Telomere length and TERT polymorphisms as biomarkers in asbestos-related diseases.

BACKGROUND: Asbestos exposure has been proposed as a risk factor for shorter telomere length. The aim of our study was to investigate whether telomere length in leukocytes and hTERT genetic polymorphisms may serve as potential biomarkers for the risk of developing asbestos-related diseases and as biomarkers of progression and chemotherapy response rate in malignant mesothelioma (MM). SUBJECTS AND METHODS: We conducted two retrospective studies. In the first study, a case-control study, telomere length and hTERT polymorphisms were determined in patients with MM, subjects with pleural plaques and controls without the asbestos related disease, who were occupationally exposed to asbestos. In the second study, a longitudinal observational study, telomere length was also determined in samples from MM patients before and after chemotherapy. Telomere length was determined by monochromatic multiplex quantitative polymerase chain reaction (PCR), while competitive allele-specific PCR was used to genotype hTERT rs10069690, rs2736100 and rs2736098. Logistic regression and survival analysis were used in statistical analysis. RESULTS: Patients with MM had shorter telomere length than subjects with pleural plaques (p < 0.001). After adjustment for age, rs2736098 CT, and rs10069690 TT and CT+TT genotypes were significantly associated with a higher risk of MM (padj = 0.023; padj = 0.026 and padj = 0.017), while rs2736100 AA and CA+AA genotypes conferred to a lower risk for MM compared to all other subjects (padj = 0.017, and padj = 0.026). Telomere length was not associated with a response to chemotherapy (p > 0.05) or time to disease progression (p > 0.05). Carriers of one or two polymorphic rs10069690 T alleles had a good response to chemotherapy (p = 0.039, and p = 0.048), these associations remained statistically significant after adjustment for age (padj = 0.019; padj = 0.017). Carriers of two polymorphic rs2736100 A alleles had a longer time to disease progression (p = 0.038). CONCLUSIONS: Shorter telomere length and hTERT polymorphisms may serve as a biomarker for the risk of developing MM. Additionally, rs10069690 and rs2736100 polymorphisms, but not telomere length, were associated with a chemotherapy response or MM progression.

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.

Occupational exposure to silica dust in Slovenia is grossly underestimated.

As a by-product or material used in various industries crystalline silica contaminates the air many occupational settings. If its fine particles are inhaled, they are deposited in the lungs and may cause the development of silicosis, chronic obstructive pulmonary disease, and lung cancer. The goal of this study was to estimate occupational exposure to respirable crystalline silica (RCS) in Slovenia and the associated health risks. To do that, we ran two cross-sectional studies, one to determine the number of workers at risk of occupational exposure to RCS in Slovene industries and the other to determine and classify changes in the lung radiographs of glass factory workers exposed to RCS, as a means to infer health risks for other RCS exposed workers in Slovenia. However, the first study shows that official public data on occupational exposure to silica in Slovenia are unreliable and incomplete and that company representatives strongly underestimate occupational exposure to silica. Measurements of total and silica dust are made by 8.3 % and 1.8 % of companies working with silica, respectively. The second study shows that about a third of the exposed workers had lung changes associated with silicosis. We have failed to achieve the goal of our study, as the obtained data are grossly underestimated and unreliable, but it has opened our eyes as to what needs to be improved. All companies need to systematically be informed about occupational health risks, field inspections need to be consistent, regular, and intensified, and health surveillance of all exposed workers implemented regularly.

Mortality, cancer incidence, and disability among professional drivers in Slovenia.

Literature data about all-cause and cause-specific mortality among professional drivers are inconsistent. Most studies report lower all-cause and higher cause-specific mortality. Higher cause-specific mortality is most often the result of malignant and circulatory diseases. The aim of our retrospective cohort study was to get a better insight into the mortality, cancer incidence, and occupational disability of the entire professional driver population in Slovenia (N=8,231) from 1997 to 2016 through standardised mortality ratio (SMR), standardised proportional mortality ratio (SPMR), standardised cancer incidence ratio (SIR), and standardised disability ratio (SDR). Total mortality was significantly lower than that of the general working population (SMR=0.49; 95 % CI=0.44-0.55). When SPMR was calculated, however, the risk of all-cause mortality increased to 1 (SPMR=1.00; 95 % CI=0.89-1.12), of cancer-related mortality to 1.13 (95 % CI=0.94-1.35), and of injury-related mortality to 1.25 (95 % CI=0.97-1.59). Cancer incidence was lower than in the general male working population for all types of cancer (SIR=0.66; 95 % CI=0.59-0.72), lung cancer included (SIR=0.56; 95 % CI=0.41-0.73). Occupational all-cause and cause-specific disability were also lower than in the rest of the working population. Even though all types of cancer and injuries were established among professional drivers in Slovenia, no major risk stand out. However, our findings may have been skewed by the healthy worker effect.

Sickness Presence among Health Care Professionals: A Cross Sectional Study of Health Care Professionals in Slovenia.

BACKGROUND AND OBJECTIVES: Presenteeism is a relatively new phenomenon that people, despite complaints and ill health that should prompt them to rest and take sick leave, go to work in any case. The highest sickness presence is largely to be found in the care and welfare and educational sectors. The aim of the study is to investigate the relations between different factors and sickness presence among health care professionals. MATERIALS AND METHODS: A cross-sectional study was conducted at the largest hospital in Slovenia involving 5865 health care professionals employed at the University Medical Centre Ljubljana in the period between 1 January 2010 and 31 December 2010. Logistic regression methods were used to assess the associations between risk factors and their interactions and sickness presence. RESULTS: Besides high odds for sickness presence in multivariate modelling for acute (OR = 359.7; 95%CI = 89.1-1452.8) and chronic disease (OR = 722.5; 95%CI = 178.5-2924.5) the highest odds were calculated for poor self-related health (OR = 3.0; 95%CI = 1.9-4.8), no possibility of replacement (OR = 1.9; 95%CI = 1.5-2.3), sickness absence > two times a year (OR = 1.6; 95%CI = 1.2-2.1), disabled workers (OR = 1.6; 95%CI = 1.0-2.5), and lower salary when on sick leave (OR = 1.5; 95%CI = 120-1.9). Risk factors interactions were not found to be associated with sickness presence among health care workers. CONCLUSIONS: The pre-requisite for higher sickness presence is workers' bad health. The results indicate that sickness presence was associated with psycho social risk factors at work and their economic consequences. Continued sickness presence might have negative rather than positive consequences on work and health care professionals' health in the future. Sickness presence needs to be taken into account for health care organizers.

Hospital Staff's Risk of Developing Musculoskeletal Disorders, Especially Low Back Pain.

INTRODUCTION: Health-related absenteeism impacts individuals, companies, and society. Its consequences are reflected in the cost of benefits, substitutes, and reduced productivity. Research shows that musculoskeletal disorders (MSDs) are the most common work-related health problem reported by hospital staff. This study determines the groups at the Ljubljana University Medical Centre that are most susceptible to MSDs, especially low back pain. METHODS: Using data from the Health Data Centre of the Slovenian National Public Health Institute and the medical centre, this cross-sectional study analysed absenteeism among medical centre employees. The correlation between MSD / low-back pain risk factors and incidence was determined using logistic regression. An odds ratio was calculated to determine the probability of MSDs, most especially low back pain via sex, age, occupation, and education. RESULTS: Sick leave at the medical centre is higher than 5%, exceeding the Slovenian healthcare sector average. MSDs, as the main reason for absence, is significantly more frequent in women, non-medical staff, and employees with a maximum secondary school education. Among the MSDs, low back pain predominates as a reason for absence and is most frequent among nurses, midwives, and employees of 20 to 44.9 years old. CONCLUSION: This study offers insight into the health status of medical centre employees. The high percentage of sick leave is mainly due to musculoskeletal disorders, including low back pain. This is an important basis for further monitoring and analysis of sick leave indicators and for planning systematic and continuous workplace health-promoting measures to manage ergonomic risk factors and reduce health-related absenteeism.

SICKNESS PRESENCE AND STRESSFUL LIFE EVENTS OF HEALTH CARE WORKERS.

AIM: The aim of the study is to investigate the relationship between sickness presence and stressful life events among health care workers. METHODS: Data were gathered from all health care workers at the University Medical Centre Ljubljana employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of two standardized international questionnaires. RESULTS: There were 57% of sickness present health care workers among the participants. The sickness present reported to have more diseases of family member than the non-sickness present (OR = 1.5; 95% CI = 1.2-2.0), loan (OR = 1.4; 95% CI = 1.1-1.6), their partner lost job (OR = 1.4; 95% CI = 1.0-1.8), or they changed the place of living (OR = 1.4; 95% CI = 1.0-2.0). CONCLUSIONS: The results of the study indicate that stressful life events with economic consequences might have an important influence on sickness presence.