Work-related musculoskeletal disorders, fatigue and stress among gas station workers in China: a cross-sectional study.

INTRODUCTION: Work-related musculoskeletal disorders (WMSDs) are disorders of the musculoskeletal system that have the highest prevalence among workers worldwide. Workers in gas stations usually work in poor ergonomic working conditions, including prolonged standing and repetitive posturing. OBJECTIVE: The study aimed to investigate the prevalence of WMSDs and fatigue and to identify the predictors of WMSDs among gas station workers. DESIGN: The present study was a cross-sectional study. SETTING AND PARTICIPANTS: 2962 gas station workers from an oil and gas company in China, with ages ranging from 17 to 75 years old, 55.47% female. RESULTS: The prevalence of WMSDs within the 12 months prior to the study was 73.23%, with the highest prevalence in the neck, shoulders, ankles and feet. Furthermore, a correlation was observed between fatigue, stress and WMSDs. Fatigue and job role were the strongest predictors of WMSDs, with an OR range of 2.211-3.413. CONCLUSIONS: This research identified the detrimental impact of WMSDs and fatigue on gas station workers, indicating the critical need for interventions to reduce WMSDs and relieve fatigue.

Prevalence and risk factors for obstructive pulmonary dysfunction caused by silica dust exposure: a multicenter cross-sectional study.

OBJECTIVE: To understand the prevalence rate of obstructive pulmonary dysfunction in workers exposed to silica dust and analyze its risk factors, so as to provide reference for the formulation of diagnostic criteria for chronic obstructive pulmonary disease caused by occupational dust. METHODS: Data collection and structured questionnaire were used to collect the data of 2064 workers exposed to silica dust who underwent health examination in Hunan Occupational Disease Prevention and Control Hospital and Yuanling Second People's Hospital from January 1, 2021 to June 30, 2022. The prevalence rate of obstructive pulmonary ventilation dysfunction was analyzed and the risk factors were analyzed. RESULTS: The prevalence rate of obstructive pulmonary ventilation dysfunction (FEV1/FVC < 70%) was 2.3% in 2064 silica dust exposed workers. The prevalence of restrictive pulmonary ventilation dysfunction (FVC/Pre < 80%) was 8.1%. The prevalence of obstructive pulmonary ventilation dysfunction in the high level exposure group was higher than that in the low level exposure group, 8.2 vs0.9% (P < 0.05). The rate of obstructive pulmonary ventilation dysfunction in female group was higher than that in male group (5.3% vs. 1.7%, p = 0.00). Workers with obstructive pulmonary dysfunction were older and worked longer than workers without obstructive pulmonary dysfunction, but there was no statistical difference. Multivariate regression analysis showed that high exposure level was a risk factor for obstructive pulmonary ventilation dysfunction in silica dust exposed workers (P < 0.05). Females were the risk factors for obstructive pulmonary ventilation dysfunction (P < 0.05). CONCLUSION: Silica dust exposure can cause obstructive pulmonary ventilation dysfunction and lead to chronic obstructive pulmonary disease. High level of exposure is a risk factor for obstructive pulmonary ventilation dysfunction. Women exposed to dust are more prone to obstructive pulmonary ventilation dysfunction than men. Early diagnosis of chronic obstructive pulmonary disease caused by silica dust and timely intervention measures are very important to delay the decline of lung function and protect the health of workers.

Cross-sectional study on the health of workers exposed to occupational noise in China.

OBJECTIVE: This study aimed to understand the health of workers exposed to occupational noise and explore the influencing factors related to workers' health, especially the impact of noise on workers' hearing. This work can provide a basis for formulating relevant measures for occupational noise prevention and control in the future. METHODS: On the basis of the key occupational disease monitoring project in Chongqing, China, in 2021, the data of 1125 workers exposed to occupational noise were analyzed. Data included demographic information, occupational history, clinical physical examination information, and noise detection information of the working environment. Chi-square test and multifactorial logistic regression were used for statistical analysis. RESULTS: The prevalence rates of abnormal electrocardiogram (ECG), blood pressure (BP), and pure tone audiometry (PTA) were 21.9% (246/1125), 27.8% (313/1125), and 18.0% (202/1125), respectively. Male workers accounted for 78.8%. Compared with male workers, female workers had a lower prevalence of abnormal PTA (OR = 0.28, 95% CI = 0.16-0.50). Workers working in medium enterprises had a lower prevalence of abnormal BP than workers in micro enterprises (OR = 0.36, 95% CI = 0.19-0.66). The prevalence of abnormal BP and PTA of workers increased with age. After adjusting for age, sex, and body mass index, the prevalence of abnormal ECG of mining workers was higher than that of manufacturing workers (OR = 1.54, 95% CI = 1.07-2.24), and the prevalence of abnormal PTA had a rising trend with the increase in noise exposure value. CONCLUSION: Noise-exposed workers have a high prevalence of abnormal ECG, BP, and PTA, and factors such as age, enterprise size, and workplace noise exposure are correlated with the aberrant health of workers. Governments, enterprises, and individuals need to attach great importance to the possible adverse effects of noise. They must also actively adopt various effective measures to protect the occupational safety and health of workers.

Ergonomic considerations for unique surgeon populations.

PURPOSE OF REVIEW: Surgeons are rapidly diversifying as a population, introducing new ergonomic challenges. This review describes the challenges that are experienced by special populations of surgeons including small-handed surgeons, pregnant surgeons, and trainees, and evidence-based solutions to overcome them. RECENT FINDINGS: Small-handed and female surgeons report more musculoskeletal complaints compared with their male counterparts. Pregnant surgeons frequently report development or worsening of musculoskeletal disorders such as carpal tunnel syndrome and low back pain. Trainees also report high rates of musculoskeletal complaints with minimal autonomy to alter their environment. Limited objective data exists regarding the ideal instruments currently available for special populations. Several small, randomized studies have proposed exercise regimens targeting the upper extremities and pregnancy-related pain syndromes with improvements in symptoms. Various methods of ergonomic education have been studied in trainees with improvements in operating room posture and performance. SUMMARY: Limited objective data is available to recommend specific surgical instruments for high-risk surgeon populations. Beneficial exercise regimens have been described for musculoskeletal disorders commonly plaguing surgeons but have yet to be studied explicitly in small-handed or pregnant surgeons and trainees.

[ISOLATED FOURTH EXTENSOR COMPARTMENT TENOSYNOVITIS DUE TO EPIDEMIC RELATED CHANGES IN THE WORKPLACE].

INTRODUCTION: We report on cases of isolated fourth extensor compartment tenosynovitis without evidence of systemic inflammation that occurred in the context of alteration in the work environment due to the COVID-19 epidemic. Early identification of the deleterious effects of virtual/technologically-dependent work from home can aid in treatment and prevention of these conditions. We describe the phenomenon and suggest a treatment approach.

Prevalence of pulmonary tuberculosis among casual labourers working in selected road construction sites in central Uganda.

INTRODUCTION: Workers with occupational exposure to respirable silica dust, such as casual labourers at road construction sites (RCSs), are known to be at high risk of developing pulmonary tuberculosis (TB). There is limited literature about the burden of PTB among this subpopulation with high occupational exposure to silica dust at road construction sites. We aimed to determine the prevalence of PTB among casual labourers working at road construction sites in central Uganda. METHODS: We enrolled 297 participants via consecutive sampling in a cross-sectional study between September 1st and September 30th, 2022, at four road construction sites in four districts in central Uganda. A structured questionnaire was administered, and the PTB patients were identified by using GeneXpert and/or computer-aided detection for TB (CAD4TB). The data were analysed with STATA version 17.0. Descriptive statistics adjusted for clustering were used to summarize the data, and the relationships between PTB and independent variables were assessed by using a mixed effects modified Poisson regression model to estimate the adjusted prevalence ratios. RESULTS: Most participants were males (95.6% [284/297]), and the median age was 29 years (interquartile range [IQR]: 25-33). The prevalence of PTB among casual labourers was 2.4% (95% CI: 1.9, 2.8). Not being vaccinated with BCG (3.45, 95% CI: 1.02, 11.61), alcohol use (2.70, 95% CI: 1.52, 4.80) and staying in shared rooms (8.13, 95% CI: 4.37, 15.12) were positively associated with having PTB. CONCLUSION: There is a high prevalence of PTB among casual labourers working at road construction sites in central Uganda. Individuals who had never been vaccinated with BCG, alcohol users and those staying in shared rooms were at an increased risk of having PTB. We recommend routine screening of casual labourers at road construction sites to optimize active TB case finding.

Magnitude of work-related musculoskeletal disorders and its associated factors among Ethiopian nurses: a facility based cross-sectional study.

INTRODUCTION: Work-related musculoskeletal disorders have a greater negative impact on nurses' well-being, both physically and emotionally. Because of this issue, nurses take excessive leave, are absent from work, quit their profession, and have a lower quality of life. This leads to an increase in human and economic losses to health care institutions. However, there is a paucity of information about work-related musculoskeletal disorders among nurses in the study area. OBJECTIVE: This study aimed to assess the magnitude of work-related musculoskeletal disorders and its factors associated among nurses in Hospitals of West Shoa Zone, Central Ethiopia, 2021. MATERIALS AND METHODS: A cross-sectional facility-based study was conducted with 406 systematically selected nurses from March 2021 to June 2021. A simple random sampling was used to select study subjects. Data were gathered through face-to-face interviews. The data has been cleaned and checked, entered Epi Data 3.1, and exported into Statistical Package for Social Sciences software version 25 for further analysis. Bivariable and multiple logistic regressions were used to determine the factors associated with outcome variable. The level of statistical significance was reported to be less than 0.05. RESULTS: The prevalence of work-related musculoskeletal disorders was 73.8% and the highest report 247 (62.2%) was seen in the lower back which was followed by the neck 182 (45.8%) and elbow 126 (31.7%), while the lowest affected body part was ankle 46(11.6%). Working in the medical ward (COR = 5.91, 95%CI: 2.53-13.79), surgical ward (COR = 9.63, 95%CI: 3.64-15.51), and operation room theater (COR = 6.02, 95%CI: 2.37-15.27) had higher risk to work-related musculoskeletal discomfort as compared to those who were worked in outpatient department. Nurses those experienced bending or twisting back as a problem during work 2.33 times more likely to have higher risk WMSDs as compared to those who didn't perceive it with (COR 2.33, 95% CI: 1.47-3.71). CONCLUSION: In this study, the prevalence of work-related musculoskeletal disorders among nurses was high. Working in room/ward, working in malposition, have no on job training to prevent work-related musculoskeletal disorders and bending or twisting back during work were identified as associated factors. Since work-related musculoskeletal disorders are preventable, educating the staff about the use of proper body mechanics and modifying the work environment is essential.

Central nervous system tumours and occupational ionising radiation exposure: a nested case-control study among the ORICAMs cohort of healthcare workers in France.

OBJECTIVE: This study aimed at investigating the relationship between occupational exposure to external ionising radiation and central nervous system (CNS) tumours mortality in healthcare workers working in France. DESIGN AND SETTING: The Occupational Radiation-Induced Cancer in Medical staff (ORICAMs) nested case-control study was conducted based on the dosimetric records of the national register of occupational dosimetry (Système d'information de la surveillance de l'exposition aux rayonnements ionisants). PARTICIPANTS AND METHODS: 33 CNS tumour deaths occurred between 2002 and 2012 among the ORICAMs cohort composed of 164 015 healthcare workers. Each case was matched to five controls alive at the time of the corresponding case's death, based on sex, year of birth, date of enrolment in the cohort and duration of follow-up. All participants were badge monitored for external radiation exposure, expressed in Hp(10). Conditional logistic regression was used to analyse the dose-response relationship between radiation dose and CNS mortality. RESULTS: Cases were exposed to a mean cumulative career radiation dose of 5.8±13.7 (max: 54.3) millisievert (mSv) compared with 4.1±15.2 (142.2) mSv for controls. No statistically significant association was found between CNS tumour mortality and cumulative whole-body career dose (OR=1.00, 95% CI 0.98 to 1.03), duration of exposure (OR=1.03; 95% CI 0.95 to 1.12) or age at first exposure (OR=0.98; 95% CI 0.91 to 1.06). CONCLUSION: We found no evidence of an association between external radiation exposure and CNS tumour risk in healthcare workers. Limitations of the study include low statistical power and short duration of follow-up.

Contemporary Concise Review 2023: Environmental and occupational lung diseases.

Air pollutants have various effects on human health in environmental and occupational settings. Air pollutants can be a risk factor for incidence, exacerbation/aggravation and death due to various lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), hypersensitivity pneumonitis or pneumonia (HP), pulmonary fibrosis such as pneumoconiosis and malignant respiratory diseases such as lung cancer and malignant pleural mesothelioma. Environmental and occupational respiratory diseases are crucial clinical and social issues worldwide, although the burden of respiratory disease due to environmental and occupational causes varies depending on country/region, demographic variables, geographical location, industrial structure and socioeconomic situation. The correct recognition of environmental and occupational lung diseases and taking appropriate measures are essential to their effective prevention.

Shunt-mediated decompression sickness in a compressed air worker with an atrial septal defect.

We report a compressed air worker who had diffuse cutaneous decompression sickness with pain in his left shoulder and visual disturbance characteristic of migraine aura after only his third hyperbaric exposure. The maximum pressure was 253 kPa gauge with oxygen decompression using the Swanscombe Oxygen Decompression Table. He was found to have a very large right-to-left shunt across a 9 mm atrial septal defect. He had transcatheter closure of the defect but had some residual shunting with release of a Valsalva manoeuvre. Thirty-two other tunnel workers undertook the same pressure profile and activities in the same working conditions during the maintenance of a tunnel boring machine for a total of 233 similar exposures and were unaffected. As far as we are aware this is the first report of shunt-mediated decompression sickness in a hyperbaric tunnel worker in the United Kingdom and the second case reported worldwide. These cases suggest that shunt-mediated decompression sickness should be considered to be an occupational risk in modern compressed air working. A right-to-left shunt in a compressed air worker should be managed in accordance with established clinical guidance for divers.

Work-related musculoskeletal disorders among desludging operators in Uganda.

BACKGROUND: Despite the limited evidence, desludging operators remain at a heightened risk of work-related musculoskeletal disorders (WMSDs). This study established the prevalence and predictors of WMSDs among desludging operators in Uganda. METHODS: A digitalized structured questionnaire was used to collect cross-sectional data on musculoskeletal disorders and routine workplace activities from 303 desludging operators in 11 cities in Uganda. These cities were purposively selected based on the presence of a fecal sludge treatment plant or wastewater treatment plant. The Nordic Musculoskeletal Questionnaire (NMQ) was used to assess WMSDs. Simple random sampling with replacements was used to select respondents. Data were analyzed using STATA version 15.0. Modified Poisson Regression was used to measure the strength of association between the independent variables and WMSDs. RESULTS: A total of 303 study participants were interviewed (97.7% response rate). The average age of the respondents was 34.0 years (SD ± 9.8). The prevalence of WMSDs among desludging operators was 29.7%. The body parts affected by MSDs were; the elbow for 4.6% (14/303), shoulder for 5.0% (15/303), and wrist/hand for 6.3% (19/303) of the respondents. At multivariable analysis, after controlling for age, desludging operators' ability to influence the availability of equipment needed to do their work (APR = 0.45, 95% CI: 0.20-0.99), and feeling that everything done was an effort (APR = 1.70, 95% CI: 1.01-2.87) were significantly associated with WMSDs. CONCLUSION: The prevalence of WMSDs was high among desludging operators in Uganda. Desludging operators' ability to influence the availability of equipment needed to do their work and frequency of feeling that everything done was an effort were significantly associated with WMSDs. Interventions should focus on ensuring adequate provision of ergonomic equipment and promoting practices that reduce the physical strain associated with desludging tasks. Additionally, comprehensive training programs addressing proper lifting techniques and posture awareness could significantly mitigate the risk of WMSDs among desludging-operators.

Ergonomic risks and musculoskeletal pain in hospital cleaning workers: Convergent Care Research with mixed methods.

OBJECTIVE: to analyze exposure to ergonomic risks and the occurrence of musculoskeletal pain in workers in the Hospital Cleaning Service. METHOD: Convergent Care Research, with data production designed using mixed methods, implemented with 149 hospital cleaning workers. The methodological strategy of the convergent parallel project was employed, using observation, photographic records, questionnaires and convergence groups. The results were integrated through joint display. Data analysis with descriptive and inferential statistics and content analysis. RESULTS: the mixing of data highlighted the multifactorial nature of exposure to ergonomic risks (uncomfortable work postures; repetitive movements; prolonged orthostatism; use of equipment not adapted to the psychophysiological needs of workers) and musculoskeletal pain in the population investigated. The latter was prevalent in the lumbar spine, ankles or feet, wrists or hands, thoracic spine and shoulders. The concept of ergonomic risk was expanded and was influenced by the psychosocial aspects of work. CONCLUSION: the workers investigated are exposed to modifiable multifactorial ergonomic risks related to musculoskeletal pain. It is possible to promote innovations and teaching-learning actions to minimize them, such as the continuing education program, collectively constructed with recommendations for improvements.

Risk of hand and forearm conditions due to vibrating hand-held tools exposure: a retrospective cohort study from Sweden.

OBJECTIVES: The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools. DESIGN: This is a retrospective cohort study. SETTING: Individuals in the Malmö Diet and Cancer Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, 'does your work involve working with vibrating hand-held tools?' (response: 'not at all', 'some' and 'much'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren's disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure. PARTICIPANTS: Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the study. RESULTS: In total, 12 220/14 342 individuals (76%) reported 'no' exposure, 1392/14 342 (9%) 'some' and 730/14 342 (5%) 'much' exposure to vibrating hand-held tools. In men, 'much' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). 'Some' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). 'Much' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren's disease or CMC-1 OA. 'Much' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women. CONCLUSIONS: Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.

A Scoping Review of Causal Associations between Occupation and Cancer Occurrence and Legal Burden of Proof.

Occupational diseases, characterized by the gradual accumulation of work-related harmful effects over extended periods, often lack a distinct, identifiable incident causative of the disease. This ambiguity in pinpointing the work-relatedness of such diseases stems from the intricate interplay between occupational risks, workers' pathophysiological predispositions, and pre-existing health conditions, all of which evolve slowly over time. Consequently, establishing a definitive causal relationship between occupational exposure and disease manifestation becomes a pivotal, yet challenging, aspect in securing industrial accident insurance benefits. In contrast to occupational accidents, where causality is relatively more discernible, the complexity escalates in the context of occupational diseases. Typically, employers maintain the majority of data pertinent to establishing causality, but this data is frequently inadequate. Furthermore, the onus of proving the work-relatedness of a disease falls on the worker, a process that necessitates specialized medical knowledge, thereby compounding the difficulty. Imposing the burden of proof on workers in occupational disease litigation could lead to a lapse in worker protection. This paper critically explores methodologies to safeguard workers, focusing specifically on the burden of proof concerning causality in occupational diseases. This analysis aims to highlight the challenges workers face in establishing a connection between their work and disease, proposing potential legal and policy solutions to ensure more equitable and just outcomes in occupational disease claims.

Oxidative Stress Assessment of Noise Exposure in the Workers Using Hearing Protection in a Pressing Industry.

BACKGROUND AND OBJECTIVE: Exposure to noise by generation of free radicals causes oxidative stress in body. The aim of this study was the evaluation of oxidative stress in workers who have used hearing protection devices during working time. MATERIAL AND METHOD: Pressing workers (n=24) of a home appliance industry were studied using hearing protection devices to reduce noise exposure. Twenty two office staff (without exposure to noise) were considered as a control group. Two groups were matched for age, work experience and smoking. Exposure to noise was measured by dosimeter method at workstations. By obtaining 3 ml blood sample, Malondialdehyde levels, Thiol groups and total antioxidant capacity were evaluated in all subjects. RESULTS: Exposure to sound pressure level in pressing workers by considering the noise reduction factor of the earplug was observed in 77.65 dB with minimum 75.1 dB and Maximum 81.22 dB. Plasma thiol groups (0.076 (0.041-0.119) vs (0.110 (0.076-0.197), mmol/l P =0.0001) and total antioxidant capacity (361.33± 54.65 vs 414.14± 96.82, µmol/ml P = 0.026) in pressing workers significantly decreased than control group. Pearson correlation showed significant results between exposure to noise and oxidative stress parameters. CONCLUSION: Exposure to noise wave cause oxidative stress in different site of body. Oxidative stress is an intermediate way for different disease due to noise exposure. Reducing of noise exposure by earplug in pressing workers is not efficient protection for oxidative stress generation. Therefore, hearing protection devices are not a barrier to the harmful effects of noise in occupational exposure.

Ergonomics in facial plastic and reconstructive surgery.

PURPOSE OF REVIEW: Understanding effective ergonomic interventions is crucial for enhancing occupational health and career longevity. There is a paucity of clear ergonomics guidelines in facial plastic and reconstructive surgery (FPRS), placing practitioners at high risk of work-related musculoskeletal disorders (WMSDs) and their consequences. RECENT FINDINGS: There is mounting evidence that FPRS specialists are at increased risk of WMSDs as compared with the public and other surgical specialties. Numerous studies have demonstrated that implementation of ergonomics principles in surgery decreases WMSDs. Furthermore, WMSDs are reported as early as the first year of surgical residency, marking the importance of early intervention. SUMMARY: Fatigue and physical injuries among surgeons occur more often than expected, particularly during complex, extended procedures that necessitate maintaining a constant posture. FPRS procedure often place surgeons into procrustean positions. Thus, integrating ergonomic practices into the practice of FPRS is essential for reducing WMSDs.

Narrative review of occupational exposures and noncommunicable diseases.

OBJECTIVE: Within the scope of the Exposome Project for Health and Occupational Research on applying the exposome concept to working life health, we aimed to provide a broad overview of the status of knowledge on occupational exposures and associated health effects across multiple noncommunicable diseases (NCDs) to help inform research priorities. METHODS: We conducted a narrative review of occupational risk factors that can be considered to have "consistent evidence for an association," or where there is "limited/inadequate evidence for an association" for 6 NCD groups: nonmalignant respiratory diseases; neurodegenerative diseases; cardiovascular/metabolic diseases; mental disorders; musculoskeletal diseases; and cancer. The assessment was done in expert sessions, primarily based on systematic reviews, supplemented with narrative reviews, reports, and original studies. Subsequently, knowledge gaps were identified, e.g. based on missing information on exposure-response relationships, gender differences, critical time-windows, interactions, and inadequate study quality. RESULTS: We identified over 200 occupational exposures with consistent or limited/inadequate evidence for associations with one or more of 60+ NCDs. Various exposures were identified as possible risk factors for multiple outcomes. Examples are diesel engine exhaust and cadmium, with consistent evidence for lung cancer, but limited/inadequate evidence for other cancer sites, respiratory, neurodegenerative, and cardiovascular diseases. Other examples are physically heavy work, shift work, and decision latitude/job control. For associations with limited/inadequate evidence, new studies are needed to confirm the association. For risk factors with consistent evidence, improvements in study design, exposure assessment, and case definition could lead to a better understanding of the association and help inform health-based threshold levels. CONCLUSIONS: By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review will help setting priorities in occupational health research. Future epidemiological studies should prioritize to include large sample sizes, assess exposures prior to disease onset, and quantify exposures. Potential sources of biases and confounding need to be identified and accounted for in both original studies and systematic reviews.

Practical cooling interventions for preventing heat strain in indoor factory workers in Thailand.

BACKGROUND: Occupational heat stress, exacerbated by factors such as climate change and insufficient cooling solutions, endangers the health and productivity of workers, especially in low-resource workplaces. OBJECTIVE: To evaluate the effectiveness of two cooling strategies in reducing physiological strain and productivity of piece-rate workers over a 9-h work shift in a southern Thailand sawmill. METHODS: In a crossover randomized control trial design, 12 (33 ± 7 y; 1.58 ± 0.05 m; 51 ± 9 kg; n = 5 females) medically screened sawmill workers were randomly allocated into three groups comprising an established phase change material vest (VEST), an on-site combination cooling oasis (OASIS) (i.e., hydration, cold towels, fans, water dousing), and no cooling (CON) across 3 consecutive workdays. Physiological strain was measured via core temperature telemetry and heart rate monitoring. Productivity was determined by counting the number of pallets of wood sorted, stacked, and stowed each day. RESULTS: Relative to CON, OASIS lowered core temperature by 0.25°C [95% confidence interval = 0.24, 0.25] and heart rate by 7 bpm [6, 9] bpm, compared to 0.17°C [0.17, 0.18] and 10 [9,12] bpm reductions with VEST. It was inconclusive whether productivity was statistically lower in OASIS compared to CON (mean difference [MD] = 2.5 [-0.2, 5.2]), and was not statistically different between VEST and CON (MD = 1.4 [-1.3, 4.1]). CONCLUSIONS: Both OASIS and VEST were effective in reducing physiological strain compared to no cooling. Their effect on productivity requires further investigation, as even small differences between interventions could lead to meaningful disparities in piece-rate worker earnings over time.

[Quantitative analysis of the characteristics and influencing factors of hearing loss among workers exposed to noise in Tianjin].

Objective: To analyze the characteristics of high-frequency average hearing loss in both ears of noise exposed workers in Tianjin in 2020, and quantitatively analyze the influencing factors of high-frequency hearing loss in both ears of workers. Methods: In March 2023, Collect and organize basic information about noise-hazardous enterprises and personal information of workers exposed to noise. Data from the Tianjin Occupational Disease and Health Hazard Factors Information Monitoring System from January 2020 to December 2020, and analyze the impact of basic information of employees, enterprise size, regional distribution, industry category, and economic type on the high-frequency average hearing loss of workers during work. Apply logistic regression to quantitatively analyze the influencing factors of abnormal high-frequency average hearing threshold of noise exposed workers. Results: The size, economic type, industry category, and regional distribution of enterprises, as well as the gender, age, length of service of workers, have an impact on the abnormal high-frequency average hearing threshold of noise exposed workers (χ(2)=733.56、3 497、27、1352.84、1197.62、2570.59、22.30、506.60, P<0.001) . Quantitative analysis using a logistic regression model showed that in the basic information of workers, noise exposed workers were male (OR=2.500, P<0.001) and aged 30-39, 40-49, and 50-59 years (OR=1.33, P<0.001; OR=1.68, P<0.001; OR=1.52, P< 0.001) , with a length of service of 4 to<10 years and≥10 years (OR=1.08, P<0.001; OR=1.615, P<0.001) being the influencing factors for high-frequency hearing loss in both ears of noise exposed workers; In terms of enterprise characteristics, medium-sized, small and micro enterprises (OR=1.12, P<0.001; OR=1.75, P<0.001; OR=2.09, P<0.001) , enterprises located in the fourth district around the city (OR=1.268, P<0.001) , and enterprises with economic types of collective economy, other economy, private economy, Hong Kong, Macao and Taiwan investment, shareholding system, and other industry economies (OR are all >1, P<0.001) are all factors affecting high-frequency hearing loss in noise exposed personnel. Conclusion: Noise is a common occupational hazard factor in Tianjin's enterprises, especially for workers in micro enterprises who face a high risk of hearing abnormalities. Therefore, enterprises need to strengthen the management and intervention of noise operations to prevent the occurrence of hearing loss in workers.

Prevalence of headaches in healthcare workers while using personal protective equipment during the COVID-19 pandemic: a systematic review and meta-analysis.

OBJECTIVES: During the COVID-19 pandemic, healthcare workers (HCWs) are at a serious risk of contracting this virus. Therefore, they should use personal protective equipment (PPE) to protect themselves. Long-term use of these devices has led to many side effects, including headaches. This study investigated the prevalence of headaches related to using PPE in HCWs during the COVID-19 pandemic. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Embase, PubMed, Scopus and Web of Science databases were searched from December 2019 to February 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All cross-sectional studies that investigated the prevalence of headache complications caused by PPE were included. DATA EXTRACTION AND SYNTHESIS: Two researchers reviewed the articles separately and independently. The Appraisal Tool for Cross-Sectional Studies was used to address study design quality and the risk of bias in cross-sectional studies. The heterogeneity of the studies was checked with the I2 statistic, and due to the high heterogeneity, the random effects model was used for synthesis. Data were analysed using Comprehensive Meta-Analysis software V.3.3.70. RESULTS: Out of 3218 articles retrieved for all side effects, 40 were eligible for this meta-analysis. The prevalence of headaches related to the use of PPE in these 40 studies, with a sample size of 19 229 people, was 43.8% (95% CI 43.1% to 44.6%, I2=98.6%, p<0.001). Based on the meta-regression results, no significant relationship was observed between the prevalence of headaches and variables such as year of publication, study location, sample size and quality of studies. CONCLUSION: Headache is one of the common side effects of PPE, which can interfere with HCWs' performance. It is suggested that manufacturers improve the quality of their equipment while healthcare managers should equip and train staff adequately to minimise side effects, ensuring health and enhanced service delivery. PROSPERO REGISTRATION NUMBER: CRD42021264874.