Associations between an international COVID-19 job exposure matrix and SARS-CoV-2 infection among 2 million workers in Denmark.

OBJECTIVES: This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics. METHODS: The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for. RESULTS: Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations. CONCLUSIONS: The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.

Hand eczema and wet work: dose-response relationship and effect of leaving the profession.

BACKGROUND: Wet work is an important risk factor for occupational hand eczema. OBJECTIVES: To examine the effect of job change in workers with occupational hand eczema caused by wet work, and to evaluate the dose-response relationship between intensity of wet work and eczema. METHOD: The study is based on a subgroup (n = 954) from a descriptive, registry-based study including all participants with occupational hand eczema caused by wet work recognized by the Danish Labour Market Insurance Authority in 2010 and 2011. A follow-up questionnaire was sent out 4-5 years later (response 58%). RESULTS: Change of profession and being outside the labour market had a positive effect on healing and improvement of hand eczema. Inverse dose-response relationships were found between the amount of time spent with wet hands at work and healing (p = 0.001) and improvement (p < 0.001), and between the frequency of hand washing at work and healing (p = 0.013) and improvement (p < 0.001). CONCLUSIONS: Leaving the profession has a positive effect on eczema; however, even minor changes in exposure to wet work were associated with healing and improvement. This information has implications with respect to advice given to patients with occupational hand eczema caused by wet work.

Difficulties in using Material Safety Data Sheets to analyse occupational exposures to contact allergens.

BACKGROUND: Information on the occurrence of contact allergens and irritants is crucial for the diagnosis of occupational contact dermatitis. Material Safety Data Sheets (MSDS) are important sources of information concerning exposures in the workplace. OBJECTIVE: From a medical viewpoint, to evaluate the information available from MSDSs, and to ascertain whether MSDS are easy to obtain, whether they serve their purpose, and whether they provide sufficient information regarding allergens to enable correct diagnosis. METHODS: MSDS and ingredients labelling were collected from consecutive patients and reviewed. If it was suspected that the MSDS were incomplete, the manufacturer, supplier, salesperson or workplace was contacted to gather more information. RESULTS: Twenty-five per cent (79/316) of patients provided material for the exposure assessment. One or more shortcomings were found in 18.6% (137/738) of the MSDS. The most frequent shortcoming was 'Missing R43/H317 while known contact allergen was present', which was observed in 63.1% (84/137). Other shortcomings were 'Names of preservatives not included in section 3 despite containing preservatives', in 48.9% (67/137), and 'Nothing about allergy in sections 2, 3, 11, 15 or 16 in the MSDS despite the content of allergens', in 20.4% (28/137). The information retrieved led to additional testing of 21 patients. CONCLUSION: Systematic exposure assessment is time-consuming. The main shortcomings are errors/omissions in the MSDS.

Occupational irritant contact dermatitis diagnosed by analysis of contact irritants and allergens in the work environment.

BACKGROUND: Irritant contact dermatitis (ICD) is a common diagnosis in patients with occupational contact dermatitis (OCD). Studies are lacking on the usefulness of material safety data sheets (MSDSs) in making the diagnosis of ICD. OBJECTIVE: To characterize irritant exposures leading to the diagnosis of occupational ICD (OICD), and to evaluate the occurrence of concomitant exposures to contact allergens. METHODS: We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010-August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing. RESULTS: OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens. CONCLUSION: In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD.

Occupational causes of male infertility.

PURPOSE OF REVIEW: To highlight and discuss the new evidence on occupational and environmental risk to male reproductive function. RECENT FINDINGS: Semen quality following occupational exposure to boron (an acknowledged experimental reproductive toxicant) and benzene, and new evidence on low-level environmental exposure to widespread xenobiotics with endocrine actions. SUMMARY: The naturally occurring semimetal boron is an experimental reproductive toxicant, but now a Turkish semen study corroborates earlier evidence that high-level occupational exposure is not toxic to human spermatogenesis. It seems that human exposure levels are below the levels that cause reproductive toxicity in rodents. On the contrary, there is now ample evidence that the carcinogenic substance benzene may cause chromosomal aberrations in sperm at very low exposure levels. This includes chromosomal deletions that are known to cause infertility, mental retardation and congenital malformations. This research highlights the need to scrutinize the chemicals for possible male-mediated developmental toxicity. Several occupational studies are addressing adult testicular function in men exposed to chemicals that may interfere with endocrine signalling such as bisphenol A and phthalates, but findings are rather inconsistent and it remains to be established whether these widespread chemicals have any impact on male fertility.