Objectives: A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared the limits of the US National Institute of Occupational Safety and Health with those of the US Occupational Safety and Health Administration. The prevalence of occupational noise-induced hearing loss is on an increasing trend globally. This review was performed to reduce the prevalence of noise-induced hearing loss. Methods: We searched 3 major databases, i.e., PubMed, Embase and Lippincott Williams & Wilkins Journals@Ovid, for studies published up until 1May 2013 without language restrictions. All study designs were included in this review. The studies were identified and retrieved by two independent authors. Results: Of 118 titles scanned, 14 duplicates were removed, and a total of 13 abstracts from all three databases were identified for full-text retrieval. From the full text, eight articles met the inclusion criteria for this systematic review. These articles showed acceptable quality based on our scoring system. Most of the studies indicated that temporary threshold shifts were much lower when subjects were exposed to a noise level of 85 dBA or lower. Conclusions: There were more threshold shifts in subjects adopting 90 dBA compared with 85 dBA. These temporary threshold shifts may progress to permanent shifts over time. Action curtailing noise exposure among employees would be taken earlier on adoption of 85 dBA as the permissible exposure limit, and hence prevalence of noise-induced hearing loss may be reduced.(J Occup Health 2014; 56: 1–11)

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Objectives: The aim of this study was to identify work-related risk factors for workplace violence in a representative sample of Korean employees. Methods: We analyzed the associations between work-related factors and workplace violence in 29,171 employees using data from the 2011 Korean Working Conditions Survey. The survey included questions about verbal abuse, unwanted sexual attention, threats and behavior that humiliated the victim, physical violence, bullying/harassment and sexual harassment, and a respondent who answered yes to any of these 6 items was considered a victim of workplace violence. Results: The prevalences of verbal abuse, unwanted sexual attention and threats/ behavior that humiliated victims in the month preceding the study were 4.8, 1.0 and 1.5%, respectively. The prevalences of physical violence, bullying/harassment and sexual harassment in the year preceding the study were 0.7, 0.3 and 0.4%, respectively. Service workers had higher prevalences of overall workplace violence. Non-regular workers (OR=2.38, 95% CI=2.01–2.84), working more than 60 hours per week as opposed to 40–48 hours per week (OR=1.83, 95% CI=1.45–2.31) and night shift work (OR=1.88, 95% CI=1.54–2.30) were significant risk factors associated with workplace violence. Conclusions: Long working hours, job insecurity and night shift work were associated with a significant increase in workplace violence among Korean employees.(J Occup Health 2014; 56: 12–20)

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Objectives: A better identification of the determinants of smoking relapse among hospital workers would be helpful in development of more effective interventions to decrease the frequency of relapses in this group. The aim of this study was to determine the predisposing enabling, and reinforcing factors associated with smoking relapse among workers at a university hospital. Methods: This was a case-control study based on a self-administered and structured questionnaire. Cases were all those workers who had relapsed after at least 6 months without smoking, and controls were ex-smokers without relapse for more than 6 months. We obtained the following information: sociode- mographic and tobacco consumption characteristics and a list of predisposing, enabling and reinforcing factors.Results: There were 342 respondents: 114 cases and 228 controls. The variables significantly and independently associated with increased risk of relapse were smoking is my vice (OR=4.02), I’ll be able to quit smoking whenever I want (OR=3.43), I have no intention to quit forever (OR=6.02), celebrations (OR=3.93) and weight gain (OR=10.61), while variables associated with lower risk were age (OR=0.88), health-care worker (OR=0.13), years of abstinence (OR=0.91), smoking is a useless habit (OR=0.19) and illness related to tobacco (OR=0.07).Conclusions: Health programs against smoking in the hospital setting should include measures aimed at preventing relapse through behavioral support therapies and dietary control with particular attention to changes in factors related to lifestyle and false beliefs (predisposing factors).(J Occup Health 2014; 56: 21–27)

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Objectives: Previous investigations on chronic kidney disease of unknown etiology characterized by tubulointerstitial damages (CKDu) in the North Central Region (NCR) of Sri Lanka have supported the involvement of social, environmental and genetic factors in its pathogenesis. Methods: We conducted a social-environmental-and-genetic epidemiology study on a male population in NCR to investigate the genetic and environmental contributors. We recruited 311 case-series patients and 504 control candidates. Of the 504 control candidates, 218 (43%) were eliminated because of the presence of hypertension, proteinuria, high HbA1c, high serum creatinine or high alpha-1 microglobulin in urine. Results and Discussion: None of 18 metals measured (μg//) in urine, including Cd, As and Pb, showed significantly higher concentrations in cases compared with controls. As speciation results showed that 75–80% of total urinary As was in the form of arsenobetaine, which is non-toxic to humans. None of the metal concentrations in drinking water samples exceeded guideline values. A genome-wide association study (GWAS) was conducted to determine the genetic contributors. The GWAS yielded a genome-wide significant association with CKDu for a single nucleotide polymorphism (SNP; rs6066043; p=5.23 × 10⁻⁹ in quantitative trait locus analysis; p=3.73 × 10⁻⁹ in dichotomous analysis) in SLC13A3 (sodium-dependent dicarboxylate transporter member 3). The population attributable fraction and odds ratio for this SNP were 50% and 2.13. Genetic susceptibility was identified as the major risk factor for CKDu. However, 43% of the apparently healthy malepopulation suffers from non-communicable diseases, suggesting their possible influence on CKDu progression.(J Occup Health 2014; 56: 28–38)

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Objectives: Despite the great impact the migration has had in economic, social and health-related fields, and the repercussions of alcohol consumption on them, few data exist concerning the extent of alcohol consumption in migrant workers. The aims of this study were to identify workers with a hazardous drinking problem by means of a self-reported questionnaire (Alcohol Use Disorders Identification Test-AUDIT) and a biomarker (carbohydrate-deficient transferrin-CDT) and to ascertain associated risk factors. Methods: A cross-sectional survey was conducted using a random sample of 385 migrant workers, undergoing a routine health examination as part of occupational health services. Results: The results showed that 13.8% (n=53) of the workers were screened as positive with the AUDIT (>8) and/or CDT (>2.6) and identified as hazardous drinkers and that 53.8% (n=207) were teetotallers. Being a man (OR: 2.0), working in the construction industry (OR: 2.8) or agriculture (OR: 2.2), being resident in Spain for more than 7 years (OR: 2.3) and sharing a house with friends were the factors most closely associated with hazardous drinking. Conclusions: Prevention-orientated programs, adjusted to the characteristics of each country and the origin of the migrants themselves, should be instituted to modify the drinking habits of migrant workers considered at risk.(J Occup Health 2014; 56: 39–48)

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Objectives: Breast cancer (BC) is a cancer that affects working age women in Japan. The aim of this study was to examine the impact that BC has on the work-related life of Japanese women and identify factors that correlate with job resignation. Methods: A cross-sectional Internet survey of cancer survivors in Japan was conducted from December 2011 to February 2012. The questionnaire included questions regarding demographic characteristics, impact of cancer diagnosis and treatment on job resignation and consultation behavior of respondents regarding work-related issues. This study reports results obtained from 105 respondents with BC. Results: The mean age of respondents at diagnosis was 42.5 ± 6.4 years, and the median time since diagnosis was 40 months. Thirty-one respondents (29.5%) lost their jobs, and 12 could not find another job after BC diagnosis. Nearly half of the respondents (47.6%) reported a decrease in personal income after diagnosis. Multiple logistic regression analysis revealed that contract or part time workers were significantly more likely to lose their jobs compared with regular, full time workers (odds ratio, 2.52; 95% confidence interval, 1.39 to 4.55; p<0.001). Seventy-nine respondents (75.2%) consulted someone regarding work-related issues. The most frequently consulted person was the boss at the workplace. Conclusions: Our findings suggest that women with BC experience various job-related problems. In order to create a supportive work environment for BC survivors, focus should be placed on facilitating communication and coordination between BC survivors, healthcare providers and coworkers.(J Occup Health 2014; 56: 49–55)

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Objectives: The aim of this study was to describe the mercury concentrations in female hairdressers associated with occupational and environmental exposure through cosmetic products and amalgam fillings.Methods: Sixty-two hair and nail samples were collected randomly from Iranian hairdressers. Hg level determination was carried out using a LECO, AMA 254, Advanced Mercury Analyzer according to ASTM, standard No. D-6722. Results: The mean mercury levels were 1.15 ± 1.03 ug/g and 1.82 ± 1.12 μg/g in the hair and nail samples, respectively with a positive correlation among them (r=0.98). A significant relation was also observed between Hg levels and the number of amalgam fillings (p<0.001), use of cosmetics (p<0.001), and use of gloves (p=0.02).Conclusions: The Hg levels in about one-third of the studied samples were higher than the USEPA-recommended 1 ug/g, which represents a serious health risk. Hairdressers with continuous use of cosmetics and a high number of amalgam fillings had significantly elevated mercury concentrations in their hair and nails, suggesting the importance of mercury exposure assessment in hidden, less-explored sources of Hg in the workplace.(J Occup Health 2014; 56: 56–61)

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Objectives: We aimed to identify current practice of sun protection and factors associated with effective use in four outdoor worker industries in Queensland, Australia. Methods: Workplaces in four industries with a high proportion of outdoor workers (building/construction, rural/farming, local government, and public sector industries) were identified using an online telephone directory, screened for eligibility, and invited to participant via mail (n=15, recruitment rate 37%). A convenience sample of workers were recruited within each workplace (n=162). Workplaces' sun protective policies and procedures were identified using interviews and policy analysis with workplace representatives, and discussion groups and computer-assisted telephone interviews with workers. Personal characteristics and sun protection knowledge, attitudes and behaviors were collated and analysed. Results: Just over half the workplaces had an existing policy which referred to sun protection (58%), and most provided at least some personal protective equipment (PPE), but few scheduled work outside peak sun hours (43%) or provided skin checks (21%). Several worker and workplace characteristics were associated with greater sun protection behaviour among workers, including having received education on the use of PPE (p<0.001), being concerned about being in the sun (p=0.002); and working in a smaller workplace (p=0.035). Conclusions: Uptake of sun protection by outdoor workers is affected by a complex interplay of both workplace and personal factors, and there is a need for effective strategies targeting both the workplace environment and workers' knowledge, attitudes and behaviors to decrease harmful sun exposure further.(J Occup Health 2014; 56: 62–72)

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Objectives: The aim of this study was to determine the rate of burnout and the contributing factors behind it among physicians in Shanghai. Methods: In this cross-sectional study, a total of 457 physicians from 21 hospitals in Shanghai completed self-reported questionnaires in June 2008. The Chinese version of the job content questionnaire (C-JCQ) and the Chinese version of the effort-reward imbalance questionnaire (C-ERI) were used to measure occupational stress. The Chinese version of Maslach Burnout Inventory (C-MBI) was used to measure burnout rate. We then performed regression analysis of physician burnout. Results: The MBI model revealed that 277 physicians (60.6%) were experiencing a mild degree of burnout and that 27 physicians (5.9%) were experiencing a severe degree of burnout. In the assessment of occupational stress, most physicians (64.8%) had a demand/control ratio higher than 1, and 21.9% of all physicians had an effort/reward ratio higher than 1, indicating a high level of occupational stress exposure. Regression analyses showed higher levels of burnout among physicians of younger age, less work experience, longer working hours, on shift duty, or from highergrade hospitals. Both the JCQ and ERI models showed good predictive power for physician burnout, with the ERI model performing better. Conclusions: Physicians in Shanghai were experiencing a high degree of burnout, which was significantly associated with occupational stress as well as distinctive personal and work characteristics. Interventions aiming at reducing job-related stress can be effective approaches to prevent burnout among physicians.(J Occup Health 2014; 56: 73–83)

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