An alumni study of a Master's in international health.

OBJECTIVES: The objective of the study was to clarify the reasons why students who graduated from a Master's programme in international health were joining the programme. Another objective was to document how the Master's degree had influenced the careers of the graduates. STUDY DESIGN: An online survey of students who graduated from a Master's programme in international health, including oral science, between 2010 and 2015. METHOD: The study used an anonymous questionnaire that contained 28 items. Topics included information such as demographics, questions about the reasons for joining the Master's programme and the benefits and influence of the programme on the career of the students. RESULTS: Of the 102 alumni who were invited to participate, 70 responded. The response rate was 69%, and we have no information about the non-responders. The results showed that the main reasons for students enrolling in the programme were to improve their competence and develop their career. Around 63% of the respondents reported that the programme had increased their competencies in the jobs they had, whereas 24% answered that their increased qualifications had enabled them to acquire new positions. Thus successfully completing the programme had a positive influence on the graduates' careers in international health. Most of the graduates, who were working, were typically employed at hospitals and universities. Several graduates had proceeded to gain further qualifications by now being enrolled in a PhD programme. CONCLUSIONS: Among the 70% of responders in this survey, the master's programme had benefitted the alumni and the programme had fulfilled their expectations. The programme had a positive influence on the alumni in areas such as increased competency, development of their careers, new positions and better salaries.

Ebola Care and Lack of Consensus on Personal Protective Respiratory Equipment.

The Ebola epidemic in West Africa presents a considerable occupational risk to the health personnel involved. The principal mode of virus transmission to health care personnel is through direct contact with the patient, although transmission by aerosols through the air may also occur. Many safety protocols have been suggested relating to personal protection and particularly respiratory protection. It is generally agreed that all health care workers should have easy access to personal protective equipment. However, the degree of respiratory safety escalates from a mask, to an adequate respirator, and finally to a whole body suit with integrated helmet and positive air pressure. Recent publications demonstrate a lack of consensus on the degree of safety necessary. The step from "safe enough" to being "absolutely safe" seems, in most countries, insurmountable because of costs and logistics.

Microbial dynamics in mixed culture biofilms of bacteria surviving sanitation of conveyor belts in salmon-processing plants.

AIMS: The microbiota surviving sanitation of salmon-processing conveyor belts was identified and its growth dynamics further investigated in a model mimicking processing surfaces in such plants. METHODS AND RESULTS: A diverse microbiota dominated by Gram-negative bacteria was isolated after regular sanitation in three salmon processing plants. A cocktail of 14 bacterial isolates representing all genera isolated from conveyor belts (Listeria, Pseudomonas, Stenotrophomonas, Brochothrix, Serratia, Acinetobacter, Rhodococcus and Chryseobacterium) formed stable biofilms on steel coupons (12°C, salmon broth) of about 10(9) CFU cm(-2) after 2 days. High-throughput sequencing showed that Listeria monocytogenes represented 0·1-0·01% of the biofilm population and that Pseudomonas spp dominated. Interestingly, both Brochothrix sp. and a Pseudomonas sp. dominated in the surrounding suspension. CONCLUSIONS: The microbiota surviving sanitation is dominated by Pseudomonas spp. The background microbiota in biofilms inhibit, but do not eliminate L. monocytogenes. SIGNIFICANCE AND IMPACT OF THE STUDY: The results highlights that sanitation procedures have to been improved in the salmon-processing industry, as high numbers of a diverse microbiota survived practical sanitation. High-throughput sequencing enables strain level studies of population dynamics in biofilm.

The effects of different hygiene procedures in reducing bacterial contamination in a model domestic kitchen.

AIMS: Few studies have compared the effectiveness of hygienic cleaning under simulated use conditions. This study compares commonly used and novel cleaning methods for food contact and hand contact surfaces in kitchens. METHODS AND RESULTS: We report results from two surveys on Norwegian consumers' cleaning procedures. Laboratory models involving cutting boards, tap handles and mobile phones contaminated with Escherichia coli and Staphylococcus aureus were used to compare the hygiene efficacy of commonly used cleaning methods together with new technologies (sprays, single-use wipes, and chlorine-based disinfectants). Commonly used cleaning methods produced a mean log10 reduction (LR) in contamination of 1.5-2.5. The efficacy could be improved by drying or including a disinfection step (mean LR 3.1-4.6). Cleaning of mobile phones was common and was improved by including humidity (1.5-1.9 mean LR). CONCLUSIONS: In many situations, traditional methods used by consumers may be sufficient to hygienically clean surfaces. However, in some situations, such as where there are infected or immune-compromised individuals, or where high risk foods are being handled, hygiene practices resulting in higher LR should be recommended. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates that data from models simulating use conditions are required to estimate the effectiveness of detergent-based removal practices and how these can be enhanced by inactivation processes such as drying and disinfection to ensure that contamination from food-borne pathogens is reduced to acceptable levels to prevent infection transmission.

Health complaints after a malodorous chemical explosion: a longitudinal study.

BACKGROUND: Physical and psychological symptoms are prevalent in populations recently affected by industrial accidents. Follow-up studies of human health effects are scarce, and as most of them focus on residents, little is known about the long-term health effects among workers exposed to malodorous emissions following a chemical explosion. AIMS: To assess whether subjective health complaints (SHC) among workers declined over a 4-year period after an oil tank explosion that emitted malodorous sulphurous compounds. METHODS: A longitudinal survey from 2008 (18 months after the explosion) to 2012, performed using the SHC inventory. Questionnaire data were analysed using a linear mixed effects model. RESULTS: There was a decrease in SHCs among the exposed workers, but they still had significantly more subjective neurological symptoms (P < 0.01) compared with controls, adjusted for gender, age, smoking habits, educational level and proximity to the explosion. CONCLUSIONS: Although there was a downward trend in SHCs among exposed workers in the follow-up period, they reported more subjective neurological complaints than controls. Symptoms may be mediated by perceived pollution and health risk perception, and adaptation or anxiety may cause a chronic effect, manifested by a dysfunctional and persistent neuropsychological response.

Reduction in respiratory symptoms among cement workers: a follow-up study.

BACKGROUND: Several studies have reported associations between cement dust exposure and adverse respiratory health effects, but there are few follow-up studies and no studies of respiratory health effects following dust control measures. AIMS: To assess changes in respiratory health among cement workers and unexposed controls after 1 year in a factory implementing a health and safety campaign with the main aim to increase use of personal protective equipment. Earlier the factory had made technical improvements which had reduced dust levels. METHODS: Respiratory questionnaire interviews and personal total dust exposure assessments were conducted in 2010 and 2011. RESULTS: A total of 171 cement workers and 98 controls participated in the study in 2010. The prevalence of cough, cough with sputum, dyspnoea and wheeze among the 134 exposed workers assessed at follow-up in 2011 was significantly lower than in 2010, but not among 63 controls followed up in 2011. Total dust exposure levels among exposed workers did not differ between 2010 and 2011. CONCLUSIONS: The prevalence of respiratory symptoms among cement workers was reduced after 1 year of follow-up following an intervention campaign to improve use of personal protective equipment.

Duties performed by occupational physicians in Norway.

BACKGROUND: Occupational health care for all is a global aim but has not yet been achieved. Further development should be based on knowledge of specific alternative models of occupational health services (OHS). Little is published on different OHS models and work as a physician in these services. AIMS: To describe duties for Norwegian physicians working in two different OHS models: internal and external. In the internal model, the physician is employed in an OHS located at the company served, whereas in the external model, OHS time is shared between several companies and the physician is often located outside the companies. METHODS: A web-based survey was sent to all members of the Norwegian Occupational Medicine Association. RESULTS: There were 206 responses (response rate of 73%). Only those working as OHS physicians were included (54%). Physicians in external OHS performed individual health examinations to a greater extent, otherwise few differences between physicians working in internal and external OHS were found. Changes in the priority of the physicians' duties through a period of 20 years seem to be related to changes in legislation and official guidelines related to OHS practice. CONCLUSIONS: In this study, OHS physicians in Norway performed a large number of individual-based health examinations but this was seen more in the external OHS model. Otherwise physicians' duties had similar priority in the external and internal models. Legislation and official guidelines seem to be of major importance to the duties performed.

Updating and prospective validation of a prognostic model for high sickness absence.

OBJECTIVES: To further develop and validate a Dutch prognostic model for high sickness absence (SA). METHODS: Three-wave longitudinal cohort study of 2,059 Norwegian nurses. The Dutch prognostic model was used to predict high SA among Norwegian nurses at wave 2. Subsequently, the model was updated by adding person-related (age, gender, marital status, children at home, and coping strategies), health-related (BMI, physical activity, smoking, and caffeine and alcohol intake), and work-related (job satisfaction, job demands, decision latitude, social support at work, and both work-to-family and family-to-work spillover) variables. The updated model was then prospectively validated for predictions at wave 3. RESULTS: 1,557 (77 %) nurses had complete data at wave 2 and 1,342 (65 %) at wave 3. The risk of high SA was under-estimated by the Dutch model, but discrimination between high-risk and low-risk nurses was fair after re-calibration to the Norwegian data. Gender, marital status, BMI, physical activity, smoking, alcohol intake, job satisfaction, job demands, decision latitude, support at the workplace, and work-to-family spillover were identified as potential predictors of high SA. However, these predictors did not improve the model's discriminative ability, which remained fair at wave 3. CONCLUSIONS: The prognostic model correctly identifies 73 % of Norwegian nurses at risk of high SA, although additional predictors are needed before the model can be used to screen working populations for risk of high SA.

Low job satisfaction does not identify nurses at risk of future sickness absence: results from a Norwegian cohort study.

BACKGROUND: Sickness absence is high in healthcare and contributes to nursing staff shortages reducing the efficiency and quality of patient care. Assessing the risk of sickness absence in working nurses opens opportunities for preventive strategies. Job satisfaction has attracted much attention in healthcare research and has been associated with sickness absence among nurses. OBJECTIVES: To investigate if job satisfaction scores are useful to identify working nurses at risk of future sickness absence. DESIGN: Prospective cohort study with a baseline period from November 2008 to March 2009 and 1-year follow-up. SETTINGS: Hospitals, nursing homes, and ambulant care settings in Norway. PARTICIPANTS: 2059 Norwegian nurses, of whom 1582 (77%) could be followed-up. METHODS: Nurses received a questionnaire at baseline and after 1-year follow-up. The questionnaire contained the Job Satisfaction Index (JSI), a 5-item scale measuring overall job satisfaction, and asked for sickness absence in the last 12 months. Baseline JSI scores were included in a logistic regression model with self-rated sickness absence at 1-year follow-up as outcome variable. Predictions of sickness absence were calibrated by the Hosmer-Lemeshow goodness-of-fit test. The ability of JSI scores to discriminate between nurses with and without sickness absence was examined by receiver operating characteristic analysis and expressed as area under the curve (AUC). RESULTS: Low job satisfaction was associated with higher odds of sickness absence (odds ratio [OR]=1.05; 95% confidence interval [CI] 1.01-1.09) and high (≥ 31 days) sickness absence (OR=1.10; 95% CI 1.06-1.14). Calibration was acceptable, but job satisfaction neither discriminated between nurses with and without sickness absence (AUC=0.54; 95% CI 0.51-0.58) nor between nurses with and without high (≥ 31 days) sickness absence (AUC=0.58; 95% CI 0.54-0.63). CONCLUSIONS: The results of this study indicated that job satisfaction was associated with sickness absence, though job satisfaction scores as measured with the JSI did not identify working nurses at risk of sickness absence.

Subjective health complaints and psychosocial work environment among university personnel.

BACKGROUND: Questionnaires are often used to study health problems in working populations. An association between self-reported symptoms and psychosocial strain has been suggested, but results from such studies are difficult to interpret, as a gender difference might be present. The knowledge in this area is not clear. AIMS: To compare the prevalence of subjective health symptoms and their relation to psychosocial work strain among men and women in different age groups, all working as university staff. METHODS: A cross-sectional survey was carried out among university personnel. The questionnaire included a subjective health complaint inventory consisting of 29 items about subjective somatic and psychological symptoms experienced during the last 30 days and psychosocial work factors. Regression analyses were performed. RESULTS: In total, 172 (86%) of 201 eligible employees participated. Women had a higher prevalence of musculoskeletal symptoms than men. Significant differences were found between the genders for headaches, neck pain and arm pain. There was a significant relationship between musculoskeletal symptoms and work strain for both genders. This was found for both men and women below 40 years and among men above the age of 40. No significant difference was found between genders regarding pseudoneurological, gastrointestinal, allergic and flu-like symptoms. CONCLUSIONS: More female than male university personnel reported musculoskeletal symptoms. The musculoskeletal symptoms were associated with high work strain in both genders, but, for women, this was limited to employees under the age of 40. The cause of this gender difference is unknown.

Reduced spread of Campylobacter jejuni in broiler chickens by stimulating the bird's natural barriers.

AIM: We have tested the effect of feed structure and feeding regime to prevent the spread of the zoonotic pathogen Campylobacter jejuni in broiler chicken flocks. METHODS AND RESULTS: Birds were offered two types of feed, control diet and a diet supplemented with 15% oat/barley hulls for structure. In addition, the birds were either fed ad libitum or intermittent. One bird in each treatment group was infected with a three-strain-mix of Camp. jejuni, and the spread of Camp. jejuni within the group was investigated. Feed structure increased the gizzard weight, delayed the spread of Camp. jejuni within the group and reduced the relative amount of Camp. jejuni in the caecum compared with the control diet. CONCLUSIONS: Our results show that stimulating the bird's natural barriers is a novel and promising intervention strategy to reduce the spread of Camp. jejuni in chicken flocks. SIGNIFICANCE AND IMPACT OF THE STUDY: Preventing Camp. jejuni in broiler chicken flocks is essential to ensure food safety because this bacterium is transferred to chicken carcasses during the slaughter process and readily survive in unprocessed poultry products. We have evaluated a novel approach for stimulation of the bird's natural barriers in the upper digestive tract with promising results.

The effect of insoluble fiber and intermittent feeding on gizzard development, gut motility, and performance of broiler chickens.

Two experiments were conducted to test the following hypothesis: exposing broiler chickens to coarse insoluble fiber in the diet will result in enhanced gizzard function and performance, improved adaptability to an intermittent feeding program, and an increase in the occurrence of reverse peristalsis. In experiment 1, 102 Ross 308 broiler chickens were either intermittently or ad libitum fed a basal diet, the basal diet diluted with 15% coarse hulls (consisting of equal weights of hulls from oats and barley), or the basal diet diluted with 15% of the same hulls finely ground in a 2 × 3 factorial arrangement with 17 individually caged birds per treatment. Birds fed ad libitum had access to feed continuously for 18 h/d, whereas those on intermittent feeding had restricted access to feed from 7 d of age. From 18 d of age, the restrictive-feeding program consisted of four 1-h meals and one 2-h meal per day. In experiment 2, 156 broiler chickens in 12 pen cages with wood shaving-lined floors were exposed to 1 of 4 treatment groups with 3 pens/treatment: intermittent or ad libitum feeding of a basal diet and intermittent or ad libitum feeding of a coarse hull diet, as described above. At 31 and 32 d of age, birds in experiment 1 were inoculated with chromium EDTA via the cloaca. There was no interaction between diet and feeding regimen. The addition of hulls increased gizzard weight and content and lowered (P < 0.001) gizzard pH, but it had no effect on the ability of the birds to handle intermittent feeding. Despite the dilution with coarse hulls, weight gain and the gain:feed ratio were not affected, which could partly be explained by an increased (P < 0.001) starch digestibility. Dietary reflux was confirmed by the presence of chromium in all intestinal tract sections. Broilers exhibited reverse peristaltic contractions of sufficient magnitude to propel the marker from the cloaca to the gizzard.

Self-rated coping styles and registered sickness absence among nurses working in hospital care: a prospective 1-year cohort study.

BACKGROUND: Sickness absence is an important problem in healthcare that affects the quality of care. Sickness absence has been related to coping strategies. Problem-focused coping was shown to be associated with low sickness absence and emotion-focused coping with high sickness absence among postal workers. OBJECTIVES: This study investigated the relationship between coping styles and sickness absence in healthcare. DESIGN: Prospective study linking self-rated coping styles at baseline with the number of episodes of sickness absence during one year of follow-up. SETTING: Somatic hospital employing 1,153 persons. PARTICIPANTS: Convenience sample of 566 female nurses working in the hospital's clinical wards and outpatient clinic. Of these, 386 (68%) nurses had complete data for analysis. METHODS: The nurses completed a questionnaire at baseline with items on health, work, and coping styles. Three styles of coping were defined: problem-solving coping (i.e., looking for opportunities to solve a problem), social coping (i.e., seeking social support in solving a problem), and palliative avoidant coping (i.e., seeking distraction and avoiding problems). Sickness absence data were retrieved from the hospital's register in the following year. The association between the coping styles and the number of both short (1-7 days) and long (>7 days) episodes of sickness absence was assessed by Poisson regression analyses with age, work hours per week, general health, mental health, and effort-reward [ER] ratio as covariates. RESULTS: Problem-solving coping was negatively associated with the number of long episodes of sickness absence (rate ratio [RR] = 0.78, 95% confidence interval [CI] = 0.64-0.95). Social coping was negatively associated with the number of both short episodes (RR = 0.88, 95% CI = 0.79-0.97) and long episodes (RR = 0.79, 95% CI = 0.64-0.97) of sickness absence. After adjustment for the ER-ratio, the associations of coping with short episodes of sickness absence strengthened and associations with long episodes weakened, however, significance was lost for both types of sickness absence. Palliative avoidant coping was not associated with sickness absence among female hospital nurses. CONCLUSION: Problem-solving coping and social coping styles were associated with less sickness absence among female nurses working in hospital care. Nurse managers may use this knowledge and reduce sickness absence and understaffing by stimulating problem-solving strategies and social support within nursing teams.

Prevention of intestinal Campylobacter jejuni colonization in broilers by combinations of in-feed organic acids.

AIM: We have tested the effect of various combinations of formic acid and sorbate on Campylobacter jejuni colonization in broiler chickens to reduce the colonization of this zoonotic pathogen in broiler chicken flocks. METHODS AND RESULTS: Chickens were offered feed supplemented with different concentrations and combinations of formic acid and/or potassium sorbate. We found little or no effect on the Camp. jejuni colonization levels in chickens that were given feed supplemented with formic acid alone. A combination of 1.5% formic acid and 0.1% sorbate reduced the colonization of Camp. jejuni significantly, while a concentration of 2.0% formic acid in combination with 0.1% sorbate prevented Camp. jejuni colonization in chickens. This inhibition was replicated in two independent trials with a combination of three different Camp. jejuni strains. CONCLUSIONS: Our results show a novel and promising intervention strategy to reduce the incidence of Camp. jejuni in poultry products and to obtain safer food. SIGNIFICANCE AND IMPACT OF THE STUDY: To ensure food safety, a reduction of the carcass contamination with Camp. jejuni through reduced colonization of this pathogen in broiler chicken flocks is important. A range of organic acids as additives in feed and drinking water have already been evaluated for this purpose. However, no studies have yet shown a complete inhibition of Camp. jejuni colonization in broiler chickens.

Symptoms, complaints, ocular and nasal physiological signs in university staff in relation to indoor environment - temperature and gender interactions.

UNLABELLED: Symptoms, signs, perceptions, and objective measures were studied in university buildings. Two problem buildings with a history of dampness and complaints were compared with two control buildings. Health investigations among university staff were performed at the workplace (n = 173) including tear film stability [non-invasive break-up time (NIBUT) and self-reported break-up time (SBUT)], nasal patency (acoustic rhinometry), nasal lavage fluid analysis [NAL: eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin] and atopy by total serum IgE and IgE antibodies (Phadiatop). Exposure assessment included inspections, thermal and atmospheric climate at 56 points modelled for all work sites. Multiple regressions were applied, controlling for age and gender. Exposure differences between problem buildings and controls were small, and variations between rooms were greater. Workers in the problem buildings had more general and dermal symptoms, but not more objective signs than the others. Adjusted day NIBUT and SBUT increased at higher night air temperatures, with B (95% CI) 0.6 (0.04-1.2) and 1.3 (-0.02 to 2.5), respectively. Higher relative humidity at mean day air temperature <22.1 degrees C was associated with adjusted NIBUT and SBUT, with B (95% CI) 0.16 (0.03-0.29) and 0.37 (-0.01 to 0.75), respectively. Air velocity below recommended winter values and reduced relative humidity in the range of 15-30% were associated with dry air and too low temperature. PRACTICAL IMPLICATIONS: Thermal climate in university buildings may be associated with both perceptions and physiological signs. Reduced night time air temperature, increased difference in air temperature between day and night, and fast changes in air temperature might impair indoor environment. This may have implication for energy-saving policies. It might be difficult to identify the exposure behind, and find the reason why, some buildings are defined as 'problem buildings'.

Pet keeping and dampness in the dwelling: associations with airway infections, symptoms, and physiological signs from the ocular and nasal mucosa.

UNLABELLED: The aim was to utilize data from a study of occupational indoor environments to analyze symptoms and physiological signs in relation to the home environment. A medical investigation was performed at the workplace among university staff (n = 173) from four university buildings in Bergen, in March 2004. Tear film break up time (BUT) was measured by two methods. Nasal patency was measured by acoustic rhinometry. Nasal lavage fluid analysis (NAL) included eosinophilic cationic protein (ECP); myeloperoxidase (MPO), lysozyme and albumin. Atopy was assessed by total serum IgE and specific IgE (Phadiatop). Totally 21%, 21%, 18%, 11%, and 27% had weekly ocular, nasal, facial dermal symptoms, headache and tiredness, respectively, 15% had a damp dwelling, and 20% had a cat or dog. Multiple linear or logistic regressions were applied, controlling for age gender, smoking, and environmental factors. Building dampness was associated with increased NAL-lysozyme (P = 0.02) and an increase of airway infections [odd ratio (OR) = 3.14, P = 0.04]. Pet keeping was associated with difficulties to concentrate (OR = 5.10, P = 0.001), heavy headedness (OR = 4.35, P = 0.004), four more days with tiredness per month (P = 0.04), and less airway infections (OR = 0.32; P = 0.02). In conclusion, pet keeping was associated with more central nervous system (CNS)-symptoms but less airway infections. Dampness in the dwelling may have inflammatory effects on the airway mucosa, possibly mediated via increased infection proneness. PRACTICAL IMPLICATIONS: The main health focus on pet keeping has been allergen exposure. Our study indicates that effects on airway infections and other types of symptoms should also be considered. The findings support the view that measures should be taken to reduce building dampness in dwellings.

Acute suppression of serum IgM and IgA in tank workers exposed to benzene.

We investigated associations between benzene exposure and alterations of proteins and cells of the immune system among workers maintaining cargo tanks containing crude oil residues. Individual exposure to benzene, benzene in blood and urine, peripheral blood lymphocytes (total lymphocytes, lymphocytes in subpopulations CD3, CD4, CD8, CD19, CD56 and CD4/CD8 ratio), complement factors C3 and C4 and serum concentration of immunoglobulins (IgG, IgA, IgM and IgE) were analysed among 13 tank workers and nine unexposed referents (catering section). Benzene exposure was measured during three consecutive 12-h work days. Blood and urine samples were collected pre-shift on the first day (baseline), post-shift on the third day, and pre-next shift on the following morning. The time spent in the cargo tank was logged. The individual geometric mean benzene exposure in the breathing zone of tank workers over 3 days was 0.15 p.p.m. (range 0.01-0.62 p.p.m.) (n = 26). The geometric mean benzene concentration in blood post-shift was 12.3 nmol/l among tank workers versus 0.7 nmol/l among the referents. Tank workers showed a decline (versus referents) in IgM from baseline to post-shift (t-test, P = 0.04) and IgA from baseline to pre-next shift (t-test, P = 0.01). They also showed a decline in CD4 T cells from baseline to post-shift (t-test, P = 0.04). Suppression correlated with benzene exposure, benzene concentrations in blood and urine and time spent in the tank. The groups did not differ significantly in the change in other immune parameters. The clinical significance is unknown and warrants further studies.

A higher risk of congenital anomalies in the offspring of personnel who served aboard a Norwegian missile torpedo boat.

BACKGROUND: In the 1990s, congenital anomalies were reported among children whose fathers had served aboard a Norwegian missile torpedo boat (MTB). The Royal Norwegian Navy asked the University of Bergen to look into this problem as one part of a general health and work environment surveillance. AIMS: To estimate any increased risk of having children with congenital anomalies and having stillborn children among the offspring of workers that had served aboard the MTB and to investigate possible differences in exposure and other risk factors between these groups. METHODS: Data from a cross-sectional study among all current employees of the Norwegian Navy (n = 2265, response rate 58%) were analysed. RESULTS: The prevalence ratio of having a child with congenital malformations associated with working on the ship was 4.0 (95% CI 1.9 to 8.6). The prevalence ratio of having a child who was stillborn or died within one week was 4.1 (95% CI 1.7 to 9.9). CONCLUSION: Service aboard the MTB was associated with an increased risk of having children with congenital birth defects and having children that were stillborn. The causes of these findings are unknown.

Benzene exposure on a crude oil production vessel.

OBJECTIVES: The aim was to describe the personal exposure to benzene on a typical crude oil production vessel and to identify factors influencing the exposure level. METHODS: The study population included process operators, deck workers, mechanics and contractors on a production vessel in the Norwegian sector of the North Sea. The personal exposure to benzene during ordinary activity, during a short shutdown and during tank work was monitored using organic vapour passive dosimeter badges (3M 3500). Information on the tasks performed on the day of sampling was recorded. Exposure was assessed by grouping the measurements according to job category, mode of operation and the tasks performed on the sampling day. Univariate analysis of variance was used to test the differences between the groups. RESULTS: Forty-two workers participated in the exposure assessment, comprising a total of 139 measurements. The arithmetic and geometric mean of benzene exposure for all measurements was 0.43 and 0.02 p.p.m., respectively. Twenty-five measurements (18%) were below the limit of detection (0.001 p.p.m.), while ten samples (7%) exceeded the occupational exposure limit of 0.6 p.p.m. The geometric mean exposure was 0.004 p.p.m. (95% CI 0.003-0.006) during ordinary activity, 0.01 p.p.m. (95% CI 0.005-0.02) during shutdown and 0.28 p.p.m. (95% CI 0.16-0.49) during tank work. Workers performing annual cleaning and maintenance of tanks containing crude oil or residues of crude oil had higher levels of exposure than workers performing other tasks, including work near open hydrocarbon-transport systems (all P < 0.001). However, because of the mandatory use of respirators, the actual personal benzene exposure was lower. The job categories explained only 5% of the variance in exposure, whereas grouping by mode of operation explained 54% of the variance and grouping by task 68%. CONCLUSION: The results show that, although benzene exposure during ordinary and high activity seems to be low in the processing area on the production vessel, cleaning of tanks and performing maintenance work in a cleaned tank have a potential for high exposure.

The effects of occupational health and safety management on work environment and health: a prospective study.

According to Norway's Internal Control Regulation, all companies are required to have an occupational health and safety (H&S) management system. This study investigated the effects of implementing or improving occupational H&S management on the work environment, H&S-related behaviour and musculoskeletal health of workers in small and medium-sized companies. A one-year prospective cohort study, using self-administered questionnaires, was performed among the managers and blue-collar workers in 226 motor vehicle repair garages. Out of 1559 workers that responded at baseline 721 workers could be identified at follow-up. These 721 workers were included in the study. The workers in companies with improved H&S management from baseline to follow-up reported increased satisfaction with the H&S activities at the garage; improved support from management and colleagues; improved health-related support and control; and increased participation in H&S activities.