RESUMEN
Surveillance for environmental contamination of antineoplastic drugs has been recommended by authoritative bodies such as the United States Pharmacopeia and the National Association of Pharmacy Regulatory Authorities. Clear guidance is needed on how to develop sampling strategies that align with surveillance objectives efficiently and effectively. We conducted a series of simulations using previously collected surveillance data from nine cancer treatment centers to evaluate different sampling strategies. We evaluated the impact of sampling 2, 5, 10, or 20 surfaces, at monthly, quarterly, semi-annual, and annual frequencies, while employing either a random or sentinel surface selection strategy to assess contamination by a single antineoplastic drug (AD) or by a panel of three ADs. We applied two different benchmarks: a binary benchmark of above or below the limit of detection and AD-specific hygienic guidance values, based on 90th percentile values as quantitative benchmarks. The use of sentinel surfaces to evaluate a three-drug panel relative to 90th percentile hygienic guidance values (HGVs) resulted in the most efficient and effective surveillance strategy.
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Antineoplásicos , Exposición Profesional , Farmacias , Humanos , Exposición Profesional/análisis , Monitoreo del Ambiente/métodos , Contaminación de Equipos/prevención & control , Antineoplásicos/análisisRESUMEN
PURPOSE: To understand the association between heart rate variability and indices of fatigue, total sleep time, and reaction time in shift workers. METHODS: Ten participants from the British Columbia Wildfire Service management team were examined over a 14-day active fire-line period. Daily measures of subjective fatigue, sleepiness, and alertness were recorded using a visual analog scale. Daily total sleep time was recorded using a wrist actigraph. Cardiac autonomic modulation was examined each morning using heart rate variability (HRV). Three measures of reaction time (simple reaction time, choice reaction tie, and discriminatory reaction time) was examined on days 1, 5, 10, and 14. Multiple linear regression analysis was utilized to examine the association between HRV and indices of fatigue, total sleep time, and reaction time. RESULTS: Mean shift duration was 13.8 ± 0.77 h. Significant inverse associations were observed between HRV and sleepiness [r = - 0.60, p = 0.000] and fatigue [r = - 0.55, p = 0.000], and a positive association with total sleep time (min) [r = 0.28, p = 0.009]. There were no significant relationships between HRV and simple reaction time (ms) [r = - 0.32, p = 0.182], choice reaction time (ms) [r = - 0.10, p = 0.850], or discriminatory reaction time (ms) [r = - 0.09, p = 0.881]. CONCLUSIONS: HRV displayed significant associations with indices of fatigue and sleep, whereby demonstrating its utility as a practical tool for monitoring the development of fatigue in wildland firefighters and for providing insight when to make lifestyle modifications to preserve alertness.
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Fatiga/fisiopatología , Bomberos , Frecuencia Cardíaca , Horario de Trabajo por Turnos , Sueño/fisiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Reacción , Lugar de TrabajoRESUMEN
BACKGROUND: Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. METHODS: To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. RESULTS: We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. CONCLUSIONS: This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.
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Promoción de la Salud/métodos , Pérdida Auditiva Provocada por Ruido/prevención & control , Neoplasias/prevención & control , Enfermedades Profesionales/prevención & control , Salud Laboral , Asma Ocupacional/etiología , Asma Ocupacional/prevención & control , Dermatitis Profesional/etiología , Dermatitis Profesional/prevención & control , Monitoreo del Ambiente/métodos , Pérdida Auditiva Provocada por Ruido/etiología , Humanos , Neoplasias/etiología , Ruido en el Ambiente de Trabajo/prevención & control , Enfermedades Profesionales/etiología , Exposición Profesional/prevención & controlRESUMEN
The purpose of this investigation was to enhance our understanding of the effects the current British Columbia Wildfire Service (BCWS) firefighting schedule have on the development of fatigue and sleep deprivation. This was a cohort study that objectively and subjectively measured sleep quantity, sleep quality, and fatigue throughout a 17-day British Columbia wildland firefighting deployment. Wildland firefighters (n = 30) conducted daily testing of sleep and fatigue measures during 14 days of activity on the fire line and three days immediately post deployment during their three-day rest period, for a total of 17 days of data collection. Sleep was assessed using wrist-worn actigraphy (ActiGraph LLC, Pensacola, FL) and subjective sleep questionnaires. Fatigue was assessed using subjective fatigue questionnaires and cognitive performance through the psychomotor vigilance test. Total sleep time was less on fire days (M = 6.6 h ± 49.2 min) compared to non-fire days (M = 6.8 h ± 92.2 min). Participants performed poorer on cognitive performance tests, (p = 0.288), and reported being significantly sleepier, (p = 0.038), toward the end of their 17-day deployment compared to day 1. Participants continued to report high levels of sleepiness, fatigue, and poor quality of sleep on their rest days compared to their fire line days. Working 14 consecutive days was associated with increased levels of objective fatigue and suboptimal sleep in wildland firefighters. Wildland firefighters reported significantly higher levels of fatigue and decreased alertness with increasing days on deployment and these levels did not improve following a three-day rest period.
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Fatiga/epidemiología , Bomberos , Privación de Sueño/epidemiología , Actigrafía/métodos , Adulto , Colombia Británica , Estudios de Cohortes , Femenino , Humanos , Masculino , Desempeño Psicomotor , Descanso , Sueño , Encuestas y Cuestionarios , Incendios ForestalesRESUMEN
Exposure to occupational carcinogens is often overlooked as a contributor to the burden of cancer. To estimate the proportion of cancer cases attributable to occupational exposure in Canada in 2011, exposure prevalence and levels of 44 carcinogens were informed by data from the Canadian carcinogen exposure surveillance project (CAREX Canada). These were used with Canadian Census (between 1961 and 2011) and Labour Force Survey (annual surveys between 1976 and 2013) data to estimate the number of workers ever exposed to occupational carcinogens. Risk estimates of the association between each carcinogen and cancer site were selected mainly from published literature reviews. Population attributable risks were estimated using Levin's equation and applied to the 2011 cancer statistics from the Canadian Cancer Registry. It is estimated that 15.5 million Canadians alive in 2011 were exposed, during at least one year between 1961 and 2001, to at least one carcinogen in the workplace. Overall, we estimated that in 2011, between 3.9% (95% CI: 3.1%-8.1%) and 4.2% (95% CI: 3.3%-8.7%) of all incident cases of cancer were due to occupational exposure, corresponding to lower and upper numbers of 7700-21,800 cases. Five of the cancer sites - mesothelioma, non-melanoma skin cancer, lung, female breast, and urinary bladder - account for a total of 7600 to 21,200 cancers attributable to occupational exposures such as solar radiation, asbestos, diesel engine exhaust, crystalline silica, and night shift work. Our study highlights cancer sites and occupational exposures that need recognition and efforts by all stakeholders to avoid preventable cancers in the future.
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Carcinógenos/toxicidad , Neoplasias/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/estadística & datos numéricos , Adolescente , Adulto , Amianto/toxicidad , Neoplasias de la Mama , Canadá/epidemiología , Censos , Femenino , Humanos , Neoplasias Pulmonares , Masculino , Persona de Mediana Edad , Neoplasias/etiología , Neoplasias/prevención & control , Prevalencia , Dióxido de Silicio/toxicidad , Neoplasias Cutáneas , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To estimate the population attributable fraction (PAF) and number of incident and fatal lung cancers in Canada from occupational exposure to diesel engine exhaust (DEE). METHODS: DEE exposure prevalence and level estimates were used with Canadian Census and Labour Force Survey data to model the exposed population across the risk exposure period (REP, 1961-2001). Relative risks of lung cancer were calculated based on a meta-regression selected from the literature. PAFs were calculated using Levin's equation and applied to the 2011 lung cancer statistics obtained from the Canadian Cancer Registry. RESULTS: We estimated that 2.4% (95% CI 1.6% to 6.6%) of lung cancers in Canada are attributable to occupational DEE exposure, corresponding to approximately 560 (95% CI 380 to 1570) incident and 460 (95% CI 310 to 1270) fatal lung cancers in 2011. Overall, 1.6 million individuals alive in 2011 were occupationally exposed to DEE during the REP, 97% of whom were male. Occupations with the highest burden were underground miners, truck drivers and mechanics. Half of the attributable lung cancers occurred among workers with low exposure. CONCLUSIONS: This is the first study to quantify the burden of lung cancer attributable to occupational DEE exposure in Canada. Our results underscore a large potential for prevention, and a large public health impact from occupational exposure to low levels of DEE.
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Contaminantes Ocupacionales del Aire/toxicidad , Gasolina/toxicidad , Neoplasias Pulmonares/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Emisiones de Vehículos/toxicidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Canadá/epidemiología , Estudios de Casos y Controles , Costo de Enfermedad , Femenino , Humanos , Neoplasias Pulmonares/etiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Exposición Profesional/estadística & datos numéricos , Sistema de Registros , Factores de Riesgo , Adulto JovenRESUMEN
Laboratory studies have shown that exposure to whole-body vibration (WBV) increases physical and mental fatigue, which are common issues professional drivers face. The objective of this study was to determine whether altering WBV exposures had any effect on driver vigilance and discomfort. A repeated measures crossover design of five truck drivers with regular 10-h routes was used. Active and passive suspension truck seats were evaluated. For each seat, WBV exposures were measured. Participants completed a discomfort questionnaire and a reaction time task before and after their shift for two weeks, one week per seat. Compared with the passive seat, the active seat significantly reduced WBV exposures, decrements in the optimal and mean reaction times (p = 0.02, 0.047, respectively), and discomfort in the lower back and wrist(s)/forearm(s) (p < 0.01, 0.01, respectively). Study results indicated that reducing WBV helps reduce discomfort and maintain vigilance, which may improve drivers' health and reduce the risk of truck collisions. Practitioner Summary: The active suspension seat used in this study reduced truck drivers' exposure to whole-body vibration (WBV) by over 33% in relation to their current industry standard passive suspension seat. This study demonstrated that reducing truck drivers' exposure to WBV reduced fatigue and discomfort development over a workday.
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Atención , Dolor de la Región Lumbar/etiología , Vehículos a Motor , Dolor Musculoesquelético/etiología , Exposición Profesional/efectos adversos , Vibración/efectos adversos , Adulto , Estudios Cruzados , Diseño de Equipo , Antebrazo , Humanos , Dolor de la Región Lumbar/prevención & control , Persona de Mediana Edad , Dolor Musculoesquelético/prevención & control , Exposición Profesional/prevención & control , Encuestas y Cuestionarios , MuñecaRESUMEN
OBJECTIVES: To estimate the numbers of workers exposed to known and suspected occupational carcinogens in Canada, building on the methods of CARcinogen EXposure (CAREX) projects in the European Union (EU). METHODS: CAREX Canada consists of estimates of the prevalence and level of exposure to occupational carcinogens. CAREX Canada includes occupational agents evaluated by the International Agency for Research on Cancer as known, probable or possible human carcinogens that were present and feasible to assess in Canadian workplaces. A Canadian Workplace Exposure Database was established to identify the potential for exposure in particular industries and occupations, and to create exposure level estimates among priority agents, where possible. CAREX EU data were reviewed for relevance to the Canadian context and the proportion of workers likely to be exposed by industry and occupation in Canada was assigned using expert assessment and agreement by a minimum of two occupational hygienists. These proportions were used to generate prevalence estimates by linkage with the Census of Population for 2006, and these estimates are available by industry, occupation, sex and province. RESULTS: CAREX Canada estimated the number of workers exposed to 44 known, probable and suspected carcinogens. Estimates of levels of exposure were further developed for 18 priority agents. Common exposures included night shift work (1.9 million exposed), solar ultraviolet radiation exposure (1.5 million exposed) and diesel engine exhaust (781â 000 exposed). CONCLUSIONS: A substantial proportion of Canadian workers are exposed to known and suspected carcinogens at work.
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Carcinógenos , Censos , Exposición Profesional/estadística & datos numéricos , Canadá , Bases de Datos Factuales , Unión Europea , Humanos , Industrias , Modelos Teóricos , Prevalencia , Factores SexualesRESUMEN
BACKGROUND: Motorized traffic is an important source of both air pollution and community noise. While there is growing evidence for an adverse effect of ambient air pollution on reproductive health, little is known about the association between traffic noise and pregnancy outcomes. METHODS: We evaluated the impact of residential noise exposure on small size for gestational age, preterm birth, term birth weight, and low birth weight at term in a population-based cohort study, for which we previously reported associations between air pollution and pregnancy outcomes. We also evaluated potential confounding of air pollution effects by noise and vice versa. Linked administrative health data sets were used to identify 68,238 singleton births (1999-2002) in Vancouver, British Columbia, Canada, with complete covariate data (sex, ethnicity, parity, birth month and year, income, and education) and maternal residential history. We estimated exposure to noise with a deterministic model (CadnaA) and exposure to air pollution using temporally adjusted land-use regression models and inverse distance weighting of stationary monitors for the entire pregnancy. RESULTS: Noise exposure was negatively associated with term birth weight (mean difference = -19 [95% confidence interval = -23 to -15] g per 6 dB(A)). In joint air pollution-noise models, associations between noise and term birth weight remained largely unchanged, whereas associations decreased for all air pollutants. CONCLUSION: Traffic may affect birth weight through exposure to both air pollution and noise.
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Contaminación del Aire/efectos adversos , Exposición Materna/efectos adversos , Ruido/efectos adversos , Resultado del Embarazo , Nacimiento Prematuro , Nacimiento a Término , Colombia Británica , Estudios de Cohortes , Intervalos de Confianza , Monitoreo del Ambiente/métodos , Femenino , Edad Gestacional , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Masculino , Oportunidad Relativa , Embarazo , Medición de RiesgoRESUMEN
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Enfermedades Cardiovasculares , Ruido en el Ambiente de Trabajo , Exposición Profesional , Humanos , Estados Unidos/epidemiología , Enfermedades Cardiovasculares/epidemiología , Ruido en el Ambiente de Trabajo/efectos adversos , Encuestas Nutricionales , Estudios Transversales , Exposición Profesional/efectos adversosRESUMEN
In British Columbia, some tree planting operations require workers to fertilize planted seedlings with polymer-coated nitrogen, phosphorus, and potassium (NPK) fertilizers. This study examined respiratory and dermal health associated with fertilizer exposure among tree planters. We interviewed 223 tree planters using an adapted version of the American Thoracic Society questionnaire supplemented with questions on dermal health. Subjects were grouped by categories of increasing duration of exposure, with workers who had not worked with fertilizer as a reference group. The relationship between exposure and reported work-related symptoms was analyzed using logistic regression, adjusting for age, cumulative tobacco cigarettes smoked, marijuana smoking status, sex, and exposure to abrasive spruce needles. An elevated odds ratio was seen for work-related cough, phlegm, nasal symptoms, nosebleed, and skin rash in the highest exposure group (>37 days of fertilizer use in the past 2 years) but was significant only for phlegm (odds ratio = 3.59, 95% confidence interval = 1.10-11.70). Trends of increasing odds ratios with increasing exposure were seen for cough, phlegm, nasal symptoms, and skin rash. The results suggest a weak association between respiratory and dermal irritation and work with fertilizer. Results highlight the need for further exposure monitoring within the tree planting industry, and larger studies to investigate the relationship between work with fertilizer and respiratory and dermal health symptoms. [Supplementary materials are available for this article. Go to the publisher's online edition of the Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a PDF file containing a respiratory and dermal health questionnaire.].
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Fertilizantes/efectos adversos , Agricultura Forestal , Enfermedades Pulmonares/inducido químicamente , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Enfermedades de la Piel/inducido químicamente , Contaminantes del Suelo/efectos adversos , Adulto , Alberta/epidemiología , Colombia Británica/epidemiología , Causalidad , Comorbilidad , Femenino , Humanos , Incidencia , Enfermedades Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Exposición Profesional/análisis , Exposición Profesional/estadística & datos numéricos , Oportunidad Relativa , Enfermedades de la Piel/epidemiología , Fumar/epidemiología , Contaminantes del Suelo/análisis , Encuestas y Cuestionarios , Árboles , Adulto JovenRESUMEN
Task-based respirable crystalline silica (RCS) exposure monitoring data was collected from construction work sites across 3 Canadian provinces: Alberta, British Columbia (BC), and Manitoba. In total 373 RCS samples were obtained from 70 worksites across 44 companies. Sampling was conducted between May 2015 and August 2020. The overall geometric mean (GM) RCS exposure was 0.045 mg/m3 (geometric standard deviation, GSD = 6.8). Alberta had the highest average exposure and the highest variability with GM of 0.060 mg/m3 (GSD = 9.3), the GM in BC was 0.044 (GSD = 4.3), and in Manitoba the GM was 0.033 (GSD = 7.0). A multivariable model was built using forward stepwise linear regression modeling. Province, task type, work environment (indoor vs. outdoor), construction material, sampling duration, and engineering control use were all statistically significant predictors of exposure level in partial F-tests (P < 0.05). Overall, the model explained 42% of the RCS concentration variability. Task type contributed most to the model's explanatory power. The task type with highest average exposure levels was demolition (GM 0.30 mg/m3, GSD 0.49). Breaking (GM 0.16 mg/m3, GSD 8.4) and grinding (GM 0.081 m/m3, GSD 7.4) also had high-exposure levels. Working outdoors was associated with exposure levels 39% lower than indoors. Exposure control measures such as local exhaust ventilation and wetting were also associated with lower exposure levels. Among construction materials, Cement, sand, and stone were associated with higher RCS exposure levels relative to the reference material, concrete. The results of this study indicate that workers in western Canada remain exposed to RCS at levels that exceed the health-based American Congress for Governmental Industrial Hygienists Threshold Limit Value of 0.025 mg/m3. Although there were some differences in exposure levels between the provinces, the determinants of exposure were similar in all 3. The overall GM RCS exposure was 0.045 mg/m3 (geometric standard deviation, GSD = 6.8). Alberta had the highest average exposure and the highest variability with GM of 0.060 mg/m3 (GSD = 9.3), the GM in BC was 0.044 (GSD = 4.3), and in Manitoba the GM was 0.033 (GSD = 7.0).
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Contaminantes Ocupacionales del Aire , Exposición Profesional , Humanos , Exposición Profesional/análisis , Contaminantes Ocupacionales del Aire/análisis , Dióxido de Silicio/análisis , Polvo/análisis , Exposición por Inhalación/análisis , Alberta , Monitoreo del Ambiente/métodosRESUMEN
In metropolitan areas, road traffic is a major contributor to ambient air pollution and the dominant source of community noise. The authors investigated the independent and joint influences of community noise and traffic-related air pollution on risk of coronary heart disease (CHD) mortality in a population-based cohort study with a 5-year exposure period (January 1994-December 1998) and a 4-year follow-up period (January 1999-December 2002). Individuals who were 45-85 years of age and resided in metropolitan Vancouver, Canada, during the exposure period and did not have known CHD at baseline were included (n = 445,868). Individual exposures to community noise and traffic-related air pollutants, including black carbon, particulate matter less than or equal to 2.5 µm in aerodynamic diameter, nitrogen dioxide, and nitric oxide, were estimated at each person's residence using a noise prediction model and land-use regression models, respectively. CHD deaths were identified from the provincial death registration database. After adjustment for potential confounders, including traffic-related air pollutants or noise, elevations in noise and black carbon equal to the interquartile ranges were associated with 6% (95% confidence interval: 1, 11) and 4% (95% confidence interval: 1, 8) increases, respectively, in CHD mortality. Subjects in the highest noise decile had a 22% (95% confidence interval: 4, 43) increase in CHD mortality compared with persons in the lowest decile. These findings suggest that there are independent effects of traffic-related noise and air pollution on CHD mortality.
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Contaminación del Aire/efectos adversos , Enfermedad Coronaria/mortalidad , Ruido/efectos adversos , Emisiones de Vehículos/toxicidad , Anciano , Anciano de 80 o más Años , Colombia Británica/epidemiología , Estudios de Cohortes , Enfermedad Coronaria/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Occupational noise might increase the risk of workplace injury through a variety of mechanisms, including interference with communication and increased stress. OBJECTIVES: The purpose of this study was to assess the effect of chronic noise exposure on serious workplace injury, and how the timing of exposure influenced risk. METHODS: The authors examined a cohort of 26â000 workers, who worked between 1950 and 1989. Cases were those hospitalised for a work-related injury (ICD-9 codes 800-999, and E codes E800-E999), from April 1989 to December 1998. Cumulative exposure levels were estimated for subjects based on a quantitative retrospective exposure assessment. An internal comparison of cumulative noise exposure and subchronic durations of noise exposure and injury was conducted using Poisson regression. There were 163 cases for the cumulative and 161 cases for the subchronic analysis. RESULTS: Cumulative noise exposure were associated with a decreased risk for injuries, with the risk generally decreasing as cumulative noise levels increased, while most durations of subchronic exposure were associated with an increased risk for injury. An inverse U-shaped trend was observed with the time period of 90 days to 1 year demonstrating the most elevated RR compared with 0-1 days of exposure. CONCLUSIONS: Workers highly exposed to noise, or exposed for long periods of time, might develop effective methods of communicating the risk and preventing injuries when exposed to noise.
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Accidentes de Trabajo/estadística & datos numéricos , Industrias , Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , Madera , Adulto , Colombia Británica/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de TiempoRESUMEN
Epidemiologic studies have shown that both air pollution and community noise are associated with cardiovascular disease mortality. Because road traffic is a major contributor to these environmental pollutants in metropolitan areas, it is plausible that the observed associations may be confounded by coexistent pollutants. As part of a large population-based cohort study to address this concern, we used a noise prediction model to assess annual average community noise levels from transportation sources in metropolitan Vancouver, Canada. The modeled annual average noise level was 64 (inter quartile range 60-68) dB(A) for the region. This model was evaluated by comparing modeled annual daytime A-weighted equivalent continuous noise levels (L(day)) with measured 5-min daytime A-weighted equivalent continuous noise levels (L(eq,day,5 min)) at 103 selected roadside sites in the study region. On average, L(day) was 6.2 (95% CI, 6.0-7.9) dB(A) higher than, but highly correlated (r=0.62; 95% CI, 0.48-0.72) with, L(eq,day,5 min). These results suggest that our model-based noise exposure assessment could approximately reflect actual noise exposure in the study region. Overall, modeled noise levels were not strongly correlated with land use regression estimates of traffic-related air pollutants including black carbon, particulate matter with aerodynamic diameter ≤2.5 µm (PM(2.5)), NO(2) and NO; the highest correlation was with black carbon (r=0.48), whereas the lowest correlation was with PM(2.5) (r=0.18). There was no consistent effect of traffic proximity on the correlations between community noise levels and traffic-related air pollutant concentrations. These results, consistent with previous studies, suggest that it is possible to assess potential adverse cardiovascular effects from long-term exposures to community noise and traffic-related air pollution in prospective epidemiologic studies.
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Contaminación del Aire/análisis , Simulación por Computador , Exposición a Riesgos Ambientales/análisis , Modelos Teóricos , Ruido del Transporte/efectos adversos , Población Urbana , Contaminación del Aire/efectos adversos , Colombia Británica , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Ciudades , Exposición a Riesgos Ambientales/estadística & datos numéricos , Humanos , UrbanizaciónRESUMEN
OBJECTIVE: Noise is probably the most ubiquitous of occupational hazards. While many jurisdictions require hearing conservation programs (HCP), the most effective intervention-engineered noise controls (ENC)-is rarely implemented. We used a qualitative study design to investigate barriers to the implementation of ENC. DESIGN & STUDY SAMPLE: Fifty-five individuals at eight food and beverage manufacturers participated. In-depth interviews were conducted and analysed using grounded theory techniques. HCP audits provided contextual information. RESULTS: None of the companies had fully implemented HCP as required by regulation. Many factors emerged as possible barriers to the implementation of engineered noise control, including: poor knowledge of relevant regulations, noise reduction options and the health impacts of noise; weak technical skills and experience; low ranking of noise as a hazard by stakeholders; issues around job insecurity, weak language skills; lack of 'quiet' machine options and information from equipment manufacturers; poor employer-regulator relationships; barriers to employee-employer reporting; informal valuation of ENC costs; and feasibility issues. CONCLUSIONS: Potential barriers to the implementation of ENC were identified, and classified at three levels at which they operated. Many barriers could be addressed by a more rigorous application of existing HCP regulation and improvements in education, technical support, and regulatory enforcement.
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Industria de Procesamiento de Alimentos , Pérdida Auditiva Provocada por Ruido/prevención & control , Ruido en el Ambiente de Trabajo/prevención & control , Adulto , Colombia Británica , Ambiente , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Cultura Organizacional , Adulto JovenRESUMEN
This pilot study is one of the first to examine the impact of job strain and shift work on both the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis using two salivary stress biomarkers and two subclinical heart disease indicators. This study also tested the feasibility of a rigorous biological sampling protocol in a busy workplace setting. Paramedics (n = 21) self-collected five salivary samples over 1 rest and 2 workdays. Samples were analyzed for α-amylase and cortisol diurnal slopes and daily production. Heart rate variability (HRV) was logged over 2 workdays with the Polar RS800 Heart Rate monitors. Endothelial functioning was measured using fingertip peripheral arterial tonometry. Job strain was ascertained using a paramedic-specific survey. The effects of job strain and shift work were examined by comparing paramedic types (dispatchers vs. ambulance attendants) and shift types (daytime vs. rotating day/night). Over 90% of all expected samples were collected and fell within expected normal ranges. Workday samples were significantly different from rest day samples. Dispatchers reported higher job strain than ambulance paramedics and exhibited reduced daily alpha-amylase production, elevated daily cortisol production, and reduced endothelial function. In comparison with daytime-only workers, rotating shift workers reported higher job strain, exhibited flatter α-amylase and cortisol diurnal slopes, reduced daily α-amylase production, elevated daily cortisol production, and reduced HRV and endothelial functioning. Despite non-statistically significant differences between group comparisons, the consistency of the overall trend in subjective and objective measures suggests that exposure to work stressors may lead to dysregulation in neuroendocrine activity and, over the long-term, to early signs of heart disease. Results suggest that further study is warranted in this population. Power calculations based on effect sizes in the shift type comparison suggest a study size of n = 250 may result in significant differences at p = 0.05. High compliance among paramedics to complete the intensive protocol suggests this study will be feasible in a larger population.
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Técnicos Medios en Salud , Ritmo Circadiano/fisiología , Cardiopatías/fisiopatología , Hidrocortisona/análisis , Saliva/química , Tolerancia al Trabajo Programado/fisiología , alfa-Amilasas/análisis , Adulto , Biomarcadores/metabolismo , Colombia Británica , Monitoreo del Ambiente , Femenino , Cardiopatías/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estrés Fisiológico/fisiologíaRESUMEN
Trucking is a key industry in Canada with around 180 000 professional drivers. As an industry it has a disproportionately high injury claim rate, particularly for back injuries. Whole-body vibration (WBV) can contribute to the onset and development of low back disorders, and is a well-documented exposure among driving professions. A widely adopted WBV mitigation measure focuses on hydraulic and/or pneumatic passive suspension systems both in the driver's seat and underneath the vehicle cab. Passive suspension 'air-ride' seats are the current industry standard but new technologies such as the electromagnetic active vibration cancelling (EAVC) seats offer potentially substantial improvements in WBV reduction. In this paper, we evaluate and compare four commonly used truck seats (three air-ride, one EAVC) for their vibration damping characteristics and WBV exposure attenuation in on- and off-road conditions. We recruited 24 professional truck drivers who drove 280 km (mixed on-road and off-road) in ore-haul trucks under four different seating conditions. Following the ISO 2631-1 WBV standard, vibration measurements were made on the cab floor and seat pad, and 8-h average weighted vibration (A(8)) and 8-h vibration dose values (VDV(8)) were calculated, as well as the Seat Effective Amplitude Transmissibility (SEAT), and daily vibration action limits (DVALs). These measures were compared between seat types, as well as road conditions. The EAVC seat gave best performance for both A(8) (0.27 m s-2) and VDV(8) (6.6 m s-1.75). The EVAC seat had the lowest SEAT tested (36.2%) and the longest DVAL. However, among the three passive air-suspension seats, two showed significantly reduced A(8) (0.43 and 0.44 m s-2) and VDV(8) (9.1 and 9.3 m s-1.75) exposures relative to the third passive air-suspension seats [A(8) (0.54 m s-2) and VDV(8) (11.1 m s-1.75)]. These differences in exposures among the three passive air-suspension seats resulted in varying DVAL times, with the worst performing seat reaching the DVAL after only 6.3 h of driving. There was also a seat by road type interaction; there were performance differences between the passive air-suspension seats on-road, but not off-road. The observed reduction of the WBV exposures measured from the EAVC seat was consistent with previous results. But we showed that there can also be substantive differences among seats that are the current industry standard. These differences were more evident on-road than off-road, which suggests that more work needs to be done to understand seat performance characteristics, and in matching the correct seat technology to the driving task. We demonstrated that WBV exposures in current industry conditions may exceed health-based exposure limits; this has policy relevance because WBV exposures are linked to prevalent and costly adverse health conditions in a working population that is ageing. Increased WBV measurement collection is recommended to ensure the anticipated exposure attenuations are achieved when seats are relied upon as an engineered control against WBV.
Asunto(s)
Dolor de la Región Lumbar , Enfermedades Profesionales , Exposición Profesional , Diseño de Equipo , Humanos , Vehículos a Motor , Exposición Profesional/efectos adversos , Vibración/efectos adversosRESUMEN
BACKGROUND: Growing evidence suggests that exposure to green space is associated with improved childhood health and development, but the influence of different green space types remains relatively unexplored. In the present study, we investigated the association between early-life residential exposure to vegetation and early childhood development and evaluated whether associations differed according to land cover types, including paved land. METHODS: Early childhood development was assessed via kindergarten teacher-ratings on the Early Development Instrument (EDI) in a large population-based birth cohort (n = 27,539) in Metro Vancouver, Canada. The residential surrounding environment was characterized using a high spatial resolution land cover map that was linked to children by six-digit residential postal codes. Early-life residential exposure (from birth to time of EDI assessment, mean age = 5.6 years) was calculated as the mean of annual percentage values of different land cover classes (i.e., total vegetation, tree cover, grass cover, paved surfaces) within a 250 m buffer zone of postal code centroids. Multilevel models were used to analyze associations between respective land cover classes and early childhood development. RESULTS: In adjusted models, one interquartile range increase in total vegetation percentage was associated with a 0.33 increase in total EDI score (95% CI: 0.21, 0.45). Similar positive associations were observed for tree cover (ß-coefficient: 0.26, 95% CI: 0.15, 0.37) and grass cover (ß-coefficient: 0.12, 95% CI: 0.02, 0.22), while negative associations were observed for paved surfaces (ß-coefficient: -0.35, 95% CI: -0.47, -0.23). CONCLUSIONS: Our findings indicate that increased early-life residential exposure to vegetation is positively associated with early childhood developmental outcomes, and that associations may be stronger for residential exposure to tree cover relative to grass cover. Our results further indicate that childhood development may be negatively associated with residential exposure to paved surfaces. These findings can inform urban planning to support early childhood developmental health.
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Cohorte de Nacimiento , Parques Recreativos , Niño , Desarrollo Infantil , Preescolar , Estudios de Cohortes , Ambiente , Humanos , ÁrbolesRESUMEN
OBJECTIVES: Diesel engine exhaust (DEE) is a known lung carcinogen and a common occupational exposure in Canada. The use of diesel-powered equipment in the construction industry is particularly widespread, but little is known about DEE exposures in this work setting. The objective of this study was to determine exposure levels and identify and characterize key determinants of DEE exposure at construction sites in Ontario. METHODS: Elemental carbon (EC, a surrogate of DEE exposure) measurements were collected at seven civil infrastructure construction worksites and one trades training facility in Ontario using NIOSH method 5040. Full-shift personal air samples were collected using a constant-flow pump and SKC aluminium cyclone with quartz fibre filters in a 37-mm cassette. Exposures were compared with published health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03 µg m-3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5 µg m-3 respirable EC). Mixed-effects linear regression was used to identify determinants of EC exposure. RESULTS: In total, 149 EC samples were collected, ranging from <0.25 to 52.58 µg m-3 with a geometric mean (GM) of 3.71 µg m-3 [geometric standard deviation (GSD) = 3.32]. Overall, 41.6% of samples exceeded the FIOH limit, mostly within underground worksites (93.5%), and 90.6% exceeded the DECOS limit. Underground workers (GM = 13.20 µg m-3, GSD = 1.83) had exposures approximately four times higher than below grade workers (GM = 3.56 µg m-3, GSD = 1.94) and nine times higher than above ground workers (GM = 1.49 µg m-3, GSD = 1.75). Training facility exposures were similar to above ground workers (GM = 1.86 µg m-3, GSD = 4.12); however, exposures were highly variable. Work setting and enclosed cabins were identified as the key determinants of exposure in the final model (adjusted R2 = 0.72, P < 0.001). The highest DEE exposures were observed in underground workplaces and when using unenclosed cabins. CONCLUSIONS: This study provides data on current DEE exposure in Canadian construction workers. Most exposures were above recommended health-based limits, albeit in other jurisdictions, signifying a need to further reduce DEE levels in construction. These results can inform a hazard reduction strategy including targeted intervention/control measures to reduce DEE exposure and the burden of occupational lung cancer.