Asbestosis, silicosis and Coal Worker's Pneumoconiosis (CWP) represent three of the most important occupationally-related dust diseases in Australia. To gain a clear picture of pneumoconiosis trends over time, a 24-yr retrospective analysis of national mortality data was performed for the period 1979 to 2002. Over 1,000 pneumoconiosis-related fatalities occurred during this time, 56% of which were caused by asbestosis, 38% by silicosis and 6% by CWP. Between 1979 and 1981, silicosis accounted for 60% of all pneumoconiosis-related fatalities in Australia, followed by asbestosis (31%). By 2002 however, asbestosis was causing 78% of all fatalities, while silicosis accounted for only 19%. Asbestos-related mortality increased three-fold between 1979 and 2002, with a clear excess risk demonstrated among males. On the other hand, mortality rates for silicosis and CWP declined significantly during the same time period. Overall, this study suggests that pneumoconiosis, particularly asbestosis, continues to be an important occupational disease in Australia. Although progress has been made in reducing deaths due to occupational silicosis and CWP, asbestosis rates continue to rise, reflecting the long latency between dust exposure and clinical disease. Countries which continue to use asbestos products in the workplace should note the tragic legacy of this material within contemporary Australia.

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Many new biomarkers are being studied, in addition to classical biomarkers, such as chemical substances and their metabolites in blood and urine and modified enzymes. Among these new biomarkers, hemoglobin adducts are thought to be especially useful for the estimation of chemical exposures. We review here the use of biomarkers for monitoring exposures to nine substances, mainly focusing on PRTR class I designated chemical substances, styrene, phenyloxirane (styrene oxide), 4,4'-methylendiphenyl diisocyanate (MDI), 4,4'-methylendianiline (MDA), 1,3-butadiene, ethylene oxide, propylene oxide, acrylamide and acrylonitrile. Hemoglobin adduct levels were elevated after exposures to styrene, MDI, MDA, 1, 3-butadiene, ethylene oxide, acrylamide and acrylonitrile. Moreover, hemoglobin adducts of butadiene, ethylene oxide, acrylamide and acrylonitrile have several useful advantages. For example, the hemoglobin adduct of 1,3-butadiene is an even more useful biomarker of exposure than urinary metabolites, and in the case of ethylene oxide, even though the concentration of ethylene oxide-Hb in the blood of workers did not exceed the value of the German exposure equivalent, a significant difference in it was found between workers and a control group. Also hemoglobin adducts of acrylamide and acrylonitrile can reflect their exposures because there are no urinary metabolites of acrylamide and acrylonitrile that are useful for exposure assessment. In addition to these advantages, hemoglobin adducts are superior to DNA adducts with respect to the availability of large amounts, availability of methods for chemical identification, and well-defined life spans due to the absence of repair. Hemoglobin adducts can be effective biomarkers for assessing exposure to and the effects of chemicals.

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This study attempted to estimate the number of annual new cases of lung cancer from workplace exposure to Environmental Tobacco Smoke (ETS) in France. The number of new lung cancer cases attributable to workplace ETS exposure in France was estimated with regard to the following factors: excess risk of lung cancer from workplace ETS exposure, incidence of lung cancer in non-exposed non-smokers, and number of French workers exposed to passive smoking. The excess risk of lung cancer from workplace ETS exposure was estimated as from 0.12 to 0.39 by different references. The French workforce, regularly exposed to ETS in their workplace is about 3.2 millions. The incidence of lung cancer of non-smokers without exposure to ETS is between 3.7 to 10 per hundred thousand. If these three factors are combined, it is estimated that exposure to workplace passive smoking causes around 14 to 125 new cases of lung cancer each year in France. New lung cancer cases from workplace exposure to ETS represent a few percent of all occupational lung cancers, and a minuscule number in regards to the whole lung cancer annual incidence (14 to 125 for 23,000 lung cancers in France=0.06% to 0.54%)

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To explore the association of job strain with CHD and metabolic syndrome in municipal workers. A cross-sectional study was completed of 450 male workers. Coronary heart disease was defined as: physician diagnosed ischemic heart disease; and/or, ischemic findings in the ECG. Metabolic syndrome was defined according to the criterion set by the National Cholesterol Education Panel. The demand-control model was used to assess job strain. Self administered questionnaires were completed after a face to face interview. Logistic regression models were constructed to assess the association of job strain with CHD and metabolic syndrome. The prevalence of metabolic syndrome and CHD were 17.8% and 8.0% respectively. Both CHD and metabolic syndrome were found to be significantly higher in higher income groups. Job demand and job control were not found to be associated with either CHD or metabolic syndrome. Metabolic syndrome was significantly more prevalent among the high job strain workers, but the significance was lost when controlled for age. The findings suggest that there is no significant association between job strain and metabolic syndrome and CHD in this sample of Turkish workers. Job strain may possibly be perceived differently in different cultures and occupations. Future studies may benefit from using a combination of different stress models and more diverse study populations.

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The aim was to explore long-term changes in the perception of job characteristics-based on the Job Content Questionnaire (JCQ)-in view of the changing labor market in Western societies. A total number of 2,821 workers from nine companies were involved in the longitudinal Belstress-project. Data were gathered on two occasions with a mean time interval of 6.6 yr. At both times, participants completed the JCQ which measures the perception of job demands, job control and social support. In addition, the instrument contains questions regarding physical job demands, job insecurity and impact of world market competition (WMC). Changes over time in the perception of the different dimensions of the JCQ were evaluated within a sample of 2,490 respondents who remained in the same job. A statistically significant long-term stability of all JCQ scales was found. As far as intra-individual changes over time are concerned, the population showed a modest average increase in the perception of job demands, control and support of approximately 3%. Long-term changes in the other scales were larger, with an average increase of 10.3% in job insecurity and 15.5% in impact of WMC. Substantial variation in these two scales was found at the level of the company and in some socio-demographic factors. While perceived job characteristics remained relatively stable over an average period of 6.6 yr, a substantial increase was noted in job insecurity and the impact of WMC. These dimensions are becoming increasingly important within the context of economic globalization and labor market flexibility.

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The exposure of gasoline pump repairers and inspectors to gasoline was studied at service stations and repair shops in Finland in April-June 2004. The average air temperature ranged from 7°C to 16°C and wind speed from 2.5 to 7 m/s. The gasoline blends contained mixtures of methyl tert-butyl ether (MTBE) and tert-amyl methyl ether (TAME), the total content of oxygenates being 11-12%. The content of benzene was <1%. Breathing zone air was collected during the work task using passive monitors. The mean sampling period was 4.5 h. The mean TWA-8 h concentrations for MTBE, TAME, hexane, benzene, toluene, ethylbenzene and xylene were 4.5, 1.3, 0.55, 0.23, 2.2, 0.26 and 1.1 mg/m³, respectively. None of the individual benzene concentrations exceeded the binding limit value for benzene (3.25 mg/m³). The sum concentration of MTBE and TAME in urine was between 8.9 and 530 nmol/l in individual post-shift samples. The individual sum concentrations of the metabolites tert-butyl alcohol and tert-amyl alcohol collected the following morning after the exposure ranged from 81 to 916 nmol/l. All individual results were below corresponding biological action levels. Exposure to aromatic hydrocarbons was estimated from post-shift urine samples, with benzene showing the highest concentration (range 4.4 and 35 nmol/l in non-smokers). The exposure levels were similar to those measured in previous studies during unloading of tanker lorries and railway wagons. The results indicated a slightly higher exposure for inspectors, who calibrated fuel pump gauges at the service stations, than for pump repairers. No significant skin exposure occurred during the study.

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To assess whether workers at Lucas Heights Science and Technology Centre (LHSTC) had different levels of cancer incidence from the New South Wales (NSW) population in Australia. A retrospective cohort study was undertaken at LHSTC. Data on 7,076 workers employed between 1957-98 were abstracted from personnel, dosimetry, and medical files. An inception cohort was defined which included 4,523 workers in employment between 1972-96 to examine cancer incidence. Cancer registrations in the inception cohort were identified to 1996 through electronic linkage of records with the NSW and the Australian national registers of cancer incidence. All-cancer incidence in workers at LHSTC was 15% below the NSW rates [SIR=0.85; 95% CI=(0.75, 0.95)]. Of 37 specific cancers and groups of cancers examined, statistically significant excesses relative to NSW rates were observed only for pleural cancer incidence [SIR=17.71; 95%=(7.96, 39.43)], and for incidence of cancer of the small intestine [SIR=4.34; 95% CI=(1.40, 13.46)]. This study gives little evidence of an increased risk of cancers associated with radiation exposure in a cohort of nuclear workers in Australia. The observed increase in the risk of cancer of the pleura was probably due to unmeasured exposures, given the lack of an established association with radiation exposure, and the strong link to asbestos exposure. Findings for cancers of the small intestine were based on small numbers and were likely to be due to chance.

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Workers involved in small-scale manufacturing businesses are known to comprise a high-risk population for occupational injury. The present study investigated the prevalence and correlates of occupational injury in this population. A self-administered questionnaire that solicited answers about occupational information including injury, demographic characteristics, health conditions and lifestyle factors was collected from a sample of 1,298 workers in 228 small-scale manufacturing enterprises (defined as fewer than 50 workers) aged 16-78 (mean 46) yr in Yashio city, Saitama, Japan (response rate 65.5%). The enterprises were randomly selected from the 2000 edition of the city commercial directory corresponding to the distribution of types of businesses in the city. Occupational injury was assessed by asking subjects, `Have you ever been injured during your work, including minor scratches and cuts in the previous 1-yr period?' The possible response was either `yes' or `no.' The prevalence of study-defined occupational injury among the workers was 35.6% (male 43.0%, female 17.9%). Among job types, manufacturing (44.2%) and driving (43.5%) had high rates of occupational injuries. Similarly, occupational injuries were high in the papermaking (54.5%) and machinery (47.7%) industries. For males, younger age, current or former smoking, insomnia symptoms, and disease(s) currently under treatment were correlated with injury, whereas for females, being unmarried, higher educational status, and insomnia symptoms were the correlating factors. Occupational injury is common among small-scale manufacturing businesses, and is associated with multiple controllable factors. Countermeasures such as prohibiting smoking during work, sleep health education, job safety training for young/inexperienced workers are appropriate methods for eliminating or reducing injuries.

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Safety practice is an important element of workplace safety and quality of health care. To investigate the safety practice and professional exposure to blood and blood-containing materials during a one-year period among Health Care Workers (HCWs) in Serbia. Cross-sectional study of 1559 Serbian HCWs using a self-administered questionnaire. Mantel-Haenszel statistics and multiple logistic regression analysis were used in statistical analysis. Fifty-nine percent (921) of HCWs had skin contact with patients blood, followed by 51% (791) with needle stick injuries, 38% (599) with cuts from sharp instruments, and 34% with contact of eye and other mucosa with patient's blood. Nurses reported professional exposure more often than others. Safety practices consisted of using appropriate barriers (gloves, mask, glasses) in all procedures with patients and were used by 58%, 23%, and 4% of HCWs, respectively. Doctors protected themselves more regularly than others. Hospital protocols for post exposure prophylaxis and safety disposal of medical waste are not common in Serbian health care settings. Safety practices in use were having hospital guidelines for safety practice in hospitals [odds ratio (OR)=1.58, 95% confidence interval (CI)=1.14-2.19], carrying out some form of intervention with risks of infection (OR=3.76, 95% CI=2.57-5.51), and HCWs aware of the professional risk of acquiring infection (OR=1.48, 95% CI=1.28-1.79). This study indicates that emphasis on work practice, attire, disposal systems and education strategies, should be employed to reduce professional exposure to blood and blood containing materials among HCWs in Serbia.

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The aim of the present study was to evaluate the physical and mental health status of female workers from five different occupational groups and to identify possible sociodemographic and gender-coded family-related factors as well as work characteristics influencing women's health. The identified predictors of health status were subjected to a gender-sensitive analysis and their relations to one another are discussed. A total of 1083 female hospital workers including medical doctors, technical and administrative personnel, nurses and a group mainly consisting of scientific personnel and psychologists completed a questionnaire measuring work- and family-related variables, sociodemographic data and the Short-form 36 Health Questionnaire (SF-36). Data were analysed by multivariate regression analyses. Female medical doctors reported highest scores for all physical health dimensions except General Health. Our study population showed general low mental health status among administrative personnel and the heterogeneous group, others, scored highest on all mental health component scores. A series of eight regression analyses were performed. Three variables contributed highly significantly to all SF-36 subscale scores: age, satisfaction with work schedule, and the unpaid work variable. Age had the strongest influence on all physical dimensions except General Health (β=-0.17) and had no detectable influence on mental health scores. The unpaid work variable (β=-0.23; p<0.001) exerted a stronger influence on General Health than did age. Nevertheless, these variables were limited predictors of physical and mental health status. In all occupational groups the amount of time spent daily on child care and household tasks, as a traditional gender-coded factor, and satisfaction with work schedule were the only contributors to mental health among working women in this study. Traditional sociodemographic data had no effect on mental health status. In addition to age, these factors were shown to be the only predictors of physical health status of female workers. Gender coded-factors matter. These findings underline the importance of including gender-coded family- and work-related variables in medical research over and above basic sociodemographic data in order to describe study populations more clearly.

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The workplace environment affects the health of workers. Unhygienic conditions are observed in the workplace environment of flour mills as fine organic flour dust gets airborne in the indoor environment of the flour mills. The present work was undertaken to study the health problems related to the workplace environment of flour mill workers. The results show that flour mill workers are receiving a heavy dose (average exposure concentration, 624 μg/m³) of flour dust. To determine the impact of flour dust on the lung function of the workers spirometric analysis was conducted. Significant declines in forced vital capacity (FVC), peak expiratory flow rate (PEFR) and forced expiratory volume in one second (FEV₁) were observed in the flour mill workers as compared to expected values. This study reveals reduced lung efficiency of flour mill workers due to excessive exposure to fine organic dust prevalent in the workplace environment. The impairment in lung efficiency was increased with duration of exposure in the flour mill workers. The analysis of questionnaires used to generate information on self-reported problems reveals that most of the workers were suffering from asthma and respiratory problems. Furthermore, the data shows that 42% of the flour mill workers were having shortness of breath problems, 34% of workers were having frequent coughing, and 19% workers were having respiratory tract irritation. We recommend the compulsory use of personal protective equipment (nose mask) by flour mill workers during working hours. This would help to protect the workers health from the flour dust prevalent in the workplace environment. A regular periodic examination is necessary to measure the impact of particulate matter on the health of the flour mill workers.

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Smoking prevalence among males is conspicuously high in Asian countries including Japan. There are few prospective intervention studies on the duration of smoking cessation within regions with a high prevalence of smokers, such as Asia. We investigated the extent to which subjects continued abstaining from smoking after receiving smoking cessation support provided for all smokers in an occupational setting, regardless of their willingness to quit smoking. The subjects were 251 male workers who were smokers and had received a smoking cessation intervention in 1997 in an occupational setting. Smoking cessation rates and body mass index (BMI) at 10, 18, 30, 42, 54, and 66 months after the initial intervention were confirmed during annual health check-ups. Those who quit smoking following the intervention and continuously abstained from smoking throughout the study period were separately examined for BMI. After five years, 10.6% of the smokers continued smoking cessation. Of the abstainers who quit following the intervention, the abstinence rate decreased in the first and second year, but it stabilized at approximately 45% after the third year. High nicotine dependence and a self-reported lack of willingness to quit smoking did not lower long-term abstinence rates. Abstainers initially gained 1.55 BMI on average, but decreased the weight gain to 0.96 BMI over six years. Introducing smoking cessation support without nicotine replacement therapy is an effective long-term strategy in a healthy population with a high smoking prevalence. Abstainers maintain their smoking cessation if they refrain from smoking for three years.

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In the processes of electronic and jewelry manufacturing, workers are employed to use their skill in tiny visual tasks (1-3 mm) and near visual distances (<35 cm) that cause visual strain. This study consisted of 3 phases: 1) a survey of workers visual health status and factors affecting their visual strain; 2) the development and implementation of guidelines in the selected factories; and 3) a resurvey to document the change. The baseline survey was conducted in Samutprakan Province during October to December, 2003. Ninety-five percent of the sampled workers were female with an average age of 26.2 yr. Fifty-two percent of the workers had at least one kind of vision problem that might have affected their work performance, and 48.3% of the work sites had substandard illumination levels. The intervention included improvement of lighting conditions, the introduction of short breaks, and correction of visual performance problems. After the intervention, the inadequate lighting problem went down to 24.5%. All factories took a rest break and 20.5% of the workers with inadequate visual performance had corrected their vision in the intervention period. Comparing pre-intervention status with the end of the program, the Critical Fusion Frequency (CFF) at one hour and two hours of work were improved with statistical significance among the electronic but not the jewelry workers. In conclusion, visual problems among vision intensive industrial workers are common. Intervention programs partially but significantly improved the situation.

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