Repeatability of self-reported data on occupational exposure to particular compounds.

The repeatability of self-reported occupational exposure to eight particular compounds was investigated in 209 males aged 49-87 years. The subjects completed an initial mailed questionnaire and were interviewed by telephone 3-5 weeks later. The study was carried out as part of a case-referent study on the relation between occupation and prostate cancer. The repeatability of answers was found to be better in the case of some agents than in that of others: kappas calculated as a measure of concordance range from 0.36 to 0.70. No substantial influence was found to be exercised by age or socioeconomic status, or by case or referent status. Although the repeatability observed was not flawless, it was concluded that self-reported exposure data would appear to be a sound basis for epidemiological studies on the aetiology of disease, whenever objective information on occupational exposure is not available.

Eosinophil-related respiratory disease in aluminium workers.

We carried out a nested case-control study in an aluminium producing plant, using the results of pre-employment examination to identify workers with an increased risk of developing work-related obstructive respiratory symptoms. Cases (n=49) are those who had become unable to work because of work-related respiratory disease. They were compared with 49 matched controls. Pre-employment eosinophil count was strongly related to the occurrence of work-related obstructive respiratory disease. This finding is interesting in the light of a possible pathogenesis.

Work environment and prostate cancer risk.

A case-referent study of 345 prostate cancer cases and 1,346 referents was carried out in the Netherlands to investigate the relationship between work environment and prostate cancer risk. Cases were selected from the Cancer Registry of the Comprehensive Cancer Centre IKO. Referents (men diagnosed with benign prostate hyperplasia) were recruited with assistance of the pathology laboratories in the IKO region. Questionnaires were mailed to all subjects to obtain information on their work history and occupational exposure. Moreover, workers in farming (n = 323), and in metal work and maintenance (n = 340), were requested to complete short supplements to the questionnaire inquiring in more detail into specific types of exposure. Significantly elevated risks were found for work in food manufacturing and for bookkeepers. Significantly elevated odds ratios (OR) were also observed for jobs held between 1960 and 1970 in administration, in storage, or as farm laborer. In addition, a statistically significant excess risk was found for subjects who reported frequent occupational exposure to cadmium. Cases who worked in farming applied pesticides during significant more days per year than the referents did. A nonsignificantly elevated OR was found for maintenance of tractors and agricultural machinery. Among metal workers, mechanics, and repairmen, nonsignificantly increased ORs were observed with regard to the use of acids, solvents, iron, and steel, and for welding and maintenance of machinery.

Socioeconomic status, urbanization grade, and prostate cancer.

In a population-based case-referent study, carried out in The Netherlands, the relationship between socioeconomic status (SES) and urbanization grade on the one hand and prostate cancer incidence on the other has been investigated. Two explanations for a potential association have been taken into account. First, there is a relationship with SES class (or with urbanization grade) in the past, referring to an effect on the induction or promotion of prostate cancer caused by variation in exposure to particular risk factors. Second, there is a relationship with current SES (or urbanization grade), resulted in differences in medical screening. Study data were obtained by means of a validated mailed questionnaire, which has been completed and returned by 345 cases (with histologically confirmed prostate cancer) and 1,346 referents (patients with benign prostate hyperplasia). The response was 79%. No clear relationship was observed with SES, based on the major job held between 1960-1970 (the period of cancer induction), nor was this the case with SES based on the longest-held job (as a proxy for current SES). A slight, but statistically nonsignificant, trend was found of higher risks in subjects living in rural areas, with an urban/rural ratio of 0.79. Considering the results of this study and those of previous studies reviewed in this paper, it might be doubted that any relationship is to be found between prostate cancer risk and SES or urbanization grade.

Smoking and drinking habits in relation to prostate cancer.

OBJECTIVE: To evaluate the role of tobacco and alcohol consumption in the aetiology of prostate cancer. PATIENTS AND METHODS: In a case-control study conducted in the Netherlands, information on smoking and drinking habits was obtained from questionnaires completed by 345 patients exhibiting primary prostate cancer and by 1346 controls with benign prostate hyperplasia. The response rate was 79%. RESULTS: No association was observed between drinking habits and the risk of prostate cancer (324 cases versus 1237 controls; odds ratio 1.36; 95%CI 0.84-2.22). A significantly elevated odds ratio was found for individuals who had smoked at any time during their lives (329 cases versus 1212 controls; odds ratio 2.12; 95%CI 1.24-3.62). However, no relationship was observed between the number of cigarettes smoked, the duration of smoking, the age at which the subjects started smoking or with the calendar period in which they were born. Odds ratios calculated for individuals who smoked in consecutive 5-year periods between 1940 and 1989 did not show any trend. Furthermore, the risk of prostate cancer among ex-smokers did not differ significantly from the risk among current smokers, even when smoking was stopped more than 25 years previously. CONCLUSION: From these findings, which do not point to the causative agent, it would appear that neither smoking nor alcohol consumption seriously increases the risk of prostate cancer.

Prostate cancer and work environment.

A case-referent study was conducted to investigate the relation between occupation and prostate cancer. For this study 109 cases and 209 referents (patients with prostate hyperplasia) were selected from the registries of four hospitals. Self-administered questionnaires were mailed to all subjects to obtain information on their occupational history. The response was 85%. Nonsignificant elevated risks were found for farmers, metal workers, mechanics and repairmen, traders, and salesmen. A significant risk excess was observed for teachers (n = 6; odds ratio [OR] 4.25; 95% confidence interval [CI] 1.14-15.79). The OR calculated for farmers older than 70 years was also significant (n = 9; OR 2.12; 95% CI 1.03-4.38). Literature was searched for additional evidence of excess risk among farmers, metal workers, mechanics and repairers, and to find clues for actual risk factors. From the review it can be concluded that these occupations may have a slightly increased risk for prostate cancer. However, the actual risk factors are uncertain.

Harmonization of criteria documents for standard setting in occupational health: a report of a workshop.

The paper presents the most important points of the discussion, recommendations, and conclusions of a workshop on harmonization of criteria documents (CDs) for standard setting in occupational health, with emphasis on standard setting in the European Community (EC). The objectives were to achieve harmonized CDs and to develop a mechanism for international cooperation. The discussion focused on three broad topics: contents of CDs; collection, assessment, and evaluation of data; and procedures for the preparation and exchange of CDs on specific chemicals. Annex A on the various procedures for standard setting by EC Member States, countries outside the EC, and international organizations and Annex B on the proposed contents of the CDs are also included.

The effects of an ergonomic-educational course. Postural load, perceived physical exertion, and biomechanical errors in nursing.

OBJECTIVES: To evaluate the results of an ergonomic-educational course for nurses we assessed the number and percentage of harmful postures and of ergonomic and biomechanical errors made before and after the course. We also studied the perceived physical exertion. MEANS AND METHODS: In all, 12 nurses who had participated in the course (trainees) and 12 who had not (controls) were recorded on video while performing standardized nursing tasks. The wards from which the two groups of nurses came were comparable, as were the patient populations. The nurses were also comparable in some personal characteristics. The tasks they performed included washing, lifting, and repositioning a patient as well as certain tasks other than patient handling. Video recordings were made once before (1-2 weeks) and twice after the course (after 3 months and after 15 months). The harmful postures, the errors made, and the ratings of perceived exertion were measured by means of the Ovako Working-posture Analysis System (OWAS), a checklist, and Borg scores, respectively. RESULTS: When the first and last measurements of all the above tasks taken as a whole were analyzed the trainees showed a significant improvement in the number and percentage of harmful postures and errors, whereas the controls did not. The same could be concluded for lifting alone. After the course the new work routine did not appear to have caused any extra perceived physical exertion. CONCLUSION: It can be concluded that the course was successful, although it should be carefully investigated as to whether nurses remain capable of working safely in daily practice. The work pressure that nurses experience during their normal duties could prevent them from working safely during everyday work.

Endotoxin exposure as a major determinant of lung function decline in pig farmers.

Exposure-response relationships for endotoxin as measured in dust and longitudinal decline in lung function were studied. A cohort of 171 pig farmers was followed over a 3-yr period. Long-term average exposure to dust and endotoxin was determined by personal monitoring in summer and winter, using data on farm characteristics and activities. Mean decline in FEV1 was 73 ml/yr and in FVC 55 ml/ yr. Long-term average exposure to dust was 2.63 mg/m3 (geometric SD [GSD] 1.30), and to endotoxin, 105 ng/m3 (GSD 1.5). Annual decline in FEV1 was significantly associated with endotoxin exposure. An increase in exposure with a factor 2 was associated with an extra decline of FEV1 of 19 ml/yr.

Physical work load and its assessment among the nursing staff in nursing homes.

A study was conducted to investigate the physical work load and the prevalence of musculoskeletal complaints of nurses in nursing homes. Thirty-six female subjects selected from three nursing homes in the Netherlands participated in an observational study. In addition, the total nursing staff (n = 668) was invited to take part in a questionnaire survey (response was 94%). It was noticed that almost 60% of the observed time was spent on nonpatient-related activities. Moreover, activities alternated rapidly and seldom lasted longer than 4 minutes on average. Twenty percent of the observed time was spent in "poor" work postures as defined by the Ovako Working Posture Analyzing System (Action Category 2 to 4). Activities contributing most to these poor work postures were patient care and household and preliminary tasks. Perceived exertion as scored on the Borg-CR10 scale was highest during patient-related activities. This holds also for a relative increase of heart rate. Questionnaire results showed prevalences of 41%, 35%, and 20% respectively, for back, arm/neck, and leg complaints. From this study it can be concluded that not only patient-related activities should be taken into consideration for the improvement of work postures and other potential strenuous aspects of nursing work. Household and preliminary tasks, ergonomic layout of the ward, and work pressure also deserve attention.