Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

Outbreak of invasive pneumococcal disease among shipyard workers, Turku, Finland, May to November 2019.

We report an outbreak of invasive pneumococcal disease and pneumococcal pneumonia among shipyard workers, in Turku, Southwest Finland. In total, 31 confirmed and six probable cases were identified between 3 May and 28 November 2019. Streptococcus pneumoniae serotypes 12F, 4 and 8 were isolated from blood cultures of 25 cases. Occupational hygiene measures and vaccination of ca 4,000 workers are underway to control the outbreak at the shipyard.

Health Problems during Compulsory Military Service Predict Disability Retirement: A Register-Based Study on Secular Trends during 40 Years of Follow-Up.

Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where persons at risk for work disability can be identified and early preventive measures initiated.

Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach.

OBJECTIVES: To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course. DESIGN: A longitudinal and cross-sectional study. SETTING: A nationwide health survey supplemented with data from records of prior compulsory military service. PARTICIPANTS: Premilitary health records (baseline) were searched for men aged 30-50 years (n=1385) who participated in a national health examination survey (follow-up). METHODS AND OUTCOME MEASURES: Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica. RESULTS: Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m(2)) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m(2)). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP. CONCLUSIONS: Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented.

Cervical and lumbar pain and radiological degeneration among fighter pilots: a systematic review and meta-analysis.

To assess the associations of acceleration force indicators (aircraft type and flight hours) with cervical and lumbar pain and radiological degeneration among fighter pilots. The PubMed, Embase, Scopus and Web of Science databases were searched until October 2013. Twenty-seven studies were included in the review and 20 in the meta-analysis. There were no differences in the prevalence of neck pain (pooled OR=1.07, 95% CI 0.87 to 1.33), cervical disc degeneration (OR=1.26, CI 0.81 to 1.96), low back pain (OR=0.80, CI 0.47 to 1.38) or lumbar disc degeneration (OR=0.87, CI 0.67 to 1.13) between fighter pilots and helicopter or transport/cargo pilots. Moreover, the prevalence of cervical (OR=1.14, CI 0.61 to 2.16) or lumbar (OR=1.05, CI 0.49 to 2.26) disc degeneration did not differ between fighter pilots and non-flying personnel. Most studies did not control their estimates for age and other potential confounders. Among high-performance aircraft pilots, exposure to the highest G-forces was associated with a higher prevalence of neck pain compared with exposure to lower G-forces (pooled OR=3.12, CI 2.08 to 4.67). The studies on the association between flight hours and neck pain reported inconsistent findings. Moreover, looking back over the shoulder (check six) was the most common posture associated with neck pain. Fighter pilots exposed to high G-forces may be at a greater risk for neck pain than those exposed to low G-forces. This finding should be confirmed with better control for confounding. Awkward neck posture may be an important factor in neck pain among fighter pilots.

Trends in musculoskeletal disorders and related health care utilization among conscripts in Finland, 1967-2006.

OBJECTIVES: The aim was to investigate time trends in musculoskeletal disorders (MSDs) among Finnish conscripts over a period of 40 years. METHODS: A nationally representative health examination survey (the Health 2000 study) was carried out in 2000-2001 among 10,000 adult Finns. All 18- to 50-year-old men were further sampled (n = 2674) and those with completion of the 6 to 12 month compulsory service were included. (n = 2296). Time trends in consultations because of MSDs during service and findings at call-up examinations were analysed. RESULTS: From 1967 to 2006 altogether 4872 MSD-related consultations were done, most commonly because of problems in the ankle or foot, knee, or back. The proportion of conscripts visiting military health care because of MSDs increased 1.6-fold (from 44 to 72%). The average number of MSD-related consultations per conscript tripled. The proportion of conscripts with > or = 6 consultations increased 5-fold and those seeking care for multisite symptoms increased 10-fold. No increase in symptoms or findings before service could be seen at preservice examinations. CONCLUSIONS: Conscripts seek care because of musculoskeletal symptoms considerably more often nowadays than before. More attention should be focused to the prevention of traumatic and overexertion injuries of the lower limbs, although the reasons for increasing careseeking should be further investigated.

IgE-mediated occupational asthma from epoxy resin.

BACKGROUND: Epoxy resins (ERs) are used in paints and other protective coatings, including flooring materials. Bisphenol A diglycidyl ether (BADGE) ERs (BADGE ERs) account for about 75% of the ERs used world-wide. ERs can cause both immediate and delayed allergic reactions, but immediate reactions are rare. METHODS: Occupational asthma (OA) was diagnosed on the basis of a specific challenge test combined with the patient's history of occupational exposure and respiratory symptoms. RESULTS: A 39-year-old nonsmoking construction worker experienced dyspnea when laying ER-containing floors, but not in other situations. He also presented skin symptoms. IgE-mediated allergy to BADGE ER could be verified with both serum IgE antibodies and skin prick tests. The specific bronchial challenge test with BADGE ER caused an immediate asthmatic reaction. On patch testing, a positive reaction was provoked by BADGE ER. CONCLUSIONS: This is the first study on a patient exposed to BADGE ER with IgE-mediated immediate OA, based on a positive inhalation challenge test. If work-related respiratory symptoms develop when handling ERs, the possibility of OA should be recognized.