Publications
191 results found
Nys E, Pauwels S, Ádám B, et al., 2023, Recognition of COVID-19 with occupational origin: a comparison between European countries., Occup Environ Med, Vol: 80, Pages: 694-701
OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.
De Matteis S, Jarvis D, Darnton L, et al., 2022, Lifetime occupational exposures and chronic obstructive pulmonary disease risk in the UK Biobank cohort, Thorax, Vol: 77, Pages: 997-1005, ISSN: 0040-6376
BACKGROUND AND AIM: Occupational exposures are important, preventable causes of COPD. We previously found an increased risk of COPD among six occupations by analysing lifetime job histories and lung function data in the population-based UK Biobank cohort. We aimed to build on these findings and elucidate the underlying potential causal agents to focus preventive strategies. METHODS: We applied the ALOHA+job exposure matrix (JEM) based on the International Standard Classification of Occupations V.1988 codes, where exposure to 12 selected agents was rated as 0 (no exposure), 1 (low) or 2 (high). COPD was spirometrically defined as FEV1/FVC less than the lower limit of normal. We calculated semiquantitative cumulative exposure estimates for each agent by multiplying the duration of exposure and squared intensity. Prevalence ratio (PR) and 95% CI for COPD were estimated using robust Poisson regression adjusted for centre, sex, age, smoking and coexposure to JEM agents. Only associations confirmed among never-smokers and never-asthmatics were considered reliable. RESULTS: Out of 116 375 participants with complete job histories, 94 514 had acceptable/repeatable spirometry and smoking data and were included in the analysis. Pesticide exposure showed increased risk of COPD for ever exposure (PR=1.13, 95% CI 1.01 to 1.28) and high cumulative exposure (PR=1.32, 95% CI 1.12 to 1.56), with positive exposure-response trends (p trend=0.004), which were confirmed among never-smokers (p trend=0.005) and never-asthmatics (p trend=0.001). CONCLUSION: In a large population-based study, occupational exposure to pesticides was associated with risk of COPD. Focused preventive strategies for workers exposed to pesticides can prevent the associated COPD burden.
Hall AL, Demers PA, VanTil L, et al., 2022, Lessons learned from presumptive condition lists in veteran compensation systems, Frontiers in Public Health, Vol: 10, Pages: 1-8, ISSN: 2296-2565
Presumptive condition lists formally accept connections between military factors and veteran health conditions. An environmental scan of such lists and their evidentiary basis was conducted across four veterans' administrations to inform other administrations considering the development of such lists. Information on included conditions, qualifying military factors, and scientific processes was obtained through targeted internet searches and correspondence with veterans' administrations. The content of presumptive condition lists across jurisdictions varied by conditions included, as well as military eligibility requirements (e.g., service in particular conflict, context, or time period). Scientific review processes to develop lists also varied across jurisdictions. Findings indicate that evidence and experience may be leveraged across compensation systems (veteran and civilian). Ongoing research to understand links between military exposures and veteran health is recommended.
Rushton L, 2021, Health Impact of Environmental Tobacco Smoke in the Horne., Rev Environ Health, Vol: 19, Pages: 291-310
Environmental tobacco smoke (ETS) can be a major constituent of air pollution in indoor environments, including the home. Regulation on smoking in the workplace and public places has made the home the dominant unregulated source of ETS, with important potential impacts on children. Between 40% and 60% of cbildren in the United Kingdom are exposed to ETS in the home. Many experimental and human and studies have investigated the adverse health effects of ETS. Substantial evidence shows that in adults ETS is associated with increased risk of chronic respiratory illness, including lung cancer, nasal cancer, and cardiovascular disease. In children, ETS increases the risk of sudden infant death syndrome, middle ear disease, lower respiratory tract illness, prevalence of wheeze and cough, and exacerbates asthma. Although banning smoking in the home would be the optimal reduction strategy, several barrier and ventilation methods can be effective. Nevertheless, such methods are not always practical or acceptable, particularly when social pressures contribute to a lack of support for ETS control in the home. Smoking cessation interventions have bad limited success. Research is needed to explore the barriers to adopting ETS risk-reducing behaviors.
Rushton L, 2021, Health Impact of Environmental Tobacco Smoke in the Horne., Rev Environ Health, Vol: 19, Pages: 291-310
Environmental tobacco smoke (ETS) can be a major constituent of air pollution in indoor environments, including the home. Regulation on smoking in the workplace and public places has made the home the dominant unregulated source of ETS, with important potential impacts on children. Between 40% and 60% of cbildren in the United Kingdom are exposed to ETS in the home. Many experimental and human and studies have investigated the adverse health effects of ETS. Substantial evidence shows that in adults ETS is associated with increased risk of chronic respiratory illness, including lung cancer, nasal cancer, and cardiovascular disease. In children, ETS increases the risk of sudden infant death syndrome, middle ear disease, lower respiratory tract illness, prevalence of wheeze and cough, and exacerbates asthma. Although banning smoking in the home would be the optimal reduction strategy, several barrier and ventilation methods can be effective. Nevertheless, such methods are not always practical or acceptable, particularly when social pressures contribute to a lack of support for ETS control in the home. Smoking cessation interventions have bad limited success. Research is needed to explore the barriers to adopting ETS risk-reducing behaviors.
Madan I, Parsons V, Ntani G, et al., 2020, A behaviour change package to prevent hand dermatitis in nurses working in the National Health Service: results of a cluster randomized controlled trial, BRITISH JOURNAL OF DERMATOLOGY, Vol: 183, Pages: 462-470, ISSN: 0007-0963
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- Citations: 10
Sadhra SS, Mohammed N, Kurmi OP, et al., 2020, Occupational exposure to inhaled pollutants and risk of airflow obstruction: a large UK population-based UK Biobank cohort, THORAX, Vol: 75, Pages: 468-475, ISSN: 0040-6376
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- Citations: 4
Driscoll T, Rushton L, Steenland K, et al., 2020, Global and regional burden of cancer in 2016 arising from occupational exposure to selected carcinogens: a systematic analysis for the Global Burden of Disease Study 2016, Occupational and Environmental Medicine, Vol: 77, Pages: 151-159, ISSN: 1351-0711
Objectives This study provides a detailed analysis of the global and regional burden of cancer due to occupational carcinogens from the Global Burden of Disease 2016 study.Methods The burden of cancer due to 14 International Agency for Research on Cancer Group 1 occupational carcinogens was estimated using the population attributable fraction, based on past population exposure prevalence and relative risks from the literature. The results were used to calculate attributable deaths and disability-adjusted life years (DALYs).Results There were an estimated 349 000 (95% Uncertainty Interval 269 000 to 427 000) deaths and 7.2 (5.8 to 8.6) million DALYs in 2016 due to exposure to the included occupational carcinogens—3.9% (3.2% to 4.6%) of all cancer deaths and 3.4% (2.7% to 4.0%) of all cancer DALYs; 79% of deaths were of males and 88% were of people aged 55 –79 years. Lung cancer accounted for 86% of the deaths, mesothelioma for 7.9% and laryngeal cancer for 2.1%. Asbestos was responsible for the largest number of deaths due to occupational carcinogens (63%); other important risk factors were secondhand smoke (14%), silica (14%) and diesel engine exhaust (5%). The highest mortality rates were in high-income regions, largely due to asbestos-related cancers, whereas in other regions cancer deaths from secondhand smoke, silica and diesel engine exhaust were more prominent. From 1990 to 2016, there was a decrease in the rate for deaths (−10%) and DALYs (−15%) due to exposure to occupational carcinogens.Conclusions Work-related carcinogens are responsible for considerable disease burden worldwide. The results provide guidance for prevention and control initiatives.
Driscoll T, Rushton L, Hutchings SJ, et al., 2020, Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016, Occupational and Environmental Medicine, Vol: 77, Pages: 133-141, ISSN: 1351-0711
Objectives This study provides an overview of the influence of occupational risk factors on the global burden of disease as estimated by the occupational component of the Global Burden of Disease (GBD) 2016 study.Methods The GBD 2016 study estimated the burden in terms of deaths and disability-adjusted life years (DALYs) arising from the effects of occupational risk factors (carcinogens; asthmagens; particulate matter, gases and fumes (PMGF); secondhand smoke (SHS); noise; ergonomic risk factors for low back pain; risk factors for injury). A population attributable fraction (PAF) approach was used for most risk factors.Results In 2016, globally, an estimated 1.53 (95% uncertainty interval 1.39–1.68) million deaths and 76.1 (66.3–86.3) million DALYs were attributable to the included occupational risk factors, accounting for 2.8% of deaths and 3.2% of DALYs from all causes. Most deaths were attributable to PMGF, carcinogens (particularly asbestos), injury risk factors and SHS. Most DALYs were attributable to injury risk factors and ergonomic exposures. Men and persons 55 years or older were most affected. PAFs ranged from 26.8% for low back pain from ergonomic risk factors and 19.6% for hearing loss from noise to 3.4% for carcinogens. DALYs per capita were highest in Oceania, Southeast Asia and Central sub-Saharan Africa. On a per capita basis, between 1990 and 2016 there was an overall decrease of about 31% in deaths and 25% in DALYs.Conclusions Occupational exposures continue to cause an important health burden worldwide, justifying the need for ongoing prevention and control initiatives.
Driscoll T, Steenland K, Pearce N, et al., 2020, Global and regional burden of chronic respiratory disease in 2016 arising from non-infectious airborne occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016, Occupational and Environmental Medicine, Vol: 77, Pages: 142-150, ISSN: 1351-0711
Objectives This paper presents detailed analysis of the global and regional burden of chronic respiratory disease arising from occupational airborne exposures, as estimated in the Global Burden of Disease 2016 study.Methods The burden of chronic obstructive pulmonary disease (COPD) due to occupational exposure to particulate matter, gases and fumes, and secondhand smoke, and the burden of asthma resulting from occupational exposure to asthmagens, was estimated using the population attributable fraction (PAF), calculated using exposure prevalence and relative risks from the literature. PAFs were applied to the number of deaths and disability-adjusted life years (DALYs) for COPD and asthma. Pneumoconioses were estimated directly from cause of death data. Age-standardised rates were based only on persons aged 15 years and above.Results The estimated PAFs (based on DALYs) were 17% (95% uncertainty interval (UI) 14%–20%) for COPD and 10% (95% UI 9%–11%) for asthma. There were estimated to be 519 000 (95% UI 441,000–609,000) deaths from chronic respiratory disease in 2016 due to occupational airborne risk factors (COPD: 460,100 [95% UI 382,000–551,000]; asthma: 37,600 [95% UI 28,400–47,900]; pneumoconioses: 21,500 [95% UI 17,900–25,400]. The equivalent overall burden estimate was 13.6 million (95% UI 11.9–15.5 million); DALYs (COPD: 10.7 [95% UI 9.0–12.5] million; asthma: 2.3 [95% UI 1.9–2.9] million; pneumoconioses: 0.58 [95% UI 0.46–0.67] million). Rates were highest in males; older persons and mainly in Oceania, Asia and sub-Saharan Africa; and decreased from 1990 to 2016.Conclusions Workplace exposures resulting in COPD, asthma and pneumoconiosis continue to be important contributors to the burden of disease in all regions of the world. This should be reducible through improved prevention and control of relevant exposures.
Rushton L, Hutchings SJ, Straif K, 2020, Occupational Cancer Burden, OCCUPATIONAL CANCERS, 2 EDITION, Editors: Anttila, Boffetta, Publisher: SPRINGER NATURE SWITZERLAND AG, Pages: 561-578, ISBN: 978-3-030-30765-3
Madan I, Parsons V, Ntani G, et al., 2019, A behaviour change package to prevent hand dermatitis in nurses working in health care: the SCIN cluster RCT., Health Technol Assess, Vol: 23, Pages: 1-92
BACKGROUND: Although strategies have been developed to minimise the risk of occupational hand dermatitis in nurses, their clinical effectiveness and cost-effectiveness remain unclear. OBJECTIVES: The Skin Care Intervention in Nurses trial tested the hypothesis that a behaviour change package intervention, coupled with provision of hand moisturisers, could reduce the point prevalence of hand dermatitis when compared with standard care among nurses working in the NHS. The secondary aim was to assess the impact of the intervention on participants' beliefs and behaviour regarding hand care, and the cost-effectiveness of the intervention in comparison with normal care. DESIGN: Cluster randomised controlled trial. SETTING: Thirty-five NHS hospital trusts/health boards/universities. PARTICIPANTS: First-year student nurses with a history of atopic tendency, and full-time intensive care unit nurses. INTERVENTION: Sites were randomly allocated to be 'intervention plus' or 'intervention light'. Participants at 'intervention plus' sites received access to a bespoke online behaviour change package intervention, coupled with personal supplies of moisturising cream (student nurses) and optimal availability of moisturising cream (intensive care unit nurses). Nurses at 'intervention light' sites received usual care, including a dermatitis prevention leaflet. MAIN OUTCOME MEASURE: The difference between intervention plus and intervention light sites in the change of point prevalence of visible hand dermatitis was measured from images taken at baseline and at follow-up. RANDOMISATION: Fourteen sites were randomised to the intervention plus arm, and 21 sites were randomised to the intervention light arm. BLINDING: The participants, trial statistician, methodologist and the dermatologists interpreting the hand photographs were blinded to intervention assignment. NUMBERS ANALYSED: An intention-to-treat analysis was conducted on data from 845 student nurses and 1111 intensive care unit nu
Madan I, Parsons V, Ntani G, et al., 2019, A behaviour change package to prevent hand dermatitis in nurses working in health care: the SCIN cluster RCT, HEALTH TECHNOLOGY ASSESSMENT, Vol: 23, Pages: VII-+, ISSN: 1366-5278
De Matteis S, Jarvis D, Darnton A, et al., 2019, The occupations at increased risk of chronic obstructive pulmonary disease (COPD): analysis of lifetime job-histories in the population-based UK Biobank Cohort, European Respiratory Journal, Vol: 54, Pages: 1-9, ISSN: 0903-1936
Occupational exposures are important, preventable causes of chronic obstructive pulmonary disease (COPD). Identification of COPD high-risk jobs is key to focus preventive strategies, but a definitive job-list is unavailable.We addressed this issue by evaluating the association of lifetime job-histories and lung function data in the population-based UK Biobank cohort, whose unprecedented sample size allowed analyses restricted to never-smokers to rule out the most important confounder, tobacco smoking. COPD was spirometrically-defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <lower limit of normal (LLN). Lifetime job-histories were collected via OSCAR, a new validated online-tool that automatically codes jobs into the UK Standard Occupational Classification v.2000. Prevalence ratios for COPD by employment duration in each job compared to lifetime office workers were estimated using robust Poisson regression adjusted for age, sex, centre and smoking. Only associations confirmed among never-smokers and never-asthmatics were considered reliable.From the 116 375 participants with complete job-histories, 94 551 had acceptable/repeatable spirometry data and smoking information and were included in the analysis. Six occupations showed an increased COPD risk also among never-smokers and never-asthmatics; most of these also with positive exposure-response trends. Interesting new findings included sculptors, gardeners, and warehouse workers.COPD patients, especially never-smokers, should be asked about their job-history for better disease management. Focussed preventive strategies in COPD high-risk jobs are warranted.
Micallef CM, Shield KD, Vignat J, et al., 2019, Cancers in France in 2015 attributable to occupational exposures, INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH, Vol: 222, Pages: 22-29, ISSN: 1438-4639
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- Citations: 31
Soerjomataram I, Shield K, Marant-Micallef C, et al., 2018, Cancers related to lifestyle and environmental factors in France in 2015, EUROPEAN JOURNAL OF CANCER, Vol: 105, Pages: 103-113, ISSN: 0959-8049
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- Citations: 38
Stanaway JD, Afshin A, Gakidou E, et al., 2018, Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017, LANCET, Vol: 392, Pages: 1923-1994, ISSN: 0140-6736
BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations.MethodsWe used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risk
Micallef CM, Shield KD, Baldi I, et al., 2018, Occupational exposures and cancer: a review of agents and relative risk estimates, OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, Vol: 75, Pages: 604-614, ISSN: 1351-0711
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- Citations: 33
El-Zaemey S, Carey RN, Darcey E, et al., 2018, Does the Size of a Company Make a Difference in the Prevalence of Exposure to Asthmagens and in the Use of Respiratory Protective Equipment?, ANNALS OF WORK EXPOSURES AND HEALTH, Vol: 62, Pages: 765-769, ISSN: 2398-7308
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- Citations: 1
Gakidou E, Afshin A, Abajobir AA, et al., 2017, Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, Lancet, Vol: 390, Pages: 1345-1422, ISSN: 0140-6736
BackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context.MethodsWe used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined.FindingsSince 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smok
De Matteis S, Jarvis D, Darnton A, et al., 2017, The occupations at increased risk of COPD in the UK Biobank Cohort, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Rushton L, 2017, The global burden of occupational disease, Current Environmental Health Reports, Vol: 4, Pages: 340-348, ISSN: 2196-5412
Purpose of Review:Burden of occupational disease estimation contributes to understanding of both magnitude and relative importance of different occupational hazards and provides essential information for targeting risk reduction. This review summarises recent key findings and discusses their impact on occupational regulation and practice.Recent Findings:New methods have been developed to estimate burden of occupational disease that take account of the latency of many chronic diseases and allow for exposure trends and workforce turnover. Results from these studies have shown in several countries and globally that, in spite of improvements in workplace technology, practices and exposures over the last decades, occupational hazards remain an important cause of ill health and mortality worldwide.Summary:Major data gaps have been identified particularly regarding exposure information. Reliable data on employment and disease are also lacking especially in developing countries. Burden of occupational disease estimates form an important part of decision-making processes.
Cherrie JW, Hutchings S, Ng MG, et al., 2017, Prioritising action on occupational carcinogens in Europe: a socioeconomic and health impact assessment, British Journal of Cancer, Vol: 117, Pages: 274-281, ISSN: 0007-0920
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 euro34 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.
Glass DC, Schnatter AR, Tang G, et al., 2017, Exposure to benzene in a pooled analysis of petroleum industry case-control studies, Journal of Occupational and Environmental Hygiene, Vol: 14, Pages: 863-872, ISSN: 1545-9624
Cases of lymphohematopoietic cancer from three petroleum industry cohorts, matched to controls from the respective cohort, were pooled into single study. Average benzene exposure was quantitatively estimated in ppm for each job based on measured data from the relevant country, adjusted for the specific time period, site and job exposure characteristics and the certainty of the exposure estimate scored. The probability of dermal exposure and of peak exposure was also assessed. Before risk was examined, an exposure estimate comparison and rationalisation exercise was performed across the studies to ensure accuracy and consistency of approach. This article evaluates the final exposure estimates and their use in the risk assessments.Overall benzene exposure estimates were low: 90% of participants accumulated less than 20 ppm-years. Mean cumulative exposure was estimated as 5.15 ppm-years, mean duration was 22 years, and mean exposure intensity was 0.2 ppm. 46% of participants were allocated a peak exposure (>3 ppm at least weekly). 40% of participants had a high probability of dermal exposure (based on the relative probability of at least weekly exposure).There were differences in mean intensity of exposure, probability of peak, and/or dermal exposure associated with job category, job site, and decade of exposure. Terminal Operators handling benzene-containing products were the most highly exposed group, followed by Tanker Drivers carrying gasoline. Exposures were higher around 1940–1950 and lower in more recent decades.Overall confidence in the exposure estimates was highest for recently held jobs and for white-collar jobs. We used sensitivity analyses, which included and excluded case-sets on the basis of exposure certainty scores, to inform the risk assessment.The above analyses demonstrated that the different patterns of exposure across the three studies are largely attributable to differences in jobs, site types, and time frames rather than study. This pro
Rushton L, 2017, Occupational cancer: recent developments in research and legislation, Occupational Medicine, Vol: 67, Pages: 248-250, ISSN: 0962-7480
De Matteis S, Jarvis D, Darnton A, et al., 2017, The occupations at increased COPD risk in the large population-vased UK Biobank Cohort, International Conference of the American-Thoracic-Society (ATS), Publisher: American Thoracic Society, ISSN: 1073-449X
Hutchings S, Rushton L, 2017, Estimating the burden of occupational cancer: assessing bias and uncertainty., Occupational and Environmental Medicine, Vol: 74, Pages: 604-611, ISSN: 1470-7926
BACKGROUND AND OBJECTIVES: We aimed to estimate credibility intervals for the British occupational cancer burden to account for bias uncertainty, using a method adapted from Greenland's Monte Carlo sensitivity analysis. METHODS: The attributable fraction (AF) methodology used for our cancer burden estimates requires risk estimates and population proportions exposed for each agent/cancer pair. Sources of bias operating on AF estimator components include non-portability of risk estimates, inadequate models, inaccurate data including unknown cancer latency and employment turnover and compromises in using the available estimators. Each source of bias operates on a component of the AF estimator. Independent prior distributions were estimated for each bias, or graphical sensitivity analysis was used to identify plausible distribution ranges for the component variables, with AF recalculated following Monte Carlo repeated sampling from these distributions. The methods are illustrated using the example of lung cancer due to occupational exposure to respirable crystalline silica in men. RESULTS: Results are presented graphically for a hierarchy of biases contributing to an overall credibility interval for lung cancer and respirable crystalline silica exposure. An overall credibility interval of 2.0% to 16.2% was estimated for an AF of 3.9% in men. Choice of relative risk and employment turnover were shown to contribute most to overall estimate uncertainty. Bias from using an incorrect estimator makes a much lower contribution. CONCLUSIONS: The method illustrates the use of credibility intervals to indicate relative contributions of important sources of uncertainty and identifies important data gaps; results depend greatly on the priors chosen.
Weston D, Parsons V, Ntani G, et al., 2017, Mixed contact methods to improve response to a postal questionnaire., Occupational Medicine-Oxford, Vol: 67, Pages: 305-307, ISSN: 1471-8405
Background: Postal questionnaires remain an important method of collecting data in trials. However, a high non-response rate can lead to biases, which may undermine the validity of the study. Aims: To assess a simple method of trying to improve response rates in an occupational health trial evaluating an intervention to prevent hand dermatitis in nurses. Methods: The trial employed questionnaires at t = 0, t = 1 month and t = 12 months. The t = 1 month questionnaire was posted to study participants (student and intensive care nurses) together with a free postage reply envelope. After 2 weeks, an e-mail was sent to non-responders reinforcing the need for completed questionnaires to be returned. Two weeks later, non-responders were sent another hard copy of the questionnaire, along with an accompanying letter. Six weeks after posting the initial questionnaires, non-responders were sent an SMS text message or were telephoned to remind them to return the questionnaire. Results: The response rates for the 744 student nurses were 8% (no reminder), 27% (after first reminder), 22% (after second reminder) and 27% (after the third reminder), resulting in a response rate of 63%. The response rates for the 959 intensive care nurses were 9% (no reminder), 24% (after first reminder), 24% (after second reminder) and 31% (after third reminder), resulting in a final response rate of 63%. Conclusions: We found that a series of regular reminders including a third, personalized reminder by SMS text or telephone had a positive impact on non-responders.
Rushton L, Hutchings SJ, 2017, Reply to 'Comment on 'The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation'' - outdoor occupation may not be linked to increased risk of melanoma in Britain, BRITISH JOURNAL OF CANCER, Vol: 116, ISSN: 0007-0920
De Matteis S, Jarvis D, Young H, et al., 2017, Occupational Self Coding and Automatic Recording (OSCAR): a novel efficient web-based tool to collect and code lifetime job-histories in large population-based studies, Scandinavian Journal of Work, Environment and Health, Vol: 43, Pages: 181-186, ISSN: 0355-3140
ObjectivesThe standard approach to the assessment of occupational exposures is through the manual collection and coding of job-histories. This method is time-consuming and costly and makes it potentially unfeasible to perform high quality analyses on occupational exposures in large population-based studies. Our aim was to develop a novel, efficient web-based tool to collect and code lifetime job-histories in the UK Biobank, a population-based cohort of over 500,000 participants.MethodsWe developed OSCAR (Occupations Self Coding Automatic Recording), based on the hierarchical structure of the UK Standard Occupational Classification (SOC) 2000, which allows individuals to collect and automatically code their lifetime job-histories via a simple decision-tree model. Participants were asked to find each of their jobs by selecting appropriate job categories until they identified their job-title, which was linked to a hidden 4-digit SOC-code. For each occupation a job-title in free-text was also collected to estimate Cohen’s kappa (κ) inter-rater agreement between SOC codes assigned by OSCAR and an expert manual coder. ResultsOSCAR was administered to 324,653 UK Biobank participants with an existing email address between June and September 2015. Complete 4-digit SOC-coded lifetime job-histories were collected for 108,784 participants (response rate: 34%). Agreement between the 4-digit SOC codes assigned by OSCAR and the manual coder for a random sample of 400 job titles was moderately good (κ=0.45; 95%CI: 0.42-0.49), and improved when broader job-categories were considered (κ=0.64; 95%CI: 0.61-0.69 at a 1-digit SOC-code level).ConclusionsOSCAR is a novel efficient, and reasonably reliable web-based tool for collecting and automatically coding lifetime job-histories in large population-based studies. Further application in other research projects for external validation purposes is warranted.
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