Occupational exposure to fine particulate matter in the reinforced concrete production and its association with respiratory symptoms and lung function.

BACKGROUND: Reinforced concrete production is widespread, but little is known about the occupational exposure to fine particulate matter (PM) in such workplaces, including from metalworking and concrete processing. Therefore, the aim was to characterize exposure to fine PM in the typical workplaces of the whole production cycle and to quantify the risk of respiratory symptoms and lung function in a cohort of reinforced concrete parts production industry. METHODS: At a reinforced concrete parts producing facility in Almaty, we collected 50 personal PM2.5 samples from the main exposure sites and the measured mass concentrations using gravimetric method. Workers also completed questionnaires on a detailed working history, respiratory symptoms (chronic obstructive pulmonary disease (COPD) Assessment Tool (CAT)), followed by spirometry. The association of cumulative dose with CAT score and forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was tested with multiple regression. RESULTS: The highest PM2.5 concentrations were found in the concrete-mixing unit (median 1180 µg/m3), followed by metalworking (510 µg/m3), armature workshop (375 µg/m3) and molding site (245 µg/m3), different from the concentrations in the office (29.5 µg/m3), Kruskall-Wallis p < 0.001. Cumulative PM2.5 dose, mg/m3-year (beta 0.10 (95% confidence interval (CI) 0.05; 0.15)) was strongly associated with CAT score, whereas production with FEV1/FVC (beta -4.96 (-8.31; -1.61)), independent of smoking and chronic bronchitis and sex. CONCLUSIONS: Mixing concrete and metalworks pose the greatest risk for worker's health in the reinforced concrete production from the inhalational exposure to aerosol, adversely affecting respiratory health.

Occupational multimorbidity in the nickel industry workers.

The purpose of the study was to obtain new data on the causes, development, prevalence and nature of occupational multimorbidity in the nickel industry workers. We extracted data from the register of occupational disease and intoxication cases in the population of the Murmansk region and the Krasnoyarsk Territory in 2007-2021. In 2007-2021, 24.6% of nickel industry workers with newly diagnosed occupational diseases developed a multimorbid pathology. Its prevalence rose from 0% in 2007 to 83.3% in 2021, and the number of occupational diseases increased by 3.17 times. Two diagnoses were found in 66 (14.9%), three in 22 (5.0%), four in fifteen (3.4%), five in eleven (2.5%), and six in three (0.7%) employees. Respiratory and musculoskeletal diseases were the most prevalent disorders, accounting for 31.5% and 23.0% of cases, respectively. Occupational multimorbidity resulted from the increased combined exposure to occupational hazards, outdated technological processes, and the working conditions in the finished product cleaners and crane operators. Multimorbid diseases can be better prevented with improvement in working conditions and better quality of periodic medical examinations.

High levels of indoor fine particulate matter during the cold season in Almaty prompt urgent public health action.

INTRODUCTION: Almaty is the largest city of Kazakhstan with extreme air pollution, mostly in the cold season, but little is known whether staying indoors could lessen the exposure. The aim was to quantitatively characterize indoor fine PM levels and to verify the contribution of ambient pollution to it in a polluted city like Almaty. METHODS: We collected forty-six 24-hour 15-min average samples of the ambient air and a similar number of paired indoor samples (total 92 samples). Predictors of both ambient and indoor PM2.5 mass concentrations in mg/m3, including ambient concentration, precipitation, minimal daily temperature and humidity, along with the indoor/outdoor (I/O) ratio were tested in the adjusted regression models at eight 15-min lags. RESULTS: Ambient air PM2.5 15-min average mass concentrations were highly variable and ranged from 0.001 to 0.694 mg/m3 (geometric mean (GM) 0.090, geometric standard deviation (GSD) 2.285). Snowing was the strongest predictor of lower ambient PM2.5 24-hour mass concentrations (median 0.053 vs 0.135 mg/m3 (p<0.001)). Indoor mean 15-min PM2.5 concentrations ranged from 0.002 to 0.228 mg/m3 (GM 0.034, GSD 2.254). In adjusted models, outdoor PM2.5 concentration explained 0.58 of all variability of the indoor concentration with a 75-min delay (R2 0.67 at lag8 on snowing days). Median I/O ranged from 0.386 (IQR 0.264 to 0.532) at lag0 to 0.442 (IQR 0.339 to 0.584) at lag8. CONCLUSION: During the cold season when fossil fuel is burnt for heating, the population in Almaty is exposed to very high fine PM levels even indoors. Urgent public health action is needed.

Exposure to Respirable Particulate Matter and Its Association with Respiratory Outcomes in Beauty Salon Personnel.

We aimed to assess exposure to respirable particulate matter (PM) of beauty salon personnel, identify its determinants and ascertain the associated respiratory effects. We collected 122 full-day respirable PM samples from 12 beauty salons (floor area ranging from 24 to 550 m3, staff from 4 to 8) in Almaty, Kazakhstan, taking 10 samples from each place using a portable SidePak AM520 monitor. We also assessed lifestyle (smoking, etc.), respiratory symptoms and health-related quality of life (HRQL) of the personnel using questionnaires. Out of 11,831 5-min data points, daily median respirable PM concentrations were highly variable and ranged from 0.013 to 0.666 mg/m3 with 8.5-times difference in the median concentrations between the venue with the highest median (0.29 mg/m3) and the least median (0.034 mg/m3). In a multivariate linear regression modelling, ambient PM2.5 concentration was the strongest predictor of daily median respirable PM concentration (beta 2.12; 95% CI 1.89; 2.39), and R2 of the model was 0.63. We also found a positive association of the median respirable PM with respiratory symptoms and seasonal allergy, but not with HRQL. Short-term respirable PM levels in the beauty salons may be very high, but the median concentrations are mainly determined by the ambient air pollution.

Asthma control in Kazakhstan: need for urgent action.

BACKGROUND: Asthma control, patients' awareness level and adherence to treatment in Kazakhstan have never been studied. The aim of this study was to verify the prevalence of controlled, poorly controlled and uncontrolled asthma in a large sample of three largest cities of Kazakhstan. METHODS: We recruited 600 (median age 54 (interquartile range (IQR) 22) years, 64% females) patients with diagnosis confirmed earlier in the outpatient facilities in Almaty, Astana and Shymkent in 2020-2021. We offered a structured questionnaire on asthma control and risk factors as of GINA and performed spirometry. We report the prevalence of asthma control, knowledge and skills and pharmacological treatment with 95% confidence interval (CI) and the association of selected predictors with asthma control. RESULTS: With the median of 9 (IQR 13) years of diagnosis, 40% of patients had comorbid COPD and 42% had allergic rhinitis, whereas 32% lived with pets. Asthma was well-controlled in only 12.3% (95% CI 9.7-15.0), partly controlled in 29.8% (95% CI 26.2-33.5) and uncontrolled in 57.8% (95% CI 53.9-61.8) patients. ACQ-5 score (range 0-5.8, median 2) equaled 0.2 (IQR 0.85) in well-controlled asthma patients, 1.4 (IQR 1) in partly controlled and 2.8 (IQR 1.4) in uncontrolled asthma patients. Knowledge and skills levels were very low. Only 54% were on inhaled corticosteroids (52.2% of them used budesonide/formoterol and 39.5% used fluticasone/salmeterol). 39% used steroids per os or parenterally within a period of 12 months (51% of patients with uncontrolled asthma). CONCLUSION: Asthma control, knowledge and skills levels of asthma patients in the largest cities of Kazakhstan remain unacceptably low, whereas pharmacological treatment is far from optimal. Urgent action should be taken to support doctors' training, and we call to launch a national asthma program to coordinate asthma care in Kazakhstan.

Evaluation of Cardiovascular Activity and Emotional Experience in Healthcare Workers (HCWs) Operating in COVID-19 Wards.

The new 2019 coronavirus or SARS-CoV-2 has been the first biological agent to generate, in this millennium, such a global health emergency as to determine the adoption of public health measures. During this sanitary emergency, the emotional experience of healthcare workers (HCWs) has been hugely tested by several factors. In fact, HCWs have been exposed to greatly tiring physical, psychological and social conditions. The authors investigated the cardiocirculatory activity of a group of HCWs as well as how they perceived stress while working in COVID-19 wards. In particular, every HCW underwent a medical check, an electrocardiographic base exam, systolic and diastolic pressure measurement, and cardio frequency measurement. Furthermore, each HCW was provided with a cardiac Holter device (HoC) and a pressure Holter (Hop). Some psychological factors were considered in order to quantify the stress perceived by each HCW while at work through the administration of two questionnaires: the "Social Stigma towards Patients due to COVID Scale (SSPCS)" and the "Professional Quality of Life Scale (ProQOL)". The HoC and HoP analysis results for HCWs working in COVID-19 OU wards showed significant variations in cardiocirculatory activity. From the analysis of the SSPCS questionnaire answers, it is clear that all of them showed a sense of duty towards their patients. The analysis of the ProQOL questionnaire answers showed that the prevailing attitude is fear; however, HCWs did not absolutely discriminate against those who had COVID-19 nor did they refuse to help those in need. Continuous monitoring of these employees, also carried out through occupational medicine surveillance, allows for the detection of critical conditions and the implementation of actions aimed at preventing chronic processes.

Occupational disease predictors in the nickel pyrometallurgical production: a prospective cohort observation.

BACKGROUND: Pyrometallurgical nickel production exposes workers to a wide range of occupational risk factors, including nickel aerosol, occupational noise and heat, but occupational (compensation) claims do not get enough attention in the literature. We, therefore, aimed to identify and analyze new occupational disease predictors in order to tailor prevention measures in the nickel pyrometallurgical production workers. METHODS: In a prospective observational study, a cohort of workers grouped in 16 occupations (N = 1424, 88% males, median age 39 (interquartile range (IQR) 31-47 years)), was fixed in 2007 at a large nickel production plant in the Russian High North. We then followed the cohort until 2021 and analyzed the association of selected predictors, including exposure to nickel and occupational group, with the risk of an occupational (compensation) claim in a Cox regression analysis. RESULTS: With 18,843 person-years of observation, occupational disease claims were confirmed in 129 workers (9% of the initial cohort, N = 108 men (84%)). Top three diagnoses were chronic bronchitis (3.81 cases/1000 workers/year), sensorineural deafness (2.36 cases/1000 workers /year) and musculoskeletal disorders (1.90 cases/1000 workers/year). Smoking was significantly associated with each diagnosis (adjusted hazard ratio (HR) ranged from 2.56 (95% confidence interval (CI) 1.17-5.57) for bronchitis to 6.69 (95% CI 1.46-30.64) for chronic obstructive pulmonary disease (COPD)). High nickel exposure was associated with occupational bronchitis and occupational asthma, whereas associations of occupational groups were also identified for COPD, asthma and musculoskeletal disorders. CONCLUSION: Smoking, high exposure to nickel and specific exposure in the occupational groups increase the risk of occupational disease claims and should be prioritized directions for targeted intervention.

SARS-CoV-2 Transmission Prevention Model Application in a Large Retail Company Before the Vaccine Introduction.

On 11 March 2020, following the spread of SARS-CoV-2, WHO declared a pandemic status. The impact on national health and economic systems has been huge. Therefore, many countries took measures to restrict the spread of the virus. Many work activities have been subjected to lockdown measures. However, some production activities, continued to remain open, i.e., large-scale food distribution, food industry, pharmacies, hospitals, etc. In order to contain the spread of the pandemic, public health measures have been implemented by the States to reduce the contagion of the virus in the workplace. Therefore, it was important to implement measures to contrast and contain the spread of SARS-CoV-2/COVID-19 in workplaces. The aim of this study was to adopt and implement a safety protocol useful to restrict the spread of SARS-CoV-2 in a large-scale retail trade company located in the south of Italy, before vaccination, during the first and second pandemic phases also exploiting telemedicine services. Antibody serological test cards were also used during the first pandemic wave and rapid antigenic swabs during the second to detect workers positive for SARS-CoV-2. A population of subjects who worked for another company similar for production activity and distribution on the territory was selected as the control group. During work activities, this group followed the minimum activity protocol provided by the Italian legislation (24 April 2020, Ministry Protocol), which provided the daily monitoring of the body temperature and in the case of SARS- CoV-2 positive subjects the extraordinary sanitation of the workplace. The measures implemented identified the positive subject for SARS-CoV-2 at an early stage. The protocol made it possible to significantly reduce the spread of the virus within large-scale retail distribution, and therefore, to avoid the temporary closure of the stores with a consequent reduction of economic losses compared with the control group.

Healthy worker survival effect at a high-altitude mine: prospective cohort observation.

Very little is known about the factors of healthy worker survival effect at high-altitude mines. We conducted this cohort observation of the new hires for a high-altitude gold mine in Kyrgyzstan with the aim to ascertain predictors of survival at work. All new hires in 2009 through 2012 for a high-altitude gold mine (3600-4500 m above sea level) were followed up to January 2022. We tested the association of demographic, physiological predictors and diagnoses at the pre-employment screening with non-survival at work in Cox proportional hazards yielding hazard ratios (HR) with their 95% confidence intervals (CI). The cumulative observation time was 5190 person-years. Blood pressure at pre-employment, lung function, the diagnoses of essential hypertension, chronic obstructive pulmonary disease (COPD) or any other analyzed physiological variables were not associated with non-survival at work. However, smoking (HR 1.55; 95% CI 1.10; 2.17) increased the likelihood of non-survival at work, independent of any diagnosis or lowland residence (HR 1.95; 95% CI 1.31; 2.90). Adjusted for covariates and all diagnoses, having chronic rheumatic fever (HR 10.95; 95% CI 2.92; 33.92), hemorrhoids (HR 1.32; 95% CI 1.01; 3.75), adhesive otitis (HR 1.74; 95% CI 1.05; 2.89) or obesity (HR 1.71; 95% CI 1.01; 2.88) were associated with non-survival at work with time. This prospective observation of new hires for a high-altitude mining operation demonstrated that selected diagnoses, smoking and lowland residence elevated the risk of early exit in prospective workers.

Prevalence of refractive errors and risk factors for myopia among schoolchildren of Almaty, Kazakhstan: A cross-sectional study.

INTRODUCTION: Very little is known about the prevalence of refractive errors among children in Kazakhstan. The aim of this study was to investigate the prevalence of refractive errors and risk factors of myopia among schoolchildren in Almaty, Kazakhstan. METHODS: In the cross-sectional study of 2293 secondary school students (age 6-16), we examined cycloplegic autorefraction and offered a questionnaire in three age groups: 1st grade (N = 769), 5th grade (N = 768) and 9th grade (N = 756). The questionnaire covered main risk factors such as parental myopia, screen time, time outdoors, sports activities, near work, gender, grade, and school shift. Adjusted logistic regression analysis was applied to test the association of risk factors with myopia. RESULTS: The mean spherical equivalent (SER) was -0.54 ± 1.51 diopters (D). The overall prevalence of refractive errors was 31.6% (95% confidence interval (CI) 29.7; 33.5); myopia 28.3% (95% CI 26.5; 30.1); hyperopia 3.4% (95% CI 2.7-4.1) and astigmatism 2.8% (95% CI 2.1; 3.5). In the multivariate adjusted regression analysis, higher class level (5th grade (odds ratio (OR) 1.78; 95% CI 1.26; 2.52) and 9th grade (OR 3.34; 95% CI 2.31; 4.82)) were associated with myopia, whereas outdoors activity more than 2 hours a day (OR 0.64; 95% CI 0.46; 0.89) and sports (OR 0.70; 95% CI 0.52; 0.93) were associated with a lower incidence of myopia. CONCLUSIONS: Myopia is a leading refractive error in schoolchildren in Almaty, Kazakhstan. Myopia prevention measures, including more time outdoors, should guide public health interventions in this population.

Occupational burn-out, fatigue and stress in professional rescuers: a cross-sectional study in Kazakhstan.

OBJECTIVES: To find predictors of burn-out in a cohort of rescuers. DESIGN: Cross-sectional study. SETTING: Republican Rescue Squad (N=105) and Republican Mudslide Rescue Service under the Ministry of Emergency Situations (N=480) in Almaty, Kazakhstan. PARTICIPANTS: In total, we included 268 (80% men, median age 38 (IQR 22) years) rescuers from both organisations. PRIMARY AND SECONDARY OUTCOME MEASURES: We offered a questionnaire to rescuers, which included Maslach Burnout Inventory, quantifying emotional exhaustion (EX), cynicism (CY) and professional efficacy (PE) along with fatigue, stress and health-related quality of life (HRQL) tools. RESULTS: Lower scores of HRQL (Physical Component Score (PCS) beta -0.04 (95% CI -0.06 to -0.02); Mental Component Score beta -0.03 (95% CI -0.05 to -0.01)), higher fatigue (Fatigue Severity Scale (FSS) score beta 0.03 (95% CI 0.03 to 0.04)) and stress (Perceived Stress Score-10 beta 0.04 (95% CI 0.02 to 0.06)) independently predicted greater EX. Lower PCS (beta -0.03 (95% CI -0.06 to -0.01)) and FSS (beta 0.02 (95% CI 0.01 to 0.03)) could predict more CY burn-out. In addition to stress, higher education (beta 0.86 (95% CI 0.40 to 1.32)) was positively associated with lower burn-out severity in PE domain. CONCLUSIONS: Fatigue, stress and HRQL were associated with burn-out in rescuers. Addressing these predictors may help guide further interventions to reduce occupational burn-out.

Occupational disease claims and non-occupational morbidity in a prospective cohort observation of nickel electrolysis workers.

Exposure to nickel aerosol in the nickel production is associated with greater occupational risk, yet little is known how many workers will develop an occupational disease and claim compensation. The aim of this analysis was to prospectively observe a cohort of nickel electrolysis workers and quantitatively assess confirmed occupational disease claims. We observed a cohort of nickel electrolysis workers (N = 1397, median age 39, 68% males) from 2008 till 2020 in one of the largest nickel producers in the Russian High North. Cumulative incidence of confirmed occupational disease claims in seven occupational groups, including electrolysis operators, hydrometallurgists, crane operators, final product cleaners, metalworkers, electricians and 'other' was analyzed and supplemented with Cox proportional hazards regression, yielding hazard ratios (HR) with their 95% confidence intervals (CI) of occupational disease claims for each group. N patients with occupational disease claims varied from 1 in 2016 to 22 in 2009, and in total 87 patients developed one or more occupational diseases (cumulative incidence 6.2%, p < 0.001 between seven groups). Accounting for 35,527 person-years of observation in total, cleaners exhibited the greatest risk (HR 2.58 (95% CI 1.43-4.64)), also adjusted for smoking, number of non-occupational diseases and group 2 (hydrometallurgists). Smoking was independently associated with having an occupational disease claim in all groups (p < 0.001), as was the number of non-work-related diseases in six groups of seven. Despite consistent improvement in the exposure control measures in nickel production, occupational morbidity persists. More effort is needed to reduce exposure in final product cleaners.

Knowledge and experience of Kazakhstan athletes in anti-doping and the impact of past educational intervention.

BACKGROUND: Although Kazakhstan National Anti-Doping Organization (KazNADO) exists since 2013, but little is yet known about anti-doping (AD) knowledge of Kazakhstan athletes. The aim of this study was to assess the AD education knowledge level and experience among Kazakhstan athletes, as well as the impact of any past AD educational program on them. METHODS: Altogether, 590 athletes (the median was age 17 years (interquartile range 8)), representing various sports, participated in the web-based study and completed the questionnaire, which consisted of socio-demographic part and ALPHA test. We assessed the association of any past AD education and experience with anti-doping knowledge using adjusted regression models. RESULTS: A total of 54.6% participants underwent doping control and 82,7% of athletes received AD education at least once. More than 300 participants (50.8%) provided correct answers for 10 questions. Age and years in sports (competition duration) were significantly associated with the ALPHA scores of athletes. Athletes who received AD education more than once in the past had significantly higher ALPHA scores than non-AD educated athletes in most questions. CONCLUSION: AD education was associated with AD knowledge. Further research is needed to identify the adherence to anti-doping knowledge.

Predictive value of 18F-fluorodeoxyglucose accumulation in visceral fat activity to detect colorectal cancer metastases (prospective observational cohort study).

Background: To evaluate functional visceral adipose tissue (VAT) activity assessed by 18F-fluorodeoxyglucose ( 18F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictive factor of metastases in colorectal cancer (CRC) patients. Methods: We reviewed study protocols and PET/CT data of 534 CRC patients; 474 patients were subsequently excluded for various reasons. The remaining 60 patients with histologically confirmed adenocarcinoma were then prospectively assessed and were exposed to 18F-FDG PET/CT after a surgical treatment and chemoradiotherapy. Age, histology, stage, and tumor grade data were recorded. Functional VAT activity was verified with maximum standardized uptake value (SUV max) using 18F-FDG PET/CT and tested as a predictive factor of later metastases in eight subdomains of abdominal regions (RE - epigastric region, RLH - left hypochondriac region, RRL - right lumbar region, RU - umbilical region, RLL - left lumbar region, RRI - right inguinal region, RP - hypogastric (pubic) region, RLI - left inguinal region) and pelvic cavity (P) in the adjusted regression models. In addition, we studied the best areas under the curve (AUC) for SUV max with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted for age regression models and receiver operating characteristic (ROC) curve analysis, 18F-FDG accumulation in RLH (cut-off SUV max 0.74; Se 75%; Sp 61%; AUC 0.668; p=0.049), RU (cut-off SUV max 0.78; Se 69%; Sp 61%; AUC 0.679; p=0.035), RRL (cut-off SUV max 1.05; Se 69%; Sp 77%; AUC 0.682; p=0.032) and RRI (cut-off SUV max 0.85; Se 63%; Sp 61%; AUC 0.672; p=0.043) could predict later metastases in CRC patients, as opposed to age, sex, primary tumor location, tumor grade and histology. Conclusions: Functional VAT activity was importantly related to later metastases in CRC patients and can be used as their predictive factor.

Fractional exhaled NO in a metalworking occupational cohort.

PURPOSE: Secondary metalworking carries exposure to relatively heavy levels of respirable particulate. We investigated the extent to which metalworking is associated with increased exhaled nitric oxide (FeNO), an established inflammatory biomarker. METHODS: We studied 80 metalworking factory employees in Kazakhstan. Informed by industrial hygiene data, we categorized them into three groups: (1) machine operators (41%); (2) welders or assemblers (33%); and (3) all others, including administrative and ancillary staff (26%). Participants completed questionnaires covering occupational history, smoking, home particulate sources, respiratory symptoms, and comorbidities. We measured exhaled carbon monoxide (CO), exhaled fractional nitric oxide (FeNO), and spirometric function. We used mixed-effects modeling to test the associations of occupational group with FeNO, adjusted for covariates. RESULTS: The median age was 51.5 (interquartile range 20.5) years; 7% were women. Occupational group (p < 0.01), daily current cigarette smoking intensity (p < 0.05), and age (p < 0.05), each was statistically associated with FeNO. Welders, or assemblers (Group 2), who had intermediate particulate exposure, manifested significantly higher exhaled FeNO compared to machinists (Group 1, with the highest particulate exposure) and all others (Groups 3, the lowest particulate): adjusted Group 2 mean 44.8 ppb (95% confidence interval (CI) 33.8-55.9) vs. Group 1 24.6 ppb (95% 20.5-28.7) and Group 3, 24.3 ppb (95% CI 17.7-30.9). Secondhand smoking and height were not associated with FeNO. CONCLUSION: In a metalworking industrial cohort, welders/assemblers manifested significantly higher levels of FeNO. This may reflect respiratory tract inflammation associated with airborne exposures specific to this group.

Alcohol Abuse and Insomnia Disorder: Focus on a Group of Night and Day Workers.

The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consumption of alcoholic beverages; (ii) the presence of insomnia; and (iii) the possible correlation between alcohol consumption and insomnia disorder. We used the AUDIT-C test (the abbreviated version of the Alcohol Use Disorders Identification Test) and the Insomnia Severity Index to assess alcohol consumption and insomnia disorder, respectively. All questionnaires were completed by workers of both sexes belonging to different types of work activities, exclusively day or night. The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers.

Exposure to respirable dust among workers fabricating aluminium trihydroxide-containing synthetic countertops.

The aim of this study is to characterize personal exposure of workers to respirable particulate matter (PM) generated in cutting and other fabrication activities when fabricating acryl polymer/aluminium trihydroxide synthetic countertops. We collected 29 personal full-day samples of respirable PM from three workers in a small private workshop. We tested differences between- and within-worker variances of mass concentrations using the Kruskall-Wallis test. We used segmented regression to test the means and medians 15-min interval concentrations changes over time and to identify a breakpoint. Respirable PM concentrations ranged nearly 100-fold, from 0.280 to 25.4 mg/m3 with a median of 2.0 mg/m3 (1-min concentrations from 13,920 data points). There were no statistical difference in daily median or geometric mean concentrations among workers, whereas the concentrations were significantly higher on days with three versus two workers present. The 15-min median concentrations (n = 974 measures) increased until 2.35 h (beta 0.177; p < 0.05), representing a 0.70 mg increase in exposure per hour. This was followed by a plateau in concentrations. The high levels of respirable PM we observed among workers fabricating aluminium trihydroxide-containing synthetic countertops highlight an unmet early prevention need.

Health-related quality of life in a general population sample in Kazakhstan and its sociodemographic and occupational determinants.

BACKGROUND: Health-related quality of life (HRQL) in the general population of Kazakhstan has never been characterized. We constructed this population-based study of the largest city in Kazakhstan, Almaty with the aim to quantitatively assess HRQL and ascertain whether occupation and lifestyle are associated with HRQL in this population. METHODS: In a random sample (N = 1500) of general population in Almaty (median age 49 (interquartile range 28) years, 50% women), we collected data on demographics, socioeconomic status, lifestyle, lifetime occupational history and general HRQL using SF-8 instrument. The association of demographic and occupational predictors with HRQL was tested in multiple regression models. RESULTS: No occupational associations were found for physical component score in the models adjusted for age, sex, income, cigarette and waterpipe smoking, electronic cigarette use, physical activity, alcohol and exposure to secondhand smoke. Ever being a manager (ß - 1.63 (95% confidence interval (CI) - 2.92; - 0.34)), a welder (ß - 5.11 (95% CI - 8.77; - 1.46)) and a secretary (ß - 5.06 (95% CI - 8.56; - 1.56)) for one year or more was associated with poorer mental component score in the models adjusted for age, sex, income, cigarette smoking, physical activity and each other. Age, income and physical activity were independent predictors of both physical and mental components. CONCLUSIONS: Occupational history is associated with HRQL in the general population in Almaty, Kazakhstan, but the mechanism explaining this association should be further elucidated.

Testosterone and occupational burnout in professional male firefighters.

BACKGROUND: Very little is known about the biologic predictors of the occupational burnout in firefighters. The aim of this study was to characterize testosterone profile of active firefighters and quantify its association with three domains of the occupational burnout. METHODS: We enrolled 100 firefighters (median age 28 (interquartile range (IQR) 9.8) years with 5 (IQR 9) years in service) of three fire departments in Almaty, Kazakhstan. Demographics, smoking status, health-related quality of life (HRQL) and burnout scores of Maslach Burnout Inventory were assessed using a questionnaire, while total blood testosterone was measured in venous blood. Logistic regression models were used to quantify the association of blood testosterone with each burnout domain in the adjusted for confounders models. RESULTS: The median blood testosterone level was 14 (IQR 3.5) nmol/l and was only predicted by age (beta - 0.14, p < 0.01, 79% power). There were no differences in blood testosterone levels between occupational groups (Group 1 (firefighters), 14.6 (IQR 3.4); Group 2 (fire truck drivers), 14.7 (IQR 5.6); Group 3 (shift commanders, division heads, department managers and engineers), 14 (IQR 4.1) nmol/l, Kruskal-Wallis p = 0.32) or departments. Testosterone could not predict EX or CY, but had a negative association with PE score reflecting more burnout (odds ratio 1.18 (95% confidence interval 1.01;1.38)), adjusted for age, mental component of HRQL and education. CONCLUSIONS: Firefighters with higher testosterone may develop burnout in PE earlier, and this should be considered for proper work placement within the rescue system.

Air pollution in the workplace: making shish kebab is an overlooked occupational hazard.

BACKGROUND: Meat grilled with wood charcoal is the most popular meal in Central Asia, but little is known about the grillers' occupational exposure to fine particulate matter (PM) in fumes. OBJECTIVES: The aim of this study was to provide a quantitative analysis of occupational exposure to fine PM in grillers in the workplace. METHODS: We assessed exposure to PM2.5 from barbecue fumes using SidePak AM520 in six popular cafes in Almaty, Kazakhstan. Grillers wore devices for 8 h of work shift for 7 days in each place. Within- and between-place variances of PM2.5 mass concentrations were calculated using analysis of variance, and we also calculated the fold range of the 95% variance within (wR0.95) and between places (bR0.95), as well as exceedance (γ) and the probability of overexposure (θ). RESULTS: Two modes of exposure were identified, including intermittent and continuous. The median of daily geometric mean PM2.5 concentrations was 0.143 (interquartile range (IQR): 0.213) and 0.404 (IQR: 0.243) mg/m3, accordingly. bR0.95 was very large (20.2), but wR0.95 was even greater (47.8), illustrating extremely high fluctuations in PM2.5 concentrations; γ was 0.116, and θ was 0.095. SIGNIFICANCE: Very high occupational exposure to barbecue fumes in grillers is overlooked and likely causes elevated health risks.