Background:Work-related cancer is an important public health issue with a large financial impact on society. The key European legislative instrument is the Carcinogens and Mutagens Directive (2004/37/EC). In preparation for updating the Directive, the European Commission commissioned a study to provide a socioeconomic, health and environmental impact assessment.Methods:The evaluation was undertaken for 25 preselected hazardous substances or mixtures. Estimates were made of the number of cases of cancer attributable to workplace exposure, both currently and in the future, with and without any regulatory interventions, and these data were used to estimate the financial health costs and benefits.Results:It was estimated that if no action is taken there will be >700 000 attributable cancer deaths over the next 60 years for the substances assessed. However, there are only seven substances where the data suggest a clear benefit in terms of avoided cancer cases from introducing a binding limit at the levels considered. Overall, the costs of the proposed interventions were very high (up to €34 000 million) and the associated monetised health benefits were mostly less than the compliance costs.Conclusions:The strongest cases for the introduction of a limit value are for: respirable crystalline silica, hexavalent chromium, and hardwood dust.
Contact between contaminated hands and the mouth or the area around the mouth (the perioral area) can result in inadvertent ingestion exposure. Exposure by this route is known to occur among children, but adults may also be exposed. Observations of 48 workers were carried out in 8 UK worksites to study hand- and object-to-mouth behavior. Each subject was observed in real-time for ~60 min during normal work activities. Each contact was recorded along with information about time of contact, glove use, respirator use, task and object type. Subjects were interviewed to gather information about smoking, nail biting and risk perception. The effects of factors (glove use, respirator use, smoking, nail biting, risk perception, work sector and task group) on contact frequency were assessed using non-parametric tests and Poisson regression models. Several determinants of contact frequency were identified, including time spent "between" work tasks, glove and respirator use, smoking and nail biting. Hand-to-mouth contact frequencies were particularly high while workers were "between" work tasks (23.6 contacts per hour, compared with the average contact frequency of 6.3 per hour). The factors that were related to contact frequency differed between object- and hand-to-mouth contacts, suggesting that these should be considered separately. These findings could be used for developing exposure models, to inform measurements of inadvertent ingestion among adults and to identify control strategies.
IntroductionIn the USA, nearly one in three people will experience herpes zoster (HZ) in their lifetime. Underserved communities may be at even higher risk due to several factors, including access to healthcare, education, and co-morbid conditions. The purpose of this study was to investigate current knowledge, attitudes, beliefs and practices (KABP) relative to HZ and HZ vaccines in a large urban city.MethodsA cross-sectional KABP survey was conducted via in-person interview among 381 participants aged ≥ 50 years in Detroit, MI, USA, from June to August 2018. Survey results were stratified into two groups [< 60 and ≥ 60 years of age (YO)] for comparison.ResultsOf the 381 participants, 373 reported their age (110 < 60 YO and 263 ≥ 60 YO). Overall, the majority of participants reported having heard of HZ and HZ vaccines. In addition, receiving a recommendation from a healthcare provider (37.5%) followed by gaining a better understanding of HZ vaccine (36.7%) and of HZ (29.9%) were leading factors that influenced participants’ willingness to receive the vaccine. Of note, 65.5% of participants < 60 YO reported the belief that HZ is preventable versus only 53.2% in those ≥ 60 YO (p = 0.001).ConclusionOur findings underscore the need to educate patients in underserved communities about HZ as well as new HZ vaccine recommendations to improve vaccination rates and reduce the incidence of HZ and its associated sequelae.Electronic supplementary materialThe online version of this article (10.1007/s40121-019-00269-2) contains supplementary material, which is available to authorized users.
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