Even if memory and concentration symptoms were associated with higher solvent exposure, the effect of solvents on self-experienced work ability was relatively weak. This in line with the improved occupational hygiene and reduced solvent exposure levels in industrialized countries, thus the effect may be stronger in high-level exposure environments. As a single question, WAS is easily included, applicable, and recommendable in occupational screening questionnaires.
Objectives Drawing on a literature review on sentinel and alert systems for identifying new/emerging work-related diseases (WRDs) a basic typology of systems was developed. These systems differ in characteristics, ability to capture new WRDs and link with prevention. The objectives of the subsequent study of a subset of systems were to describe in-depth aims, drivers and obstacles of the systems and use of their data in practice, for prevention and detecting new/emerging WRDs. Methods Twelve systems were chosen reflecting the different types (linked to compensation or not, aimed at all WRDs or a subset of diseases, sentinel systems, workers only or general public). Six systems were described based on desk research and six other systems were studied through interviews with different actors to gather information on the operation of the systems and the use of the gathered data for prevention. Results Several important themes emerged from the comparative tables, related to the design and performance of the system: visibility, reporting methods, exposure assessment, data quality, linkage to other institutions, and related to data use for prevention, alert on hazardous situations, awareness on new/emerging diseases. Conclusions Each system has its strengths and limitations, closely related to its purpose and the country that developed it. Sentinel systems seem to be best equipped for prevention and alert on new/emerging diseases. Enhancing reporting needs to balance required information and perceived reward for reporters. Embedding of systems in governmental or public health organisations is important in terms of financing, expertise and dissemination of results. Objectives High school dropout has unfavourable consequences. We examine the association between dropout and mortality and estimate the mediating role of an unfavourable work trajectory. Methods Subjects born in Norway 1967-1976 were followed up in several national registries. The association between dropping out of high school by age 23 and all-cause and causespecific mortality 10 years onwards were estimated as hazard ratios (HR), applying Cox regression in confounder-adjusted models. Characteristics relating to different trajectories during follow-up were considered as mediators of dropout effects on survival. Oral Presentation OtherResults Thirty-nine percent out of 396 373 participants were classified as dropouts. All-cause mortality during follow-up was 69 per 1 00 000 person-years (2689 cases). The crude dropout HR was 2.1 (1.9-2.3), being reduced to 1.8 (1.6-2.0) in the confounder-adjusted model. After including the potential mediators in the model, dropouts no longer had an excess mortality compared to non-dropouts (HR 1.0, CI (0.9-1.1)). Mediators relating to financial situation, social benefits and employment accounted for the largest reduction in the association. Deaths caused by overdose and drug dependence were strongly associated with dropout (454 cases; rate 12; confounder-adjusted HR 5.0 (3.8-6.5)). Inclusion of work trajectory factors attenu...
ObjectivesOccupational diseases (ODs) are globally underdetected, and chronic solvent encephalopathy (CSE) is no exception. The aim was to study how the recommended policies and protocols were followed in occupational health services (OHS) periodical health examinations where symptomatic CSE cases have remained undetected.MethodsWe retrospectively studied the medical records of occupational CSE cases (n=18) found in a screening project, which had not been detected in preceding OHS health examinations. We collected data from three sources: OHS units, the screening project and the Finnish Institute of Occupational Health. We analysed the health examinations conducted between symptom onset and the detection of CSE: regularity, content, use of recommended screening tools, exposure estimation and whether a physician was involved in the examinations, as recommended.ResultsThe mean duration of symptoms before OD identification was 7.3 years (range 3–13), and 36 health examinations had been conducted. Fifteen workers had attended these (1–9 times each) while suffering from CSE symptoms, and two before symptoms. Only one had not had access to OHS. The recommended symptom screening questionnaire, Euroquest, was used in five (14%) examinations, and previous solvent exposure inquired once. A physician was involved in 24 (67%) examinations, whereas the rest were carried out by a nurse.ConclusionsAlthough health examinations are conducted, guidelines are not followed. This may be due to a lack of awareness concerning CSE, and may apply to other ODs. In addition to legislation and policies, OH professionals must be continuously educated to improve awareness, prevention and detection of ODs.
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