Socioeconomic inequalities in health in the working population: the contribution of working conditions.
BACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991 among inhabitants of 18 municipalities in the southeastern Netherlands. Data concerned 4521 working men and 2411 working women and included current occupational class (seven classes), working conditions (physical working conditions, job control, job demands, social support at work), perceived general health (very good or good versus less than good) and demographic confounders. Data were analysed with logistic regression techniques. RESULTS: For both men and women we observed a higher odds ratio for a less than good perceived general health in the lower occupational classes (adjusted for confounders). The odds of a less than good perceived general health was larger among people reporting more hazardous physical working conditions, lower job control, lower social support at work and among those in the highest category of job demands. Results were similar for men and women. Men and women in the lower occupational classes reported more hazardous physical working conditions and lower job control as compared to those in higher occupational classes. High job demands were more often reported in the higher occupational classes, while social support at work was not clearly related to occupational class. When physical working conditions and job control were added simultaneously to a model with occupational class and confounders, the odds ratios for occupational classes were reduced substantially. For men, the per cent change in the odds ratios for the occupational classes ranged between 35% and 83%, and for women between 35% and 46%. CONCLUSIONS: A substantial part of the association between occupational class and a less than good perceived general health in the working population could be attributed to a differential distribution of hazardous physical working conditions and a low job control across occupational classes. This suggests that interventions aimed at improving these working conditions might result in a reduction of socioeconomic inequalities in health in the working population. (+info)
Methodological issues in biomonitoring of low level exposure to benzene.
Data from a pilot study on unmetabolized benzene and trans,trans muconic acid (t,t-MA) excretion in filling station attendants and unexposed controls were used to afford methodological issues in the biomonitoring of low benzene exposures (around 0.1 ppm). Urinary concentrations of benzene and t,t-MA were measured by dynamic head-space capillary GC/FID and HPLC, respectively. The accuracy of the HPLC determination of t,t-MA was assessed in terms of inter- and intra-method reliability. The adequacy of urinary t,t-MA and benzene as biological markers of low benzene exposure was evaluated by analysing the relationship between personal exposure to benzene and biomarker excretion. Filling station attendants excreted significantly higher amounts of benzene, but not of t,t-MA, than controls. Adjusting for occupational benzene exposure, smokers excreted significantly higher amounts of t,t-MA, but not of unmetabolized benzene, than nonsmokers. A comparative analysis of the present and previously published biomonitoring surveys showed a good inter-study agreement regarding the amount of t,t-MA and unmetabolized benzene excreted (about 0.1-0.2 mg/l and 1-2 micrograms/l, respectively) per unit of exposure (0.1 ppm). For each biomarker, based on the distribution of parameters observed in the pilot study, we calculated the minimum sample size required to estimate the population mean with given confidence and precision. (+info)
Lead exposure in the lead-acid storage battery manufacturing and PVC compounding industries.
This study was conducted as part of the Human Exposure Assessment Location (HEAL) Project which comes under the United Nations Environment Programme/World Health Organisation (UNEP/WHO) Global environmental Monitoring System (GEMS). The objective of the study was to evaluate workers' exposure to lead in industries with the highest exposure. All subjects were interviewed about their occupational and smoking histories, the use of personal protective equipment and personal hygiene. The contribution of a dietary source of lead intake from specified foods known to contain lead locally and personal air sampling for lead were assessed. A total of 61 workers from two PVC compounding and 50 workers from two lead acid battery manufacturing plants were studied together with 111 matched controls. In the PVC compounding plants the mean lead-in-air level was 0.0357 mg/m3, with the highest levels occurring during the pouring and mixing operations. This was lower than the mean lead-in-air level of 0.0886 mg/m3 in the lead battery manufacturing plants where the highest exposure was in the loading of lead ingots into milling machines. Workers in lead battery manufacturing had significantly higher mean blood lead than the PVC workers (means, 32.51 and 23.91 mcg/100 ml respectively), but there was poor correlation with lead-in-air levels. Among the lead workers, the Malays had significantly higher blood lead levels than the Chinese (mean blood levels were 33.03 and 25.35 mcg/100 ml respectively) although there was no significant difference between the two ethnic groups in the control group. There were no significant differences between the exposed and control group in terms of dietary intake of specified local foods known to contain lead. However, Malays consumed significantly more fish than the Chinese did. There were no ethnic differences in the hours of overtime work, number of years of exposure, usage of gloves and respirators and smoking habits. Among the Malays, 94.3% eat with their hands compared with 9.2% of the Chinese. Workers who ate with bare hands at least once a week had higher blood lead levels after adjusting for lead-in-air levels (mean blood lead was 30.2 and 26.4 mcg/100 ml respectively). The study indicated that the higher blood lead levels observed in the Malay workers might have been due to their higher exposure and eating with bare hands. (+info)
Contact dermatitis in Alstroemeria workers.
Hand dermatitis is common in workers in the horticultural industry. This study determined the prevalence of hand dermatitis in workers of Alstroemeria cultivation, investigated how many workers had been sensitized by tulipalin A (the allergen in Alstroemeria) and took stock of a wide range of determinants of hand dermatitis. The 12-month period prevalence of major hand dermatitis amounted to 29.5% whereas 7.4% had minor dermatitis. Of these workers, 52.1% were sensitized for tulipalin A. Several personal and work-related determinants played a role in the multifactorial aetiology of hand dermatitis. Factors which showed a significant relationship with major hand dermatitis were: female sex, atopic dermatitis, chapped hands and the frequency of washing hands. It may be concluded that the Alstroemeria workers are a population at risk of developing contact dermatitis and it might be useful to carry out an educational campaign to lower the high prevalence. (+info)
The feasibility of conducting occupational epidemiology in the UK.
A postal survey was carried out of 1,000 UK companies to collect information about employee biographical and work history records. The overall response rate was 46%. All companies collected surname, forenames, address, date of birth and National Insurance number--information needed for cross-sectional studies. Other biographical details such as maiden name and National Health Service number were collected less often, which could increase the cost and difficulty of tracing ex-employees. Seventy per cent reported destroying their records within 10 years of an employee leaving, rising to 82% for companies with fewer than 100 employees. The destruction of employee records creates problems for historical cohort studies and case-control studies, and may hamper ex-employees trying to claim benefit for occupational-related illness. If the scope of future occupational epidemiology is to be improved, guidelines for the collection and retention of the data required must be developed and industry encouraged to participate. (+info)
Cohort study of art glass workers in Tuscany, Italy: mortality from non-malignant diseases.
This investigation studies cause-specific mortality of art glass workers employed in 17 industrial facilities in Tuscany, Italy. A cohort of 3,390 workers employed for at least 1 year was enumerated from company payrolls. Follow-up was between the start of employment in each factory and 31 December 1993. The cause-specific expected mortality was computed relative to Tuscany rates and specified for gender, 5-year age groups and calendar year. Separate analyses were carried out for the jobs of makers and formers and for batch mixers. Among males (3, 180 individuals) observed mortality for non-cancer causes was higher than expected for hypertensive disease [standardized mortality ratio (SMR) = 178, 90% confidence interval (90% CI) = 96-301], pneumoconiosis (SMR = 200, 90% CI = 94-376) and diseases of the genitourinary system (SMR = 169, 90% CI = 95-279). Increases for the above causes were shown also among makers and formers: hypertensive disease (SMR = 182, 90% CI = 85-341), pneumoconiosis (SMR = 250, 90% CI = 109-493) and diseases of the genitourinary system (SMR = 224, 90% CI = 121-380). For batch mixers an increase was present for cerebrovascular disease. The observed mortality for cancer causes was above the expected for cancers of the larynx, lung, stomach and brain. This study points to the existence for Tuscan glass workers of health effects in addition to cancer; previously observed carcinogenic effects were also confirmed. (+info)
Irritant contact dermatitis due to 1-bromo-3-chloro-5,5-dimethylhydantoin in a hydrotherapy pool. Risk assessments: the need for continuous evidence-based assessments.
A physiotherapist working in hydrotherapy presented to occupational health with irritant contact dermatitis. Subsequent investigation revealed that the likely causative agent was 1-bromo 3-chloro 5,5 dimethylhydantoin which was used to disinfect the hydrotherapy pool. A COSHH risk assessment had been performed which failed to take full account of current knowledge and this agent had been introduced into the workplace. The development of adverse health effects among staff and other pool users lead to a review of this risk assessment and eventually a return to less hazardous chlorine-based disinfection. Had an evidence-based approach been combined with an appropriate COSHH assessment prior to and following changes in the workplace then unnecessary risk to employees would not have occurred. (+info)
Mushroom worker's lung resulting from indoor cultivation of Pleurotus osteatus.
Indoor cultivation of oyster mushroom Pleurotus osteatus lead to an outbreak of extrinsic allergic alveolitis in two workers. High titer of indirect fluorescent antibody and positive precipitins against basidiospores of P. osteatus were demonstrated in sera of the patients. Mushroom workers should protect themselves from the basidiospores, being aware of their pathogenicity. (+info)