Bacterial contamination of coffee and personal exposure to inhalable dust and endotoxin in primary coffee processing factories in Ethiopia.

INTRODUCTION AND OBJECTIVE: Endotoxins from gram-negative bacteria might be released when the coffee cherries are processed and may cause respiratory health problems among workers in the coffee industry. The relationship between bacterial contamination and occupational exposure to endotoxin levels has not been thoroughly explored previously in primary coffee processing factories in Ethiopia, or elsewhere. The aim of this study was to characterize the level of personal endotoxin exposure and its relations with bacterial contamination of coffee cherries in such factories in Ethiopia. MATERIAL AND METHODS: A cross-sectional study was conducted from March 2020 - February 2021 in 9 primary coffee processing factories in 3 regions in Ethiopia. A total of 180 personal air samples were collected to analyze workers' exposure to inhalable dust and endotoxin. Correlation tests were performed to assess the relationship between total bacteria and endotoxin levels and between inhalable dust and endotoxin levels. RESULTS: The geometric mean (GM) of personal inhalable dust exposure among machine room workers and hand pickers were 9.58 mg/m3 and 2.56 mg/m3, respectively. The overall GM of endotoxin exposure among machine room workers and hand pickers were 10,198 EU/m3 and 780 EU/m3, respectively. Gram-negative bacteria were found in all 54 coffee samples. The correlation between inhalable dust and endotoxin exposure was significant (r=0.80; P <0.01). CONCLUSIONS: About 92% of the samples from hand pickers and all samples from machine room workers exceeded the occupational exposure limit of 90 EU/m3 recommended by the Dutch Expert Committee on Occupational Standards. Prevention and control of bacterial contamination of the coffee in primary coffee processing are suggested to reduce endotoxin exposure that might cause respiratory health problems among coffee workers.

Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey.

BACKGROUND: Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. METHODS: The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. RESULTS: The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. CONCLUSION: In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.

Predictors of shift work disorder among nurses: a longitudinal study.

BACKGROUND: Shift work is associated with sleep problems and impaired health. The main aim of the present study was to explore predictors of developing shift work disorder (SWD) among Norwegian nurses using a longitudinal design. METHODS: A total of 1533 nurses participating in a survey on shift work, sleep and health responded to questionnaires at baseline and at follow-up about two years later. SWD was defined as problems of excessive sleepiness and/or complaints of insomnia related to the work schedule. RESULTS AND CONCLUSIONS: There was a significant reduction (p < 0.001) in the prevalence of SWD from baseline to follow-up, from 35.7% to 28.6%. Logistic regression analyses showed significant risks of having SWD at follow-up and the following variables measured at baseline: number of nights worked the last year (OR = 1.01, 95% CI = 1.01-1.02), having SWD (OR = 5.19, 95% CI = 3.74-7.20), composite score on the Epworth Sleepiness Scale (OR = 1.08, 95% CI = 1.04-1.13), use of melatonin (OR = 4.20, 95% CI = 1.33-13.33), use of bright light therapy (OR = 3.10, 95% CI 1.14-8.39), and symptoms of depression measured by the Hospital Anxiety and Depression Scale (OR = 1.07, 95% CI = 1.00-1.14). In addition, leaving night work between baseline and follow-up was associated with a significantly reduced risk of SWD at follow-up (OR = 0.12, 95% CI = 0.07-0.22).

Airway symptoms and lung function among male workers in an area polluted from an oil tank explosion.

OBJECTIVE: To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later. METHODS: In a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy, recent infection, and age. RESULTS: Exposed men had significantly more upper (ORirritated nose = 2.89 [95% confidence interval = 1.31 to 6.37]) and lower (ORdyspnea uphill = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers. CONCLUSIONS: Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event.

Sleep and health in oil rig workers--before and after a two week work period offshore.

This study compared subjective sleep and subjective health complaints among Norwegian oil rig workers, before and after a two week work period. The study also compared differences between two different work schedules. The workers worked either two weeks of day shift (n=90) or two weeks of a swing shift schedule (n=93), involving one week of night shifts, immediately followed by one week of day shifts. Overall, the workers reported significantly poorer sleep quality and more complaints of insomnia at the end compared to the start of the work period. However, there was no significant difference in terms of subjective health complaints. Furthermore, there were no clear differences in changes in sleep quality, insomnia or subjective health complaints during the work period between day- and swing shift workers. However, at the end of the work period a higher proportion of insomniacs were seen among swing shift workers compared with day workers. To conclude, sleep quality and complaints of insomnia became worse during the work period. However, there were few differences in changes in terms of sleep or subjective health complaints between day- and swing shift, suggesting that 12 h day shift affected sleep and health similarly to the schedule involving night work.

Shift work disorder in nurses--assessment, prevalence and related health problems.

BACKGROUND: This study investigates the prevalence of symptoms of shift work disorder in a sample of nurses, and its association to individual, health and work variables. METHODOLOGY/PRINCIPAL FINDINGS: We investigated three different shift work disorder assessment procedures all based on current diagnostic criteria and employing symptom based questions. Crude and adjusted logistic regression analyses were performed with symptoms of shift work disorder as the dependent variable. Participants (n = 1968) reported age, gender, work schedule, commuting time, weekly work hours, children in household, number of nights and number of shifts separated by less than 11 hours worked the last year, use of bright light therapy, melatonin and sleep medication, and completed the Bergen Insomnia Scale, Epworth Sleepiness Scale, Global Sleep Assessment Questionnaire, Diurnal Scale, Revised Circadian Type Inventory, Dispositional Resilience (Hardiness) Scale--Revised, Fatigue Questionnaire, questions about alcohol and caffeine consumption, as well as the Hospital Anxiety and Depression Scale. CONCLUSIONS/SIGNIFICANCE: Prevalence rates of symptoms of shift work disorder varied from 32.4-37.6% depending on the assessment method and from 4.8-44.3% depending on the work schedule. Associations were found between symptoms of shift work disorder and age, gender, circadian type, night work, number of shifts separated by less than 11 hours and number of nights worked the last year, insomnia and anxiety. The different assessment procedures yielded similar results (prevalence and logistic regression analyses). The prevalence of symptoms indicative of shift work disorder was high. We argue that three symptom-based questions used in the present study adequately assess shift work disorder in epidemiological studies.

Measures to counteract the negative effects of night work.

OBJECTIVES: Night work is associated with several negative health outcomes as well as accidents and reduced productivity. The aim of this study was to identify factors that may counteract the negative effects of night work. METHODS: We conducted searches for studies of scientifically based countermeasures of the negative effects of night work in PubMed and Thomson Reuters' ISI Web of Knowledge and inspected the reference lists of relevant literature. RESULTS: We identified studies describing countermeasures such as proper personnel selection, bright light therapy, melatonin administration, naps, exercise, sleepiness detection devices, and the use of stimulants to improve wakefulness and hypnotics to improve daytime sleep. CONCLUSIONS: There is some research supporting countermeasures (eg, bright light, melatonin, naps, use of stimulants, proper work scheduling) as a means to improve adaptation to night work. However, there is little evidence that such countermeasures reduce the long-term health consequences of night work. Future studies should aim at identifying both work and individual factors which are related to differential health outcomes of night work. Better study designs (eg, longitudinal designs and use of standardized outcome measures) are needed in future research.

Shift work and age in petroleum offshore industry.

BACKGROUND: Shift work is associated with sleep and health problems. Tolerance to shift work is reported to decrease with age. Shift work tolerance should be considered in different shift work populations. The aim of the study was to examine the relationship between age, shift work exposure, shift type, and morningness and sleep/health problems in oil rig shift workers. MATERIAL AND METHODS: A total of 199 workers participated. They worked either two weeks of 12-h day shifts (n = 96) or two weeks of swing shifts (n = 103) (one week of 12-h night shifts followed by one week of 12-h day shifts), followed by four weeks off work. The workers filled out questionnaires on demographics, work, sleep, and health. RESULTS: We found no significant associations between age or years of shift work exposure and any of the sleep, sleepiness, or health parameters. There was a significant association between shift type and sleep duration, showing that swing shift workers had longer sleep duration than day shift workers. In addition, we found a significant association between the interaction age*, shift type, and sleep duration, where sleep duration was negatively associated with age for the swing shift workers and positively associated with age for the day shift workers. There were significant associations between morningness and sleep latency, sleep efficiency, and insomnia. CONCLUSIONS: Older workers may tolerate shift work well. Age, shift work exposure time, and shift type seemed not to affect shift work tolerance in this population. However, this may be due to a healthy worker effect and/or selection bias.

Shift work disorder among oil rig workers in the North Sea.

STUDY OBJECTIVES: Shift work disorder (SWD) is a circadian rhythm sleep disorder caused by work hours during the usual sleep period. The main symptoms are excessive sleepiness and insomnia temporally associated with the working schedule. The aim of the present study was to examine SWD among shift workers in the North Sea. DESIGN AND PARTICIPANTS: A total of 103 shift workers (2 weeks on 7 nights/7days, 12-h shifts, 4 weeks off), mean age 39.8 years, working at an oil rig in the North Sea responded to a questionnaire about SWD. They also completed the Pittsburgh Sleep Quality Index, Bergen Insomnia Scale, Epworth Sleepiness Scale, Composite Morningness Questionnaire, Subjective Health Complaint Inventory, Demand/Control, and Instrumental Mastery Oriented Coping (based on the Utrecht Coping list). Most of these instruments were administered during the first day of the 2-week working period, thus reflecting symptoms and complaints during the 4-week non-work period. The shift workers were also compared to day workers at the oil rig. RESULTS: Twenty-four individuals were classified as suffering from SWD, yielding a prevalence for SWD of 23.3%. During the 4-week non-work period, individuals with SWD reported significantly poorer sleep quality, as measured by the Pittsburgh Sleep Quality Index, and more subjective health complaints than individuals not having SWD. There were no differences between the 2 groups in sleepiness, insomnia, circadian preference, psychological demands, or control. Individuals with SWD reported significantly lower scores on coping. The reports of shift workers without SWD were similar to those of day workers regarding sleep, sleepiness, subjective health complaints, and coping. CONCLUSIONS: The prevalence of SWD was relatively high among these shift workers. Individuals with SWD reported poorer sleep quality and more subjective health complaints in the non-work period than shift workers not having SWD.