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P1.1 STUDY OF RESPIRATORY CONDITION OF WORKERS EMPLOYED IN THE SILICA FACTORY OF HAMADAN IN 2003
R. Shabani1, S. Tavana2, H. Mahjoob2, N. Habibi2, S. Mirarab2, T. Shirmohamadi2.Department Of Nursing, Islamic Azad University, Hamadan, Iran
Introduction: Silicosis is an occupational respiratory disease caused by inhaling respirable crystalline silica dust. This paper reports our survey of the lung condition of all silica grinding workers in Hamadan.
Methods: All workers exposed to silica while working in the glass factory and silica grinding factory were selected as study subjects. The study was cross sectional in design, and sampling was non-probable. A questionnaire on demographic data, respiratory signs and symptoms, and habits was administered. All workers underwent spirometry measurements and chest x ray.
Results: The mean (SD) age of 309 workers was 38.2 (9.8) years, range 16–61 years. Most of these (37.5%) had been exposed to silica dust for 1−5 years, 38.5% had many respiratory signs and symptoms such as cough, sputum, and exercise dyspnoea, and 38.2% smoked. There was a negative relationship between the starting age of smoking and smoking duration with spirometry index, and use of a paper mask had no effect on spirometry index. The type of ventilation in the factory affected forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC).
Conclusions: The research finding revealed that 21% of the workers had both positive radiological and spirometry evidence. The investigation into these cases made it clear that the type of ventilation available in the factories was not standard, a special mask was not available for the workers, and with regard to disposal, sufficient water for the stonebreaking machines was not supplied in the Azandaryan area. As there is a direct relationship between silicosis and some dangerous diseases such as tuberculosis and cancer, periodical examinations, twice a year, to ensure rapid diagnosis and and prevent spread of such diseases, is important. In addition, storing and transportation of the raw materials was not up to standard, which should be corrected as soon as possible. Another factor was the high density of silica dust in the air, which was 5–8 times greater than that permissible (0.5 mg/m3).
P1.2 THE STUDY OF PULMONARY DISORDERS AMONG WORKERS IN AZARAB COMPANY IN ARAK, IRAN
S. Samadi, Bs-eJonaid, A. Chehrai, M. Taheri.Arak University of Medical Sciences, Arak, Iran
Background: There are several agents recognised to cause occupational lung diseases.
Objective: To investigate of pulmonary disorders among workers who work in Azarab Co., Arak, Iran.
Materials and methods: This research was a cross sectional analytical study performed in 2004. The study population comprised workers who worked in the SPP unit in the company as the case group, and workers in the design unit as the control group. Data collection tools included a questionnaire, spirometry, and use of a sampling pump. Of all the workers in these units of the company, 101 of the case group and 47 of the control group participated in this research and completed the questionnaires. Questionnaires were carried out in face to face interviews. Pollution was measured with a sampling pump and filters analysed by atomic absorption. Finally, collection data was analysed by SPSS software.
Results: The lung functions mean including vital capacity (VC), forced VC (FVC), forced expiratory volume (FEV)1, FEV1VC, FEV1FVC, forced expiratory flow (FEF)25–75, and FEF25–75F were lower in the case group than in the control group. The t test results according to lung function indicated a significant difference only in VC, FVC, and FEV1 (p<0.05). The respiratory symptoms reported in the questionnaires (cough, excretion of sputum, tightness, and dyspnoea) were found at a mean (SD) percentage of 25 (24.8)%, 29 (28.7)%, 27 (26.7)%, and 33 (32.7)% respectively in the case group, and 4 (8.5)%, 5 (10.6)%, 3 (6.4)%, and 3 (6.4)% in the control group. The χ2 test results for these were significant (p<0.05). The greatest abnormality found by spirometry in the case and control groups was 23.8% (mild restriction) and 6.4% (mild restriction) respectively, and χ2 test showed a significant difference (p<0.05). Comparing lung function with duration of employment gave a significant difference (p = 0.01; two tailed) only in VC, FVC, FEV1, and FEF25–75.
Conclusion: This research indicated which airborne particles affected the respiratory system. There can be several emphases when dealing with the prevention of occupational lung diseases. Primary prevention, the backbone of prevention of all workplace disease, is best achieved by elimination of exposure.
P1.3 RESPIRATORY STATUS IN CALIFORNIA FARMERS: ASSOCIATIONS BETWEEN AGRICULTURAL DUST EXPOSURES, PULMONARY FUNCTION AND HIGH RESOLUTION CT (HRCT) SCANS
M. B. Schenker1, D. Mitchell1, K. Lee1, D. Shelton1, J. Parker2.1Department of Epidemiology and Preventive Medicine, School of Medicine, University of California, Davis, CA, USA; 2Pulmonary and Critical Care, School of Medicine, West Virginia University, WV, USA
Introduction: The California Central Valley is an area of intensive agriculture and seasonally high levels of inorganic dust. Mixed agricultural dusts are known sources of occupational lung disease. This substudy of the UC Davis Farmer Health Study investigated the respiratory status of farmers working in the valley.
Methods: From a cohort of farm operators who had pulmonary function tests (PFT) in the field in 1995–6, 31 male farmers with below normal lung function (cases) were age and sex matched with farmers of normal lung function (controls). They were reassessed in the winter of 2002–3 using an interviewer administered questionnaire, PFT including diffusion and lung volumes, and high resolution computed tomography (HRCT) scans of the chest.
Results: Mean (SD) age of farmers was 66.9 (11.2) years, and 79% (n = 49) were still farming. Of the group, 32% had an forced expiratory volume in 1 second (FEV1) below 80% predicted, 24% had forced vital capacity (FVC) below 80% predicted, and 40% FEV1/FVC below 0.7. HRCT scores for airway pathologies ranged from 0 (no abnormalities) in 56.5% to 23 (maximum possible 54), and scores for interstitial abnormalities ranged from 0 (85.5%) to 7 (maximum possible 72). Cases performed significantly less well than controls in FEV1, FVC, FEF25–75 and diffusion capacity (DLCO), (p<0.025), but there was no significant difference in lung volumes. Similarly, with HRCT cases had significantly (p<0.05) more pathology for airway disease, but there was no significant difference in interstitial scarring. Univariate associations were found between HRCT identified airway disease and PFT measures of airflow obstruction, and also with age or smoking status. Among cases, there was an association between dust exposure and CT airway score (p<0.05), FEV1 and FEV1/FVC (p<0.05), but no association was found between dust exposure and pulmonary function or HRCT scarring.
Conclusions: There was good correlation between HRCT measures of airway disease and pulmonary function tests, but little evidence of interstitial disease either in farmers with lower lung function or those with normal values.
P1.4 INCIDENCE OF MESOTHELIOMA IN NEW SOUTH WALES (NSW), AUSTRALIA
A. Johnson1, M. Tan1, S. Ware1, G. Berry2, G. Marks3, D. Yates1.Workers’ Compensation (Dust Diseases) Board, Sydney, NSW, Australia; 2G.Berry Consulting, Sydney, NSW, Australia; 3Woolcock Institute of Medical Research, Sydney, NSW, Australia
Introduction: Australia has been one of the highest users of asbestos per capita in the world.
Methods: We report the incidence of MM in NSW for the last 15 years and compare these data with other published figures. The numbers of incident MM cases from 1985–2001 were sourced from the Australian Mesothelioma Surveillance Program, Australian Mesothelioma Register, NSW Central Cancer Registry, and Dust Diseases Board.
Results: The incidence of mesothelioma in NSW continues to increase. The commonest industry in which cases reported asbestos exposure was the building industry (21%).
Conclusions: The incidence rate in males in NSW (4.5/100 000/year) is among the highest in the world. Asbestos was widely used up until the 1970s in NSW, meaning the incidence of mesothelioma is likely to continue to increase.
Acknowledgement: Supported by the Workers Compensation (Dust Diseases) Board.
P1.5 A PROSPECTIVE STUDY OF WORKERS’ RESPIRATORY HEALTH AND INDOOR AIR QUALITY IN POULTRY OPERATIONS
A. Senthilselvan1, J. Feddes2, N. Cherry1, J. Beach1, A. Bentham1, C. Ouellette2, I. Wenger1, P. Willson3, V. Juorio1.1Department of Public Health Sciences, Canada; 2Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada, 3VIDO, University of Saskatchewan, Saskatoon, Canada
Introduction: In Canada, the majority of poultry is raised in totally confined buildings in which workers are exposed to indoor airborne contaminants. Previously, no studies have been conducted to evaluate respiratory health and air quality changes as a function of flock age.
Methods: Within a 200 km radius of Edmonton, 20 layer and 15 broiler operations were chosen. Each broiler operation was visited a total of four times: twice during the early and latter parts of the 6 week production cycle in both winter and summer. Egg layer operations were visited three times during the early, middle, and latter parts of the 40 week production cycle. Detailed respiratory health and acute symptom questionnaires were administered, and pre-shift and post-shift pulmonary function measurements were determined during each visit. Each worker carried a personal environmental sampling backpack (PESB II) throughout the work shift for continuous environmental measurements
Results: In the prospective study, 70% of the planned visits have been completed. Mean (SD) dust and endotoxin concentrations from personal sampling were 3.69 (2.14) mg/m3 (range 0.34 to 9.40) and 7639.3 (5351.7) EU/m3 (range 884.0 to 25 096.9) respectively. Broiler operations had slightly higher mean dust concentrations than layer operations. Mean (SD) age of the 29 workers who had at least one visit completed was 39.3 (11.3) years. Most commonly reported chronic respiratory symptoms were phlegm production (37.9%) and wheeze with cold (27.6%). Mean post-shift pulmonary function tended to be lower than pre-shift, but the differences were not statistically significant.
Conclusion: Results from the initial analysis indicate that workers in broiler and layer poultry operations were exposed to higher levels of dust and endotoxins. The association between these exposures and acute and chronic respiratory health will be explored in the final analysis.
P1.6 CHRONIC RESPIRATORY HEALTH EFFECTS AMONG CEMENT FACTORY WORKERS IN A DEVELOPING COUNTRY: EFFECTS OF CUMULATIVE DUST EXPOSURE
J. Mwaiselage1, M. Bråtveit1, B. Moen1, Y. Mashalla2.1Section for Occupational Medicine, University of Bergen, Bergen, Norway; 2Department of Physiology, Muhimbili University College of Health Sciences, Dar Es Salaam, Tanzania
Introduction: Several studies have been carried out to evaluate the association between occupational cement dust exposure and respiratory disorders. However, the effects of cumulative dust exposure have not been analysed thoroughly.
Methods: This cross sectional study included all male production workers (n = 126) from six sections, maintenance workers (n = 88), and office workers (n = 32). Respiratory symptoms and information on demographics, work history, and smoking habits were collected with a self administered questionnaire. Ventilatory functions of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) were also assessed. Personal sampling of total dust (n = 120) was carried out from 80 randomly selected workers with a 37 mm Millipore sampler. Cumulative total dust exposure for each worker was calculated as the sum of the products of geometric mean dust concentration and the years worked in a specific work area.
Results: The overall response rate was 94.7%. The geometric mean of total dust exposure was higher in the crane (38.6 mg/m3), packing (21.3 mg/m3), and crusher (13.5 mg/m3) sections than in the cement mill (3.2 mg/m3), kiln (2.9 mg/m3), raw mill (1.8 mg/m3), maintenance (1.2 mg/m3), and administration block (0.3 mg/m3). The overall cumulative total dust exposure ranged 0.3–926.4 mg/m3 year. Cumulative dust exposure was significantly associated with reduced FVC (0.8 ml/mg/m3 year), FEV1 (1.7 ml/s/mg/m3 year) and PEF (1.5 ml/s/mg/m3 year). Cumulative total dust exposure of >300.0 versus <100.0 mg/m3 year was significantly associated with airflow limitation (adjusted odds ratio (OR) = 9.9), chronic cough (3.6), chronic sputum production (6.7), dyspnoea (4.8), wheezing (6.9), chronic bronchitis (4.6), and COPD (7.5).
Conclusions: The results indicate an exposure–response relationship between cumulative total cement dust exposure and chronic respiratory disorders.
P1.7 PREVALENCE OF RESPIRATORY SYMPTOMS AMONG WORKERS IN INDUSTRIES OF SOUTH TEHRAN, IRAN, IN 2003
M. Ghasemkhani1, S. Firouzbakhsh2.1Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; 2Division of Pulmonary Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Objective: To determine the prevalence of respiratory symptoms from occupational exposures among workers in industries of south Tehran, Iran.
Methods: This was a cross sectional study in which 880 workers were studied by multistage random sampling. Data were collected via a questionnaire containing items on demographic characteristics, cigarette smoking, occupational history, and respiratory symptoms.
Results: The mean (SD) age of the workers was 38.5 (10.2) years; range 19–70 years. Of 880 workers under study, 260 (29.5%) were smokers. It was observed that 70% of workers were exposed in the workplace to chemical agents such as dust, gas, and smoke pollutants. The prevalence of respiratory symptoms were cough (20%), morning phlegm (41%), breathlessness (41.7%), feeling of tightness (24%), and nose irritation (23.5%).
Conclusions: The high percentage of dust and gas exposures among workers in industries of south Tehran may cause respiratory symptoms and pulmonary damage. Engineering controls and industrial hygiene are recommended.
P1.8 RESPIRATORY SYMPTOMS AND PULMONARY FUNCTION IN PAPER RECYCLING WORKERS
C.-HLin, L.-MLin1, H.-WKuo1, W.-MLiang1.Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Taiwan; 1Institute of Environmental Health, China Medical University, Taichung, Taiwan
Objective: To assess the respiratory symptoms and pulmonary function of four types of workers in a paper recycling plant in central Taiwan.
Methods: A total of 321 workers were included in the study. All workers’ respiratory symptoms were evaluated using the American Thoracic Society (ATS) questionnaire, and pulmonary function was also assessed using a dry spirometer, based on the ATS criteria. The same trained assistant performed all measurements.
Results: The workers’ exposure to paper dust was very low. Levels of fine particles were highest in the paper machine area, and coarse particle concentration was highest in the pulping process area. Using multiple logistic regression analysis, we found that administrative workers had the highest risk of developing respiratory symptoms, compared with the other job types. Smoking level (packs/year) and work duration were dose dependently related to risk of respiratory symptoms. However, the latter association was non-significant. The predicted forced vital capacity values found in a review of the literature were generally 20% higher than those found in the current study. The prevalence rates of pulmonary abnormalities were highest among administrative workers compared with the other job types, and were dose dependently related to work duration, although these associations were not significant.
Conclusions: A large proportion of workers had respiratory symptoms despite the relatively low paper dust levels. This may be attributed to lifestyle habits in the workplace, such as smoking. The authors recommend, therefore, that paper recycling plants be made smoke free workplaces.
P1.9 TUBERCULIN SKIN TEST POSITIVE CONVERSION RATE IN HEALTH CARE PERSONNEL AND HEALTH SCIENCE STUDENTS AT SRINAGARIND HOSPITAL, THAILAND
N. Chaiear1, J. Buapeun2, N. Saejiw3, W. Reechaipichitkul4, W. Boonsawas4.1Unit of Occupational Medicine, Department of Community Medicine, Thailand; 4Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Thailand; 2Infectious Control Unit, Srinagarind Hospital, Khon Kaen, Thailand; 3Institute of Allied Health Science and Public Health,Walailak University, Nakon Sri-Thammarat, Thailand
Introduction: The HIV/AIDS epidemic in Thailand has made possible the re-emergence of tuberculosis (TB). The emergence of antibiotic resistant TB strains exacerbates this serious public health concern. Healthcare personnel are at greatest risk. The tuberculin skin test (TST) was studied to determine overall incidence and the conversion rate of TST positive healthcare personnel and health science students.
Methods: A prospective study was conducted at Srinagarind Hospital between 2001 and 2003 among consenting healthcare personnel and health science students. Participants were evaluated through questionnaire, TST, chest radiograph, and sputum examination. Reaction to the TST was carried out with PPD-TRC (from the Thai Red Cross) using the Mantoux technique. TST conversion was defined as a subject with an initial negative and a subsequent positive result.
Results: In 2001, 774 healthcare personnel and 96 health science students had a negative TST. Of these, 201 (26.0%) healthcare personnel and 81 (84.4%) health science students had a follow up test in 2003; 28 and 5 of these, respectively, were positive. The resulting conversion rate was 16.2% (95% confidence interval (CI) 12.4% to 25%) and 6.8% (0.9% to 12.8%), respectively. Overall, 196 healthcare personnel and 24 health science students had a positive TST between 2001 and 2003. The incidence density of TST positives in healthcare personnel was 12.9 per 100 person years (95% CI 11.2 to 14.9) and 4.05 per 100 person years (95% CI 2.6 to 6.0) in health science students. A chest radiograph was performed on 134 healthcare personnel and three health science students in 2003; pulmonary TB was indicated in two.
Conclusion: The incidence and conversion rate of TST was significantly higher among healthcare personnel than health science students. Healthcare personnel working at the university hospital were at greater risk of tuberculous infection. To lower the risk, appropriate preventive measures must be applied.
P1.10 PREVALENCE OF VENTRICULAR AND SUPRAVENTRICULAR PREMATURE BEATS WITH 24 HOUR HOLTER ELECTROCARDIOGRAPHY IN HEALTHY JAPANESE WORKERS
T. Tai, K. Iwasaki, T. Sasaki.Department of Work Stress Control, National Institute of Industrial Health, Kawasaki, Kanagawa, Japan
Introduction: Many Japanese workers tend to think of themselves as healthy. As a result, they do not notice the importance of their health until they lose it. For example, long working hours can lead ultimately to karoshi (death from overwork). Thus, we need to promote the importance of maintaining health. In the workplace, resting electrocardiograms (ECGs) are often performed. However, these ECGs are short duration, thus their ability to detect arrhythmias is minimal. Longer ECG recordings can increase the possibility of detecting arrhythmias and encourage workers to look after their health. There are few data on healthy workers given 24 hour Holter ECGs. This paper reports a preliminary investigation on 105 healthy workers to clarify the prevalence of arrhythmias with 24 hour Holter ECGs and to clarify whether long ECG recordings promote better health.
Methods: We recorded a 24 hour Holter ECG for each of the 105 workers aged 20–62 years using a cardiomemory RAC-102 (Nihon Kohden Co., Ltd. Japan). Data were then analysed with an electrocardiograph analysing system DSC-3100 (Nihon Kohden Co., Ltd, Japan).
Results: The prevalence of isolated ventricular (VPBs) and supraventricular premature beats (SVPBs) was 62.9 and 85.9%, respectively. The prevalence of isolated VPBs was higher than that reported previously; however, the number of isolated VPBs and SVPBs in the vast majority of workers was <10 per 24 hours. The number of isolated VPBs was similar to that found in other studies. Long ECG recording encouraged workers to think of their health because they were aware of the results of the 24 hour ECG recording and thus had more interest in their health.
Conclusions: Long ECG recording may lead to improvement in work health.
P1.11 ERGONOMIC EVALUATION OF DRUDGERY REDUCING TECHNOLOGIES FOR WOMEN IN AGRICULTURE THROUGH HEART RATE AND PERCEIVED EXERTION
S. Hasalkar, R. Budihal, R. Shivalli, N. Biradar.All India Co-ordinated Research Project-Family Resource Management, College of Rural Home Science, University of Agricultural Sciences, Dharwad, Karnataka, India
Introduction: Indian agriculture is a labour intensive industry, and the majority of the population is dependent on agriculture. Rural women in India are the major labour force in agriculture. They perform almost all agricultural activities, from sowing up to harvesting and post-harvest activities. Under the All India Coordinated Research Project on Ergonomics of Farmwomen’s Drudgery, research was conducted to assess the drudgery of farm women and to evolve tools/techniques to increase the efficiency of the women.
Methods: Thirty healthy women of 25–35 years of age, performing agricultural activities regularly, were selected for the study. Heart rate, energy expenditure, and the perceived exertion by the farm women were the parameters used to evaluate the drudgery of selected farm activities experienced by the farm women with existing and improved tools and techniques.
Results: The results revealed that the physiological cost of work for farm women while weeding with an improved weeding tool was reduced (by 0.84 beats/min) compared with weeding with the traditional tool (‘saral kurpi’). The top dressing of fertiliser activity showed 2.07 beats/min reduction while working with the improved fertiliser trolley compared with the existing method. The incidence of musculoskeletal problems was reduced and the grip strength was improved with the use of improved tool/techniques. The work output increased significantly while performing the weeding activity with the improved tool, the saral kurpi. Farm women expressed significantly lowered perceived exertion while performing the selected farm activities with the improved tool/technique compared with the use of traditional tools.
Conclusion: In today’s agricultural situation, women are in need of such improved agricultural tools, which can reduce the circulatory stress and physiological cost of work and increase their efficiency and work output. Only this can help women to be released from the drudgery and become the primary partners in agricultural development.
P1.12 MYOCARDIAL INFARCTION RISK AMONG TRUCK DRIVERS
V. Malinauskiene, A. Azaraviciene.Institute of Cardiology Kaunas University of Medicine, Kaunas, Lithuania
Introduction: Studies in Western societies have confirmed that professional drivers are at increased myocardial infarction (MI) risk, although the exact reasons have not yet been elucidated.
Objective: To investigate the effect of occupational and lifestyle risk factors on the risk of first MI among professional truck drivers.
Methods: We conducted a case–control study among men aged 25–64 years who were residents in Kaunas in 1997–2000. We identified MI cases (n = 448) from the MI hospital register and controls (n = 1777) without clinical diagnosis of ischaemic heart disease. We obtained information on potential MI risk factors through a personal interview using standardised questionnaires for both groups. We interviewed 60 truck drivers in the case group and 108 controls. We used the Swedish version of the demand–control questionnaire to assess the effect of job strain on first MI risk. We conducted the logistic regression analysis to evaluate the adjusted odds ratios (ORs) for definite risk factors for truck drivers.
Results: We found that age adjusted OR of MI for truck drivers was 2.36 (95% confidence interval; 1.67 to 3.35). After adjustment for education, smoking, arterial hypertension, and obesity, the OR of MI was 2.26 (1.58 to 3.24). After adjustment for job strain it decreased to 1.8 (0.96 to 5.22). The logistic regression analysis within the subgroup of professional drivers showed that the adjusted OR of MI for arterial hypertension was 3.20 (1.57 to 6.55). The adjusted OR for smoking was 2.48 (1.12 to 5.49), and for job strain 2.91 (1.23 to 6.98).
Conclusions: We found that occupational and lifestyle risk factors influence the increased risk of MI among truck drivers.
P1.13 EFFECT OF WORK WITH OCCUPATIONAL SOURCES OF 50 HZ ELECTRIC AND MAGNETIC FIELDS ON CARDIOVASCULAR DISEASES
L. Fatkhutdinova, R. Zalyalov, Z. Bercheeva, V. Goloviznin, N. Amirov.Department of Hygiene and Occupational Health, Medical University, Kazan, Russian Federation
Introduction: Sources of power frequency electromagnetic fields (EMF) are widespread. There are only a limited number of studies dealing with a link between exposure to 50 Hz EMF and cardiovascular diseases. Recently published studies123 have failed to provide consistent results.
Methods: The study base consisted of workers employed at different enterprises. In 2000–2004 they underwent periodical medical examination at a large regional occupational diseases centre. The computerised database contains personal data (name, sex, age), current occupation, description of work factors, and disease codes according to IDC-10 for 6439 persons; mean (SD) age 40.3 (9.9) years. The study group included 4487 men (69.7%) and 1952 women (30.30%); mean (SD) age 39.6 (10.6) and 41.9 (7.9) years, respectively. In a cross sectional study, the prevalence of major groups of cardiovascular diseases was investigated. Two experts estimated possible occupational exposure to 50-Hz EMF: yes or no. Generalised linear/nonlinear models were used to calculate adjusted odds ratio; exposure to 50 Hz EMF, sex, age, and their interactions being included in the model.
Results: Workers exposed to 50 Hz EMF had slightly (but significantly) excess risk of arterial hypertension (adjusted OR 1.49 (95% confidence interval 1.07 to 2.07) for men and 1.23 (1.04 to 1.45) for women); chronic coronary heart disease (adjusted OR 1.28 (1.01 to 1.62)), and vein diseases (adjusted OR 1.64 (1.24 to 12.16)).
Conclusions: The results obtained have shown that occupational exposure to 50 Hz EMF might be a risk factor for arterial hypertension, coronary heart disease, and vein diseases. Sex differences were found; risk of arterial hypertension was higher for men than for women.
P1.14 UTILITY OF NAILFOLD CAPILLARY MICROSCOPY IN THE EARLY DIAGNOSIS OF VIBRATIONS MICROVASCULAR DISEASE
V. Cupelli1, M. Massi1, V. Ciuti1, P. Catalano2, G. Arcangeli1.1Department of Occupational Medicine, University of Florence, Italy; 2Occupational Medicine USL 9, Regione Toscana, Italy
Introduction: Morphological evaluation of the microvascular system with nailfold capillary microscopy is useful for obtaining information either on patients attending angiology clinics or on workers exposed to vibration without clinical symptoms.
Methods: In the study, 88 workers (mean (SD) age 47.1 (7.71) years and working age 20.4 (8.3) years), who used vibrating tools, were included. Using a questionnaire, data about clinical history, actual symptoms, type of vibrating tools, and working conditions were collected, and nailfold capillary microscopy was used to assess morphological and functional microvascular abnormalities. Based on the results, subjects were divided into two groups: 33 workers with occupational microvascular disease and 55 subjects with occupational exposure to handheld vibrating tools.
Results: Comparing the group of pathological workers with the group of vibration exposed subjects, the observed nailfold capillary abnormalities were greater in the first group, although some abnormalities were also present in asymptomatic subjects or in workers with <10 years’ vibration exposure time. Some subjects, although exposed to “low vibration dose”, presented microvascular abnormalities, thus it may be supposed that a small percentage of workers are hypersensitive.
Conclusions: Nailfold capillary microscopy is, therefore, a useful method for monitoring vibration exposed workers to obtain an early diagnosis and to pinpoint hypersensitive subjects who should not work with vibrating tools.
P1.15 SENSORY PERCEPTION: AN OVERLOOKED TARGET OF OCCUPATIONAL EXPOSURE TO INDUSTRIAL CHEMICALS
F. Gobba.Chair of Occupational Medicine, Department of Hygiene, University of Modena and Reggio Emilia, Modena, Italy
The effect of industrial chemicals on the sensory perception of exposed workers has received scant attention from the medical community to date, and the scientific literature is mainly limited to some case reports or isolated studies. Possible explanations for this include the complexity of sensory perception, and the lack of agreement among researchers on methods for testing large groups of subjects. Nevertheless, despite the difficulties in research, some experimental and epidemiological studies show that vision, hearing, and olfactory function can be affected by chemicals, and some data exist also for touch and taste. As an example, metals such as lead, manganese, and mercury, and solvents such as carbon disulphide, ethanol, n-hexane, styrene, tetrachloroethylene, and toluene can affect visual function. Metals such as arsenic, lead, manganese, mercury, and platinum, and also solvents such as carbon disulphide, n-hexane, styrene, toluene, trichloethylene, and xylene can have a direct effect on hearing and/or induce a synergistic effect with noise in inducing hearing impairment. Olfactory function may be damaged by exposure to metals such as cadmium, chromium, manganese, mercury, and nickel, by organic solvents such as acetone, benzene, carbon disulphide, toluene, trichloethylene, and xylene, or by inorganic compounds as ammonia and chlorine. Lead, mercury, organophosphates, styrene, and xylene can impair touch. Cadmium, lead, and mercury, and solvent mixtures may induce a reduction in taste perception. The pathogenesis of the toxicity of chemicals to sensory perception may be related to an action on receptors, nerve fibres, and/or the brain, but the pathogenetic mechanisms remain to be elucidated.
Conclusions: Even though an existing body of evidence shows that occupational (and also environmental) exposure to chemicals can affect sense organs, knowledge is incomplete, and largely inadequate for an estimation of a “safe” threshold of exposure. Further research in this field is certainly necessary, especially on the effect of co-exposures, on the “global” impact on different senses, and on the pathogenesis.
P1.16 BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) POLYMORPHISM ASSOCIATED WITH INCREASED SYMPTOM REPORTING AMONG MERCURY EXPOSED DENTAL PERSONNEL
N. J. Heyer1, D. Echeverria1,2, J. S. Woods1,2, A. C. Bittner1,2, F. M. Farin2.1Battelle CPHRE, Seattle, WA, USA.; 2Department of Environmental Health, University of Washington, Seattle, WA, USA
Introduction: We hypothesised an association between brain derived neurotrophic factor (BDNF) polymorphism and increases in self reported symptoms among dental personnel exposed to mercury.
Methods: The study comprised 193 male dentists and 230 female dental assistants exposed to mercury. DNA buccal cell samples were collected and analysed for the presence of a previously identified single nucleotide polymorphism at nucleotide 196 (G→A), which produces a valine to methionine substitution at codon 66 (V66M). Mercury exposure was evaluated by work history and using mercury concentrations in spot urinary samples. A self administered computerised questionnaire was used to collect information on severity, frequency, and duration for 45 self reported symptoms. A priori grouping resulted in 11 current symptom groupings, and 12 recent or chronic symptom groupings. Separate regression analyses were conducted for dentists and dental assistants to evaluate the independent effects of BDNF category and Hg exposure, controlling for age, race, alcohol and tobacco use, and medical history.
Results: Genotyping results identified 68% WT, 28% Het, and 4% Mut within this population. There were 10 significant (p<0.10) associations between BDNF and symptoms: seven dental assistants and three dentists. All were in the expected direction. There were 12 significant associations between chronic mercury exposure based on work history and symptoms: nine dental assistants and three dentists (one in the unexpected direction). Acute urinary mercury did not show a strong pattern of associations with symptoms. There were no significant interactions between BDNF status and chronic mercury exposure for symptoms. Dominant symptoms included memory, coordination, depression, and anxiety.
Conclusions: These results confirm that the frequency and severity of self reported symptoms are increased among people with BDNF variants and with chronic mercury exposure, and that BDNF status may be useful as a measure of susceptibility. Symptoms clustered around problems that are consistent with those previously reported for both BDNF and mercury related health effects.
Acknowledgement: Supported by ES04696 and ES07033.
P1.17 PREVALENCE AND TYPOLOGY OF WORKAHOLIC WORKERS
F. Deschamps, B. Signoret.Department of Occupational Health, Faculté de Médecine, Reims, France
Introduction: Work addiction has been identified as a serious and legitimate type of compulsive disorder. It has become a common word: “workaholic”.
Objective: To evaluate the prevalence of workaholism and to identify the typology of the workaholic workers.
Methodology: Non-selected managerial staff completed an anonymous questionnaire, including an adapted version of the Robinson Work Addiction Risk Test, during the annual occupational medical examination. This inventory for which 15 responses were made on a 4 point scale had adequate test–retest reliability. Individuals with score results <30 were considered as non-workaholic, between 31 and 45 borderline, and workaholic >46 points.
Results: From the total of 463 workers included in the study and belonging to various industrial branches, there were 447 usable responses. Sixteen individuals refused to participate in the study. Of the subjects who participated, 78% were male, mean age was 43 years, and 5% were workaholic with a mean score of 48.3 points. The workaholics suffered more frequently than the other managerial staff group from lower back pain and sleeplessness. They used large amounts of anti-anxiety medications.
Discussion: The results showed a relationship between workaholism and poorer physical wellbeing. It is probably possible to maintain levels of work enjoyment while simultaneously reducing the feeling of being driven to overwork. This represents an interesting personal and organisational challenge for future consideration.
P1.18 SELF REPORTED HEALTH IN MEAT PROCESSING INDUSTRY WORKERS IN BRITTANY, FRANCE
C. Cohidon1, P. Morisseau2, F. Derriennic1.1Department of occupational health, Institut de Veille Sanitaire, Saint-Maurice, France; 2Mutualité Sociale Agricole du Morbihan, Vannes, France
Introduction: Meat processing industry workers (beef, pork, and poultry slaughtering and cutting processes) are exposed to many difficult working conditions such as cold temperature, noise, and repetitive musculoskeletal movements.
Objective: To describe, in this population, the physical and psychological components of self reported health and their associations with psychosocial and factual working conditions.
Methods: A questionnaire was sent to 6000 meat processing industry workers in the four French departments of Brittany. The questionnaire contained sociodemographic, behavioural factors and job characteristics. Psychosocial factors at work were evaluated using the Karasek questionnaire (psychological demand, decision latitude, and social support at work) completed by a few questions on satisfaction about pay, perspective of promotion, and satisfaction about quality of work. Self reported health was explored as health outcome, with the Nottingham Health Profile (NHP). Men and women were analysed separately.
Results: Participation rate was about 50%. Women had systematically higher mean scores than men for each dimension of the NHP. Significant associations were observed between high demand and high score for all domains of the NHP for women, and for emotional reactions, energy, and social isolation for men. Low latitude decision and low social support were associated with emotional reactions for both sexes and with social isolation, sleep, and energy in women. Poor satisfaction about job quality was associated with high score of pain, emotional reactions, and energy for both sexes. In men only, a high score in most domains of NHP was associated with the lack of prospect of promotion (data are still under analysis).
Conclusion: This study highlights poor self reported health among the meat processing industry workers in Brittany, France, compared with other results from the French working population. In this population, most domains of the NHP are strongly associated with psychosocial factors at work such as an important psychological demand, low latitude decision, low social support, and poor satisfaction about quality of work, and women are particularly vulnerable.
P1.19 FAIRNESS AND JOB STRAIN: EXPOSURES TO BOTH AMONG LICENSED PRACTICAL NURSES IN BC NURSING HOMES
A. Ostry1, M. Cohen2.1Department of Healthcare and Epidemiology, University of British Columbia, Vancouver, Canada; 2Hospital Employees’ Union of British Columbia, Vancouver, Canada
We surveyed 310 licensed practical nurses and care aides working in eight long term care institutions located in Vancouver, Canada. Response rates averaged 70% across the eight worksites. We conducted a complete literature search of the job strain and related literature in order to identify survey instruments for possible adaptation for use in this workforce. We also conducted a series of intense focus groups with workers and managers to better understand the work conditions and broad workplace issues likely to contribute to job strain and other adverse physical and psychosocial work conditions. We combined results from the literature search and focus groups to develop a research instrument that measured the work conditions at these eight work sites. Using factor analysis, we identified two factors that we labelled “fairness” and “support”. Using the items that made up these two factors, as well as items measuring classical (Karasek) job strain, we used logistic regression analyses to compare the impact of these factors on job satisfaction, self reported health status, and pain. We found that while high job strain and “unfairness” produced statistically significant associations with all the outcomes, a combination of “unfairness” and “high job strain” produced stronger associations.
P1.21 STUDY OF THE SOCIAL AND OCCUPATIONAL DETERMINANTS OF PSYCHOLOGICAL DISTRESS AT WORK: SURVEY OF 231 SERVICE EMPLOYEES
S. Fanello, E. Parot.Département Universitaire de Santé Publique, UFR Médecine, 49045 Angers cedex 01, France
Introduction: The objectives of this work were to assess the extent of psychological distress among employees of a service company in the district of Maine-et-Loire and to assess the risk factors and moderators of this distress in order to develop effective prevention measures.
Population and methods: A random sampling, stratified by job categories, selected the 310 employees necessary for this survey. The questionnaire included five sections: social and occupational data (27 items); 14 questions about “stress moderators” (Duke Social Support Index), leisure activities and health behaviours; the General Health Questionnaire (GHQ) 12; and 60 questions about the individual’s perception of the work environment, divided into nine subsections (perceived workload, predictability of work, autonomy, recognition, social support at work, fairness at work, perception of the company’s values, and training). The data were collected on an anonymous and confidential basis. SPSS™ software (version 10.1) was used for data analysis, including both univariate (Pearson’s χ2, one way analysis of variance, correlation) and multivariate (logistic regression) analyses.
Results: The response rate was 75%. The 231 respondents were representative of the company for sex, age, and job groups. The mean (SD) GHQ 12 score was 12.7 (6.1). Psychological distress (score >12/36) was noted among 41.6% of respondents. After logistic regression, the principal social determinants of psychological distress were age (> 40 years, p = 0.004), sex (women, p = 0.02), transportation difficulties (p = 0.055), sedative use (p = 0.009), and job group (with management as the reference category, p = 0.006). Of the job related determinants, only autonomy at work remained significant after logistic regression, most especially control over work pace (p = 0.013). Multivariate analysis found two items among the stress moderators to be related to psychological distress: meeting with friends less than once a month (p = 0.009) and not having laughed hard during the previous week (p = 0.009).
Discussion and conclusion: Psychological distress is high in this company. Prevention activities to reduce or eliminate the risk factors must directly affect the environment and the work source (changes will require appropriate training, participatory management, and the development of more equitable policies). It is also necessary to help the employees by offering them relaxation activities or opportunities for discussion where they can express their points of view about work. The occupational physician must manage this rehabilitation, the process of return to work, and the follow up of individuals who have or have previously had mental health problems.
P1.22 PSYCHOSOCIAL FACTORS AT WORK, DEPRESSION, AND CARDIOVASCULAR RISK FACTORS IN A WORKING POPULATION OF MEN AND WOMEN: THE IHPAF CASE–CONTROL STUDY
S. Radi1, T. Lang1, V. Lauwers-Cancès1, G. Chatellier2, LyndaLarabi3, R. De Gaudemaris3.1Unité INSERM 558, Toulouse, France; 2Département d’Informatique Hospitalière, Hôpital G Pompidou, Paris, France; 3Service de Médecine et Santé au Travail, CHU, Grenoble, France
Objective: To examine the relationship between organisational constraints at work (psychological demand, decision latitude, and social support at work), depressive symptoms, and cardiovascular risk factors (obesity, smoking, alcohol consumption, and sedentary behaviours).
Methods: The study was conducted among 426 men and 183 women selected from a cohort study designed to examine the relationship between behaviours and incident hypertension. Twenty volunteer occupational physicians included 203 cases on their 739 incident hypertensive subjects and matched each case for age (±10 years) and sex with two controls.
Results: In men, low decision latitude was related to high alcohol consumption (odds ratio (OR) 2.75; 95% confidence interval (CI) 1.36 to 5.59). In women, low social support at work was associated with obesity (OR 15.65; 95% CI 4.28 to 57.20). In both genders, low social support at work was significantly related to depressive symptoms (OR 2.34; 95% CI 1.08 to 5.05 in men, and 9.31; 95% CI 2.08 to 41.74 in women). Men who reported depressive symptoms were less likely to be obese (0.2% v 9.2%; p<0.0001) and more likely to have sedentary behaviours (72.7% v 56.0%; p = 0.03) than those who did not report depressive symptoms.
Conclusions: Our results support the hypothesis that the link between organisational working conditions and behaviours on the one hand and depression on the other hand might explain the relationship with cardiovascular disease. These occupational factors may have different effects in men and in women.
P1.23 WHAT PREVENTIVE MEASURES COULD PROTECT HEALTHCARE WORKERS FROM SARS?
W. Q. Chen1, T. W. Wong2, W. H. Ling1, C. Y. Lu1, Y. T. Hao1, Q. Liu1, J. Q. Fang1, Z. N. Lin1, Y. He1, F. T. Luo1, J. Jing1, L. Ling1, X. Ma1, Y. M. Liu1, G. H. Chen1, J. Huang1, Y. S. Jiang1, W. Q. Jiang1, H. Q. Zou1, G. M. Yan1.1Sun Yat-sen University, Guangzhou, China; 2 The Chinese University of Hong Kong, Hong Kong, China
Introduction: Health care workers (HCWs) were at high risk of contracting severe acute respiratory syndrome (SARS) during the epidemic in Guangzhou from November 2002 to May 2003. We explored risk factors for SARS transmission among HCWs and assessed the effectiveness of preventive measures they used during the outbreak.
Methods: We conducted a self administered questionnaire survey of 1147 HCWs working in the frontline in three hospitals that cared for SARS patients in Guangzhou from mid May, 2003. We collected data on their demographic characteristics, history of subsequent SARS, use of protective measures, and health related behaviours during the period of the epidemic. We used logistic regression analysis to determine the odds ratios of protective clothing (wearing face shield/eye wear, masks and gloves), demographic variables, history of caring for seriously ill SARS patients, air ventilation in the wards and offices, and personal hygiene practices.
Results: A total of 90 HCWs among our study subjects subsequently developed SARS. The risk of infection was positively and significantly associated with a history of caring for seriously ill patients and contact with patients face to face when providing care. Protective factors included washing hands using an automatic tap, wearing face shield/eye wear, and wearing double gloves while working.
Conclusions: The use of face-shields/eye wear and double gloves, and washing hands using an automatic tap were protective factors while caring for seriously ill patients, and a history of face to face contact with patients while working were risk factors for contracting SARS among HCWs in hospitals in Guangzhou.
P1.24 INFLUENCE OF HYGIENE BEHAVIOUR ON NICKEL EXPOSURE AMONG NICKEL PROCESSING PLANT WORKERS IN INDONESIA
J. Spickett, N. Furgaan, K. Rumchev.School of Public Health, Curtin University of Technology, Perth, WA
Introduction: Some nickel compounds may enter the body and induce health impairment among exposed workers. Results of studies indicate that chemical concentrations of nickel in the blood and urine as a result of occupational exposure is associated with the hygiene behaviour of workers. The study was conducted in a nickel processing plant in Indonesia.
Hypothesis: Improvement in hygiene behaviour is associated with reduced serum and urine nickel concentrations among exposed workers.
Objective: To evaluate the influence of changes in hygiene behaviour on nickel exposure, and to assess the effectiveness of three worksite education strategies aimed to reduce occupational nickel exposure.
Methods: A quasi-experimental study was conducted to improve the hygiene behaviour of workers and to evaluate the effectiveness of worksite health education intervention programmes. The study subjects were grouped into three groups according to the type of intervention programme implemented: (a) booklet only; (b) booklet and lectures on nickel exposure; (c) booklet, lectures, and feedback. During the study the nickel concentrations in air dust, urine, and blood were measured.
Results: The study results demonstrated a significant increase in knowledge, behaviour, and attitude among workers during the post-intervention assessment compared with the pre-intervention period, with the highest improvement established among the third intervention group, which included booklet, lectures, and feedback. Furthermore, the study established a significant difference in urine and serum nickel concentrations before and after the intervention.
P1.25 DATABASES AND STATISTICS ON WORK ACCIDENTS IN BRAZIL: EVALUATION ISSUES AND CHALLENGES AHEAD
C. Salim.Fundacentro/Ministry of Labor and Employment, Belo Horizonte, Minas Gerais, Brazil
Introduction: In Brazil, the statistics on work accidents are known to be partial and limited. This situation arises because such information is a subproduct of federal administrative registers and other databases and not a result of national research on a population basis. For this reason, the statistics often have several problems in relation to data quality and historic consistency. This can lead to problems of reliability, lack of representativeness regarding temporal and geographic distributions, absence of information regarding informal work, and aggregations converging with similar information. In fact, immediate and specific questions are often unsolved, such as the different profiles about modalities of work accidents. In these statistics, work diseases usually have identification problems and have been very undernumerated.
Method: The following administrative records were examined: Mortality System, Hospital Internment Authorization Occupational Injuries Report, General Cadastre of Employment and Unemployment, and the Annual Social Information Relation. Through data extraction for each tabulator, tables were generated and analysed, verifying the data coherency and completeness of data field. Using statistical package programs, discrepancies weren detected when modelling the databases relating to “occupational injuries”.
Results: Structurally, when the same tabulator is used, variables are able to be more integrated, even when informatics resources, inconsistencies, and no convergence of variables are frequently present. There are also problems with time references, as, for example, day of accident, or day of retirement. In some cases, the place of accident is reported to be the headquarters of the company, and age classes are different between the databases, all of this making for more difficult adjustments and less accurate estimates.
Conclusions: Some inferences have been reached that could contribute to an effective harmonisation of the data, under new technical conditions, which would improve the quality of the statistics in this field in order to support the formulating, monitoring, and evaluation of public policies relating to workplaces in Brazil.
P1.26 NEEDLE STICK INFECTIONS (NSI) AMONG HEALTHCARE WORKERS
G. V. Ganapathy, P. Thirumalaikolundusubramanian.Madurai Medical College, Madurai, India
Aim: One of the most devastating occupational risk to healthcare workers is exposure to blood borne pathogens (hepatitis B and C, and HIV). As nurses and interns are intimately associated with needles in their routine activities, we tried to evaluate the frequency of needle stick injuries (NSI), to explore the circumstances, and to identify the high risk areas, workers’ perception of risk of blood borne disease, and their level of adherence to universal guidelines.
Methods: Questionnaires were given to the participants, and they were asked to cite NSI they had had (during January–April 2004), the probable reasons and place of occurrence, their physical and psychological reactions, and their knowledge, attitude, and practice of pre-exposure prophylaxis (such as use of gloves) and post-exposure prophylaxis (PEP).
Results: Of the 260 questionnaires distributed, 200 were returned (response rate 76.9%). Of these, 132 had experienced an NSI. Among the 13 who had an NSI while treating patients with HIV/hepatitis, only four of them took PEP within 36 hours. Only 12 took the trouble of testing their blood and the patient’s blood for HIV/hepatitis. Only 22 reported and discussed this with their colleagues. Of the 200, only 39 used gloves; 86 were embarrassed to use them in front of their colleagues and the rest did not use them. Regarding treatment, 44 of them squeezed the site of injury and washed with running water. Regarding attitude, 16 felt that they have a 10% chance of developing HIV, 62 felt anxious, 24 depressed, 26 prayed, and 30 were casual. The wards where NSI were relatively prominent were obstetrics and gynaecology, nephrology (during haemodialysis), blood banks, medicine, and surgery.
Discussion: The occurrence of NSI in our study population in South India, where HIV infections are rampant, seems to be sizeable, which underlines the need for prevention. Most of these injuries occurred at the time of re-sheathing of needles. It is disheartening to note that only 22% had practised appropriate first aid for an NSI and even fewer had taken the appropriate PEP. Not wearing gloves while dealing with sharp objects indicates that the workers’ level of knowledge and adherence to guidelines are suboptimal, and warrants special emphasis in training programmes. Hospitals must adopt a rigid protocol to ensure that precautions are taken to reduce healthcare workers’ accidental exposure to potentially infected blood. Comprehensive programmes to prevent NSI, including educational activities, incident reporting, and monitoring of NSI cases may minimise the high cost of an NSI and its associated psychological trauma.
P1.27 OCCUPATIONAL HEALTH PROVISION IN UK UNIVERSITIES: INSTITUTIONAL FACTORS AND PARTICIPATION IN THE OHSHE SURVEYS
S. Allender, K. M. Venables.Department of Public Health, University of Oxford, Oxford, UK
Introduction: There is no requirement for UK employers to provide an occupational health (OH) service and there is little evidence based guidance. University work involves a range of hazards but few UK universities have a comprehensive OH service. Early data from the OHSHE (Occupational Health Services in Higher Education) surveys were presented to EPICOH 2002.
Methods and results: This new study used data from a questionnaire mailed in 2003 and from data held by the Higher Education Statistics Agency (HESA). The questionnaire was on type of OH provision, and services were grouped into: inhouse (66), externally provided (60), and no or ad hoc provision (32). The most recent (2000–1) HESA dataset was purchased. It covered 158 UK universities and gave undergraduate and postgraduate student numbers, which we used as an indicator of size of institution (HESA has few data on staff). Undergraduate numbers ranged from 0 to 139 300 and postgraduate numbers from 0 to 17 125. Universities were classified by research activity using a recognised UK grouping, here called groups A (19), B (41), C (45), and “other” (53). OHSHE surveys of OH staffing and services were carried out in 2001–2 and 2002–3, and 88 of the 158 universities responded in at least one. The 66 universities with inhouse services were large, with a median of 15 568 students compared with 11 035 (external OH provision) and 4515 (no or ad hoc provision) (p<0.001). An inhouse service was associated (p<0.001) with research activity group: 56% of universities with inhouse OH services were in the two most research active groups, but 53% of those with no or ad hoc arrangements were in the lowest group. The presence of an inhouse service was associated (p<0.001) with OHSHE response status: 79% of these universities had responded, compared with 42% of those with externally provided services and 34% of those with no or ad hoc services.
Conclusions: The type of OH provision in UK universities is related to need, in that the investment in an inhouse service was associated with large institutional size and high research activity. Universities with inhouse OH services were more likely to respond to the OHSHE surveys and this should be taken into account when interpreting results from the OHSHE project.
P1.28 POLICY IMPLICATIONS OF EXPOSURE TO ORGANIC SOLVENTS IN THE NEW ZEALAND PRINTING INDUSTRY
S. Pritchett.Environmental Studies, School of Earth Sciences, Victoria University of Wellington, New Zealand
Exposure to organic solvents in the printing industry has been linked to increased incidences of cancer, chronic toxic encephalopathy and irritant contact dermatitis. Maternal exposure to the organic solvents toluene and xylene (both used in the printing industry) has been linked to an increased risk of spontaneous abortions. Some health research specific to the New Zealand printing industry was carried out in the 1980s and 1990s. One 1990 study looked at the effect of organic solvent exposure on 41 printers in Canterbury and Westland, and found that the respondents had varying degrees of acute and chronic neurotoxicity. More recent research (1998) on chronic solvent neurotoxicity identified printers as being one of the most affected occupational groups to be affected by organic solvents. However, peer reviewed scientific literature on the impact of organic solvents on New Zealand printers is generally lacking. The international peer reviewed scientific literature may not always be relevant to the organic solvents used in the New Zealand context. The lack of current data on the impact of the exposure to organic solvents in the New Zealand printing industry means there is minimal impetus for adopting environmental management systems or cleaner production technologies that could encourage viable alternatives to using organic solvents. This study was undertaken to evaluate the current peer reviewed literature on the impact of occupational exposure to organic solvents used in the New Zealand printing industry to establish: (a) the health risks to workers in the printing industry; (b) the gaps in knowledge for the New Zealand printing industry; (c) and the policy implications of these gaps.
P1.29 SEARCHING FOR A SOLUTION TO THE PROBLEM OF ASBESTOS(IS) IN CROATIA
V. Deckovic-Vukres.Croatian National Institute of Public Health, Zagreb, Croatia
Introduction: For years, workers with asbestos related disease have been struggling for entitlements grounded on occupational disease and for related damages. Occupational medicine physicians have also been lobbying for the harmonisation of criteria for the recognition of asbestosis as an occupational disease. In 2003, the Croatian government passed a decision permanently abandoning asbestos based manufacture.
Methods: The paper analyses European regulations and the latest directive of the European Parliament and the Council of Europe restricting the manufacture and use of asbestos, as well as epidemiological data on the patients with disease in Croatia.
Results: Asbestosis is the second most common occupational disease in Croatia and accounted for 18% of all occupational diseases registered in period 1990–2003. Sector ministries were requested, in collaboration with competent institutions, to: (a) produce uniform criteria for establishing asbestosis and those for establishing the level of damage; (b) establish periodicity of preventive medical examinations of all employees (and pensioners) whose exposure to asbestos is or was occupational; (c) try to identify all manufacturing processes still using asbestos and carry out inspectional surveillance there; (d) look into the possibility of transition to non-asbestos production, and of gradual cessation of the manufacture, use, and marketing of products containing asbestos; and (e) implement a sanitation programme for the removal of environmental pollution with asbestos.
Conclusion: The greatest responsibility burden lies on the work safety inspectorate and employers, who must advise a competent authority before starting any asbestos removal work. Another obligation is medical examinations of the exposed workers. One more obligation is keeping of all medical findings and data for a minimum of 40 years beyond the end of exposure to asbestos.
P1.30 DOES CHRONIC DEBILITATING FATIGUE CONTRIBUTE TO ABSENTEEISM IN THE STEEL INDUSTRY?
K. Chatterjee.Department of Occupational Health Services, Durgapur Steel Plant, Durgapur, West Bengal, India
Introduction: Absenteeism is common in industries, and the steel industry is not an exception. The impact of absenteeism on the technoeconomics of production and associated loss is immense. From an occupational health point of view it is important to look into the various statistics of and the reasons for absenteeism. The paper has taken into account the absenteeism cases of the last 5 years.
Methods: The details of absentees were taken from the ‘sick/fitness’ register of the Occupational Health Service of Durgapur Steel Plant. Workers’ age, nature of jobs, exposure history, sex, length of absence, frequency of disease, and chronicity were included.
Results: A total of 754 absentee cases were reported in the last 5 years, which is 3.4% of the total employee strength. The age ranged from 25–59 years. Women were found to be absent more frequently (2.65%) than men (0.9%). Of the cases, 49.2% were absent for >15 days. Regarding type of illness, 25% of the absentees suffered from gastrointestinal tract disorders, 22% from infective diseases, and 25% of cases amounted to self certified sickness. About 63% of the cases visited the OHS certified Centre >1 to ⩽5 times. Main factors contributing to chronic absenteeism were generalised debilitation (74.9%) and alcoholism (26.3%). Common symptoms of debility cases reported were generalised malaise, ill defined general weakness, arthralgia, sleep disturbances, and headache.
Conclusions: The study has demonstrated that most of the absentees were chronic in nature and most of these suffer from generalised debilitation and alcoholism. It also shows that chronic debilitating fatigue does exist in the steel industry in India, and is a major cause of absenteeism.
P1.31 MANAGERS’ SLEEP
M. Delanoë1, J.-GBlanc3, F. Harmandon1, E. Mullens2.1Occupational Health, MSA Tarn-Aveyron, Albi, France; 2Sleep Laboratory, Fondation Bon Sauveur, Albi, France; 3CRAM Midi-Pyrénées, Toulouse, France
Introduction: Since 1996, the SVS 81 association (http://www.SVS81.org) has worked for better awareness of sleep disorders, alertness, and security at work. A survey allowed us to write educative documents for occupational medicine and shift workers. During 2003, we studied the sleep habits of managers (for example, plant managers, craftsmen, executive managers).
Methods: Managers of 1981 corporations in the Tarn area of France were investigated with a sleep questionnaire. These constitute objective data determined by stratification, including the kind of activity, size, and legal fields of the companies.
Results: Of the 430 questionnaires returned, we analysed 233 completed files. There were 159 (68%) males and 74 (32%) females. The mean age was 45.4 years, range 19–71 years. Respondents have excessive daytime sleepiness; 41% struggle against the need for sleep, sometimes or often, during working hours, and 51% have insufficient sleep during their working periods. Extrinsic insomnia (environmental adjustment) concerns 41% during work periods versus 19% during holidays. Obstructive sleep apnoea syndrome was present in 11%, and 21% use sleep inducing drugs. Fifty seven per cent would “love” to take a nap, and it seems that the longer the working hours, the more important is the need for a nap.
Conclusions: Sleep/wake disorders of managers are the same as other workers. SVS 81 is to launch a new document to give managers information and to encourage better health promotion.
P1.32 PERCEIVED FATIGUE AND ITS REFLECTION IN CARDIOVASCULAR SYSTEM ACTIVITY UNDER 12 HOUR SHIFTS IN CONTROL ROOM WORKERS
N. Bobko.Institute for Occupational Health, Kiev, Ukraine
Introduction: Twelve hour shifts are known to impact negatively on good health maintenance and production safety, especially on predominantly mental work.12 The rest between consecutive 12 hour shifts is not sufficient for workers’ recovery, and accumulated fatigue takes place.
Objective: To reveal perceived fatigue and its objective reflection in parameters of cardiovascular system (CVS) activity in different shifts of a working week cycle.
Methods: Heart rate and systolic and diastolic blood pressure (BP) were measured in electricity distribution network controllers every 2 hours during working shifts over three 8 day periods under 2 day shift rotation (17 workers, 1224 subject observations). A 5 point scale was used to estimate the perceived level of fatigue experienced by the controllers at the end of each working shift.
Results: After the first shifts the increase in perceived fatigue (up to the middle level) led to an increase in the minimum level of BP reached during a shift. This shows an adequate reaction; increase in the CVS efforts to maintain the required performance under increase in production load. After the second consecutive shift the opposite reaction was revealed: under slight fatigue, BP was found at the same level as after the first shift under mid level fatigue, and after mid level fatigue, BP was found at a lower level, suggesting an inadequate reaction to the increased production requirements.
Conclusion: Human beings are not sensitive to the increase in physiological price to their cardiovascular system to maintain professional performance, even at the stage of exhaustion of its resources. Such insensitivity makes it possible for hidden pathology to accumulate, and makes it reasonable to elaborate and use systems for monitoring CVS activity in the workplace.
P1.33 MONITORING OF OCCUPATIONAL NOISE EXPOSURE AND ASSESSMENT AUDIOMETRY ABILITY FOR WORKERS IN A CEMENT FACTORY
R. Gholamnia1, Y. Rasoulzadeh1, G. Hosieni2, I. Mohebi1, S. Sanatti2.1Department of Occupational Health, Faculty of Health, Uromiah of Medical Science University, Uromiah, Iran; 2Health and Safety Centre, Uromiah Cement Factory, Iran
Introduction: Auditory impairment, especially hearing loss caused by noise in the workplace, is a common problem in many building industries. The connection between noise exposure and a decline in hearing ability has been known for centuries. Noise affects the auditory system as well as non-auditory systems such as hypertension, anxiety, mental stress, and nerve excitation.
Objective: To survey noise exposure and monitor the auditory effect of noise in the workplace.
Methods: To measure noise level, the workplace in factory was divided into sections such as packaging, furnace, preheater, compressor house, milling, stone breaker, and welding unit. To measure sound pressure level, a sound level meter (B & K Model) was used. For audiometric test and assessment, a Wollton audiometer was used.
Results: A total of 23 workers’ files were selected and analysed to determine hearing impairment. The results of the noise tests showed that occupational sound exposure level is higher than the standard level (85 dB). The mean (SD) sound pressure level was 83.6 (4.6) dB. The greatest and lowest exposure level was found in the packaging house (88 dB) and welding site (74 dB).
Conclusion: The results reveal that there are significantly different exposure levels compared with the standard occupational exposure level. For this reason, the workers suffered from noise pollution. The results also revealed audiometry and non-audiometry effect in the workplace, and showed that higher noise levels can cause reduce auditory power or increase auditory threshold. Our study demonstrated that with increasing age, experience, and duration of exposure, hearing impairment increased. Additionally, hearing loss occurred at high frequency (for right ear 37 (20) dB of hearing loss and for left ear 31 (18) dB hearing loss at 4000 Hz). The body is unable to mount a defence against this noise.
P1.34 METHODOLOGICAL ISSUES ON EVALUATION OF OCCUPATIONAL EXPOSURE TO RADON AND GAMMA RADIATION IN SOME UNDERGROUND WORKPLACES AND IN OFFICES
F. Bochicchio1, V. Bianco2, C. Carelli2, C. Nuccetelli1.1ITechnology and Health Dept., Istituto Superiore di Sanità, Roma (Italy); 2Safety and Enviroment Dept., Telecom Italia S.p.A., Roma (Italy)
Introduction: Control of occupational exposure to ionising radiation of natural origin was introduced in 1996 in the European directive on radioprotection and, consequently, into the national regulations of many countries, including Italy. In the Italian legislation of 2000, particular attention was devoted to radon exposure in underground workplaces. An interesting problem is given by the dense network (several hundreds of thousands) of underground workplaces (small inspection rooms) used by the Italian telecommunication company operator (Telecom Italia SpA) for the maintenance of the underground cable network. In such places, radon concentration can reach high levels, and although a single small inspection room is generally visited once a year, maintenance workers can spend a total of many hours per week in various rooms. However, the actual radon concentration during the maintenance operations, when these small rooms are open with a significant air exchange with outdoor air, may not be much different than the average values. Besides radon, protection from gamma radiation emitted from natural radionuclides is also included in the directive, and, more specifically, a European guideline was recently devoted to gamma radiation emitted from building materials.
Methods: Radon concentration will be measured by alpha track passive detectors exposed for four consecutive periods of 3 months in 18 small inspection rooms selected in areas where high underground radon concentration is expected. Moreover, in some of these places, hourly radon concentration will be monitored by active equipment before, during, and after a maintenance operation, in order to estimate actual exposure during such operations. As regards gamma radiation, indoor exposure (in, for example, dwellings and offices) is generally evaluated by direct indoor measurement. Recently, two of us developed a method to evaluate indoor gamma exposure in houses and apartments on the basis of outdoor gamma dose rate measurements in conjunction with a model that needs some information on the building structure. Within the collaboration between Istituto Superiore di Sanità and Telecom Italia SpA, this method will be tested and adapted to office buildings, comparing its estimates with direct indoor measurements of gamma radiation.
Results: Experimental measurements are ongoing, but the first results are expected to be available in September and will be presented at the symposium.
P1.35 SERUM MELATONIN RHYTHMS AND PROLACTIN LEVELS IN WORKERS EXPOSED TO ELECTROMAGNETIC FIELDS AROUND HIGH VOLTAGE ELECTRIC POWER LINES
A. El Safty1, Y. Nassar2.1Department of Industrial Medicine & Occupational Diseases, Cairo University, Cairo, Egypt; 2Department of Medical Biochemistry, Cairo University, Cairo, Egypt
Introduction: One of the more contentious issues in the scientific community today is that of the biological effects of electromagnetic fields (EMFs) and whether or not they adversely affect health. Many authors have studied the effect of EMFs on melatonin and prolactin serum levels.
Methods: The studied population comprised 52 adult males working in an electric power station, and a matched control group of 20 men. All subjects underwent full history taking, clinical examination, and investigations, including measurements of melatonin and prolactin serum level.
Result: Our results revealed a significant reduction of serum melatonin levels and an increase in prolactin secretion in workers exposed to EMFs around high voltage power lines. A significant correlation was detected between the reduction in serial measurements of melatonin levels and the strength of electric fields, while no such correlation was detected for prolactin level. Although a negative correlation was found between serial melatonin levels and duration of exposure, it was not significant. Previous studies reported that reduction of melatonin increases cell vulnerability to alteration by carcinogenic agents. Concerning prolactin, no such correlation was detected.
Conclusion: We concluded from our study that exposure to EMFs is a significant threat as it significantly decreased melatonin production with consequent increase in risk of development of hormone dependent cancers such as breast and prostate. Additionally, increased prolactin secretion, such as demonstrated in our work, has an impact on reproductive health.
Recommendations: We recommend periodic screening tests for early detection of cancer in high risk workers.
P1.36 NOISE INDUCED HEARING LOSS IN BUDDHACHINARAJ HOSPITAL, THAILAND
N. Suchat, O. Krisanakriengkrai.Faculty of Public Health, Naresuan University, Thailand
Objective: To study the effect of occupational health hazards (noise) on workers’ health, preventive action can be taken on source, path, and personal protective equipment.
Methods: In May–Jun 2003, we performed an audiometry test (FONIX FA-12) on 66 workers in nine jobs: central supply, airway equipment supply, security, equipment repair, car drivers, prosthesis maker, laundry, operating room team, and land and field group. An abnormal result would be a high tone drop at 4000 Hz, and results were divided into five categories. Cat 1: there is some degree of hearing loss at >30 dB; cat 2: there is some degree of hearing loss at low tone >45 dB and high tone >60 dB; cat 3: there is some hearing loss compared with age; cat 4: there is more hearing loss compared with age; and cat 5: normal.
Results: Abnormal audiogram was found in: central supply (1/1), airway equipment supply (6/9) security (0/11), equipment repair (0/11), car drivers (0/7), prosthesis maker (0/4), laundry (1/16), operating room team (1/2), and land and field group (0/5).
Conclusions: There are some degrees of health hazard for workers of a hospital. Noise sources include electric hand drills, washing machines, nozzles and air pumps to dry plastic tubes, grinding machines, and car engines. Categories 1, 2, and 3 will be referred to a physician, and category 4 will receive warning and protection.
P1.38 PERSONNEL EXPOSURE TO NON-IONISING ELECTROMAGNETIC RADIATION IN HOSPITAL PHYSIOTHERAPY DEPARTMENTS
C. Szanto.Institute of Public Health, Cluj-Napoca, Romania
Objective: To evaluate the risk to nurses of exposure to electromagnetic fields in hospital physiotherapy departments in the Transylvania area, Romania.
Methods: The methods and measuring instruments were similar to those used in Western countries. Measurements were performed in 64 workplaces with exposure to radiofrequency electromagnetic fields of short wavelength (27 MHz), in 31 workplaces with exposure to microwaves (2.5 GHz), and in 144 workplaces with exposure to low frequency fields (10–100 Hz). Mean values were calculated for each type of exposure, in order to estimate the health risk faced by the exposed medical personnel. The reference values were those currently used in the European Union.
Results: The mean values of exposure to radiofrequency electromagnetic waves and microwaves were considerably high. Thus, the mean (SD) value of the electric flux density around the short wave therapy devices was 12.4 (21.3) mW/cm2 while the average magnetic flux density was 6.8 (9.0) mW/cm2. With the microwave therapy devices, the average power density of the electric flux was 44.4 (41.2) mW/cm2 and the magnetic flux was 43.1 (45.4) mW/cm2. The high standard deviations are due to the wide ranging power densities obtained from various types of measured devices. This was also true with the low frequency equipment, but the calculated mean values (and each individual value as well) remained below the legal maximum admissible limits. The mean value of the magnetic fluxes from all measured low frequency devices and related work places was B = 25.5 (41.0) mT.
Conclusion: Except in the case of the low frequency devices, there is an important risk associated with exposure to high frequency electromagnetic waves for hospital nurses who operate short wave and microwave therapy equipment, the levels of the generated non-ionising radiation being much greater than the maximum allowable limits.
P1.39 EVALUATION OF NOISE POLLUTION AND ITS EFFECTS ON THE AUDITORY SYSTEM AMONG WORKERS WHO WORK IN THE SPP UNIT, ARAK AZARAB COMPANY
S. Samadi, A. Talkhabi, B. Jonaid, K. Ali, T. Majid.Arak University of Medical Sciences, Arak Azrab Company, Tarbit Modarrese University, Shahid Beheshti University of Medical Sciences, Iran
Background: Noise pollution is a serious problem in industries, and can have an effect on the auditory or other physiological parameters, and on efficiency. In many countries, attention has been focused on noise for increasing work efficiency and reducing its effects on the body.
Objective: To measure noise and evaluate its effects on the auditory system. The places which noise levels exceed the TLV can then be recognised, and also controlled.
Materials and methods: The research design was cross sectional. The population was all workers who worked in the first shift in the SPP unit of Azarab Co. The data was gathered by audiometer, noise meter, and analyser. After measuring the noise, all workers completed a questionnaire. The data was statistically analysed by SPSS software.
Results: Based on noise measurements, the SPP unit was divided into three zones: A, B, and C, in which the levels of Leq(8) were 96.6, 92.2, and 82.2 dB(A) respectively. In zone A, noise levels at frequencies of 3000, 4000, and 6000 Hz were 87.5, 87.2, and 82 dB(A) respectively. The average hearing loss in these frequencies was 22.86, 22.71, and 23.14 dB(A) respectively. The greatest hearing loss was seen at 4000 Hz. The rates of hearing loss in zones B and C were lower than in zone A. On the whole, there were significant differences between noise levels and rate of hearing loss (p<0.05). The average hearing loss was higher with increasing noise and also with employment duration.
Conclusion: Noise levels exceeded permissible limits and most of the workers had hearing loss. It is recommended that the noise should be reduced at the source or in transmission. If measures aimed at the source or at transmission are not feasible, individual protection equipment should be used. All workers should be examined every 6 months. If workers are susceptible to hearing loss, their jobs must be changed.
P1.40 HEALTH EFFECTS FOLLOWING LONG TERM EXPOSURE TO THORIUM DUSTS: A 20 YEAR FOLLOW UP STUDY IN CHINA
X.-AChen1, Y.-ECheng1, H. Xiao1, G. Feng2, Y.-HDeng2, Z.-LFeng2, L. Chen1, X. M. Han2, Y.-JYang1, Z. H. Dong1, R. Zheng.1Laboratory of Industrial Hygiene, Ministry of Health, PO Box 8018, Beijing 100088, China; 2Hospital of Baiyun Obo Rare-earth Iron Mine Baiyun Obo, Baotou 014080, China
A 20 year follow up study was carried out at Baiyun Obo Rare-earth Iron Mine in China, which has been operation since 1958. Its ore contains 0.04% ThO2. The purpose of this study was to investigate possible health effects in dust exposed miners following long term exposure to thorium containing dusts and thoron progeny. The highest thorium lung burden among 1158 measurements of 638 miners was 11.11 Bq. The incidence of stage O+ pneumoconiosis was increased among dust exposed miners. An epidemiological study showed that the lung cancer mortality of the dust exposed miners was significantly (p<0.005) higher than that of the controls. We believe the difference results from long term exposure to thorium containing dusts (carcinogens are ThO2 and SiO2) and thoron progeny. This is the first evidence in humans of the carcinogenicity of inhaled thorium containing dusts and thoron progeny. The total person years of observation for the dust exposed miners and the controls was 62 712 and 34 672 respectively.
P1.41 SCALE DEVELOPMENT FOR ASSESSMENT OF OCCUPATIONAL HEALTH HAZARDS AMONG FARM WOMEN IN INDIA
S. Sinwal, S. Singh.
Introduction: India is mainly an agricultural country, having farming as one of the largest occupations. Occupational health in agriculture is a new concept. Agriculture consistently ranks among the industries with highest work related injuries and deaths.
Objective: To develop a scale to assess occupational health hazard among farm women, as they make up 46% of the total agricultural workforce.
Methods: The scale was developed and standardised using the Likert Summated rating method. Data was collected from 50 subjects to assess hazard proneness.
Results: For the scale, approximately 90 statements were excluded and 74 retained. The final list of 40 statements was made after expert evaluation. In item analysis, t values of each statement were calculated and statements with highest t value were selected. After collection and analysis of data it was concluded that most of the respondents (74%) fell into the category of high hazard incidence and no respondent was reported as having a low incidence of hazard proneness.
Conclusion: Such high scores indicate that working conditions of women farmers in India are alarming. The hazards faced by them in agriculture calls for the immediate attention of planners and policy makers.