ObjectiveNumerous exposure assessment methods (EAM) exist for investigating health effects of occupational exposure to pesticides. Direct (eg, biomonitoring) and indirect methods (eg, self-reported exposures) are however associated with degrees of exposure misclassification. We systematically reviewed EAM in studies of occupational pesticide exposure.MethodsWe searched for articles reporting observational epidemiological studies in MEDLINE and Embase published 1993 to 2017. The relative frequency of EAM was analysed according to EAM type (direct and indirect methods), health outcome, study design, study location (country) and specificity of assessment. Temporal trends in EAM were analysed.ResultsIn 1298 included articles 1521 EAM occurrences were documented. Indirect EAM (78.3%), primarily self-reported exposures (39.3%) and job titles assessments (9.5%), were mainly applied in case-control studies (95.0%), in high-income countries (85.0%) and in studies of doctor-diagnosed health outcomes (>85%). Direct EAM (20.8%), primarily biomonitoring of blood (15.6%) or urine (4.7%), were predominantly applied in cross-sectional studies (29.8%), in lower middle-income countries (40.9%) and in studies of neurological (50.0%) outcomes. Between 1993 to 2017 no distinct time trends regarding the ratio indirect to direct methods was seen. Within the category of indirect methods use of self-reported exposures and job exposure matrices increased while assessments by job titles and registers decreased. The use of algorithms showed no trend. The specificity of pesticide assessment increased since studies assessing exposure by using job title as a proxy declined. Assessments of type of pesticide increased.ConclusionOver the last 25 years, the ratio (5:1) of indirect to direct EAM applied in articles on occupational pesticide epidemiology stayed relatively constant; changes were mainly attributable to increasing use of self-reported exposures and job exposure matrices. This review, combined with studies assessing EAM validity, will inform on magnitudes of exposure misclassification and help improve the quality of studies on occupational pesticides exposure.

The association between shift work and hypertension seems mainly attributable to behavioral mechanisms.

Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.

Practice of very high endurance and aquatic sports may be associated with increased asthma risks. Athlete participation as such showed no association with asthma risk.

Background Beyond smoking, several risk factors for the development of chronic obstructive pulmonary disease (COPD) have been described, among which socioeconomic status including education is of particular interest. We studied the contribution of education to lung function and symptoms relative to smoking in a group of never-smokers with COPD compared to a group of long-time ex-smokers with COPD. Methods We used baseline data of the COSYCONET cohort, including patients of GOLD grades 1–4 who were either never-smokers (n=150, age 68.5y, 53.3% female) or ex-smokers (≥10 packyears) for at least 10 years (n=616, 68.3y, 29.9% female). Socioeconomic status was analyzed using education level and mortality was assessed over a follow-up period of 4.5 years. Analyses were performed using ANOVA and regression models. Results Spirometric lung function did not differ between groups, whereas CO diffusing capacity and indicators of lung hyperinflation/air-trapping showed better values in the never-smoker group. In both groups, spirometric lung function depended on the education level, with better values for higher education. Quality of life and 6-MWD were significantly different in never-smokers as well as patients with higher education. Asthma, alpha-1-antitrypsin deficiency, and bronchiectasis were more often reported in never-smokers, and asthma was more often reported in patients with higher education. Higher education was also associated with reduced mortality (hazard ratio 0.46; 95% CI 0.22–0.98). Conclusion Overall, in the COSYCONET COPD cohort, differences in functional status between never-smokers and long-time ex-smokers were not large. Compared to that, the dependence on education level was more prominent, with higher education associated with better outcomes, including mortality. These data indicate that non-smoking COPD patients’ socioeconomic factors are relevant and should be taken into account by clinicians.

ObjectiveTraditional gold mining is associated with mercury exposure. Especially vulnerable to its neurotoxic effects is the developing nervous system of a child. We aimed to investigate risk factors of mercury exposure among children in a rural mining town in Chile.MethodsUsing a validated questionnaire distributed to the parents of the children, a priori mercury risk factors, potential exposure pathways and demographics of the children were obtained. Mercury levels were measured through analyzing fingernail samples. Logistic regression modeling the effect of risk factors on mercury levels above the 75th percentile were made, adjusted for potential confounders.ResultsThe 288 children had a mean age of 9.6 years (SD = 1.9). The mean mercury level in the study population was 0.13 µg/g (SD 0.11, median 0.10, range 0.001–0.86 µg/g). The strongest risk factor for children’s odds of high mercury levels (>75th percentile, 0.165 µg/g) was to play inside a house where a family member worked with mercury (OR adjusted 3.49 95% CI 1.23–9.89). Additionally, children whose parents worked in industrial gold mining had higher odds of high mercury levels than children whose parents worked in industrial copper mining or outside mining activities.ConclusionMercury exposure through small-scale gold mining might affect children in their home environments. These results may further help to convince the local population of banning mercury burning inside the households.

Our study suggests a negative long-term impact from snap-fit assembly on workers' upper limb function. Company physicians should be vigilant for signs of upper limb musculoskeletal disorders among workers exposed to snap-fit assembly.

Background: Reducing occupational ill-health from chemical and biological agents is realized primarily through the mitigation and elimination of hazardous exposures. Despite evidence of declining exposure in European and North-American workplaces, comprehensive studies of the effectiveness of workplace interventions for reducing hazardous exposure and associated work-related ill-health seem rare. We reviewed occupational intervention studies targeting exposure to chemical and biological agents, and determined trends in frequency and quality of such studies. Methods: We searched Embase, Medline, and Web of Science for peer-reviewed original articles on occupational intervention studies published 1960-2019, aimed at reducing workers' exposure to dusts, gases, fumes, or liquids of chemical, biological, or mineral nature, or workers' risks for associated health outcomes. The frequency of articles, intervention types, intervention endpoints, and study quality of published intervention studies between 1960 and 2019 and according to 10-year intervals were analyzed. Results: Of 3,663 retrieved articles, 146 intervention studies were identified and reviewed, of which 63 concerned control measures, 43 behavioral change, 28 use of personal protective equipment, and 12 workplace policies. Intervention endpoints were occupational exposures (73%), health outcomes (22%), and a combination of both (5%). Of reviewed studies, 38% involved a control group, 16% randomized the intervention, 86% were planned interventions, and 86% compared exposure or health outcomes pre and post intervention. Over time the number of intervention studies identified in this search increased from none during 1960-1969 to ∼60 during 2000-2009 and 2010-2019, respectively. The study quality improved over time, with no studies during 1960-1989 that complied with the highest quality criteria. During 2000-2009 and 2010-2019 16 and 12% of studies, respectively, were judged to be of highest quality. Conclusion: Despite an improvement over the last six decades in the frequency and quality of intervention studies targeting exposure to chemicals and biological agents, the absolute number of intervention studies remains low, particularly when considering Ohlander et al. Interventions in Occupational Health only high quality studies. Occupational exposure to chemical and biological agents is still causing excessive disease in workforces worldwide. To reduce occupational ill-health caused by these exposures, it is important to expand the evidence on (cost-)effectiveness and transferability of interventions to reduce exposure and health effects.