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1.
Ann Work Expo Health ; 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-33999177

RESUMO

OBJECTIVE: To estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces. METHODS: The Australian Workplace Exposure Survey (AWES)-Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016-2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV during their most recent working day. We created a library of HAV magnitude levels for each tool/task and estimated each worker's daily HAV exposure level using standard formulae. We categorized each worker as to whether they exceeded the daily occupational limits of 2.5 and 5.0 m/s2. Results were extrapolated to the Australian working population using a raked weighting method. RESULTS: In our sample of 4991 workers, 5.4% of men and 0.7% of women exceeded the HAV action limit of 2.5 m/s2 on their most recent working day. We estimate that 3.8% of the Australian workforce exceeds the HAV limit of 2.5 m/s2 and 0.8% exceeds the 5 m/s2 limit. Men were more likely to exceed the HAV limits than women, as were those with trade qualifications, and those who worked in remote locations. Workers in the construction, farming, and automobile industries had the highest prevalence of HAV exposure. Tool groups that contributed to higher exposure levels included: compactors, rollers, and tampers; power hammers and jackhammers; and underground mining equipment. CONCLUSIONS: HAV is common in the Australian working population. Given the health risks associated with this exposure, reduction strategies and interventions should be developed, with engineering controls as the starting point for exposure reduction strategies.

2.
Asia Pac J Public Health ; : 10105395211007648, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33847173

RESUMO

Disparities in exposure to workplace hazards exist between Maori and non-Maori workers in New Zealand, with Maori workers generally incurring poorer conditions. This study aimed to determine if these ethnic disparities are similar after migration to Australia. A national cross-sectional telephone survey asked participants what tasks they undertook in their job to assess exposure to carcinogens as well as whether they experienced ethnic discrimination, bullying, job precariousness, or job strain. A total of 389 New Zealand Caucasians and 152 Maori/Pasifika workers were recruited. After adjustment, 79% of Maori/Pasifika compared with 67% of New Zealand Caucasian workers were assessed as being exposed to at least one carcinogen at work (adjusted prevalence ratio [aPR] = 1.2, 95% confidence interval [CI] = 1.1-1.4). Maori/Pasifika workers were also more likely to report ethnic discrimination (aPR = 6.9, 95% CI = 2.6-18.3) and fair or poor current health (aPR = 1.9, 95% CI = 1.1-3.2) than New Zealand Caucasians. Some ethnic disparities in exposure to workplace hazards in New Zealand are apparent after migration to Australia.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33807727

RESUMO

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.


Assuntos
Exposição Ocupacional , Saúde do Trabalhador , Países em Desenvolvimento , Pessoal de Saúde , Humanos , Renda , Pobreza
4.
Med Lav ; 112(2): 171-176, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33881012

RESUMO

INTRODUCTION: The SARS-CoV-2/Covid-19 pandemic is a challenge for public health and occupational medicine and developing prevention and protection strategies needs expertise from many disciplines. To make prevention successful, individuals have to be motivated to participate and, in turn, motivation depends on understanding how and why prevention measures are implemented. We present a structured approach (the Cycle of prevention) which involves different stakeholders and perspectives to develop, and monitor, prevention strategies in transparent and effective ways.


Assuntos
Saúde do Trabalhador , Humanos , Pandemias , Equipe de Assistência ao Paciente
5.
Ann Work Expo Health ; 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33733676

RESUMO

A common chemical exposure in alumina refining is caustic mist. Although recognized as a strong airways irritant, little is known of the chronic respiratory effects of caustic mist in alumina refining. A suitable metric for caustic mist exposure assessment in alumina refining for epidemiological purposes has not been identified. Peak exposure is likely to be important, but is difficult to assess in epidemiological studies. In this study, we investigate the respiratory effects of caustic mist in an inception cohort (n = 416) of alumina refinery workers and describe the development and use of a peak exposure metric for caustic mist. We then compare the results with a metric based on duration of exposure. Participants were interviewed annually about respiratory symptoms and had a lung function test. Job history data were collected from each interview and levels of caustic mist were measured periodically by air monitoring. We found a weak association between the caustic mist peak exposure metric and reported cough (P for linear trend = 0.079) with the highest peak exposure group odds ratio = 2.32 (95% confidence interval: 1.27, 4.22). For lung function, we found declines in the forced expiratory volume in 1 second and forced vital capacity for changes in annual and absolute lung function for both metrics of exposure, but only the ratio of absolute lung function was statistically associated with an increasing duration of caustic exposure (P for linear trend = 0.011). In this cohort, we did not observe an association with respiratory symptoms or consistent decrements in lung function. There was little difference between the exposure metrics used for investigation of the chronic effects from caustic mist.

6.
Environ Res ; 197: 110887, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33607095

RESUMO

BACKGROUND: The etiology of follicular lymphoma (FL), a common non-Hodgkin lymphoma subtype, is largely unknown. OBJECTIVE: We performed a systematic review and meta-analysis of observational studies examining the relationship between occupational exposures and FL risk. METHODS: We searched Ovid MEDLINE, Ovid EMBASE, and Web of Science for eligible observational studies examining job titles or occupational exposures prior to January 1, 2020. We performed a narrative synthesis and used random-effects models to generate meta-estimates of relative risk (RR) with 95% confidence intervals (95%CI) for exposures reported by three or more studies. RESULTS: Fifty-eight studies were eligible. Ten cohort and 37 case-control studies quantified FL risk in relation to any exposure to one or more occupational groups or agents. Eight cohort and 19 case-control studies examined dose-response relationships. We found evidence of a positive association with increasing plasma concentration of dichlorodiphenyldichloroethylene (DDE; meta-RR = 1.51, 95%CI = 0.99, 2.31; I2 = 0.0%) and polychlorinated biphenyls (PCBs; meta-RR = 1.47, 95%CI = 0.97, 2.24; I2 = 8.6%). We observed a positive association with exposure to any solvent (meta-RR = 1.16, 95%CI = 1.00, 1.34; I2 = 0.0%) and chlorinated solvents (meta-RR = 1.35, 95%CI = 1.09, 1.68; I2 = 0.0%). Single studies reported a significant positive dose-response association for exposure to any pesticide, hexachlorobenzene, any organophosphate, diazinon, metolachlor, carbaryl, lindane, trichloroethylene, oils/greases, and extremely low-frequency magnetic fields. Job title-only analyses suggested increased risk for medical doctors and spray painters, and decreased risk for bakers and teachers. Overall, studies demonstrated low risk of bias, but most studies examined small numbers of exposed cases. CONCLUSIONS: Current evidence indicates a positive association between FL and occupational exposure to DDE, PCBs, any solvent and chlorinated solvents. Our findings may help guide policies and practices on the safe use of solvents and inform models of lymphomagenesis. Future studies with larger sample sizes and comprehensive quantitative exposure measures may elucidate other avoidable carcinogenic exposures.

8.
Am J Ind Med ; 63(12): 1109-1115, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33047357

RESUMO

BACKGROUND: Occupational exposures to hazardous chemicals among healthcare workers can result in long-term adverse health outcomes. Research on such exposures from low- and middle-income countries is limited. The aim of this study was to estimate the prevalence of exposures to a range of chemicals used in healthcare settings among Bhutanese healthcare workers. METHODS: A cross-sectional study was conducted among healthcare workers (n = 370) working in three hospitals in the western region of Bhutan. Demographic and occupational information was collected, and exposures to asthmagens, carcinogens, ototoxic and other agents were assessed using a web-based tool. The prevalence of exposure to these chemicals was calculated and the circumstances resulting in such exposures were examined. RESULTS: The prevalence of exposure to one or more asthmagen, carcinogen, and ototoxic agent was 98.7%, 28.1%, and 7.6%, respectively; and was 6.2% for anesthetic gases and 2.2% for antineoplastic drugs. The most common exposures were to latex, and cleaning and disinfecting agents in the asthmagens group; formaldehyde in the carcinogens group; and p-xylene among ototoxic agents. The circumstances resulting in exposures were using latex gloves, using bleach and chlorhexidine for cleaning, using formaldehyde as a disinfectant and in the laboratory, and using p-xylene in the laboratory. CONCLUSIONS: The results indicate that a large proportion of Bhutanese healthcare workers are occupationally exposed to chemicals linked to chronic diseases, with exposure prevalence higher than in high-income countries. The study provides information that can be used to formulate policies and to implement control measures to protect healthcare workers.

9.
Am J Ind Med ; 63(12): 1116-1123, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32944994

RESUMO

BACKGROUND: Information is scarce about the occupational health effects of exposure to alumina dust. This study examines the respiratory effects of inspirable alumina dust exposure in alumina refineries. METHODS: An inception cohort study at three alumina refineries in Western Australia recruited 416 participants (351 males, 65 females) between 1995 and 2000 who were followed up annually until 2008 or until exit from study. At each health interview a respiratory questionnaire and lung function test was undertaken, measuring forced expiratory volume in one second (FEV1 ) and forced vital capacity (FVC). Participants provided job histories which were combined with air monitoring data to calculate cumulative exposure to inspirable alumina dust (mg/m3 -years). Generalized estimating equations with Poisson distribution and mixed effects models were used to examine the effects of alumina exposure. RESULTS: The number of exposed participants was relatively small (n = 82, 19.7%). There was no association between alumina dust exposure and prevalence of cough, wheeze or rhinitis. No associations were found between measures of lung function and tertiles of alumina exposure in the first two follow-ups, or the whole follow-up period, though there was a suggestive dose-response trend across exposed groups for decline in absolute FEV1 (p for trend = .06). For mean annual change in FEV1 and FVC based on the first three follow-ups it was not possible to rule out an effect above a threshold level of exposure. CONCLUSION: There is no evidence of an association between exposure to alumina and the reporting of respiratory symptoms but some evidence for an effect on lung function.

10.
Artigo em Inglês | MEDLINE | ID: mdl-32610505

RESUMO

Background: Occupational noise-induced hearing loss (ONIHL) is one of the most common yet preventable occupational diseases. The aim of this study was to estimate the economic burden of ONIHL in the Australian working population by quantifying and monetising ONIHL-related loss of Quality Adjusted Life Years (QALY) and Productivity Adjusted Life Years (PALYs). Methods: We simulated the number of moderate-to-severe ONIHL by multiplying the age-specific prevalence of occupational noise exposure by the excess risks of ONIHL. Life table modelling was applied to workers with ONIHL. The QALY and PALY weights attributable to hearing loss were sourced from published data. The 2016 Gross Domestic Product per full-time equivalent worker in Australia was used to estimate the cost of productivity loss due to ONIHL. The cost due to the loss of well-being was quantified using willingness to pay thresholds derived from an Australian longitudinal study. Results: Under current occupational noise exposure levels in Australia, we estimated that over 80,000 male workers and over 31,000 female workers would develop ONIHL over 10 years of exposure. Following this cohort until the age of 65 years, the estimated loss of QALYs and PALYs were 62,218 and 135,561 respectively, with a projected loss of AUD 5.5 billion and AUD 21.3 billion due to well-being and productivity loss, respectively. Reducing noise exposure at work would substantially reduce the economic burden of ONIHL. Conclusion: ONIHL imposes substantial burden on Australian economy. Interventions to reduce occupational noise exposure are warranted.


Assuntos
Perda Auditiva Provocada por Ruído/epidemiologia , Ruído Ocupacional/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Austrália/epidemiologia , Feminino , Perda Auditiva Provocada por Ruído/etiologia , Humanos , Tábuas de Vida , Estudos Longitudinais , Masculino , Ruído Ocupacional/efeitos adversos , Exposição Ocupacional/efeitos adversos
11.
Int J Occup Environ Med ; 11(3): 128-139, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32683425

RESUMO

BACKGROUND: Collection of reliable and valid occupational history data is of utmost importance to assess work-related exposures and their health effects. Few standardized questionnaires are available for the collection of occupational history data in low-and-middle income countries. OBJECTIVE: To adapt and test a validated questionnaire developed in the United States by the National Institute of Safety and Health, in order to assess occupational chemical exposures among health care workers in Bhutan. METHODS: The questionnaire was first adapted to suit the Bhutanese context with the advice of an expert review committee. 30 health care workers then completed the questionnaire at baseline and 10-14 days later. Test-retest reliability was assessed by calculating Cohen's κ and percentage agreement. RESULTS: The questionnaire had high test-retest reliability. Cohen's κ ranged from 0.61 to 1.00, and percentage agreement ranged from 86.7% to 100%. Further adaptations included omitting questions on chemicals not available in Bhutan. CONCLUSION: The adapted questionnaire is appropriate for assessing occupational chemical exposures among health care workers in Bhutan.


Assuntos
Substâncias Perigosas/toxicidade , Pessoal de Saúde , Exposição Ocupacional/análise , Inquéritos e Questionários , Adolescente , Adulto , Butão/epidemiologia , Comparação Transcultural , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas , Estados Unidos , Adulto Jovem
12.
Am J Ind Med ; 63(9): 803-816, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32573821

RESUMO

BACKGROUND: Disparities in exposure to occupational hazards may be linked to social position as well as the type of job a person holds. This study aimed to describe the prevalence of exposure to workplace hazards among three migrant worker groups and to assess whether social disparities in exposure for these groups remain after adjusting for occupational characteristics. METHODS: Data were collected in 2017/2018 from 1630 Australian workers born in New Zealand, India, and the Philippines. Weighted estimated prevalence of exposure to 10 carcinogens and four psychosocial hazards (discrimination, job strain, vulnerability, and insecurity) was calculated for sociodemographics and occupation. Regression estimated the likelihood of exposure by sociodemographics after adjustment for occupational characteristics. RESULTS: Exposure to workplace hazards ranged from 11.7% (discrimination) to 61.2% (exposed to at least one carcinogen). Compared with workers born in India, New Zealand born workers were over twice as likely to be exposed to diesel engine exhaust (adjusted odds ratio [aOR] = 2.60) and 60% more likely to be exposed to at least one carcinogen (aOR = 1.60) but less likely to be exposed to any psychosocial hazard. Social disparities by country of birth, sex, age, education, and number of years in Australia, as well as company size, employment type, and hours, worked remained associated with greater likelihood of reporting one or more workplace hazards after adjusting for occupational characteristics. CONCLUSION: Examining sociodemographic as well as occupational characteristics helps to clarify groups most likely to be exposed to workplace hazards who can be hidden when examining occupational characteristics alone.

13.
Int J Epidemiol ; 49(2): 376-379, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32485733

RESUMO

Most epidemiological studies of disease aetiology do not consider potential risk factors at work. This may be because work is a complex exposure: people usually have a series of different jobs over their working lifetime; within each job there may be a range of different tasks; and there may be a variety of exposures in each job. Because of this complexity, many epidemiologists do not have the expertise or training to assess occupational exposures accurately. Our web-based application, OccIDEAS, manages the process of occupational agent assessment in epidemiological studies. The epidemiologist chooses the agents of interest for the study and OccIDEAS provides an online set of questionnaires that are tailored to those agents. The participant is asked specific questions about their job and evidence-based algorithms provide an assessment of exposure to each agent. OccIDEAS puts the world's best occupational epidemiological expertise within reach of any researcher.

14.
Occup Environ Med ; 77(8): 564-567, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32467312

RESUMO

BACKGROUND: Increased mammographic density is one of the strongest risk factors for breast cancer. Night shiftwork and its related factors, which include light at night, phase shift and sleep disruption, are believed to increase breast cancer risk however, their effects on mammographic density have barely been studied. METHODS: This study included 1821 women enrolled in the Breast Cancer Environment and Employment Study between 2009 and 2011. Mammographic density was measured using the Cumulus software program. The association of night shiftwork factors with square root transformed absolute dense area (DA) and percentage dense area (PDA) were modelled using linear regression adjusted for confounders. RESULTS: Ever doing graveyard shiftwork (between 24:00 and 05:00 hours) was not associated with PDA (ß=-0.10; 95% CI -0.27 to 0.08)) and DA (ß=-0.12; 95% CI -0.33 to 0.09)). No association was found between night shiftwork related factors (light at night, phase shift and sleep disturbance) with PDA or DA. CONCLUSIONS: Shiftwork and its related factors are not associated with mammographic density. Using high-quality, comprehensive shiftwork data from a large population-based breast cancer case-control study, this study suggests that mammographic density does not play a role in the relationship between shiftwork and breast cancer risk.


Assuntos
Densidade da Mama , Neoplasias da Mama/epidemiologia , Jornada de Trabalho em Turnos/estatística & dados numéricos , Mama/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Humanos , Mamografia , Fatores de Risco , Austrália Ocidental/epidemiologia
15.
Occup Environ Med ; 77(8): 535-539, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32265234

RESUMO

OBJECTIVE: To assess the predictive value of bronchial hyper-responsiveness (BHR) for the subsequent development of respiratory symptoms, airflow limitation and decline in lung function among aluminium smelter workers. METHODS: An inception cohort study of new employees at two Australian aluminium smelters was conducted. Participants completed a modified British Medical Research Council respiratory questionnaire, spirometry and a methacholine bronchial challenge test at baseline and at annual follow-up reviews. BHR was defined as PD20 ≤4000 µg. Poisson and mixed effects models were fitted to respiratory symptoms and lung function (forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC)). RESULTS: Baseline interview and lung function testing were completed by 278 workers, who were followed for a median of 4 years. BHR at baseline, present in 82 workers, was not associated with incident wheeze risk ratio (RR)=1.07 (95% CI 0.74 to 1.55) and cough RR=0.78 (95% CI 0.45, 1.35), but there was some increased risk of chest tightness RR=1.40 (95% CI 0.99, 1.98) after adjustment for age, sex, smoking and atopy. BHR at baseline was associated with lower FEV1 and FVC, although the rate of annual decline in FEV1 or FVC was similar between those with or without BHR. The specificity of BHR was 77% for wheeze, 70% for cough and 77% for chest tightness, but the sensitivity was poor, at 33%, 24% and 39%, respectively. CONCLUSION: Methacholine challenge testing at entry to employment was not sufficiently predictive of later adverse respiratory outcomes, and notwithstanding the study limitations is unlikely to be a useful pre-employment or preplacement screening test in the aluminium smelting industry.


Assuntos
Testes de Provocação Brônquica , Pneumopatias/epidemiologia , Doenças Profissionais/epidemiologia , Adulto , Alumínio , Asma/fisiopatologia , Estudos de Coortes , Tosse , Feminino , Humanos , Estudos Longitudinais , Pneumopatias/fisiopatologia , Masculino , Metalurgia , Cloreto de Metacolina/administração & dosagem , Doenças Profissionais/fisiopatologia , Testes de Função Respiratória , Sons Respiratórios , Inquéritos e Questionários , Vitória
16.
Am J Ind Med ; 63(7): 624-633, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32236973

RESUMO

BACKGROUND: Healthcare workers are occupationally exposed to various hazardous chemicals and agents that can potentially result in long-term adverse health effects. These exposures have not been comprehensively examined at a population level. The aim of this study was to examine occupational exposures to a wide range of asthmagens, carcinogens, and ototoxic agents among healthcare workers in Australia. METHODS: Data were collected as part of the Australian Work Exposures Studies, which were computer-assisted telephone surveys conducted in 2011, 2014, and 2016 to assess the prevalence of occupational exposures to carcinogens, asthmagens, and ototoxic agents, respectively, among Australian workers. Using data on healthcare workers, the prevalence of exposures to these agents was calculated and associations of demographic variables and occupation groups with exposure status were examined. RESULTS: The prevalence of exposure to at least one asthmagen, carcinogen, and ototoxic agent was 92.3%, 50.7%, and 44.6%, respectively. The most common exposures were to (a) cleaning and sterilizing agents in the asthmagen group; (b) shift work in the carcinogen group; and (c) toluene and p-xylene among ototoxic agents. Exposure varied by occupation, with exposure to carcinogens and ototoxic agents highest among personal carers and exposure to carcinogens most likely among nursing professionals and health and welfare support workers. CONCLUSION: The results demonstrate that a substantial proportion of Australian healthcare workers are occupationally exposed to asthmagens, carcinogens, and ototoxic agents. These exposures are more common among certain occupational groups. The information provided by this study will be useful in prioritizing and implementing control strategies.

17.
Chronobiol Int ; 37(7): 1034-1047, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32233647

RESUMO

Experimental evidence suggests that perinatal light imprinting of circadian clocks and systems may affect downstream physiology and cancer risk in later life. For humans, the predominant circadian stimulus is the daily light-dark cycle. Herein, we explore associations between perinatal photoperiod characteristics (photoperiod: duration of daylight as determined by time-of-year and location) and childhood cancer risk. We use pooled data on 182,856 mothers and babies from prospective birth cohorts in six countries (Australia, Denmark, Israel, Norway, UK, USA) within the International Childhood Cancer Cohort Consortium (I4C). Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). In line with predicted differential dose-responses, restricted cubic splines indicate a potential non-linear, non-monotonic relationship between perinatal mean daily photoperiod (0-24 h) and childhood cancer risk. In a restricted analysis of 154,121 individuals who experienced third trimester photoperiods exclusively within the 8-16-h range, the relative risk of developing childhood cancer decreased by 9% with every hour increase in third trimester mean daily photoperiod [HR: 0.91 (95%CIs: 0.84-0.99)]. In conclusion, in this first study of perinatal photoperiod and childhood cancer, we detected an inverse ["protective"] linear association between third trimester mean daily photoperiod and childhood cancer risk in the 8-16-h set of the total study population. Limited statistical power impeded the investigation of risks with individuals exposed to more extreme photoperiods. Future studies are needed to confirm differential photoperiod-associated risks and further investigations into the hypothesized circadian imprinting mechanism are warranted.

18.
Hemasphere ; 4(1): e327, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32072143

RESUMO

Despite the identification of acquired genetic mutations associated with Myeloproliferative Neoplasms (MPNs) there is a paucity of information relating to modifiable risk factors that may lead to these mutations. The MOSAICC Study was an exploratory case-control study of polycythemia vera (PV), essential thrombocythemia (ET), and Myelofibrosis (MF). MPN patients and population controls (identified by General Practitioners) and non-blood relative/friend controls were recruited from 2 large UK centers. Participants completed a telephone-based questionnaire analyzed by unconditional logistic regression analysis adjusting for potential confounders. Risk factors for MPNs identified included increasing childhood household density [odds ratio (OR) 2.55, 95% confidence interval (CI) 1.16-5.62], low childhood socioeconomic status (OR 2.30, 95%CI 1.02-5.18) and high pack years smoking (OR 2.19, 95%CI 1.03-4.66) and current smoking restricted to JAK2 positive PV cases (OR 3.73, 95%CI 1.06-13.15). Obesity was linked with ET (OR 2.59, 95%CI 1.02-6.58) confirming results in previous cohort studies. Receipt of multiple CT scans was associated with a strongly increased risk of MPN although with wide confidence intervals (OR 5.38, 95%CI 1.67-17.3). Alcohol intake was inversely associated with risk of PV (OR 0.41, 95%CI 0.19-0.92) and ET (OR 0.48, 95%CI 0.24-0.98). The associations with childhood household density, high pack years smoking and alcohol were also seen in multivariate analysis. This is the largest case control study in MPNs to date and confirms the previously reported associations with obesity and cigarette smoking from cohort studies in addition to novel associations. In particular, the role of smoking and JAK2 mutation cases merits further evaluation.

19.
J Natl Cancer Inst ; 112(1): 30-37, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31498409

RESUMO

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert advisory group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs program. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating, and integrating evidence to identify causes of human cancer. The advancements adopted include the strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals, and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention.


Assuntos
Carcinógenos/antagonistas & inibidores , Neoplasias/prevenção & controle , Animais , Humanos , Agências Internacionais/organização & administração , Motivação , Avaliação de Programas e Projetos de Saúde , Vigilância em Saúde Pública
20.
Artigo em Inglês | MEDLINE | ID: mdl-31817396

RESUMO

Asbestos-containing materials (ACMs) were used extensively throughout much of the 20th century and can still be found in many Australian homes. Therefore, we developed a mobile application ("app"), called ACM Check, which guides users through a home inspection to identify and assess certain types of in situ ACM. A cross-sectional study was conducted using the app to collect data on the type and condition of in situ asbestos in Australian residential settings. Since being released in June 2017, we have received data for 702 home inspections. Of these, 578 (82.3%) houses contained a total of 1895 in situ materials categorised as positive for asbestos by the app. The most prevalent ACMs were used for the backing board to electrical meter boxes (50% of homes), eaves and soffit linings (44.2% of homes), and fencing (28.1% of homes). While the majority of ACMs were categorised as 'very low' or 'low' priority for removal or remediation, 6.6% of all ACMs were considered to be of 'high' priority. Mobile apps offer a platform to help increase people's awareness of possible health hazards found in the residential environment, such as asbestos, while also being used to collect data for public and environmental health research.


Assuntos
Asbestos/análise , Telefone Celular , Aplicativos Móveis , Características de Residência , Austrália , Estudos Transversais , Humanos , Reprodutibilidade dos Testes
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