Cancer surveillance among workers in plastics and rubber manufacturing in Ontario, Canada.

OBJECTIVE: Occupational exposure to agents in plastics and rubber manufacturing has been associated with elevated risk of certain cancers. We sought to evaluate cancer risk among workers employed in occupations and industries with these exposures as part of an ongoing surveillance programme in Ontario, Canada. METHODS: The Occupational Disease Surveillance System (ODSS) cohort was established using workers' compensation claims data and includes 2.18 million workers employed from 1983 to 2014. Workers were followed for site-specific cancer diagnoses in the Ontario Cancer Registry through 2016. Cox proportional hazard models were used to estimate adjusted HR and 95% CI. RESULTS: We identified 81 127 workers employed in plastics and rubber manufacturing industries or materials processing and product fabricating occupations. Compared with all other women in the ODSS, those in materials processing occupations had an elevated rate of lung cancer (HR 1.38, 95% CI 1.20 to 1.58) that was not observed among men. An elevated rate of breast cancer was observed among female labourers (HR 1.36, 95% CI 1.01 to 1.82) and moulders (HR 1.47, 95% CI 0.91 to 2.37) in plastics and rubber product fabricating occupations. Overall, elevated rates were observed for oesophageal, liver, stomach, prostate and kidney cancer in job-specific subgroups, including mixing and blending, bonding and cementing, and labouring. There was little evidence of association for lymphatic or haematopoietic cancers. CONCLUSIONS: Findings for lung and breast cancer in women are consistent with other studies and warrant further attention in Ontario. Given the relatively young age at end of follow-up, surveillance in these workers should continue as the cohort ages.

Teachers' work and health in Brazil: thoughts on the history of research, strides, and challenges. / Trabalho e saúde de professoras e professores no Brasil: reflexões sobre trajetórias das investigações, avanços e desafios.

This Essay discusses the theme of teachers' work and health in Brazil. The objectives are to describe the initial history of research on teachers' health, discuss elements leading to a consensus on the characterization of the group's work and principal health problems, and systematize the main strides and challenges. The Essay draws on more than two decades of research and practice in this field. Based on this experience, the authors identify the movements, the accumulated evidence, and prospects for future development. The elements brought to the discussion point to substantial growth in the field: the number of studies, the diversity and scope of topics, the groups of men and women teachers studied, and the experiences with application of the knowledge (programs and interventions). Despite these strides, the studies and practices still emphasize the individual and the disease, with little or no attention to work factors (work process and management) in the health/disease process. Issues pertaining to gender differences (in work and in health status) also remain invisible. There is little linkage between researchers and teachers' movements (a relevant characteristic of the first initiatives in the field). There are no public policies to regulate the workplace and work management. The contributions to the discussion provide insight for thought to assist the identification of critical nodes and analytical scenarios with the potential for progress in this field of research and intervention.

Este Ensaio discute a temática de trabalho e saúde docente no Brasil. Tem como objetivos: descrever trajetórias iniciais das investigações de saúde do/a professor/a no contexto brasileiro; discutir elementos que consolidaram consenso com relação à caracterização do trabalho e os principais problemas de saúde neste grupo; e sistematizar seus principais avanços e desafios. O Ensaio é organizado com base na experiência de mais de duas décadas em investigações e práticas nessa temática. Valendo-se dessa experiência identificam-se seus movimentos, as evidências acumuladas e perspectivas potenciais de desenvolvimento futuro. Com base nos elementos trazidos à discussão observa-se o crescimento substantivo do campo: do número de investigações, da diversidade e abrangência dos temas abordados, dos grupos de professores/as estudados/as e das experiências de aplicação do conhecimento (programas e intervenções). Apesar desses avanços, as investigações e práticas ainda mantêm a ênfase no indivíduo e na doença, com ausência ou abordagem limitada dos fatores do trabalho (processo e gestão do trabalho) no processo saúde/doença. Questões relativas aos diferenciais de gênero (no trabalho e na situação de saúde) também permanecem invisíveis. Observa-se pouca articulação de pesquisadores/as e movimentos docentes (uma característica relevante das primeiras iniciativas no campo). Registra-se ausência de políticas públicas de regulação dos ambientes e gestão do trabalho. Os aspectos trazidos à discussão fornecem uma base de reflexão, de modo a auxiliar na identificação de nós críticos e de cenários analíticos com potencial para avançar nesse campo de investigação e de intervenção.

Este Ensayo discute la temática de trabajo y salud docente en Brasil. Tiene como objetivos: describir trayectorias iniciales de investigaciones de salud del/a profesor/a en el contexto brasileño; discutir elementos que consolidaron el consenso referente a la caracterización del trabajo y los principales problemas de salud en este grupo; además de sistematizar sus principales avances y desafíos. El estudio está organizado en base a la experiencia de más de dos décadas en investigaciones y prácticas en esta temática. Valiéndose de esta experiencia se identifican sus movimientos, las evidencias acumuladas y perspectivas potenciales de su desarrollo futuro. En base a los elementos en liza se observa un crecimiento sustancial del área de estudio: número de investigaciones, diversidad y alcance de los temas abordados, grupos de profesores/as estudiados/as, así como de las experiencias de aplicación del conocimiento (programas e intervenciones). A pesar de esos avances, las investigaciones y prácticas todavía mantienen el énfasis en el individuo y en la enfermedad, con ausencia o un enfoque limitado sobre los factores del trabajo (proceso y gestión del trabajo) en el proceso salud/enfermedad. Las cuestiones relacionadas con los diferenciales de género (en el trabajo y situación de salud) también permanecen invisibles. Se observa poca coordinación de investigadores/as y movimientos docentes (una característica relevante de las primeras iniciativas en el área de estudio). Se constata la ausencia de políticas públicas de regulación en entornos y gestión laborales. Los aspectos planteados proporcionan una base de reflexión, con el fin de que ayuden en la identificación de problemas clave y escenarios analíticos con potencial para avanzar en este campo de investigación y de intervención.

Trabalho e saúde de professoras e professores no Brasil: reflexões sobre trajetórias das investigações, avanços e desafios / Trabajo y salud de profesoras y profesores en Brasil: reflexiones sobre trayectorias de investigaciones, avances y desafíos / Teachers' work and health in Brazil: thoughts on the history of research, strides, and challenges

Este Ensaio discute a temática de trabalho e saúde docente no Brasil. Tem como objetivos: descrever trajetórias iniciais das investigações de saúde do/a professor/a no contexto brasileiro; discutir elementos que consolidaram consenso com relação à caracterização do trabalho e os principais problemas de saúde neste grupo; e sistematizar seus principais avanços e desafios. O Ensaio é organizado com base na experiência de mais de duas décadas em investigações e práticas nessa temática. Valendo-se dessa experiência identificam-se seus movimentos, as evidências acumuladas e perspectivas potenciais de desenvolvimento futuro. Com base nos elementos trazidos à discussão observa-se o crescimento substantivo do campo: do número de investigações, da diversidade e abrangência dos temas abordados, dos grupos de professores/as estudados/as e das experiências de aplicação do conhecimento (programas e intervenções). Apesar desses avanços, as investigações e práticas ainda mantêm a ênfase no indivíduo e na doença, com ausência ou abordagem limitada dos fatores do trabalho (processo e gestão do trabalho) no processo saúde/doença. Questões relativas aos diferenciais de gênero (no trabalho e na situação de saúde) também permanecem invisíveis. Observa-se pouca articulação de pesquisadores/as e movimentos docentes (uma característica relevante das primeiras iniciativas no campo). Registra-se ausência de políticas públicas de regulação dos ambientes e gestão do trabalho. Os aspectos trazidos à discussão fornecem uma base de reflexão, de modo a auxiliar na identificação de nós críticos e de cenários analíticos com potencial para avançar nesse campo de investigação e de intervenção.

Este Ensayo discute la temática de trabajo y salud docente en Brasil. Tiene como objetivos: describir trayectorias iniciales de investigaciones de salud del/a profesor/a en el contexto brasileño; discutir elementos que consolidaron el consenso referente a la caracterización del trabajo y los principales problemas de salud en este grupo; además de sistematizar sus principales avances y desafíos. El estudio está organizado en base a la experiencia de más de dos décadas en investigaciones y prácticas en esta temática. Valiéndose de esta experiencia se identifican sus movimientos, las evidencias acumuladas y perspectivas potenciales de su desarrollo futuro. En base a los elementos en liza se observa un crecimiento sustancial del área de estudio: número de investigaciones, diversidad y alcance de los temas abordados, grupos de profesores/as estudiados/as, así como de las experiencias de aplicación del conocimiento (programas e intervenciones). A pesar de esos avances, las investigaciones y prácticas todavía mantienen el énfasis en el individuo y en la enfermedad, con ausencia o un enfoque limitado sobre los factores del trabajo (proceso y gestión del trabajo) en el proceso salud/enfermedad. Las cuestiones relacionadas con los diferenciales de género (en el trabajo y situación de salud) también permanecen invisibles. Se observa poca coordinación de investigadores/as y movimientos docentes (una característica relevante de las primeras iniciativas en el área de estudio). Se constata la ausencia de políticas públicas de regulación en entornos y gestión laborales. Los aspectos planteados proporcionan una base de reflexión, con el fin de que ayuden en la identificación de problemas clave y escenarios analíticos con potencial para avanzar en este campo de investigación y de intervención.

This Essay discusses the theme of teachers' work and health in Brazil. The objectives are to describe the initial history of research on teachers' health, discuss elements leading to a consensus on the characterization of the group's work and principal health problems, and systematize the main strides and challenges. The Essay draws on more than two decades of research and practice in this field. Based on this experience, the authors identify the movements, the accumulated evidence, and prospects for future development. The elements brought to the discussion point to substantial growth in the field: the number of studies, the diversity and scope of topics, the groups of men and women teachers studied, and the experiences with application of the knowledge (programs and interventions). Despite these strides, the studies and practices still emphasize the individual and the disease, with little or no attention to work factors (work process and management) in the health/disease process. Issues pertaining to gender differences (in work and in health status) also remain invisible. There is little linkage between researchers and teachers' movements (a relevant characteristic of the first initiatives in the field). There are no public policies to regulate the workplace and work management. The contributions to the discussion provide insight for thought to assist the identification of critical nodes and analytical scenarios with the potential for progress in this field of research and intervention.

Work-related mental disorders and their inclusion in health policies in the Brazilian Unified Health System (Sistema Único de Saúde).

This study discusses the inclusion of mental disorders as work-related diseases in occupational health policies in Brazil. Mental disorders first appeared as a group of occupational diseases in 1999. Establishing mental disorders as occupational diseases was a result of the confluence of several factors: a broader notion of health, a positive shift in public perception regarding preconceived judgements relating to mental disorders and the improvement in the process that defines social security benefit entitlements due to the implementation of a new methodology in 2007.

[The essentials of workplace analysis for examining occupational disability claims]. / Berufskundliche Grundlagen für die Beurteilung der Berufsunfähigkeit (I).

The insurance branch that covers the risk of occupational disability ranks among the most important private entities for offering security as far as the limitation or loss of one's ability to work is concerned. The financial risk of the insurer, the existential concerns and expectations of the claimant, as well as the legal framework and the need for a careful interdisciplinary evaluation, necessitate a professional review and assessment of the facts conducted with a sense of both responsibility and sensitivity. Carefully deliberated and sustainable decisions benefit both insurers and the insured. In order to achieve this, an opinion is required in many--and especially the more complex--cases from an external medical expert, which in turn can only be plausible and conclusive when based on a comprehensive review of the claimant's working environment and its particular (and often unique) requirements. This article is intended to increase the reader's understanding of the coherencies of workplace analysis and medical assessments, as required by insurance law and legislation. In addition, the article delivers valuable clues and guidance, both for medical experts and claims managers at insurance companies. Primarily, the claimant's occupation, as conceived in the terms and conditions of the insurance companies, is explained. The reader is then introduced to the various criteria to be considered when a claimant has several jobs at the same time, is self-employed, could be transferred to another job, is simply unable to commute to the workplace, or is prevented from working due to legal restrictions related to an illness. The article goes on to address the crucial aspect of how the degree of disability is to be measured under different circumstances, namely using the quantitative and the qualitative approach. As a reliable method for obtaining the essential data regarding the claimant's specific working conditions, which are required by both the medical expert and the insurance company's claims manager, the reader is provided with an insider's insights into on-site workplace analysis. The value of this pragmatic and proven method is subsequently demonstrated when the article addresses the often decisive part of the medical expert's assessment. In its conclusion the article points out the importance of workplace analysis to the entire process of evaluating occupational disability claims and the effort and monies to be saved by attaching value to thorough workplace analysis at an early stage.

[Work-related disability among postal employees: incidence, duration, and social security costs in 2008]. / Incapacidade laboral entre trabalhadores do ramo Correios: incidência, duração e despesa previdenciária em 2008.

This study analyzed the characteristics of Brazilian postal workers that received sick leave benefits in 2008. The databases were from the Unified Benefits System (SUB) and the National Registry of Social Information (CNIS). The incidence rate was 556.5 benefits per 10,000 employees, and the leading causes of work-related sick leave were injuries, musculoskeletal disorders, and mental disorders. Areas most frequently reported in injuries were knees and legs, wrists and hands, ankles and feet, and shoulders and arms, with higher incidence rates in men. Women were more affected by musculoskeletal disorders and mental disorders. Average sick leave lasted longer in men, and the incidence of benefits increased with age. The States with the highest incidence rates were Mato Grosso do Sul, Goiás, and Santa Catarina, and security benefits averaged BRL 1,847.00. Postal work may involve additional risk of injuries to the limbs, due to the long distances carrying heavy weight, assault, and dog bites.

Costs of occupational injuries and diseases in Québec.

PROBLEM: Occupational injuries and diseases are costly for companies and for society as a whole. This study estimates the overall costs of occupational injuries and diseases in Québec, both human and financial, during the period from 2005 to 2007. METHOD: The human capital method is used to estimate lost productivity. A health indicator (DALY) is used in combination with a value of statistical life (VSL) to estimate, in monetary terms, the pain and suffering costs resulting from occupational injuries. RESULTS: The costs of occupational injuries and diseases occurring in a single year in Québec are estimated at $4.62 billion, on average, for the 2005-2007 period. Of this amount, approximately $1.78 billion is allocated to financial costs and $2.84 billion to human costs. The average cost per case is $38,355. In view of the limitations identified in the study, it can be argued that this is an underestimation of the costs. Result analysis allows the injury/disease descriptors and industries for which the costs are highest to be identified. PRACTICAL APPLICATIONS: The results of these estimates are a relevant source of information for helping to determine research directions in OHS and prevention. The methodology used can be replicated for the purposes of estimating the costs of injuries and diseases in other populations.

The scope and specific criteria of compensation for occupational diseases in Korea.

The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.

Incapacidade laboral entre trabalhadores do ramo Correios: incidência, duração e despesa previdenciária em 2008 / Work-related disability among postal employees: incidence, duration, and social security costs in 2008 / Incapacidad laboral entre los trabajadores de Correos: incidencia, duración y gastos en pensiones durante 2008

Analisou-se o perfil dos trabalhadores do ramo de atividade Correios que receberam benefícios auxílio-doença, no Brasil, em 2008. Os dados originaram-se do Sistema Único de Benefícios (SUB) e do Cadastro Nacional de Informações Sociais (CNIS). A incidência foi de 556,5 benefícios por 10 mil empregados, e as principais causas de afastamento foram traumatismos, doenças osteomusculares e transtornos mentais. Locais de traumas mais notificados foram joelho e perna, punho e mão, tornozelo e pé, ombro e braço, com as maiores incidências em homens. Mulheres foram as mais acometidas por doenças osteomusculares e transtornos mentais. A duração do auxílio-doença foi maior entre homens, havendo aumento da incidência de benefícios com o envelhecimento. Os estados de Mato Grosso do Sul, Goiás, Santa Catarina foram os de maiores incidências, e a despesa previdenciária foi de R$ 1.847,00. É possível que a atividade postal apresente riscos adicionais de acidentes em extremidades devido ao excesso de peso carregado por longas distâncias, risco de assaltos ou de acidente por mordedura de cães.

This study analyzed the characteristics of Brazilian postal workers that received sick leave benefits in 2008. The databases were from the Unified Benefits System (SUB) and the National Registry of Social Information (CNIS). The incidence rate was 556.5 benefits per 10,000 employees, and the leading causes of work-related sick leave were injuries, musculoskeletal disorders, and mental disorders. Areas most frequently reported in injuries were knees and legs, wrists and hands, ankles and feet, and shoulders and arms, with higher incidence rates in men. Women were more affected by musculoskeletal disorders and mental disorders. Average sick leave lasted longer in men, and the incidence of benefits increased with age. The States with the highest incidence rates were Mato Grosso do Sul, Goiás, and Santa Catarina, and security benefits averaged BRL 1,847.00. Postal work may involve additional risk of injuries to the limbs, due to the long distances carrying heavy weight, assault, and dog bites.

Se analizó el perfil de los trabajadores de Correos en Brasil que recibieron subsidios por enfermedad en 2008. Los datos proceden de las bases de datos del Sistema Único de Beneficios y del Registro Nacional de Información Social. La incidencia fue de 556,5 subsidios de enfermedad por cada 10.000 empleados y las principales causas de solicitud fueron las lesiones, las enfermedades musculoesqueléticas y los trastornos mentales. Las partes del cuerpo, cuyas lesiones fueron más comunes, eran: la rodilla y la pierna, la muñeca y la mano, el pie y el tobillo, el hombro y el brazo, con mayor incidencia en los hombres. Las mujeres fueron las más afectadas por las enfermedades osteomusculares y los trastornos mentales. La duración del subsidio de enfermedad fue mayor en los hombres y hubo un aumento de la incidencia de este subsidio con el envejecimiento. El gasto en pensiones fue de R$ 1.847,00 y los estados de Mato Grosso do Sul, Goiás y Santa Catarina fueron los de más alta incidencia. Es posible que la actividad postal presente riesgos adicionales de accidentes en las extremidades.

[Health status, morbidity and injury rate in divers serving in the Kola North].

The authors analyzed the health status of military personnel (males) of the Northern Fleet who did call-up military service (n = 420) and served on contract (n = 1370) in special diving positions in the Kola Arctic over the past few years. For the comparison of the rate of the decline of health level in different conditions of service the authors presented the averaged results of studies previously performed in the same period of time in the service personnel of coastal military units in the European North, troops from the surface ship crews and crew nuclear submarine. In the article there are considered the features of the primary disease and injury. Research and monitoring of causative-consecutive relationships between the features of military professional activity and the level and structure of primary morbidity rate allow to form the main directions of vocational rehabilitation for fleet specialists.

Occupational diseases among workers employed in various branches of the national economy.

INTRODUCTION: The purpose is to present the incidence of occupational diseases and their causal factors in the sections and divisions of the national economy in Poland. MATERIAL AND METHODS: The analysis is based on the cases of occupational diseases obligatorily reported in 2009-2011 from all over the country to the Central Register of Occupational Diseases. Data is presented as absolute numbers and average annual incidence rates per 100 000 persons employed in NACE-classified sections and divisions. RESULTS: 'lhe average annual incidence of occupational diseases was 20.6 cases per 100 000 of employed people. The highest rates were recorded in mining and quarrying (337.8), the production of metals (169.8), non-metallic mineral products (81.6), motor vehicles and transport equipment (59.7), chemicals (30.1). Specific situation in which high incidence rate is due to a single discase prevails in forestry, where tick-borne diseases represent 96.3% of all recorded cases, in education, where chronic voice disorders account for 96.5% of cases, and in human health and social work activities, where infectious diseases with the dominant hepatitis C represent 68.2% of the cases. Tlhe most common causes of occupational diseases in sections and industrial divisions with the highest incidence included: industrial dust, noise and vibration. In the manufacturing industry asbestos was the cause of 20.5% of occupational diseases and 55% of occupational cancers. CONCLUSIONS: Careful monitoring of working conditions and implementing health prevention programs should be exercised in sections and divisions of the national economy where a high risk of occupational diseases has been found.

[The Königsteiner Empfehlung of 2012 - essential alterations and modifications]. / Die Königsteiner Empfehlung von 2012 - Wesentliche Neuerungen und Änderungen.

BACKGROUND: Since 1974, the recommendation for assessment of hearing impairment caused by noise - formerly known as "Königsteiner Merkblatt" (now: "Königsteiner Empfehlung") - has been representing the state of the art for the assessment of the occupational disease BK-No. 2301. It was updated several times, the last time in 2012. It provides a summary of the current medical knowledge. A new measurement for the entire working life - the Effective Noise Dose by Liedtke - was introduced. Otoacoustic emissions (OAE) are now the crucial tests in order to detect a hair cell dysfunction. As from now the tinnitus has to be put under a more comprehensive examination. On the strength of post experience the previous speech audiometry (Freiburger Test) is reliable, it was retrained. In future the indication for hearing aids will be oriented towards the aid guidelines of the legal health insurance. The questionnaire for the expert opinion was revised and the fee was adapted.

[A comparative study of the occupational disease list between Taiwan region and the mainland].

OBJECTIVE: To provide technical reference for the revision of the list of occupational diseases of China, the list of occupational diseases between the Taiwan district and the Mainland China have been analyzed and compared. METHODS: Focus on the system of occupational diseases list between the Taiwan district and the Mainland China, the literature analysis and comparative methods were commonly used, and to explore the similarities and differences of the list of occupational diseases between the mainland and Taiwan. RESULTS: The list of occupational diseases between the mainland and Taiwan shows uniformity in the legislative process, the status and role, classification, but exists difference in the enumeration mode, the legal basis of the development, the institutions to develop the list, classification and coverage et al. CONCLUSION: To revise the National List of Occupational Diseases, the socio-economic development requirements should be based on, combined with social security capacity, gradually expand the coverage of occupational diseases, to adapt to the needs of the occupational disease prevention.

[Health state of Governmental Fire Fighting Service workers in North-East Regional Center of Ministry of Emergencies over 2003-2008].

The study was aimed at evaluation of health state in Governmental Fire Fighting Service workers in North-East Regional Center of Ministry of Emergencies over 2003-2008. Using medical statistic analysis, the authors determined levels and statistically significant tendencies in dynamics of general and primary morbidity, labour losses, disability and mortality, defined the most important social and epidemiologic classes of diseases in firemen.

World Trade Center Health Program; addition of certain types of cancer to the list of WTC-related health conditions. Final rule.

Title I of the James Zadroga 9/11 Health and Compensation Act of 2010 amended the Public Health Service Act (PHS Act) to establish the World Trade Center (WTC) Health Program. The WTC Health Program, which is administered by the Director of the National Institute for Occupational Safety and Health (NIOSH), within the Centers for Disease Control and Prevention (CDC), provides medical monitoring and treatment to eligible firefighters and related personnel, law enforcement officers, and rescue, recovery, and cleanup workers who responded to the September 11, 2001, terrorist attacks in New York City, at the Pentagon, and in Shanksville, Pennsylvania, and to eligible survivors of the New York City attacks. In accordance with WTC Health Program regulations, which establish procedures for adding a new condition to the list of covered health conditions, this final rule adds to the List of WTC-Related Health Conditions the types of cancer proposed for inclusion by the notice of proposed rulemaking.