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1.
Artigo em Inglês | MEDLINE | ID: mdl-34636977

RESUMO

OBJECTIVES: Numerous studies have examined the health consequences of workplace bullying, but little is known about workplace antecedents of workplace bullying. This study examines whether high psychological demands, low levels of justice at work, and low decision latitude increase the occurrence of being bullied or witnessing bullying. METHODS: In 2007, 4489 Danish public employees answered a questionnaire with follow-ups in 2009 (72%) and 2011 (73% of 2009 respondents). We examined the longitudinal association between exposure to job stressors in 2007 and 2009 and bullying in 2009 and 2011, respectively, on an individual and work-unit level. For each working condition (psychological demands, decision latitude, procedural and relational justice), we calculated a mean value. Odds ratios were calculated by logistic regression. RESULTS: Low levels of individual-level relational justice, compared to high levels, were associated with a higher risk of both witnessing episodes of bullying (OR 1.66, 95% CI 1.11-2.48) and perceiving oneself as a target of bullying (OR 2.21, 95% CI 1.17-4.16). Low levels of work-unit level relational justice were associated with a higher risk of witnessing bullying (OR 1.55, 95% CI 1.04-2.30) but not perceiving oneself as a target of bullying. The other workplace characteristics exhibited no or less consistent associations across the different analytical approaches. CONCLUSION: Low levels of relational justice prospectively predicted the occurrence of workplace bullying within a 2-year period for three out of four methodological approaches, suggesting that relational justice plays a role in the prevention of workplace bullying.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34478560

RESUMO

Objectives Several studies have examined the health consequences of workplace threats and violence, however, due to methodological issues the epidemiological evidence is limited. The purpose of this study was to examine the prospective association between self-labelled exposure to work-related threats and violence and the risk of depression, measured by a standardized psychiatric interview and new prescriptions of anti-depressive medication. Methods Employees were recruited from the Danish PRISME cohort established in 2007 where 4489 Danish public employees answered a postal questionnaire with follow-ups in 2009 and 2011. In all three waves, depression was diagnosed by clinical interviews with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). In addition, we ascertained prescription of anti-depressive medication from a national register. Using logistic regression and Cox proportional hazard models, we estimated the association between exposure to threats and violence at baseline and SCAN depression and prescription of anti-depressive medication during two years of follow-up. Results Self-labelled exposure to work-related threats and violence was associated with a risk of SCAN diagnosed depression two years later, odds ratios (OR) 2.20 [95% confidence interval (CI) 1.13-4.28] and OR 2.11 (95% CI 1.05-4.24), respectively, with indication of a dose-response. Self-labelled exposure to work-related threats and violence was associated with prescription of anti-depressive medication in a two-year period, hazard ratios (HR) 2.55 (95% CI 1.47-4.40) and HR 1.47 (95% CI 0.70-3.06), respectively. Conclusion Exposure to work-related threats or violence is associated with an increased risk of depression two years later, measured with a psychiatric interview and register data on prescribed antidepressants.

3.
Acta Psychiatr Scand ; 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34523121

RESUMO

OBJECTIVE: To examine the hypothesis that PTSD with delayed expression in some cases occurs without subthreshold PTSD symptoms above background levels bridging the gap between the traumatic exposure(s) and the clinical diagnosis. METHODS: We performed systematic searches of peer-reviewed papers in English referenced in Pubmed, Embase, or PsycINFO and ascertained 34 prospective studies of PTSD symptom trajectories identified by latent class growth statistical modeling. Studies with delayed and low-stable trajectories provided appropriate data for this study. We computed the difference between the delayed trajectory PTSD symptom sumscore and the low-stable PTSD sumscore at the observed points in time after the traumatic event(s). RESULTS: In 29 study populations, the latent class growth analyses displayed delayed trajectories, and in these, we identified 110 data points (% PTSD sumscore difference/months since traumatic exposure). The median PTSD symptom sumscore was 25% higher during the initial 6 months among individuals in the delayed trajectory compared to those in low-stable trajectory. From this level, the difference widened and reached a plateau of 40-50% higher. The variation was large, and the baseline participation rate and loss to follow-up were exceeding 25% in the majority of the studies. Heterogeneity of populations, measures, and analyses precluded formal meta-analysis. CONCLUSION: Delayed PTSD is preceded by PTSD symptoms during the first year in most cases. Still, few individuals may experience an asymptomatic delay. The results underpin the rationale for monitoring PTSD symptoms and may inform forensic assessments in that delayed PTSD without symptoms bridging the traumatic event is rare.

4.
Eur J Epidemiol ; 36(8): 861-872, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34420151

RESUMO

Human health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was - 32 g (95% CI-79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose-response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy.


Assuntos
Poluentes Atmosféricos/toxicidade , Anormalidades Congênitas/etiologia , Exposição Ambiental/efeitos adversos , Crescimento/efeitos dos fármacos , Exposição Materna/efeitos adversos , Bifenilos Policlorados/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Estudos de Coortes , Anormalidades Congênitas/epidemiologia , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Bifenilos Policlorados/análise , Gravidez , Resultado da Gravidez , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
5.
Thorax ; 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34244457

RESUMO

INTRODUCTION: The risk of asbestosis, malignant mesothelioma and lung cancer among motor vehicle mechanics is of concern because of potential exposure to chrysotile asbestos during brake, clutch and gasket repair and maintenance. Asbestos has also been used in insulation and exhaust systems. METHODS: We examined the long-term risk of incident mesothelioma, lung cancer, asbestosis and other lung diseases and mortality due to mesothelioma, lung cancer, asbestosis and other lung diseases in a nationwide cohort of all men registered as motor vehicle mechanics since 1970 in Denmark. This was compared with the corresponding risk in a cohort of male workers matched 10:1 by age and calendar year, with similar socioeconomic status (instrument makers, dairymen, upholsterers, glaziers, butchers, bakers, drivers, farmers and workers in the food industry, trade or public services). RESULTS: Our study included 138 559 motor vehicle mechanics (median age 24 years; median follow-up 20 years (maximum 45 years)) and 1 385 590 comparison workers (median age 25 years; median follow-up 19 years (maximum 45 years)). Compared with other workers, vehicle mechanics had a lower risk of morbidity due to mesothelioma/pleural cancer (n=47 cases) (age-adjusted and calendar-year-adjusted HR=0.74 (95% CI 0.55 to 0.99)), a slightly increased risk of lung cancer (HR=1.09 (95% CI 1.03 to 1.14)), increased risk of asbestosis (HR=1.50 (95% CI 1.10 to 2.03)) and a chronic obstructive pulmonary disease risk close to unity (HR=1.02 (95% CI 0.99 to 1.05)). Corresponding HRs for mortality were 0.86 (95% CI 0.64 to 1.15) for mesothelioma/pleural cancer, 1.06 (95% CI 1.01 to 1.12) for lung cancer, 1.79 (95% CI 1.10 to 2.92) for asbestosis, 1.06 (95% CI 0.86 to 1.30) for other lung diseases caused by external agents and 1.00 (95% CI 0.98 to 1.01) for death due to all causes. CONCLUSIONS: We found that the risk of asbestosis was increased among vehicle mechanics. The risk of malignant mesothelioma/pleural cancers was not increased among vehicle mechanics.

6.
Scand J Public Health ; : 14034948211018387, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34120525

RESUMO

BACKGROUND: Pregnancy can make it difficult to cope with demands at work and may affect women's well-being. We investigated if a manager-targeted educational intervention reduced demanding occupational exposures and improved the psychosocial work environment and well-being among pregnant employees. METHODS: Data came from a cluster randomised trial in Danish hospitals and day-care institutions. Work units were assigned randomly and were non-blinded to the intervention, where managers were either invited to participate in a three-hour seminar addressing job adjustment in pregnancy or assigned to a control group undertaking their usual practice. Self-reported outcomes by pregnant employees at the work units were the proportion of pregnant employees with demanding occupational exposures, good psychosocial work environment and good well-being. Mixed logistic regression was applied in the population of responders and in intention-to-treat analyses using multiple imputations. RESULTS: We included 915 pregnant employees: 451 in the intervention group and 464 in the control group. Of 216 invited managers, 103 (48%) participated in the seminar. A total of 339 (37%) pregnant employees answered the questionnaire. The proportion of pregnant employees who had demanding occupational exposures, good psychosocial work environment and good well-being in the intervention versus the control group were 36% versus 39% (odds ratio (OR)=0.90, 95% confidence interval (CI) 0.57-1.44), 56% versus 59% (OR=1.01, 95% CI 0.60-1.71) and 77% versus 73% (OR=1.13, 95% CI 0.68-1.87), respectively. CONCLUSIONS: This manager-targeted educational intervention did not reduce demanding occupational exposures and did not improve the psychosocial work environment or the well-being among pregnant employees in hospital and day-care settings. Comprehensive and participatory interventions may be considered in future studies.

7.
Environ Sci Technol ; 55(14): 9926-9937, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34180659

RESUMO

We aimed to assess the relationships among the adipose tissue's (AT) oxidative microenvironment, in situ accumulated persistent organic pollutant (POP) concentrations, and cancer development. POP and oxidative stress levels were quantified in AT samples from 382 adults recruited within the GraMo cohort (2003-2004) in Granada (Spain). The 16-year cancer incidence was ascertained by reviewing health/administrative databases. Cox-regression models and mediation analyses were performed. The enzymes superoxide dismutase (SOD) and glutathione reductase (GRd) were positively associated with the risk of non-hormone-dependent (NHD) cancer [adjusted hazard ratio (HR) 1.76; 95% confidence interval (CI): 1.17, 2.64 and HR 2.35; 95% CI: 1.41, 3.94, respectively]. After adjustment for covariates, polychlorinated biphenyl-138 (PCB-138) (HR 1.78; 95% CI: 1.03, 3.09), ß-hexachlorocyclohexane (ß-HCH) (HR 1.70; 95% CI: 1.09, 2.64), and hexachlorobenzene (HR 1.54; 95% CI: 1.02, 2.33) were also positively associated with the risk of NHD cancer. Although confidence intervals included the null value, probably because of the modest number of cancer cases, we observed a potential mediation effect of SOD and GRd on the associations between ß-HCH and the risk of NHD tumors (percent mediated = 33 and 47%, respectively). Our results highlight the relevance of human AT's oxidative microenvironment as a predictor of future cancer risk as well as its potential mediating role on POP-related carcinogenesis. Given their novelty, these findings should be interpreted with caution and confirmed in future studies.


Assuntos
Poluentes Ambientais , Hidrocarbonetos Clorados , Neoplasias , Praguicidas , Bifenilos Policlorados , Tecido Adiposo/metabolismo , Adulto , Poluentes Ambientais/metabolismo , Humanos , Hidrocarbonetos Clorados/metabolismo , Incidência , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Oxirredução , Poluentes Orgânicos Persistentes , Praguicidas/metabolismo , Bifenilos Policlorados/metabolismo , Microambiente Tumoral
8.
Int J Infect Dis ; 108: 382-390, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34022336

RESUMO

OBJECTIVE: Our study aimed to compare symptoms day by day for non-hospitalized individuals testing positive and negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: In total, 210 positive-test and 630 negative-test healthcare workers in the Central Denmark Region were followed for up to 90 days after testing, between April and June, 2020. Their daily reported COVID-19-related symptoms were compared graphically and by logistic regression. RESULTS: Thirty per cent of the positive-test and close to 0% of the negative-test participants reported a reduced sense of taste and smell during all 90 days (adjusted odds ratio [aOR] 86.07, 95% CI 22.86-323). Dyspnea was reported by an initial 20% of positive-test participants, declining to 5% after 30 days, without ever reaching the level of the negative-test participants (aOR 6.88, 95% CI 2.41-19.63). Cough, headache, sore throat, muscle pain, and fever were temporarily more prevalent among the positive-test participants; after 30 days, no increases were seen. Women and older participants were more susceptible to long-lasting COVID-19 symptoms. CONCLUSION: The prevalence of long-lasting reduced sense of taste and smell is highly increased in mild COVID-19 patients. This pattern is also seen for dyspnea at a low level, but not for cough, sore throat, headache, muscle pain, or fever.


Assuntos
COVID-19 , SARS-CoV-2 , Feminino , Seguimentos , Pessoal de Saúde , Humanos , Reação em Cadeia da Polimerase
10.
Artigo em Inglês | MEDLINE | ID: mdl-33670148

RESUMO

Bisphenol A (BPA) is considered an endocrine disruptor and has been associated with deleterious effects on spermatogenesis and male fertility. Bisphenol F (BPF) and S (BPS) are structurally similar to BPA, but knowledge of their effects on male fertility remains limited. In this cross-sectional study, we investigated the associations between exposure to BPA, BPF, and BPS and semen quality in 556 men 18-20 years of age from the Fetal Programming of Semen Quality (FEPOS) cohort. A urine sample was collected from each participant for determination of BPA, BPF, and BPS concentrations while a semen sample was collected to determine ejaculate volume, sperm concentration, total sperm count, sperm motility, and sperm morphology. Associations between urinary bisphenol levels (continuous and quartile-divided) and semen characteristics were estimated using a negative binomial regression model adjusting for urine creatinine concentration, alcohol intake, smoking status, body mass index (BMI), fever, sexual abstinence time, maternal pre-pregnancy BMI, and first trimester smoking, and highest parental education during first trimester. We found no associations between urinary bisphenol of semen quality in a sample of young men from the general Danish population.


Assuntos
Análise do Sêmen , Motilidade Espermática , Compostos Benzidrílicos , Estudos Transversais , Dinamarca , Feminino , Humanos , Masculino , Fenóis , Gravidez , Adulto Jovem
11.
Eur J Epidemiol ; 36(5): 479-496, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33580479

RESUMO

In the last decade, many studies have examined associations between poor psychosocial work environment and depression. We aimed to assess the evidence for a causal association between psychosocial factors at work and depressive disorders. We conducted a systematic literature search from 1980 to March 2019. For all exposures other than night and shift work and long working hours, we limited our selection of studies to those with a longitudinal design. We extracted available risk estimates for each of 19 psychosocial exposures, from which we calculated summary risk estimates with 95% confidence intervals (PROSPERO, identifier CRD42019130266). 54 studies were included, addressing 19 exposures and 11 different measures of depression. Only data on depressive episodes were sufficient for evaluation. Heterogeneity of exposure definitions and ascertainment, outcome measures, risk parameterization and effect contrasts limited the validity of meta-analyses. Summary risk estimates were above unity for all but one exposure, and below 1.60 for all but another. Outcome measures were liable to high rates of false positives, control of relevant confounding was mostly inadequate, and common method bias was likely in a large proportion of studies. The combination of resulting biases is likely to have inflated observed effect estimates. When statistical uncertainties and the potential for bias and confounding are taken into account, it is not possible to conclude with confidence that any of the psychosocial exposures at work included in this review is either likely or unlikely to cause depressive episodes or recurrent depressive disorders.


Assuntos
Transtorno Depressivo/psicologia , Estresse Psicológico , Local de Trabalho/psicologia , Humanos , Exposição Ocupacional
12.
Int Arch Occup Environ Health ; 94(5): 1033-1040, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33559749

RESUMO

PURPOSE: Occupational inhalant exposures have been linked with a higher occurrence of chronic productive cough, but recent studies question the association. METHODS: We included participants from two general population studies, the Copenhagen City General Population Study and the Copenhagen City Heart Study, to assess contemporary (year 2003-2017) and historical (1976-1983) occupational inhalant hazards. Job titles one year prior to study inclusion and an airborne chemical job-exposure matrix (ACE JEM) were used to estimate occupational exposure. The association between occupational exposures and self-reported chronic productive cough was studied using generalized estimating equations stratified by smoking status and cohort. RESULTS: The population consisted of 5210 working individuals aged 20-65 from 1976 to 1983 and 64,279 from 2003 to 2017. In smokers, exposure to high levels of mineral dust, biological dust, gases & fumes and the composite variable vapours, gases, dusts or fumes (VGDF) were associated with chronic productive cough in both cohorts with odds ratios in the range of 1.2 (95% confidence interval, 1.0;1.4) to 1.6 (1.2;2.1). High levels of biological dust were only associated with an increased risk of a chronic productive cough in the 2003-2017 cohort (OR 1.5 (1.1;2.0)). In non-smokers, high levels of VGDF (OR 1.5 (1.0;2.3)) and low levels of mineral dust (OR 1.7 (1.1;2.4)) were associated with chronic productive cough in the 1976-1983 cohort, while no associations were seen in non-smokers in the 2003-2017 cohort. CONCLUSION: Occupational inhalant exposure remains associated with a modestly increased risk of a chronic productive cough in smokers, despite declining exposure levels during the past four decades.


Assuntos
Poluentes Ocupacionais do Ar , Tosse/epidemiologia , Exposição por Inalação , Doenças Profissionais/epidemiologia , Exposição Ocupacional , Adulto , Idoso , Doença Crônica , Tosse/fisiopatologia , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/fisiopatologia , Razão de Chances , Fumar/epidemiologia , Espirometria , Adulto Jovem
13.
Occup Environ Med ; 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33436380

RESUMO

OBJECTIVE: The aim was to test if targeting managers with an educational intervention reduces absence among pregnant employees. METHODS: The study was a non-blinded cluster randomised trial conducted in hospitals and daycare institutions from two administrative Danish Regions and two Danish municipalities. Clusters (work units) were assigned randomly and non-blinded to either (1) intervention, where all managers were invited to participate in a 3-hour seminar addressing needs and options for adjustment of work in pregnancy, or (2) control, with practice as usual. The primary outcome based on payroll data was long-term pregnancy-related absence, defined as ≥12.5% cumulated absence during pregnancy weeks 1-32. Intention-to-treat analysis was applied using mixed logistic regression. RESULTS: Ninety work units were included (56 hospital departments and 34 daycare units) with 451 pregnant employees in the intervention group and 464 in the control group. Work units had on average 11 pregnant employees with no difference between the groups. 103 of the 216 invited managers (48%) participated in a the 3-hour seminar. In the intervention group, 154 (34%) had long-term pregnancy-related absence during pregnancy weeks 1-32 vs 166 (36%) in the control group. Relative odds of having long-term pregnancy-related absence, when being in the intervention group, was 1.06 (95% CI 0.71 to 1.58), with an interclass correlation coefficient of 0.07. CONCLUSION: An educational intervention targeting managers did not reduce pregnancy-related absence among pregnant employees. TRIAL REGISTRATION NUMBER: NCT03002987.

14.
Int J Epidemiol ; 49(6): 1847-1855, 2021 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-32974645

RESUMO

BACKGROUND: Maternal stressors during pregnancy are potential risk factors for asthma in offspring. However, previous studies have been limited by the use of self-reported data focusing on stressors either in private life or at work. This study examined the association between maternal stressors both in private life and at work during pregnancy and asthma in offspring. METHODS: In the Danish National Birth Cohort, 75 156 live-born singletons born during 1996-2002 were identified. Maternal information on job title were available around weeks 12-16 of gestation. Data on maternal bereavement, life-threatening illness, suicide attempt and alcohol or drug abuse of a close relative and offspring childhood asthma (3-10 years of age) were obtained from Danish nationwide registers. Maternal psychosocial work stressors (job control, psychological job demands, emotional job demands, work-related violence and threats of work-related violence) were estimated by the use of job-exposure matrices. The association between maternal stress and childhood asthma was analysed in Cox models adjusted for maternal age, comorbidity and parity. RESULTS: Neither private-life nor work stressors were related to onset of asthma in offspring. Separate analyses by parental atopy or onset of asthma in offspring supported the main findings. CONCLUSIONS: This study does not support an elevated risk of childhood asthma related to exposure to stress during pregnancy.


Assuntos
Asma , Efeitos Tardios da Exposição Pré-Natal , Asma/epidemiologia , Feminino , Humanos , Mães , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fatores de Risco , Estresse Psicológico/epidemiologia
15.
Int Arch Occup Environ Health ; 94(3): 547-556, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33188448

RESUMO

AIM: This study investigates if non-bullied employees in Work units (WUs) where bullying occur, are more prone to leave the WUs than employees in WUs with no bullying, and if the prevalence of workplace bullying had an impact on leaving the WUs. Leaving the workplace was defined by unemployment or change of workplace at follow-up. METHODS: We had data from 8326 Danish public health invited employees from 302 WUs. Of these 3036 responded to a questionnaire on working conditions and health in 2007. WUs were classified into three categories of WUs: (1) no bullying (0% bullied), (2) moderate prevalence of bullying (< 10% bullied), and (3) high prevalence of bullying (≥ 10% bullied). Bullied respondents were used to classify the WUs and excluded in the analyses. RESULTS: We found odds ratios (ORs) for unemployment 1 year later of 1.27 [95% CI 0.69-2.37] in WUs with moderate prevalence of bullying and 1.38 [95% CI 0.85-2.23] among employed in WUs with high prevalence of bullying, adjusted for size of WUs, age, sex, and job category. For turnover 1 year later the ORs were 1.27 [95% CI 0.78-2.15] and 1.46 [95% CI 0.99-2.15] in WUs with moderate and high prevalence of bullying, respectively. CONCLUSION: We did not find that non-bullied employees leave the WUs with moderate and high prevalence of bullying more than employees in WUs with no bullying behaviour 1 year later. Leaving the workplace tended to be higher among employees in WUs with high prevalence of bullying compared to no and moderate bullying.

16.
Ugeskr Laeger ; 182(51)2020 12 14.
Artigo em Dinamarquês | MEDLINE | ID: mdl-33317690

RESUMO

Night work has been associated with sleep disorders as well as cardiovascular, endocrinologic, metabolic and immunological disturbances as shown in this review. Several night shifts in a row and more than one night shift per week is associated with increased risk of pregnancy-related complications. A dose-response pattern has been shown between the number of night shifts during pregnancy and the risk of miscarriage, hypertensive disorders and sick leave. Individual risk assessment of pregnant night workers should focus on their general health, the intensity of night shifts and other adverse working conditions.


Assuntos
Aborto Espontâneo , Complicações na Gravidez , Transtornos do Sono-Vigília , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Feminino , Humanos , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Sono , Tolerância ao Trabalho Programado
17.
PLoS One ; 15(12): e0243826, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370308

RESUMO

PURPOSE: Recent studies suggest that occupational inhalant exposures trigger exacerbations of asthma and chronic obstructive pulmonary disease, but findings are conflicting. METHODS: We included 7,768 individuals with self-reported asthma (n = 3,215) and/or spirometric airflow limitation (forced expiratory volume in 1 second (FEV1)/ forced expiratory volume (FVC) <0.70) (n = 5,275) who participated in The Copenhagen City Heart Study or The Copenhagen General Population Study from 2001-2016. Occupational exposure was assigned by linking job codes with job exposure matrices, and exacerbations were defined by register data on oral corticosteroid treatment, emergency care unit assessment or hospital admission. Associations between occupational inhalant exposure each year of follow-up and exacerbation were assessed by Cox regression with time varying exposure and age as the underlying time scale. RESULTS: Participants were followed for a median of 4.6 years (interquartile range, IQR 5.4), during which 870 exacerbations occurred. Exacerbations were not associated with any of the selected exposures (high molecular weight sensitizers, low molecular weight sensitizers, irritants or low and high levels of mineral dust, biological dust, gases & fumes or the composite variable vapours, gases, dusts or fumes). Hazards ratios ranged from 0.8 (95% confidence interval: 0.7;1.0) to 1.2 (95% confidence interval: 0.9;1.7). CONCLUSION: Exacerbations of obstructive airway disease were not associated with occupational inhalant exposures assigned by a job exposure matrix. Further studies with alternative exposure assessment are warranted.


Assuntos
Asma/epidemiologia , Asma/patologia , Progressão da Doença , Exposição Ocupacional/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/patologia , Feminino , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade
18.
PLoS One ; 15(9): e0237422, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881896

RESUMO

In a recent population-based study, an elevated risk of the Metabolic syndrome (MetS) and type 2 diabetes was found in childless men compared to those who have fathered one or more children. Therefore, by using a larger cohort of more than 22 000 men from the Malmo Preventive Project (MPP) we aimed to expand our observations in order to evaluate the metabolic profile of childless men and to evaluate if childlessness is an additional and independent predictor of major adverse cardiovascular events (MACE), mortality and incident diabetes when accounting for well-known biochemical, anthropometric, socio-economic and lifestyle related known risk factors. Logistic regression was used to assess risk of MACE, diabetes and MetS at baseline. Multivariate Cox regression was used to evaluate the risks of MACE and mortality following the men from baseline screening until first episode of MACE, death from other causes, emigration, or end of follow-up (31st December 2016) adjusting for age, family history, marital status, smoking, alcohol consumption, educational status, body mass index, prevalent diabetes, high blood lipids, increased fasting glucose and hypertension. Childless men presented with a worse metabolic profile than fathers at the baseline examination, with elevated risk of high triglycerides, odds ratio (OR) 1.24 (95%CI: 1.10-1.42), high fasting glucose OR 1.23 (95%CI: 1.05-1.43) and high blood pressure, OR 1.28 (95%CI: 1.14-1.45), respectively. In the fully adjusted prospective analysis, childless men presented with elevated risk of cardiovascular mortality, HR: 1.33 (95% CI: 1.18-1.49) and all-cause mortality, HR 1.23 (95%CI: 1.14-1.33), respectively. In conclusion, these results add to previous studies showing associations between male reproductive health, morbidity and mortality. Male childlessness, independently of well-known socio-economic, behavioral and metabolic risk factors, predicts risk of cardiovascular disease and mortality. Consequently, this group of men should be considered as target population for preventive measures.


Assuntos
Doenças Cardiovasculares/mortalidade , Adulto , Estudos de Coortes , Intervalos de Confiança , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Estilo de Vida , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Morbidade , Razão de Chances , Fatores de Risco
19.
Artigo em Inglês | MEDLINE | ID: mdl-32870384

RESUMO

Maternal psychosocial stress may impact child neurodevelopment, but little is known regarding psychosocial job strain. We hypothesized high psychosocial job strain during pregnancy was associated with behavioural problems in the 11-year-old children. Mothers in the Danish National Birth Cohort (1996-2002) were included if they worked, provided information on job strain [Karasek's model: high job strain (often job demand/seldom job control) and passive (seldom or sometimes job demands/seldom job control)] during early pregnancy. At the 11-year follow-up, children (N = 30,592), mothers (N = 30,993), and teachers (N = 12,810) responded to the Strength and Difficulties Questionnaire (SDQ), a screening tool for child behaviour. Scores for hyperactivity, conduct, emotional and peer problems were dichotomised [80% (no) vs. 20% (yes)] according to Danish norms (yes/no). Maternal job strain was not associated with behavioural problems with teachers as informants. When assessed by child or mother, high maternal job strain increased risk of child behavioural problems, but risks were more pronounced for mothers in passive jobs [maternal assessment of total difficulties/odds ratio (95% confidence interval): high strain-girls: 1.16 (0.97-1.40); boys: 1.24 (1.02-1.50). Passive girls: 1.43 (1.21-1.68); boys: 1.25 (1.05-1.49)]. This is one of the first studies on this topic. The different types of maternal job strain were partly associated with child behavioural problems at 11 years; more so if mothers worked in passive rather than the hypothesized high strain jobs. Findings showing dependency on informant could not only indicate unmeasured confounding or rater's bias, but also selection in the smaller numbers of teacher informants or different environments of interaction with the children.

20.
Scand J Work Environ Health ; 46(6): 557-569, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32895725

RESUMO

Objectives This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes. Method In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area. Results Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration. Conclusions Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases - eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep - additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.


Assuntos
Jornada de Trabalho em Turnos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Ritmo Circadiano/fisiologia , Fadiga/epidemiologia , Fadiga/prevenção & controle , Humanos , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/prevenção & controle , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Saúde do Trabalhador , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/prevenção & controle , Risco , Sono , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/prevenção & controle
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