07-2.26) higher in those who worked with display screens for &amp;gt; 20 hours a week; risk of abnormal menstrual cycle length was 3.46-fold (95% CI = 1.41-8.43) higher in technicians, 2.86-fold (95% CI = 1.24-6.61) higher in nurses, 2.63-fold (95% CI = 1.19-5.79) higher in other healthcare workers, and 2.14-fold (95% CI = 1.42-3.21) higher in those who were unsatisfied with their job. Conclusions: It was found that occupational exposures may increase the risk of menstrual disorders. A plan of action is needed to reduce the frequency of menstrual disorders by preventing occupational exposures experienced by healthcare workers.

Occupational noise exposure and tinnitus: the HUNT Study

Objective We aimed to assess the association between occupational noise exposure and tinnitus. Further, to assess whether the association depends on hearing status. Design In this cross-sectional study, tinnitus (>1 h daily) was regressed on job exposure matrix (JEM)-based or self-reported occupational noise exposure, adjusted for confounders. Study sample The 14,945 participants (42% men, 20–59 years) attended a population-based study in Norway (HUNT4, 2017-2019). Results JEM-based noise exposure, assessed as equivalent continuous sound level normalised to 8-h working days (LEX 8 h), over the working career or as minimum 5 years ≥85 dB) was not associated with tinnitus. Years of exposure ≥80 dB (minimum one) was not associated with tinnitus. Self-reported high noise exposure (>15 h weekly ≥5 years) was associated with tinnitus overall and among persons with elevated hearing thresholds (prevalence ratio (PR) 1.3, 1.0–1.7), however not statistically significantly among persons with normal thresholds (PR 1.1, 0.8–1.5). Conclusions Our large study showed no association between JEM-based noise exposure and tinnitus. This may to some extent reflect successful use of hearing protection. High self-reported noise exposure was associated with tinnitus, but not among normal hearing persons. This supports that noise-induced tinnitus to a large extent depends on audiometric hearing loss.

COVID-19 vaccine effectiveness among healthcare workers: a hospital-based cohort study

ObjectivesHealthcare workers (HCWs) were the first to be prioritised for COVID-19 vaccination. This study aims to estimate the COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 symptomatic infection among HCWs in Portuguese...

Association of Childhood Respiratory Status with Adult Occupational Exposures in a Birth Cohort.

Rationale: People with better early-life respiratory health may be more likely to work in occupations with high workplace exposures in adult life compared with people with poor respiratory health. This may manifest as a healthy worker effect bias, potentially confounding the analysis of environmental exposure studies. Objectives: To evaluate associations between lung function in adolescence and occupational exposures at initial adult employment. Methods: The TCRS (Tucson Children's Respiratory Study) is a long-term prospective study of respiratory health beginning at birth. Associations between respiratory function at age 11 years and occupational exposures at first job at age 26 years were evaluated with logistic regression. We calculated percentage predicted values for forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1:FVC ratio, and forced expiratory flow from 25% to 75% of vital capacity at age 11. At the 26-year visit, participants self-reported occupational exposures to dust, smoke, and fumes/gas at first job in a standardized interview. Results: Forced expiratory flow from 25% to 75% of vital capacity and FEV1:FVC ratio at age 11 were positively associated with dust workplace exposures at the first job. Each 10% increase in percentage predicted prebronchodilator FEV1:FVC ratio was associated with 30% higher odds of workplace dust exposure (odds ratio for a 1% increase, 1.03 [95% confidence interval, 1.00-1.06; P = 0.045]). Similar associations were observed for FEV1 and FVC with workplace smoke exposures. We also observed modification by time at job: associations were stronger for those who remained in their jobs longer than 12 months. In addition, those with better function at age 11 were more likely to stay in their jobs longer than 12 months if their first jobs involved exposure to dust. Conclusions: Childhood lung function affects initial career choice. This study supports the premise of the healthy worker effect.

Occupational history associates with ALS survival and onset segment

Objective To identify associations between occupational settings and self-reported occupational exposures on amyotrophic lateral sclerosis (ALS) survival and phenotypes. Methods All patients seen in the University of Michigan Pranger ALS Clinic were invited to complete an exposure assessment querying past occupations and exposures. Standard occupational classification (SOC) codes for each job and the severity of various exposure types were derived. Cox proportional hazards models associated all-cause mortality with occupational settings and the self-reported exposures after adjusting for sex, diagnosis age, revised El Escorial criteria, onset segment, revised ALS Functional Rating Scale (ALSFRS-R), and time from symptom onset to diagnosis. Multinomial logistic regression models with three categories, adjusted for age, assessed the association between occupational settings and exposures to onset segment. Results Among the 378 ALS participants (median age, 64.7 years; 54.4% male), poorer survival was associated with work in SOC code “Production Occupations” and marginally with work in “Military Occupation”; poor survival associated with self-reported occupational pesticide exposure in adjusted models. Among onset segments: cervical onset was associated with ALS participants having ever worked in “Buildings and Grounds Cleaning and Maintenance Occupations,” “Construction and Extraction Occupations,” and “Production Occupations”; bulbar onset with self-reported occupational exposure to radiation; and cervical onset with exposure to particulate matter, volatile organic compounds, metals, combustion and diesel exhaust, electromagnetic radiation, and radiation. Conclusion Occupational settings and self-reported exposures influence ALS survival and onset segment. Further studies are needed to explore and understand these relationships, most advantageously using prospective cohorts and detailed ALS registries.

Impact of Previous Occupational Exposure on Outcomes of Chronic Obstructive Pulmonary Disease.

: BackgroundOccupational exposures have been regarded as a risk factor for the development of chronic obstructive pulmonary disease (COPD). However, there is little knowledge regarding the effect of occupational exposure on the treatment outcomes of COPD. Therefore, the aim of this study was to evaluate the question of whether occupational exposure can have a potential impact on COPD outcomes. Methods: Information regarding self-reported occupational exposure for 312 patients with COPD from the Korean Obstructive Lung Disease (KOLD) Cohort were included. A comparison of the rate of acute exacerbation, annual lung function change, and quality of life according to the presence or absence of occupational exposure was performed. Results: Seventy-six patients (24.4%) had experienced occupational exposure; chemical materials were most common. At enrollment, a higher COPD-specific version of the St. George Respiratory Questionnaire total score (39.7 ± 18.8 vs. 33.1 ± 17.6, p = 0.005) and a higher exacerbation history in the past year (30.3% vs. 17.5%, p = 0.017) were observed for patients with occupational exposure compared to those without occupational exposure. Furthermore, in the follow-up period, after adjusting for potential confounders, a higher frequency of acute exacerbation (odd ratio, 1.418; 95% confidence interval, 1.027–1.956; p = 0.033) and a more rapid decline in forced expiratory volume in 1 s (p = 0.009) was observed for COPD patients with occupational exposure compared to those without occupational exposure. Conclusions: In the KOLD cohort, worse outcomes in terms of exacerbation rate and change in lung function were observed for COPD patients with occupational exposure compared to those without occupational exposure. These findings suggest that occupational exposure not only is a risk factor for COPD but also might have a prognostic impact on COPD.

Collecting occupation and hazards information in primary care using O*NET.

The objective of this study was to determine the feasibility of collecting occupation and occupational hazard data in a primary care setting, using the Occupational Information Network (O*NET) database to assist with classification. We collected data from 204 employed adult primary care patients in Toronto, Canada, on their occupation and exposure to occupational hazards, and mapped their job titles to the O*NET database. We compared their self-reported occupational hazard exposures with the likelihood of exposure on O*NET. Exposure to repetitive arm movement was reported by 78%, to vapors/gas/dust/fumes by 30%, to noise by 30%, and to heavy loads by 31%. Significant differences in exposure to vapors/gas/dust/fumes were associated with work precarity. We matched the majority of job titles (89%) to O*NET categories. Collecting employment information in primary care setting was feasible, with the majority of job titles mapping onto O*NET classifications.

A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension

A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension

Relationship between self-reported hearing impairment and occupational exposure to aggressive agents in workers

The goal of this study was to estimate the relationship between self-reported hearing impairment and occupational exposure to too aggressive agents in Mosul workers. This is an analytical cross-sectional study was conducted in out-patient of Ibn Sina Teaching Hospital in City of Mosul, Iraq. Data collection: data were categorized into two parts; part one included information related to workers' socio-demographic characteristics like (age, gender, duration of working, work Environment, and specific diseases like hypertension). Part two included a hearing assessment. A Self-reported questionnaire (HHIE) which was developed by Ventry and Weinstein and its scores were classified based on American Speech-Language-Hearing Association (ASHA) draft guidelines, was used in the present study. A total of 500 workers participated in this study. The largest proportion of the sample was composed of men (63.7%). Regarding the occupational environment, 62 % of workers had between 0 and 4 years of work, followed by individuals with ten years or more (28%). In addition, there was a higher prevalence of closed work environments (50.5%). Among the most prevalent occupational exposures, 30.5% were exposed to noise, followed by chemical substances (17.3%) and industrial dust (8.2%). Difficulty hearing was reported by 8.2 % of participants.

Relationship between self-reported hearing impairment and occupational exposure to aggressive agents in workers

The goal of this study was to estimate the relationship between self-reported hearing impairment and occupational exposure to too aggressive agents in Mosul workers. This is an analytical cross-sectional study was conducted in out-patient of Ibn Sina Teaching Hospital in City of Mosul, Iraq. Data collection: data were categorized into two parts; part one included information related to workers' socio-demographic characteristics like (age, gender, duration of working, work Environment, and specific diseases like hypertension). Part two included a hearing assessment. A Self-reported questionnaire (HHIE) which was developed by Ventry and Weinstein and its scores were classified based on American Speech-Language-Hearing Association (ASHA) draft guidelines, was used in the present study. A total of 500 workers participated in this study. The largest proportion of the sample was composed of men (63.7%). Regarding the occupational environment, 62 % of workers had between 0 and 4 years of work, followed by individuals with ten years or more (28%). In addition, there was a higher prevalence of closed work environments (50.5%). Among the most prevalent occupational exposures, 30.5% were exposed to noise, followed by chemical substances (17.3%) and industrial dust (8.2%). Difficulty hearing was reported by 8.2 % of participants.

Occupational cold exposure and symptoms of carpal tunnel syndrome – a population-based study

BackgroundCold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).MethodsIn this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression.ResultsThe study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62–6.33), as was ambient cooling (OR 2.00; 95% CI 1.03–3.88) and severe ambient cooling (OR 4.02 95% CI 2.09–7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88–13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67.ConclusionsSelf-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure–response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment.

Associations of self-reported occupational exposures and settings to ALS: a case–control study

BackgroundEnvironmental exposures contribute to the pathogenesis of amyotrophic lateral sclerosis (ALS), a fatal and progressive neurological disease. Identification of these exposures is important for targeted screening and risk factor modification.ObjectiveTo identify occupational exposures that are associated with a higher risk of ALS using both survey and standard occupational classification (SOC) coding procedures, and to highlight how exposure surveys can complement SOC coding.MethodsALS participants and neurologically healthy controls recruited in Michigan completed a detailed exposure assessment on their four most recent and longest held occupations. Exposure scores were generated from the exposure survey, and occupations were assigned to SOC codes by experienced exposure scientists.ResultsThis study included 381 ALS and 272 control participants. ALS participants reported higher duration-adjusted occupational exposure to particulate matter (OR = 1.45, 95% CI 1.19–1.78, p < 0.001), volatile organic compounds (OR = 1.22, 95% CI 1.02–1.45, p = 0.029), metals (OR = 1.48, 95% CI 1.21–1.82, p < 0.001), and combustion and diesel exhaust pollutants (OR = 1.20, 95% CI 1.01–1.43, p = 0.041) prior to ALS diagnosis, when adjusted for sex, age, and military service compared to controls. In multivariable models, only occupational exposure to metals remained significant risk (OR = 1.56, 95% CI 1.11–2.20, p = 0.011), although in an adaptive elastic net model, particulate matter (OR = 1.203), pesticides (OR = 1.015), and metals (1.334) were all selected as risk factors. Work in SOC code “Production Occupations” was associated with a higher ALS risk. SOC codes “Building and Grounds Cleaning and Maintenance Occupations”, “Construction and Extraction Occupations”, “Installation, Maintenance, and Repair Occupations”, and “Production Occupations” were all associated with a higher exposure to metals as determined using survey data.DiscussionOccupational exposure to particulate matter, volatile organic compounds, metals, pesticides, and combustion and diesel exhaust and employment in “Production Occupations” was associated with an increased ALS risk in this cohort.