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OVERTIME AND INJURIES AT WORK
Evidence is growing that long working hours can impair health. Studies in selected occupations have also described a greater risk of injury. Dembe et al1 extend the observation to a nationally representative sample of US working adults. Responses from the National Longitudinal Survey of Youth were used to assess the impact of overtime and extended hours on occupational injuries during 1987–2000. The investigation, which encompassed 110 000 jobs and 90 000 person-years of work time, found that the injury hazard rate was 61% higher in jobs with overtime schedules. A strong dose-response effect was seen after adjusting for age, gender, occupation, industry, and region. The analysis allowed for time at risk and so tends to discount the simple idea that those working overtime have more time in which to harm themselves. A related editorial discusses the implications of the research.2
PREVENTING SKIN DISEASE
Occupational skin disease is common and potentially avoidable. Flyvholm et al3 describe a randomised controlled trial to prevent skin problems in gut cleaners from swine slaughterhouses. The work features barriers to regular glove wearing and exposure to several risk factors for dermatitis such as water, salt, guts, gastric fluids, and disinfectants. An intervention, planned around education and evidence based guidelines, was evaluated by questionnaire. After one year the three month prevalence of hand and forearm eczema had reduced in departments receiving advice, but rose slightly in the non-intervention group. The guidelines led to more frequent use of gloves with a cotton underlining and better provision of skin care products. An evidence based programme can have an impact in preventing occupational eczema.
Domestic cleaners are at higher risk of asthma, but little is known about the responsible agents. To investigate, Medina-Ramón et al4 conducted a case-control study nested within a community sample of women aged 30–65. Cleaners with and without symptoms were compared. In a subset, personal interviews were conducted, and measurements made of lung function and airborne chlorine and ammonia. Cases were more likely than controls to use bleach, especially at higher exposure levels (odds ratio 4.9, 95% CI 1.5–55). Associations were found with accidental release of cleaning agents. The findings have public health relevance, given widespread use of bleaches and cleaning agents at work and at home.
HEART AND LUNG DISEASE IN DUSTY JOBS
Several microorganisms have been implicated in atherosclerosis, while environmental exposures to fine particulates portend an excess of cardiorespiratory morbidity. Koskela et al5 have studied the relation between dust exposure, respiratory infections, and ischaemic heart disease (IHD) in a cohort from dusty jobs; 6000 granite and foundry workers, hired in 1940–76, were followed until 1992 using data from national registers and questionnaires. Chronic bronchitis, pneumonia, and upper airways infections were predictors of IHD (relative risk 1.7–2.1), but dust exposure per se, although related to respiratory morbidity, did not add significantly to the risks. Chronic infections of the respiratory tract may contribute independently to IHD, but the risk seems not to be accentuated by exposure to dusts in these industries.