Health Surveillance Of Workers Research Articles

Clinical investigation of former workers exposed to asbestos: the health surveillance experience of an Italian University Hospital.

The need for health surveillance of former workers exposed to asbestos was provided by law in Italy after the asbestos ban in 1992. We describe the results of the health surveillance of former workers exposed to asbestos, conducted over 27 years, from 1994 to 2020, at the Operative Unit of Occupational Medicine of the University Hospital of Bari. We adopted the health surveillance protocol, which was validated at the national level in 2018. A total of 1,405 former workers exposed to asbestos were examined. We proceeded with diagnosing pathologies in 339 cases (24% of the cohort subjected to surveillance), with diagnoses of some cases involving multiple pathologies. Specifically, pleural plaques were diagnosed in 49.2% of the 339 cases, asbestosis in 35.9%, malignant pleural mesothelioma (MPM) in 20.3%, mesothelioma of the vaginal tunic of the testis (MTVT) in 9.1%, lung cancer in 5.8%, and laryngeal cancer in 0.8%. Despite the 1992 asbestos ban, asbestos-related diseases remain a serious public health issue. It is important to establish criteria that ensure the health surveillance of formerly exposed workers minimizes costs, reduces the number of invasive examinations, and optimizes achievable results.

Comparison of the application of new and old specification for occupational health surveillance of radiation workers and analysis of influencing factors

Objective: To investigate the impact of the implementation of GBZ 98-2020 "Health Requirements and Surveillance Specifications for Radiation Worker" on the results of occupational health examination for radiation workers. Methods: In April 2022, the subjects of the study were the radiation workers who underwent occupational health examination in Occupational Disease Prevention and Treatment Institute of Hefei. The radiation workers whose registration period was from May 1, 2021 to April 30, 2022 were the new standard group, and the occupational health surveillance standard was GBZ 98-2020 "Health Requirements and Surveillance Specifications for Radiation Worker". The radiationl workers registered from May 1, 2020 to April 30, 2021 were the old standard group, whose occupational health surveillance standards were GBZ 98- 2017 "Health Requirements for Radiation Workers" and GBZ 235-2011 "Specifications for Occupational Health Surveillance for Radiation Workers". To analyze whether there were differences between the two groups in the detection rate of missing items in the examination, re-examination, and the detection rate of occupational contraindications. The radiation workers whose occupational health examination results showed re-examination and/or occupational contraindications were judged to be in the unqualified group. Univariate and multivariate logistic regression analysis was used to find the factors affecting the determination of unqualified group. Results: The missing item detection rate of radiation workers in the new standard group was 3.04% (63/2074) , significantly higher than that in the old standard group (0.68%, 14/2054) (P<0.05) . The re-examination and occupational contraindications detection rates in the new standard group were 5.93% (123/2074) and 0.58% (12/2074) , respectively, which were significantly lower than those in the old standard group (13.83%, 284/2054) and 2.34% (48/2054) (P<0.05) . The missing item detection rate of males in the new standard group was 2.78% (40/1440) , which was significantly higher than that in the old standard group (0.72%, 11/1536) (P<0.05) . The re-examination and occupational contraindications detection rates of males in the new standard group were 3.61% (52/1440) and 0.21% (3/1440) , respectively, which were significantly lower than those in the old standard group (12.17%, 187/1536) and 2.08% (32/1536) (P<0.05) . The missing item detection rate of females in the new standard group was 3.63% (23/634) , which was significantly higher than that in the old standard group (0.58%, 3/518) (P<0.05) . The re-examination detection rate of females in the new standard group was 11.20% (71/634) , which was significantly lower than that of females in the old standard group (18.73%, 97/518) (P<0.05) . Univariate logistic regression analysis showed that gender, radiation classification, determination basis, occupational health examination category, and registration category were all influencing factors for the unqualified occupational health examination results of radiation workers (P<0.05) . Multivariate logistic regression analysis showed that the risk of being judged as unqualified based on the old standard was 2.466 times that of the new standard (95%CI: 1.975-3.080, P<0.05) , and the risk of being judged as unqualified for females was 1.869 times that of males (95%CI: 1.498-2.333, P<0.05) , the risk of being judged as unqualified for radiation workers during and after employment was 0.802 times that of pre-employment individuals (95%CI: 0.650-0.989, P<0.05) , and the risk of being judged as unqualified for re-examined individuals was 4.056 times that of initial examinees (95%CI: 3.161-5.203, P<0.05) . Conclusion: The results of occupational health examination of radiation workers are related to the determination basis, gender, occupational health examination category, and registration category. The implementation of GBZ 98-2020 "Health Requirements and Surveillance Specifications for Radiation Worker" may reduce the detection rate of unqualified personnel.

Altered Haematological Parameters in Gasoline Station Workers Due to Benzene Exposure

Benzene is harmful to human health and early detection of haematological alterations is important in preventing adverse health effects. This study aimed to investigate the biomarkers of benzene exposure and its effects due to haematological alterations. Gasoline station workers with potential risks according to the biomatrix concerning benzene exposure underwent blood and urine evaluation for the biological monitoring of urinary trans, trans-muconic acid (tt-MA), and haematological and biochemical parameter evaluation. The results were analysed for correlations between biological and haematological effects. The tt-MA biomarker was detected in some workers and approximately 50% of workers had a blood profile that showed abnormal parameters with respect to the haemoglobin (Hb), haematocrit (Hct) and white blood cell parameters, which were outside the normal range. A significant correlation was observed between the tt-MA biomarker’s level and the levels of the haematological and biochemical parameters, which were Hb, Hct, eosinophil, neutrophil, SGOT and blood creatinine. The level of urinary tt-MA as a marker of benzene exposure correlated with haematological and biochemical changes in the blood, suggesting that the gasoline station workers were affected by benzene exposure. Moreover, the current study suggests that early detection of haematological abnormalities may be possible by analysing biomarkers of their effects through regular health surveillance of workers.

Does occupational health surveillance lead to risk reduction for workers exposed to hand-intensive work?

This mixed method study aimed to describe what risk-reducing actions were proposed by ergonomists after the execution of a guided process for occupational health surveillance for workers exposed to hand-intensive work in ten companies. Another aim was to describe the exposed workers' proposals for risk-reducing actions, including their perceptions of potential changes in the self-assessed exposure levels and work-related pain. Several actions, targeting organizational, technical, and/or individual measures were proposed. Proposals from the ergonomists more often targeted the personal measures, whereas the workers' proposals targeted technology or organizational changes. Six companies implemented at least one of the action proposals. These action proposals were not related to evaluation metrics, nor were they evaluated. This study indicates that both ergonomists and companies need guidance on how to improve to work in a participatory process for the implementation and evaluation of risk-reducing actions, e.g., by how to better include workers’ experiences.

Prevalence and risk factors of computer vision syndrome-assessed in office workers by a validated questionnaire.

Computer vision syndrome (CVS) is a common occupational health problem, but its clinical definition, prevalence and risk factors are not well defined. In general, non-validated diagnostic instruments have been used to assess its prevalence. For this reason, the aim of this study is to estimate the prevalence and potential risk factors for CVS using a validated questionnaire. A cross-sectional study (n=238) was carried out in Italian office workers using digital devices. All participants responded to an anamnesis, a digital exposure questionnaire, and the validated Italian version of the Computer Vision Syndrome Questionnaire. A battery of 3 ocular surface and tear ophthalmic tests (break-up time, BUT), Schirmer II and corneal staining) was performed. The mean age (±SD) was 45.55 (11.02) years, 64.3% were female. 71.4% wore glasses to work, whose design was monofocal (for distance) in 47.6%, monofocal (for near) in 26.5%, general progressive in 16.5% and occupational progressive in 8.8% of cases. 35.7% used digital devices >6 hours/day in the workplace. The prevalence of CVS was 67.2%. In the multivariate model, female sex (aOR: 3.17; 95% CI [1.75-5.73]), the use of digital devices >6 hours/day at workplace (aOR: 2.07; 95% CI [1.09-3.95]) and the use of optical correction at work (aOR: 2.69; 95% CI [1.43-5.08]) significantly increased the odds of CVS. Association was observed between presenting CVS and having abnormal BUT (χ2=0.017). The prevalence of CVS in Italian office workers, especially among females, was high. Intensive use of digital devices at work (>6 hours/day) and the use of optical correction at work significantly increased the odds of CVS. There is an association between poor tear stability and CVS. Further research is needed on the influence of wearing optical correction on CVS. The use of a validated questionnaire in health surveillance of digital workers is strongly recommended.

A workers' health surveillance online training programme for occupational physicians.

To support occupational physicians (OPs) in the implementation of workers' health surveillance (WHS), a training programme was developed. (i) To evaluate the effects of a WHS training programme for OPs on knowledge, self-efficacy and skills to implement WHS. (ii) To evaluate to what extent a WHS training programme is acceptable and feasible for implementation in practice. A single-blinded randomized controlled trial with waiting-list control group was used. The WHS training programme consisted of an e-learning and a 4.5-h online training session. OPs completed a knowledge test (0-8), self-efficacy questionnaires on knowledge and skills (6-60), and vignette assignments (0-16) to measure skills. OPs completed the questionnaires, either before and after the WHS training programme (intervention group), or before the training programme (control group) while receiving the training programme after the waiting period. All OPs completed questionnaires about the training's acceptability, and feasibility for implementation in practice. ANCOVA and Poisson regression analyses were conducted. The self-efficacy score (M = 44.1 versus M = 37.2) (P < 0.001) and skills score (M = 9.6 versus M = 8.3) (P < 0.05) of OPs in the training group (N = 16) were higher than the control group (N = 23). No effect was found on knowledge. Evaluation of acceptability and feasibility showed that 21 (58%) OPs were very satisfied with the training part on initiating WHS, and 29 (85%) would recommend the WHS training programme to colleagues. This WHS training programme has a positive effect on self-efficacy and skills of OPs to implement WHS, and may be acceptable and feasible to implement in practice.

Upper Limb Disorders in Catering Workers

The literature reports that catering workers are exposed to various occupational health hazardsé. This study aims to assess a cohort of catering workers in relation to upper limb disorders, thus contributing to the quantification of work-related musculoskeletal disorders in this occupational sector. Here, 500 employees, of which 130 were males and 370 were females, with an overall mean age of 50.7 years and an average length of service of 24.8 years, were examined. All subjects completed a standardized questionnaire: the medical history questionnaire of diseases of the upper limbs and spine proposed in "Health surveillance of workers", third edition, EPC. The obtained data enables the following conclusions to be drawn. Musculoskeletal disorders affect a wide range of catering workers. The most affected anatomical region is the shoulder. These disorders increase with advancing age, specifically shoulder, wrist/hand disorders and daytime and nighttime paresthesias. Employment seniority in the catering sector increases the likelihood of all considered conditions. An increase in weekly workload exclusively affects the shoulder region. This study aims to serve as an impetus for further research that seeks to better analyze musculoskeletal problems in the catering sector.

Essentially Unprotected. Health Data and Surveillance of Essential Workers during the COVID-19 Pandemic

Essentially Unprotected. Health Data and Surveillance of Essential Workers during the COVID-19 Pandemic

Portrait of training and worker health surveillance actions in Santa Catarina

Portrait of training and worker health surveillance actions in Santa Catarina

Lnc-TC/miR-142-5p/CUL4B signaling axis promoted cell ferroptosis to participate in benzene hematotoxicity

Exposure to benzene causes damage to the hematopoietic system, but the mechanisms are still unclear. Competitive endogenous RNAs (ceRNAs) are the epigenetic regulatory axis of long non-coding RNA (lncRNA)-microRNA-mRNA, which are shown to play roles in benzene-induced hematotoxicity. Ferroptosis, a lipid peroxidation-dependent cell death, has been reported to be regulated by ceRNAs. We hypothesized that ceRNAs regulated ferroptosis to participate in benzene hematotoxicity. In this study, we observed that the expression of lncRNA TC (Lnc-TC) and CUL4B were increased, but miR-142-5p was decreased in benzene-exposed workers. Correlation analysis suggested that the ceRNAs had co-expression relationships, and were associated with blood cell counts. We further explored the role of ceRNA in vitro, and discovered that 1,4- benzoquinone (1,4-BQ) stimulated ferroptosis in AHH-1 cells by inhibiting the expression of GPX4 and SLC7A11, which was partially relieved by knockdown of Lnc-TC and CUL4B. Finally, by interfering with Lnc-TC and miR-142-5p expression, we confirmed that Lnc-TC acted as a microRNA sponge to reduce the accessibility and inhibition of miR-142-5p to CUL4B, thus increasing the expression of CUL4B. In summary, Lnc-TC/miR-142-5p/CUL4B signaling axis promoted cell ferroptosis to participate in benzene hematotoxicity, and was a potential biomarker for risk screening and health surveillance of benzene-exposed workers.

What Personal and Work-Related Characteristics of Dutch Construction Workers With Knee Osteoarthritis Are Associated With Future Work Ability?

To assess personal and work-related characteristics of construction workers with knee osteoarthritis (KO) associated with their ability to perform their current profession in the following 2 years. A cross-sectional study was performed among Dutch construction workers diagnosed with KO using data from the Worker Health Surveillance. Logistic regression was used to assess the characteristics associated with future work ability. On the basis of 344 construction workers with KO, being able to perform their current profession in 2 years' time was associated with working weekly 36 to 45 hours (odds ratio [OR], 3.0 to 6.3), performing high-intensity exercises 1 to 2 times weekly (OR, 2.0 to 2.6), being younger than 56 years (OR, 0.2 to 0.3), and not performing strenuous work activities such as lifting and kneeling (OR, 0.4 to 0.5). To keep construction workers with KO at work, intervention studies should evaluate the effects of reducing strenuous work activities and promote leisure-time exercise.

Effects of the Silica Dust on the Nasal Mucosa of Ceramic Workers

Background. Adverse health effects due to occupational exposures are a global public health concern and have been studied for many years. Ceramic workers are occupationally exposed to a wide range of toxic substances as they manage clay (silico-aluminous feldspar mixed with sodium, potassium salts and iron oxide). The objective of this study was to assess the presence of any inflammation or alteration of the nasal mucosa of ceramic workers by nasal cytology. Materials and methods. Twenty-eight ceramic workers from Caltagirone (Italy) were enrolled. Nasal symptoms, atopy, health habits and workplace features were assessed by a special questionnaire, and nasal mucosa health was evaluated by nasal cytology. Results. The cytological study of the nasal mucosa revealed the constant presence of abundant, thick and filamentous mucus, as well as a reorganization of the nasal cellularity with a prevalence of muciparous hyperplasia and metaplasia in the study group, and only in a lesser extent for the subjects with some protective environmental measures. Conclusions. The ceramic workers showed chronic inflammatory rhinitis on nasal cytology, with a remodelling of the nasal mucosa and thick mucus. Nasal cytology may be a helpful tool either for the health surveillance of the ceramic workers, or for the screening of any pathology of the upper airways.

Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work: a qualitative exploration

BackgroundIn order to reduce work-related upper limb disorders, the Swedish Work Environment Authority introduced an occupational health surveillance targeting hand-intensive work. A process model, aimed at supporting the employers as well as the occupational health service provider (i.e., ergonomist) in the work process with the occupational health surveillance, was developed. The objective of this qualitative study was to explore ergonomists’ experiences of the execution of occupational health surveillance for hand-intensive work when following the novel process model as well as factors influencing the execution.MethodsSemi-structured individual interviews were conducted with ten ergonomists on one occasion regarding their experience of following the work process. Qualitative content analysis with an inductive approach was used for analyzing the data.ResultsThe ergonomists’ experiences were summarized in one theme “A joint roadmap supporting a participatory process” and two categories “Clear structure provided by the components” and “The process influenced by collaboration and context”. The ergonomists valued being guided by the systematics of the model, which provided structure and clarity in their work. Factors affecting the execution were related to communication deficiencies and uncertainties regarding expectations between different roles and functions (e.g., ergonomists and contact person, lack of information to workers). Additional factors, for instance, companies’ routines and the ergonomist’s intra-organizational support, such as access to IT-resources, could also affect the process.ConclusionsThe findings reveal that this process model facilitates the ergonomists’ work and cooperation with a client company. However, the process model needs to be developed and accompanied by a guideline with information related to the process, including e.g., description of a start-up meeting and of the roles/functions of the involved parties.

Results of the 2019 Survey of Engineered Nanomaterial Occupational Health and Safety Practices.

In collaboration with RTI International, the U.S. National Institute for Occupational Safety and Health (NIOSH) administered a survey to North American companies working with nanomaterials to assess health and safety practices. The results would contribute to understanding the impact of the efforts made by the NIOSH Nanotechnology Research Center (NTRC) in communicating occupational health and safety (OHS) considerations for workers when handling these materials. The survey, developed by RAND Corporation, was conducted online from September 2019–December 2019. Forty-five companies or organizations in the U.S. and Canada that fabricate, manufacture, handle, dispose, or otherwise use nanomaterials completed the survey. The survey was designed to answer research questions regarding the nanomaterials in use, which resources the companies have consulted for OHS guidance, and the overall OHS culture at the companies. Other questions specifically addressed whether the companies interacted with NIOSH or NIOSH resources to inform OHS policies and practices. Among participating companies, 57.8% had a maximum of 50 employees. Gold nanoparticles and polymers were most common (n = 20; 45.5% each), followed by graphene (36.4%), carbon nanotubes and nanofibers (34.1%), and zinc oxide nanoparticles (31.8%). Environmental monitoring was performed by 31.8% of the companies. While 88.9% of the companies had laminar flow cabinets, only 67.5% required it to be used with ENMs. Information and training programs were indicated by 90% of the sample, and only 29.6% performed specific health surveillance for ENM workers. Personal protective equipment primarily included gloves (100%) and eye/face protection (97.7%). More than a third (37.8%) of the respondents reported using at least one NIOSH resource to acquire information about safe handling of ENMs. The small number of companies that responded to and completed the survey is a considerable limitation to this study. However, the survey data are valuable for gauging the reach and influence of the NIOSH NTRC on nano OHS and for informing future outreach, particularly to small businesses.

Characterization Analysis of Airborne Particulates from Australian Underground Coal Mines Using the Mineral Liberation Analyser

Exposure monitoring and health surveillance of coal mine workers has been improved in Australia since coal workers’ pneumoconiosis was reidentified in 2015 in Queensland. Regional variations in the prevalence of mine dust lung disease have been observed, prompting a more detailed look into the size, shape, and mineralogical classes of the dust that workers are being exposed to. This study collected respirable samples of ambient air from three operating coal mines in Queensland and New South Wales for characterization analysis using the Mineral Liberation Analyser (MLA), a type of scanning electron microscope (SEM) that uses a combination of the backscattered electron (BSE) image and characteristic X-rays for mineral identification. This research identified 25 different minerals present in the coal samples with varying particle size distributions for the overall samples and the individual mineralogies. While Mine 8 was very consistent in mineralogy with a high carbon content, Mine 6 and 7 were found to differ more significantly by location within the mine.

Carpal tunnel syndrome and Raynaud's phenomenon: a narrative review.

Raynaud's phenomenon (RP) is a recognized symptom associated with carpal tunnel syndrome (CTS) and is also the vascular manifestation of hand arm vibration syndrome (HAVS). The symptoms of HAVS and CTS are such that there is a significant possibility of misdiagnosis and an incorrect attribution of vascular and sensory symptoms. An understanding of the relationship between RP and CTS is essential when undertaking health surveillance of vibration-exposed workers presenting with combined vascular and sensory symptoms. To clarify the relationship between CTS and Raynaud's phenomenon. A systematic search was undertaken of studies that reviewed links between CTS and Raynaud's phenomenon (RP). A total of 4170 papers were identified, with 21 articles that were then reviewed in full, including 1 meta-analysis of 8 studies. Eighteen papers, not included in the meta-analysis, were found including 3 case control studies, 9 case reports, 2 prospective studies and 4 retrospective reviews. Papers were reviewed on the basis of the diagnostic criteria used for CTS and RP. Our review of the literature confirms a substantial body of evidence of a relationship between RP and CTS. It is recommended that assessment of vibration exposed individuals who report concurrent RP and separate sensory symptoms suggestive of, or compatible with CTS, should formally exclude CTS before attributing symptoms to HAVS.

Occupational health surveillance of healthcare workers during COVID 19 pandemic: a narrative review.

Background and aims:Current literature has increasingly highlighted the risk of spreading the SARS-COV-2 infection in healthcare settings and showed the need for occupational health surveillance of HCWs during the current epidemiological emergency from COVID-19, as a preventive measure to minimize the spread of the infection. The purpose of this narrative review was to evaluate the literature and discover what the latest developments are about the management of the occupational health surveillance of healthcare workers (HCWs) during COVID-19 pandemic.Methods:We searched for publications in MEDLINE, Pubmed and Google Scholar using selected keywords. Each article was reviewed and categorized into one or more of the following three categories based on its subject matter: early diagnosis of COVID-19 in HCWs, detection of worker susceptibility to severe COVID-19, medical examination of HCWs returning to work after COVID-19.Results:Selected articles showed the RT-PCR test for Sars-CoV-2 as the gold standard to enable rapid identification of infected HCWs; an effective schedule of occupational health surveillance allows the identification of the susceptibility of the workers to severe Covid-19 and protect HCWs returning to work from the disease.Conclusions:The findings of the present narrative review show the need to strenghten the occupational health surveillance of HCWs during the current COVID-19 pandemic, with the aim not only to contain the spread of the infection in healthcare settings, but also to protect HCWs coming back to work after the disease. (www.actabiomedica.it)

Exposure prevention and health surveillance of low-income workers in small rural enterprises in India

Exposure prevention and health surveillance of low-income workers in small rural enterprises in India

The health surveillance of workers exposed to EMF: an outline of criteria

The health surveillance of workers exposed to EMF: an outline of criteria

Occupational health among primary care workers: situational diagnosis.

The field of workers' health within the scope of the Brazilian Unified Health System needs to revitalize its space in terms of coordinating care in primary health care based on social determinants of health. To contextualize and describe the health-related situational diagnosis of primary care workers from the metropolitan region of Fortaleza, state of Ceará, Brazil. This was a descriptive, quantitative, and exploratory study conducted at a primary care unit in the metropolitan region of Fortaleza, Ceará, from January to March 2019. The study population was composed of 38 health care professionals from the primary care unit. The following questionnaires were applied to obtain the situational diagnosis: the World Health Organization Disability Assessment Schedule and the Occupational Health Questionnaire. Most participants were women (89.47%) and community health agents (18,42%). There were negative impacts on health conditions, such as work-related physical and mental discomfort, which was evidenced by sleep problems, sedentary lifestyle, poor access to health care services, and type of physical activity, which difer in terms of function and hierarchical levels in the field of work. This study showed that the questionnaires provide useful inputs regarding occupational health through the situational diagnosis and adequately address the health-disease process, as seen in primary care workers. Comprehensive care, comprehensive worker health surveillance, and participatory administration of health services should be optimized.