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1.
Am J Ind Med ; 64(4): 251-257, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33547652

RESUMO

BACKGROUND: Cigarette smoking and occupational exposures each have been reported to increase the risk of idiopathic pulmonary fibrosis (IPF), a disease previously considered of unknown origin. We investigated the risk of IPF mortality associated with combined smoking and occupational exposures. METHODS: A registry study of Swedish construction workers (N = 389,132), linked baseline smoking and occupational data with registry data on cause of death and hospital care diagnoses. Occupation was classified by the likelihood of exposure to vapors, gases, dusts, or fumes using a job-exposure matrix. Those likely exposed to asbestos or silica were excluded from the analysis. Age-adjusted relative risks [RRs] were calculated using Poisson regression. Follow-up observation began at age 40 and ended at age 89. RESULTS: Heavy smokers at baseline who were exposed to inorganic dusts during their working life had an increased risk of IPF mortality (RR 1.70; 95% confidence interval [CI] 1.11-2.60), while there was no statistically increased risk in the other exposure groups. There were dose-response relationships between smoking at baseline and IPF mortality among both unexposed and dust exposed workers, with similar risk for dust exposed and unexposed, except among baseline heavy smokers, where workers exposed to inorganic dust manifested the highest risk (RR 4.22; 95% CI 2.69-6.60). Excluding workers with chronic obstructive pulmonary disease or emphysema did not affect the results substantively. CONCLUSION: A clear dose-response relationship was seen between smoking at baseline and IPF, supporting a causal relationship. Occupational exposure to inorganic dusts, excluding silica and asbestos, was associated with increased risk of IPF in baseline heavy current smokers.

2.
Cancer Med ; 10(4): 1431-1438, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33455057

RESUMO

BACKGROUND: The relation between obesity, blood pressure (BP) and bladder cancer (BC) risk and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies. We investigated body mass index (BMI) and BP in relation to BC risk by stage and grade, and BC-specific mortality, including separately among never-smokers aimed at minimizing confounding by smoking. METHODS: We analyzed 338,910 men from three Swedish cohorts, with 4895 incident BC's (940 among never-smokers) during follow-up. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals adjusted for smoking status. HRs for BMI and BP were corrected for their regression dilution ratios, calculated from 280,456 individuals with 758,641 observations. RESULTS: Body mass index was positively associated with non-muscle invasive BC (NMIBC, HR per 5 kg/m2 , 1.10 [1.02-1.19]) and NMIBC grade 3 (HR 1.17 [1.01-1.34]) in the full cohort, with similar effect sizes, albeit non-significant, among never-smokers. Systolic BP was positively associated with muscle-invasive BC (MIBC, HR per 10 mmHg, 1.25 [1.00-1.55]) and BC-specific mortality (HR 1.10 [1.01-1.20]) among never-smokers, with weaker and non-significant associations in the full cohort. CONCLUSIONS: In an analyses of BMI, BP and BC risk by stage and grade among men, we found modest positive associations between BMI and NMIBC and NMIBC grade 3. SBP was positively associated with MIBC and BC-specific mortality in an analysis of never-smokers, which may reflect the association, un-confounded by smoking, also in a broader population.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33165622

RESUMO

Objectives This study aimed to investigate whether change from the construction industry to work in other industries at age 45-55 years lowered risks of disability benefits (DB) later in life (60-64 years of age). We hypothesized that risks would be lowered the most among those changing from the heaviest occupations. Methods The study included men employed in the construction industry during 1971-1993. We selected workers from the largest occupational groups in heavy (concrete workers and painters) and less heavy (drivers, electricians and foremen) occupations. The occurrence of DB in 1990-2015 was retrieved from national registers. Regression analyses were used to calculate relative risks (RR) of DB at 60-64 years, comparing those working in other industries to those still in the construction industry at the age of 45, 50 and 55 years. Results Shifting out of from the construction industry was related to lowered DB risks at 60-64 years in all selected occupations. Effects were most pronounced among those who, at 55 years of age, worked in an industry other than construction, with significantly reduced RR for DB among concrete workers [RR 0.63, 95% confidence interval (CI) 0.51-0.77], electricians (RR 0.61, 95% CI 0.47-0.77) and foremen (RR 0.78, 95% 0.63-0.96). Conclusions Risks for DB at 60-64 years of age were reduced among those who changed from construction work to other industries. Notable reductions were observed among workers originating from both heavy and less heavy occupations, and future studies should explore other factors, in addition to heavy workload, as motivators for leaving the construction industry.

4.
Int J Cancer ; 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32525555

RESUMO

Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m2 , 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI 0.88-0.97). However, these associations were partially driven by PCa's detected by asymptomatic screening and, for height, also by symptoms unrelated to PCa. The HR of localised PCa's, per 5 kg/m2 , was 0.88, 95% CI 0.83 to 0.92 for screen-detected PCa's and 0.96, 95% CI 0.90 to 1.01 for PCa's detected through lower urinary tract symptoms. BMI was positively associated with PCa-specific mortality in the full population and in case-only analysis of each PCa risk category (HRs per 5 kg/m2 , 1.11-1.22, P for heterogeneity = .14). More active health-seeking behaviour among tall and normal-weight men may partially explain their higher risk of localised PCa. The higher PCa-specific mortality among obese men across all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.

5.
Am J Ind Med ; 63(8): 685-692, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32445513

RESUMO

BACKGROUND: Work on Swedish petroleum tankers before the late 1980s has been associated with an increased risk of hematologic malignancy (HM). Since then, ship modernizations have decreased occupational exposure to gases, including the carcinogen benzene. We explored the risk of HMs in Swedish seafarers who had worked on newer types of tankers. METHODS: A case-referent study in male seafarers from a cohort of all Swedish seafarers was set up by record linkage with the Swedish Cancer Registry using the subjects' personal identification number. For each case (N = 315), five referents were randomly chosen from within the cohort, matched by birth year and three different periods of first sea service (<1985, 1985-1991, and ≥1992). Information on the type of ship and dates of service was retrieved from the Swedish Seafarers' Registry. Odds ratios (OR) were calculated by conditional logistic regression together with 95% confidence intervals (CI). RESULTS: The OR of HM was 1.07 (95% CI, 0.80-1.42) for work on tankers. In seafarers that had started to work on tankers ≥1985, the OR was 0.85 (95% CI, 0.50-1.43). For those who started to work on tankers before 1985, the OR was 1.17 (95% CI, 0.84-1.21) and 1.32 (95% CI, 0.86-2.03) if the cumulative time on tankers exceeded 5 years of service. In this last group, the OR of multiple myeloma was 5.39 (95% CI, 1.11-26.1). CONCLUSION: Although limited by crude exposure contrast and a short follow-up, work on tankers after 1985 was not associated with an increased risk of HM among Swedish seafarers.

6.
Int Arch Occup Environ Health ; 93(5): 571-575, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31915923

RESUMO

PURPOSE: The present study examined a possible association between occupational exposure to noise, working and living in cold conditions, and the risk of mortality in myocardial infarction and stroke. METHODS: The present cohort study consists of 194,501 workers in the Swedish construction industry that participated in health examinations between 1971 and 1993. Noise exposure was defined on a job-exposure matrix based on a survey of the working conditions carried out during the mid 1970s. All workers were categorised into three main regions of Sweden, differing in temperature: Reference (Götaland), colder (Svealand), and coldest (Norrland). Relative risks (RR) were analysed by negative binomial regression adjusting for age, BMI, and smoking habits. RESULTS: Moderate and high noise exposure was associated with increased risk of myocardial infarction (RR 1.10-1.13 with 95% CI over unit) and stroke mortality (RR 1.15 to 1.19 with 95% CI over unit). There was an increased risk for myocardial infarction (RR 1.10, 95% CI 1.01-1.20), but not for stroke mortality (RR 1.09, 95% CI 0.94-1.25) associated with living and working in the coldest region. There was an interaction on the risk of myocardial infarction mortality between different regions and noise exposure (p = 0.016), but not for stroke mortality (p = 0.88). CONCLUSIONS: The study indicates an interaction between working at hazardous noise levels and living and working in cold conditions for increased mortality in myocardial infarction.

7.
Scand J Public Health ; 48(8): 832-838, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31820671

RESUMO

Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971-1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3-3.9) and women (relative risk 2.1; 95% confidence interval 1.6-2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2-2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75-89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1-3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8-3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a 'lighter' psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.

8.
Scand J Work Environ Health ; 46(1): 77-84, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31419303

RESUMO

Objectives This study aims to provide insight into educational differences in duration of working life by working life expectancy (WLE) and working years lost (WYL) through disability benefits and other non-employment states in the Netherlands. Methods Monthly information on employment status of the Dutch population (N=4 999 947) between 16 and 66 years from 2001‒2015 was used to estimate working life courses and loss of working years for specific non-employment states. Across educational groups, bi-directional transitions between paid employment and non-employment states were calculated. Using a multistate model, the WLE and WYL at age 16, 30, 50 and up to 66 years as statutory retirement age were estimated for each educational group, stratified by gender. Results Low-educated men and women had a 7.3 (men) and 9.9 (women) years lower WLE at age 30 than high-educated men and women. Among low-educated men, 3.4 working years were lost due to disability benefit compared to 0.8 among high-educated men. Low-educated women lost 3.0 working years due to disability benefit compared to 1.4 among high-educated women. Conclusions There are large educational inequalities over the course of working life. Among low-educated workers, more working years are lost due to unemployment, no income, and especially disability benefits. The latter reflects large educational inequalities in health and working conditions. The metrics of WLE and WYL provide useful insights into the life-course perspective on working careers.

9.
Scand J Public Health ; 48(4): 405-411, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29366393

RESUMO

Aims: Study objectives were to investigate how changes in social insurance legislation influenced the incidence of disability pension. Methods: The study included 295,636 male construction workers who attended health examinations between 1971 and 1993, aged 20-60 years and without previous disability pension. Via the Swedish National Insurance Agency national register we identified 66,046 subjects who were granted disability pension up until 2010. The incidence rates were calculated and stratified according to age and diagnosis. Results: The incidence rate of disability pension was fairly stable until the 1990s when large variations occurred, followed by a strong decreasing trend from the early 2000s to 2010. Trends in incidence rates, stratified by age and diagnosis, showed a consistent decrease in cardiovascular disease for all age groups. In subjects aged 30-49 years there was a high peak around 2003 for musculoskeletal diseases and psychiatric diseases. For the age group 50-59 years, musculoskeletal diagnosis, the most common cause of disability pension, had a sharp peak around 1993 and then a decreasing trend. In the 60-64 age group, the incidence rate for psychiatric diagnosis was stable, while incidence rates for musculoskeletal diagnosis varied during the 1990s. Conclusions: There are considerable variations in the incidence rate of disability pension over time, with different patterns depending on age and diagnosis. Changes in social insurance legislation, as well as in administration processes, seem to influence the variation.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pensões/estatística & dados numéricos , Previdência Social/legislação & jurisprudência , Adulto , Estudos de Coortes , Indústria da Construção , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia , Adulto Jovem
10.
Int J Epidemiol ; 48(6): 2018-2025, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31363756

RESUMO

BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium. METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries. RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH. CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.


Assuntos
Hipertensão/epidemiologia , Fumar/efeitos adversos , Hemorragia Subaracnóidea/epidemiologia , Adulto , Índice de Massa Corporal , Causas de Morte , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Análise de Regressão , Fatores Sexuais , Fumar/epidemiologia , Hemorragia Subaracnóidea/mortalidade , Suécia/epidemiologia
11.
Occup Environ Med ; 76(5): 326-331, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30850390

RESUMO

OBJECTIVES: The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period. METHODS: A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships. RESULTS: The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00). CONCLUSIONS: Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.


Assuntos
Fenômenos Biomecânicos/fisiologia , Indústria da Construção/métodos , Traumatismos Ocupacionais/etiologia , Neuropatia Radial/etiologia , Adulto , Indústria da Construção/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/epidemiologia , Estudos Prospectivos , Neuropatia Radial/epidemiologia , Fatores de Risco , Suécia/epidemiologia , Vibração/efeitos adversos
12.
Scand J Work Environ Health ; 45(1): 63-72, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30132781

RESUMO

Objectives The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE). Methods A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively over a 13-year case ascertainment period (2001-2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register. Results There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18-1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers. Conclusion Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.


Assuntos
Fenômenos Biomecânicos , Indústria da Construção , Exposição Ocupacional/efeitos adversos , Síndromes de Compressão do Nervo Ulnar/cirurgia , Adulto , Força da Mão/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Estudos Prospectivos , Fatores de Risco , Suécia/epidemiologia
13.
Respir Med ; 144: 36-41, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30366582

RESUMO

BACKGROUND: There is controversy as to whether airflow limitation should be defined as forced expiratory volume in 1 s (FEV1)/vital capacity (VC) < 0.7 or as FEV1/VC< the lower limit of normal (LLN). The aim was to examine whether different definitions of airflow limitation differ in predicting mortality. METHODS: Longitudinal prospective study of a national cohort of Swedish workers (199,408 men; 7988 women), aged 20-64 years with spirometry without bronchodilation at baseline followed from 1979 until death, or censorship at 2010. Airflow limitation (AL) by Global Obstructive Lung Disease criteria, ALGOLD, was defined as FEV1/VC < 0.7; ALLLN as FEV1/VC < LLN. All all-cause, COPD and cardiovascular disease mortality was analyzed among men and women in relation to ALGOLD and ALLLN, adjusted for age and smoking. RESULTS: Among men, all-cause mortality risks were similar by airflow limitation criteria: ALGOLD RR = 1.32, 95% CI 1.26-1.38; ALLLN, RR = 1.37, 95% CI 1.31-1.44. The risk estimates were also similar by airflow limitation definition for cardiovascular mortality and for COPD mortality. Among women, all-cause mortality was also similar by airflow limitation criteria, but significantly higher as compared to men: ALGOLD RR = 2.10, 95% CI 1.66-2.66; ALLLN, RR = 2.09, 95% CI 1.66-2.62. Also cardiovascular and COPD mortality by airflow limitation criteria was significantly higher among women as compared to men. CONCLUSIONS: Defined either as FEV1/VC < 0.7 or as FEV1/VC < LLN, airflow limitation predicted excess mortality risk of similar magnitude. Mortality in relation to airflow limitation was higher among women compared to men.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/mortalidade , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ventilação Pulmonar , Adulto , Fatores Etários , Causas de Morte , Estudos de Coortes , Indústria da Construção , Feminino , Volume Expiratório Forçado , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Estudos Prospectivos , Fatores Sexuais , Fumar , Espirometria , Capacidade Vital , Adulto Jovem
14.
Int Arch Occup Environ Health ; 91(6): 689-694, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29855719

RESUMO

OBJECTIVE: The aim was to examine if exposure to whole-body vibration (WBV) increases the risk for hospitalization due to lumbar disc herniation. METHODS: The study basis is a cohort of 288,926 Swedish construction workers who participated in a national occupational health surveillance programme from 1971 until 1992. Job title, smoking habits, body weight, height and age were registered at the examinations. Assessment of WBV were made for each of the constituent occupations by constructing a job-exposure matrix (JEM). Exposure to WBV was graded on a scale from 0 to 5. In addition, the occurrence of hospitalization due to lumbar disc herniation from January 1st 1987 until December 31st 2010 was collected from a linkage with the Swedish Hospital Discharge Register. Poisson regressions were used to estimate relative risk with 95 percent confidence intervals (95% CI), adjusting for age, height, weight and smoking, using white-collar workers and foremen as a reference group. RESULTS: There was an increased risk for hospitalization due to lumbar disc herniation for workers in the construction industry exposed to medium to high WBV compared to white-collar workers and foremen 1.35 (1.12-1.63). When restricting the analyses to include workers 30-49 years of age at the time of the hospital admission the risk was 1.69 (95% CI 1.29-2.21). CONCLUSION: This study further supports that occupational exposure to whole-body vibration increases the risk for hospitalization due to lumbar disc herniation.


Assuntos
Deslocamento do Disco Intervertebral/epidemiologia , Deslocamento do Disco Intervertebral/etiologia , Vértebras Lombares/patologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Vibração/efeitos adversos , Adulto , Estudos de Coortes , Indústria da Construção , Hospitalização/estatística & dados numéricos , Humanos , Dor Lombar/etiologia , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Sistema de Registros , Fatores de Risco , Suécia
15.
Spine J ; 18(8): 1313-1317, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29246850

RESUMO

BACKGROUND CONTEXT: Tobacco smoking is an injurious habit associated with a number of chronic disorders. Its influence on disc metabolism and degeneration including lumbar spinal stenosis (LSS) has been investigated in the literature. PURPOSE: We aimed to investigate whether tobacco smoking is an independent risk factor for undergoing surgical intervention for LSS. STUDY DESIGN/SETTING: This is a prospective cohort study. PATIENT SAMPLE: The patient sample of 331,941 workers was derived from a Swedish nationwide occupational surveillance program for construction workers. OUTCOME MEASURE: The outcome measure included the incidence of undergoing surgical intervention for LSS in tobacco smokers versus no smokers. MATERIALS AND METHODS: At inclusion, age, sex, body mass index (BMI), workers' job title, and self-reported smoking habits were registered. The workers were divided into four categories: never smoked, former smoker, moderate current (1-14 cigarettes/day), and heavy current (≥15 cigarettes/day). Patients who underwent a surgically treated LSS were defined using the relevant International Classification of Diseases (ICD) disease code derived from the Swedish National Patient Register. RESULTS: A total of 331,941 participants were included in the analysis. Forty-four percent of the participants were non-smokers, 16% were former smokers, 26% were moderate smokers, and 14% were heavy smokers. The vast majority of construction workers were males (95%). During the average follow-up of 30.7 years, 1,623 participants were surgically treated for LSS. The incidence rate ratio (IRRs) of LSS varied across smoking categories, with the highest values found in heavy smokers. Compared with non-smokers, all smoking categories show an increased incidence of surgically treated LSS. The findings were consistent even when the comparison was performed for participants with BMIs between 18.5 and 25 and for participants aged between 40 and 74 years. CONCLUSIONS: Tobacco smoking is associated with an increased incidence of surgically treated LSS. The effect seems to be dose related, whereby heavy smokers have a higher risk than moderate or former smokers.


Assuntos
Procedimentos Neurocirúrgicos/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Estenose Espinal/epidemiologia , Fumar Tabaco/epidemiologia , Adulto , Idoso , Indústria da Construção/estatística & dados numéricos , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/cirurgia , Estenose Espinal/cirurgia , Suécia
16.
Occup Environ Med ; 74(11): 827-829, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28780566

RESUMO

OBJECTIVE: To investigate whether the decreased use of paints based on organic solvents has caused a decreased risk for neuropsychiatric disorders in painters by studying their incidence in disability pensions. METHODS: The incidence of disability pension in Swedish painters who had participated in health examinations between 1971 and 1993 was studied through linkage with Swedish registers of disability pension over 1971-2010 and compared with the incidence in other construction workers as woodworkers, concrete workers and platers. When phasing out began in the 1970s, about 40% of paints were based on organic solvents and it had decreased to 4% in 1990s. The analysis was adjusted for age, time period, body mass index and smoking. RESULTS: The painters (n=23 065) had an increased risk of disability pension due to neurological diagnosis (n=285, relative risk (RR) 1.92, 95% CI 1.67 to 2.20) and psychiatric diagnosis (n=632, RR=1.61, 95 % CI 1.42 to 1.82). For neurological disorders there was a time trend with a continuously decreasing risk from 1980 onwards, but there was no such trend for psychiatric disorders. CONCLUSIONS: High exposure to organic solvents increased the risk for disability pension in neurological disorders, and the risk decreased when the use of organic solvents decreased. The painters also had an increased risk of disability pension due to psychiatric disorders, but the causes have to be further investigated.


Assuntos
Indústria da Construção , Pessoas com Deficiência , Doenças do Sistema Nervoso/prevenção & controle , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/efeitos adversos , Pensões , Solventes/efeitos adversos , Adulto , Indústria da Construção/tendências , Humanos , Incidência , Masculino , Transtornos Mentais/induzido quimicamente , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/induzido quimicamente , Doenças Profissionais/induzido quimicamente , Ocupações , Compostos Orgânicos/efeitos adversos , Pintura , Medição de Risco , Fatores de Risco , Suécia , Indenização aos Trabalhadores
18.
Occup Environ Med ; 74(9): 621-627, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28391246

RESUMO

OBJECTIVES: The objectives of this study are to investigate the relation between obesity and labour force exit via diagnosis-specific disability benefits, and whether physical workload modifies this association. METHODS: A longitudinal analysis was performed among 3 28 743 Swedish construction workers in the age of 15-65 years. Body weight and height were measured at a health examination and enriched with register information on disability benefits up to 37 years later. Diagnoses of disability benefits were categorised into cardiovascular diseases (CVDs), musculoskeletal diseases (MSDs), mental disorders and others. A job exposure matrix, based on self-reported lifting of heavy loads and working in bent forward or twisted position, was applied as a measure of physical workload. Cox proportional hazards regression analyses were performed, and the relative excess risk due to interaction (RERI) between obesity and physical workload was calculated. RESULTS: Obese construction workers were at increased risk of receiving disability benefits (HR 1.70, 95% CI 1.65 to 2.76), mainly through CVD (HR 2.30) and MSD (HR 1.71). Construction workers with a high physical workload were also more likely to receive a disability benefit (HR 2.28, 95% CI 2.21 to 2.34), particularly via MSD (HR 3.02). Obesity in combination with a higher physical workload increased the risk of disability benefits (RERI 0.28) more than the sum of the risks of obesity and higher physical workload, particularly for MSD (RERI 0.44). CONCLUSIONS: Obesity and a high physical workload are risk factors for disability benefit. Furthermore, these factors are synergistic risk factors for labour force exit via disability benefit through MSD. Comprehensive programmes that target health promotion to prevent obesity and ergonomic interventions to reduce physical workload are important to facilitate sustained employment.


Assuntos
Indústria da Construção , Pessoas com Deficiência , Emprego , Obesidade/complicações , Ocupações , Pensões , Trabalho , Adolescente , Adulto , Doenças Cardiovasculares/complicações , Seguimentos , Humanos , Masculino , Doenças Musculoesqueléticas/complicações , Doenças Profissionais/etiologia , Exposição Ocupacional , Postura , Modelos de Riscos Proporcionais , Aposentadoria , Fatores de Risco , Suécia , Adulto Jovem
19.
Int Arch Occup Environ Health ; 90(2): 161-168, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27815725

RESUMO

PURPOSE: To get knowledge of the work environment for seafarers sailing under the Swedish flag, in terms of safety climate, ergonomical, chemical and psychosocial exposures, and the seafarers self-rated health and work ability. METHODS: A Web-based questionnaire was sent to all seafarers with a personal e-mail address in the Swedish Maritime Registry (N = 5608). Comparisons were made mainly within the study population, using Student's t test, prevalence odds ratios and logistic regressions with 95% confidence intervals. RESULTS: The response rate was 35% (N = 1972; 10% women, 90% men), with 61% of the respondents working on deck, 31% in the engine room and 7% in the catering/service department (1% not classifiable). Strain on neck, arm or back and heavy lifting were associated with female gender (p = 0.0001) and younger age (below or above 30 years of age, p < 0.0001). Exposures to exhausts, oils and dust were commonly reported. Major work problems were noise, risk of an accident and vibrations from the hull of the ship. The safety climate was high in comparison with that in land-based occupations. One-fourth had experienced personal harassment or bullying during last year of service. CONCLUSIONS: Noise, risk of accidents, hand/arm and whole-body vibrations and psychosocial factors such as harassment were commonly reported work environment problems among seafarers within the Swedish merchant fleet.


Assuntos
Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Navios/estatística & dados numéricos , Adolescente , Adulto , Idoso , Poluentes Ambientais , Ergonomia , Feminino , Assédio não Sexual/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Ruído Ocupacional/estatística & dados numéricos , Cultura Organizacional , Inquéritos e Questionários , Suécia/epidemiologia , Vibração , Local de Trabalho
20.
Dis Colon Rectum ; 59(2): 110-4, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26734968

RESUMO

BACKGROUND: Current studies reporting on the risk of smoking and development of symptomatic diverticular disease have reported conflicting results. OBJECTIVE: The aim of this study was to investigate the association between smoking and symptomatic diverticular disease. DESIGN: This is a cohort study SETTINGS: : Information was derived from the Swedish Construction Workers Cohort 1971-1993. PATIENTS: Patients were selected from construction workers in Sweden. MAIN OUTCOME MEASURES: The primary outcome measured was the development of symptomatic diverticular disease and complicated diverticular disease (abscess and perforation) as identified in the Swedish Hospital Discharge Register. Adjusted relative risks of symptomatic diverticular disease according to smoking status were estimated by using negative binomial regression analysis. RESULTS: In total, the study included 232,685 men and 14,592 women. During follow-up, 3891 men and 318 women had a diagnosis of later symptomatic diverticular disease. In men, heavy smokers (≥15 cigarettes a day) had a 1.6-fold increased risk of developing symptomatic diverticular disease compared with nonsmokers (adjusted relative risk, 1.56; 95% CI, 1.42-1.72). There was evidence of a dose-response relationship, because moderate and ex-smokers had a 1.4- and 1.2-fold increased risk compared with nonsmokers (adjusted relative risk, 1.39; 95% CI, 1.27-1.52 and adjusted relative risk, 1.14; 95% CI, 1.04-1.27). These relationships were similar in women, but the risk estimates were less precise owing to smaller numbers. Male ever-smokers had a 2.7-fold increased risk of developing complicated diverticular disease (perforation/abscess) compared with nonsmokers (adjusted relative risks, 2.73; 95% CI, 1.69-4.41). LIMITATIONS: We were unable to account for other confounding variables such as comorbidity, prescription medication, or lifestyle factors. CONCLUSIONS: Smoking is associated with symptomatic diverticular disease in both men and women and with an increased risk of developing complicated diverticular disease.


Assuntos
Abscesso , Divertículo , Trato Gastrointestinal/patologia , Perfuração Intestinal , Fumar , Abscesso/epidemiologia , Abscesso/etiologia , Adulto , Estudos de Coortes , Diverticulite/epidemiologia , Diverticulite/etiologia , Divertículo/complicações , Divertículo/diagnóstico , Divertículo/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Perfuração Intestinal/epidemiologia , Perfuração Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Suécia/epidemiologia , Tempo
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