Microextraction techniques for occupational biological monitoring: Basic principles, current applications and future perspectives.

The application of green microextraction techniques (METs) is constantly being developed in different areas including pharmaceutical, forensic, food and environmental analysis. However, they are less used in biological monitoring of workers in occupational settings. Developing valid extraction methods and analytical techniques for the determination of occupational indicators plays a critical role in the management of workers' exposure to chemicals in workplaces. Microextraction techniques have become increasingly important because they are inexpensive, robust and environmentally friendly. This study aimed to provide a comprehensive review and interpret the applications of METs and novel sorbents and liquids in biological monitoring. Future perspectives and occupational indicators that METs have not yet been developed for are also discussed.

Systemic inflammation indices as hematological biomarkers of inflammatory response in non-silicotic workers exposed to respirable silica dust.

This cross-sectional study was performed to assess whether systemic inflammatory indices, including systemic inflammation response index (SIRI), systemic immune­inflammation index (SII), and aggregate index of systemic inflammation (AISI), can be considered as possible inflammatory markers in silica-exposed workers with no diagnosis of silicosis. We studied 371 non-silicotic workers exposed to respirable silica dust (RSD) and 1422 reference workers. The workers' exposure to RSD were assessed and the inflammatory indices were compared between subgroups of the exposed workers based on the severity and duration of exposure. Correlations between inflammatory indices and the pulmonary function parameters were investigated. Also, the receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off values of the SII, SIRI, and AISI. Significant dose-response relationships were observed between duration of exposure and all indices except monocytes and LMR. No significant interaction was observed between duration of exposure to RSD and smoking. Borderline significant correlations were observed between AISI and SIRI with forced expiratory volume (FEV1) and FEV1 to forced vital capacity (FVC) ratio. Higher AUCs were obtained for SII and AISI, respectively. The cut-off values for these biomarkers to be considered abnormal were > 348.48 for SII, > 183.78 for AISI, and > 0.768 for SIRI. Overall, the present study showed for the first time, that SII, AISI, and SIRI might be considered as available, easy-to-obtain, and non-expensive markers of inflammation in non-silicotic workers with a long duration of exposure to RSD who are at risk of developing silicosis in subsequent years.

Low-level occupational exposure to BTEX and dyschromatopsia: a systematic review and meta-analysis.

Objectives. The present study aimed to assess whether occupational exposure to low concentrations of benzene, toluene, ethylbenzene and xylene (BTEX) is associated with color vision impairment. Methods. We queried PubMed, Scopus, Embase, Web of Science and ProQuest as the main databases, as well as gray literature such as Google Scholar. A random-effects model was used to assess relative risk. A funnel plot was created to assess publication bias. Meta-regression analysis was applied to identify variables that explain the between-study variation in the reported risk estimate. Results. An overall standardized mean difference of 0.529 (95% confidence interval [0.269, 0.788]; p < 0.0001) was obtained in the random-effects model, which corresponded to a medium-size effect. Duration and the levels of exposure to benzene, toluene and xylene were the significant predictors of the magnitude of the combined risk estimate. Chronic exposure to low levels of BTEX was associated with dyschromatopsia determined by the color confusion index. Conclusions. The impairments can occur even at exposures lower than the occupational exposure limits of BTEX. However, there are several flaws in the determination of workers' exposure, which did not allow to establish how low a level of these chemicals can cause color vision impairment.

Pulmonary function and respiratory symptoms in workers exposed to respirable silica dust: A historical cohort study.

Background: The adverse health effects of silica are still a major concern in some industries. The purpose of this study was to evaluate pulmonary function in a group of sub-radiological silicotic workers after 11 years of silica dust exposure. Methods: The study sample consisted of 381 exposed and 254 non-exposed workers. The history of pulmonary function parameters was obtained from workers' medical records. The data were collected through interviews with employees and completing questionnaires on demographic variables, detailed occupational and medical history, and respiratory symptoms. Workers' exposure to silica dust was also determined. Results: The mean frequency of workers' exposure to silica dust was 6.3 times greater than its exposure limit. All pulmonary function parameters were significantly lower in the silica-exposed workers, and the difference between the two groups was still statistically significant after adjusting the potential confounding variables. FEV1 showed the greatest reduction, and FVC and FEV1 showed a significant decreasing trend. Also the prevalence of respiratory symptoms was significantly higher in smokers than in nonsmokers among silica-exposed workers. Conclusions: Even in the absence of radiographic evidence of silicosis, exposure to high levels of silica dust is associated with reductions in pulmonary function. In the absence of radiological evidence of silicosis, progressive deterioration of FEV1 over time most likely indicates sub-radiological silicosis. The effects were associated with the severity and duration of exposure. Exposure to sub-TLV levels of silica dust may not affect pulmonary function. Smoking appears to have a synergistic effect in relatively high silica exposures.

Prevalence of job burnout in Iranian nurses: A systematic review and meta-analysis.

BACKGROUND: Nurses experience many job tensions, which lead to job burnout. The consequences of nurses' job burnout include absenteeism, reduced quality of patient care, interpersonal conflicts with colleagues, physical and mental problems, reluctance to provide care with patients, and quitting the job. OBJECTIVE: The present study aimed to investigate the prevalence of job burnout among nurses in Iran using a meta-analysis method. METHOD: The study was conducted through a meta-analysis method based on the PRISMA checklist. An unlimited search was conducted until 2020 to access the Persian and English papers in national databases, including Medlib, SID, Iranmedex, and Magiran, and databases including Cochrane, Science-Direct, PubMed, Scopus, and Web of Science. The keywords were "job burnout, nurse, and Iran." The data were searched and extracted by two researchers independently. All analyses were performed using version 2.0 of the Comprehensive Meta-Analysis (CMA) software. RESULTS: The prevalence of job burnout was investigated in 14 papers with a sample size of 2271 individuals with an average age of 31.44 years old, and a confidence interval of 55% (44-66%). Fars province, with 89.2%, had the highest, and Zanjan province, with 25.9%, experienced the lowest prevalence of job burnout. The overall prevalence of job burnout was 44% in males and 66% in females so that the highest prevalence was in women. CONCLUSION: The prevalence of job burnout in nurses was high in some areas of Iran. A special attention by managers is needed in this field because of the several roles played by the nurses in the healthcare system and the improvement of public health. Implementation of plans to reduce the job burnout and to improve the mental health of nurses by reducing work hours, giving more opportunities to them to express their opinion(s) in amount of salary and benefits, and creating better working conditions are recommended.