Background: Exposure to high ergonomic risk resulted in an increasing prevalence of musculoskeletal disorders among dental professional. However, little is known about the high exposure risk impact on work ability among dental professionals.

Objective: We conducted a cross-sectional study to examine the association between ergonomic risk exposure and work ability among young dental professionals in their early careers.

Methods: A total of 230 dental professionals including dentists, dental assistants, and nurses were clustered sampled from three hospitals in Guangzhou, south of China. We used the Quick Ergonomic Check (QEC) to assess participants' ergonomic risk exposure and Work Ability Index (WAI) to evaluate their work ability. Demographics and other factors related with WAI were also included in the data collection. Multiple linear regression was applied to analyze the association between ergonomic exposure scores and WAI.

Results: A total of 218 participants (94.8%) had valid data and consent forms. The participants' average WAI was 39.6, of which the poor and moderate WAI composed 31%. High and very high ergonomic risk exposure level was 45.9% for the neck and 21.1% for the wrist/hand. In general, WAI decreased with higher ergonomic exposure level. With adjustment of other potential risk factors, the ergonomic scores for wrist/hand and total scores for the whole body were significantly associated with the decreased WAI.

Conclusion: High ergonomic risk exposure might risk in reducing work ability among young dental professionals. Intervention measures toward ergonomic risk should be taken to prevent WAI from decreasing in their early careers.

Objectives: Work engagement is defined as a positive, fulfilling feeling about one's job and is associated with higher productivity and morale. We performed a cross-sectional study to investigate whether work engagement is related to healthier dietary behaviors among Japanese workers.

Methods: The present study was part of the Japanese Study of Health, Occupation, and Psychosocial Factors Related to Equity. A validated food frequency questionnaire was used to evaluate daily nutritional intake. The following seven nutrients were considered: salt intake, dietary fat (saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids), dietary fiber, folate, and isoflavone. Multivariable linear regression analysis was performed, adjusting for job stress, psychological distress, and other confounders. The baseline survey inquired about work engagement among 2,233 employees of 12 workplaces in Japan, representing a range of industries.

Results: The mean age of the sample was 43.4 ± 9.7 years and 89.7% of the participants were male. The mean score of work engagement was 2.9 ± 1.0. Higher work engagement was significantly positively associated with higher salt intake (β = 0.17, SE = 0.06, P = .006), monounsaturated fatty acids (β = 0.29, SE = 0.13, P = .03), polyunsaturated fatty acids (β = 0.28, SE = 0.09, P = .001), dietary fiber (β = 0.23, SE = 0.09, P = .012), and folate (β = 10.2, SE = 2.9, P = .005) consumption, but not saturated fatty acid (β = 0.16, SE = 0.11, P = .13) or isoflavone (β = 0.64, SE = 0.36, P = .072).

Conclusion: The present study suggested that higher work engagement is associated with a healthier pattern of dietary behaviors among workers. Improving work engagement may be a novel target for workplace health promotion.

Objectives: Along with technological innovations for improving the efficiency of printing, nanoparticles have been added to the surface of toners, and there is concern about the harmful effects of those components. We investigated, through a long-term observation following intratracheal instillation using rats, whether exposure to a toner with external additives can cause tumorigenesis.

Methods: Female Wistar rats were intratracheally instilled with dispersed toner at low (1 mg/rat) and high (2 mg/rat) doses, and the rats were sacrificed at 24 months after exposure, after which we examined pulmonary inflammation, histopathological changes, and DNA damage in the lung. Rats that had deceased before 24 months were dissected at that time as well, to compare tumor development.

Results: Although alveolar macrophages with pigment deposition in the alveoli were observed in the 1 and 2 mg exposure groups, no significant lung inflammation/fibrosis or tumor was observed. Since immunostaining with 8-OHdG or γ-H2AX did not show a remarkable positive reaction, it is thought that toner did not cause severe DNA damage to lung tissue.

Conclusion: These results suggest that toner with external additives may have low toxicity in the lung.

Objective: The aim of this study was to evaluate the validity of self-reported medication use for hypertension, diabetes, and dyslipidemia by comparison with health insurance claims among employees of large-sized companies in Japan.

Methods: Participants were 61 676 participants of 13 large-sized companies in Japan. Self-reports on medication use were obtained through web- or paper-based questionnaires conducted at the annual health checkup in fiscal year 2016. Health insurance claims for medication were obtained from corporate health insurance associations from April 1, 2016, to March 31, 2017. Agreement rate, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and kappa statistics of self-reporting were examined for different reference periods (1-, 2-, and 3- months, and 1-year). Subgroup analysis was conducted stratified by sex, age, body mass index, smoking, alcohol drinking, blood pressure, hemoglobin A1c, and low-density lipoprotein cholesterol.

Results: Agreement, sensitivity, specificity, PPV, and NPV were 0.98, 0.90, 0.98, 0.87, and 0.99 for hypertension, 0.99, 0.89, 1.00, 0.89, and 1.00 for diabetes, and 0.98, 0.86, 0.99, 0.83, and 0.99 for dyslipidemia, respectively, between self-reports and claims data for 3 months. Kappa statistics were highest with the 3-month reference period of claims data for hypertension, diabetes, and dyslipidemia. No major concordance was observed between the subgroups.

Conclusion: This validation of self-reported medication use for hypertension, diabetes, and dyslipidemia showed almost perfect reliability among employees of large-sized companies in Japan.

Objectives: This study was designed to investigate the possible effect of exposure to extremely low frequency electromagnetic fields (ELF-EMFs) on occupational burnout syndrome and the severity of depression experienced among thermal power plant workers and the role of oxidative stress.

Methods: In this cross-sectional study, 115 power plant workers and 124 administrative personnel of a hospital were enrolled as exposed and unexposed groups, respectively, based on inclusion and exclusion criteria. Levels of oxidative stress biomarkers, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (Cat), and total antioxidant capacity were measured in serum samples. Exposure to electric and magnetic fields was measured using the IEEE Std C95.3.1 standard at each workstation. The burnout syndrome and the severity of depression were assessed using the Maslach Burnout and Beck Depression Inventory.

Results: The levels of MDA and SOD were significantly lower in the exposed group than the unexposed group. The exposed group reported a higher prevalence of burnout syndrome and higher depression severity. Multiple linear regression showed that work experience, MDA level, and levels of exposure to magnetic fields are the most important predictor variables for burnout syndrome and severity of depression. In addition, a decrease in the level of Cat was significantly associated with increased burnout syndrome.

Conclusion: The thermal power plant workers exposed to ELF-EMFs are at risk of burnout syndrome and depression. These effects may be caused directly by exposure to magnetic fields or indirectly due to increased oxidative stress indices.

Objectives: Occupational health (OH) professionals could play a prominent role in smoking cessation treatment and support (SCTS) and help individuals and workplaces become smoke free. However, their role has not been evaluated. The aim of this study was to assess differences between OH professionals' perceptions of their role in SCTS by measuring three groups of OH professionals' attitudes, knowledge, and motivation concerning SCTS.

Methods: We collected data through an online survey completed by a cross-sectional sample of OH professionals: OH physicians (n = 182), OH nurses (n = 296), and OH physiotherapists (n = 96), collected from national trade union registers. The differences between the OH professional groups were analyzed using ANOVA, the Kruskal-Wallis, and chi-square tests.

Results: The OH professionals had a positive attitude toward offering SCTS and were highly motivated to enhance their knowledge of this topic and acquire further training. The OH physicians and OH nurses assessed their current knowledge as sufficient. Conversely, the OH physiotherapists' level of knowledge was seen as insufficient. Traditionally, OH physicians and OH nurses have been responsible for carrying out SCTS, but the majority of the OH physiotherapists thought that SCTS should also be included in their job description.

Conclusions: All the OH professionals were highly motivated to deepen their knowledge of SCTS. The barriers between different professionals need to be recognized in occupational health services (OHS). OHS should organize its SCTS more effectively, strengthen their contributions to smoking cessation programs, and recognize the potential of OH physiotherapists for providing SCTS and enable them to expand their training.

Objectives: This descriptive study aims to examine the relationship between the safety awareness of healthcare professional and their safety behaviors.

Methods: The study was carried out on 418 healthcare professionals working in a training and research hospital in Ankara/Turkey. The survey method was used as data collection tool. The questionnaire consisted of 3 sections and 18 questions. First section consisted of questions on sociodemographic characteristics and, second section consisted of the awareness scale and third section consisted of safety behaviors scale.

Results: The safety awareness and safety behaviors are scored on a scale from 1 (completely disagree) to 5 (completely agree). The safety awareness and safety behaviors has an average score of 3.85 ± 0.81 and 3.56 ± 0.82, respectively. The safety awareness and safety behavior levels of healthcare professionals were found to be high.

Conclusion: A significant positive correlation was found between safety awareness and safety behaviors and it was concluded that the increase in safety awareness led to an increase in safety behavior.

Aims: Employers in the United States incur substantial costs associated with substance use disorders. Our goal was to examine the effectiveness of employer-led interventions to reduce the adverse effects of drug misuse in the workplace.

Methods: We conducted a systematic review of studies that evaluated the effectiveness of recommended workplace interventions for opioids and related drugs: employee education, drug testing, employee assistance programs, supervisor training, written workplace drug-free policy, and restructuring employee health benefit plans. We searched PubMed MEDLINE, EMBASE (embase.com), PsycINFO (Ebsco), ABI Inform Global, Business Source Premier, EconLit, CENTRAL, Web of Science (Thomson Reuters), Scopus (Elsevier), Proquest Dissertations, and Epistemonikos from inception through May 8, 2019, with no date or language restrictions. We included randomized controlled trials, quasi-experimental studies, and cross-sectional studies with no language or date restrictions. The Downs and Black questionnaire was used to assess the quality of included studies. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results: In all, 27 studies met our inclusion criteria and were included in the systematic review. Results were mixed, with each intervention shown to be effective in at least one study, but none showing effectiveness in over 50% of studies. Studies examining the impact of interventions on workplace injuries or accidents were more commonly reported to be effective. Although four studies were randomized controlled trials, the quality of all included studies was “fair” or “poor.”

Conclusions: Despite the opioid epidemic, high-quality studies evaluating the effectiveness of employer-led interventions to prevent or reduce the adverse effects of substance use are lacking. Higher quality and mixed methods studies are needed to determine whether any of the interventions are generalizable and whether contextual adaptations are needed. In the meantime, there is a reason to believe that commonly recommended, employer-led interventions may be effective in some environments.

Objectives: The study investigated the links between workplace measures implemented in response to COVID-19 with mental health and work performance of employees in Japan.

Methods: This was a cross-sectional study of a sample from a cohort study of full-time employees. Participants (n = 1448) completed an online self-report questionnaire on March 19-22, 2020. Multiple linear regression was conducted to ascertain their fear of and worry associated with COVID-19, psychological distress, and work performance.

Results: The number of workplace measures correlated positively with respondents' fear of and worry associated with COVID-19 (adjusted standardized β = 0.123, P < .001), negatively with psychological distress and positively with work performance (adjusted standardized β = −0.068, P = .032; adjusted standardized β = 0.101, P = .002; respectively).

Conclusions: Workplace measures may promote and maintain the mental health and work performance of employees during the COVID-19 epidemic. The positive association between the number of measures and fear and worry about COVID-19 may reflect increased awareness about COVID-19 among employees resulted from taking the measures.

Introduction: Low back pain (LBP) is a major health problem with significant public health and economic burden. Few studies have clarified the role of psychosocial factors in LBP occurrence. In this study, we assessed psychosocial and occupational factors associated with LBP, within the last 12 months, among nurses in Saudi Arabia.

Methods: A cross-sectional study was conducted in 16 hospitals across Riyadh, Saudi Arabia. A sample of 427 nurses was surveyed. The anonymous questionnaire contained valid and reliable questions assessing LBP, as pain between the costal margins of the 12th rib and the gluteal folds, and questions related to psychosocial and work-related factors experienced by the nurses. Descriptive statistics were reported for all variables. Univariate and multivariate logistic regression analyses assessed the likelihood of significant associations between study variables and LBP.

Results: The prevalence of reported LBP was 80%. Factors associated with LBP in univariate analysis were frequent lifting (OR = 2.32; 95%CI: 1.34-4.01), work-related stress (OR = 5.81; 95%CI: 3,37-9,62), lack of job satisfaction (OR = 2.08; 95%CI: 1.13-3.85), work-related problems (OR = 2.40; 95%CI: 1.44-4.02), and financial problems (OR = 2.08; 95%CI: 1.26-3.38), while factors that remained significantly associated with LBP in the final multivariate analyses were frequent lifting (OR = 2.04; 95%CI:1.09-3.81), work-related stress (OR = 4.22; 95%CI: 2.34-7.48), and lack of job satisfaction (OR = 1.87; 95%CI: 1.24-3.58).

Conclusion: The prevalence of LBP is high in this sector of the health-care workforce. Ergonomic and psychosocial factors may be considered contributing factors for low back pain. Special attention to stress-reduction, counseling, and policies to improve job satisfaction are recommended in order reduce LBP and improve the health and safety of nurses in Saudi Arabia.

Introduction: In times of extending working lives, it is relevant to understand why, today, most workers leave employment long before regular retirement age. Financial factors have been central for explaining retirement timing, yet their impact seems rather complicated. This study explores the motivation to keep working, in relation to the economic household conditions among older workers and it investigates the impact of socio-demographic, individual and work factors on the motivation to keep working (MTW), again differentiated by economic household condition.

Methods: Based on data from wave three (2018) of the lidA Cohort Study, a representative interview study of socially insured employees born in 1959 or 1965 in Germany, descriptives and linear regression analyses were performed among 2835 employed participants. For all analyses, the sample was divided into five household equivalized net income groups.

Results: The groups with low and second lowest income were most motivated to work longer, followed by those with the highest income. The lowest income group exhibited most adverse scores for work indicators and health. Furthermore, in this group, MTW was unrelated to physical and mental health indicating that the comparably high motivation may be driven by financial imperatives.

Discussion and Conclusions: The findings indicate that many workers with low income may find themselves forced to extend their working life, irrespective of their health. This requires increased attention by research as well as policy. Policy might have to acknowledge group specific negative side effects of regulations effectively extending working lives.

On 31 December 2019, the World Health Organization (WHO) received reports of pneumonia cases of unknown etiology in the city of Wuhan in Hubei Province, China. The agent responsible was subsequently identified as a coronavirus-SARS-CoV-2. The WHO declared this disease as a Public Health Emergency of International Concern at the end of January 2020.

This event evoked a sense of déjà vu, as it has many similarities to the outbreak of severe acute respiratory syndrome (SARS) of 2002-2003. Both illnesses were caused by a zoonotic novel coronavirus, both originated during winter in China and both spread rapidly all over the world. However, the case-fatality rate of SARS (9.6%) is higher than that of COVID-19 (<4%). Another zoonotic novel coronavirus, MERS-CoV, was responsible for the Middle East respiratory syndrome, which had a case-fatality rate of 34%.

Our experiences in coping with the previous coronavirus outbreaks have better equipped us to face the challenges posed by COVID-19, especially in the health care setting. Among the insights gained from the past outbreaks were: outbreaks caused by viruses are hazardous to healthcare workers; the impact of the disease extends beyond the infection; general principles of prevention and control are effective in containing the disease; the disease poses both a public health as well as an occupational health threat; and emerging infectious diseases pose a continuing threat to the world. Given the perspectives gained and lessons learnt from these past events, we should be better prepared to face the current COVID-19 outbreak.

Objectives: Limited information exists concerning occupational risks in decontamination work after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Workers involved tend to be migrant workers, face various health risks, and are usually from a low socioeconomic background and generally have difficulty in finding employment. We report a specific case to illustrate the way these workers tend to get injured during working hours and draw attention to the problems arising.

Case presentation: A 59-year-old Japanese male decontamination worker was referred to our emergency department after a fall while he was working in an Exclusion Zone surrounding the FDNPP. He was blind in his right eye. He was diagnosed with traumatic multiple rib fractures and a tube thoracostomy was performed. He was discharged from hospital after 7 days. Payment has been changed from “occupational accident,” which is required to be reported to the Local Labor Standards Office, to “general medical treatment” which is no obligation.

Conclusion: Trauma or physical injury of any kind is an occupational hazard for workers, especially those operating in the chaotic and unpredictable environments following any disasters. Companies employing such workers and owners of any facilities or locations in which they may be working are responsible for the safety of their workers. They should provide appropriate training and should comply with all prevailing Employment Laws and follow mandatory safety regulations. If companies and authorities are in breach of any laws, ignore their responsibilities, or jeopardize the health of their workers, they should be held accountable.

Objective: To examine whether the cross-sectional association of leisure-time physical activity and walking during commuting to work with depressive symptoms depends on the level of work-related physical activity among Japanese workers.

Methods: Participants were 2024 workers aged 19-69 years in two manufacturing companies in Japan. Leisure-time physical activity and walking during commuting to work were ascertained via a self-administered questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. The odds ratio (OR) of depressive symptoms (CES-D score ≥16) was estimated by using multiple logistic regression with adjustment for covariates.

Results: Leisure-time physical activity was inversely associated with depressive symptoms; multivariable-adjusted ORs (95% confidence intervals) of having depressive symptoms for leisure-time physical activity were 1.00 (reference), 0.85 (0.64, 1.12), 0.69 (0.51, 0.94), and 0.59 (0.44, 0.80) for 0, >0 to <3.0, 3.0 to <10.0, and ≥10.0 MET-h/wk, respectively (P for trend <.001). This inverse trend for leisure-time physical activity was clearer among individuals who had low physical activity at workplace (less than 7.0 MET-h/d). For walking to work, such an inverse association was not observed.

Conclusion: Leisure-time physical activity was associated with fewer depressive symptoms, especially in workers with low work-related physical activity.

Objectives: It has been reported that South Korea ranked as one of the longest-working nations among OECD countries. This study sought to examine the association between long working hours and musculoskeletal pain among Korean medical residents.

Methods: We analyzed a cross-sectional survey of 1,077 medical residents in South Korea. Working hours per week were categorized as follows: <60, 60-79, 80-99, and ≥100. Musculoskeletal pains (ie, upper limb, lower limb, and low back pain) over the past 3 months were categorized into three groups: no pain, pain without interfering with work, and pain interfering with work. Multinomial logistic regression was used to examine the association between long working hours and musculoskeletal pains after adjusting for covariates.

Results: We found that the average working hours of medical resident was 85.6 hours per week in South Korea. Compared to the medical residents working <60 hours, those working ≥100 hours per week were more likely to have upper limb pain (PR: 1.77, 95% CI: 1.37, 2.30) interfering with work or low back pain (PR: 2.15, 95% CI: 1.51, 3.06) interfering with work, whereas no statistically significant association was observed in the analysis of lower limb pain.

Conclusions: This study suggests that extremely long working hours are associated with upper limb and low back pain interfering with their work among Korean medical residents.

Objectives: Welders demonstrate a significant prevalence of work-related musculoskeletal disorders as indicated by high rates of illness-related absenteeism. The aim of the study was to investigate the effects of a 24-week exercise program on workload, physical performance, and overall health in welders.

Methods: Seventy-seven professional welders were assigned to either a control group (CG), an endurance training group (ETG), or a strength training group (STG). Both groups conducted a 24-week, standardized and progressive endurance or resistance exercise training program. Before (TP1) and after training (TP2) all participants performed an experimental welding task (EWT) in order to test the hypothesis that training would reduce the relative load (%MVC) of eight skeletal muscles measured by surface electromyography. Secondary outcome measures included further EWT-induced stress parameters and a series of health-related outcome measures.

Results: Results revealed a lower muscle load in participants of the ETG and STG for trapezius muscle at TP2 compared to T1 (P < .05 vs CG). Rate of perceived exertion and visual analogue scale were decreased, while increase of maximum EWT duration was found in participants of the ETG and STG after training (P < .05 vs CG). At T2, body fat (%) decreased and physical performance (bicycle exercise test, isometric strength of core muscles) increased in ETG and STG (P < .05).

Conclusion: Both regular endurance and strength training represent effective strategies for reducing workload and improving physical performance of welders. The results emphasize the importance of physical fitness for welders and might motivate health professionals in steel-industry to offer access to exercise training programs.

Objectives: It is common to find doctors working long and odd hours and many at times without rest and sleep. Despite the evidence of adverse risk, jeopardizing patient safety under the hands of fatigue doctors under such working hours has not changed in many places. It has argued that with such training and subsequent experience, such issues with patient safety reduce. Fatigue too is argued as subjective, as those who can withstand the stress still perform. Nevertheless, undeniably working under fatigue is not safe for both the patient and the doctor. This study is a novel attempt to explore and objectify the state of fatigue using quantitative EEG among post-call doctors.

Method: Seven volunteer post-call doctors were recruited to go through an EEG recording before and after their on-call rotation while at rest and subsequently while carrying out Stroop Test, putting their cognitive function at work.

Results: The doctors have worked up to 33 hours in a row and have had sleep of an average of 1.5 hours. It is found that during task there is a statistically significant increase in theta (frontal and occipital regions) and beta (occipital region) band power while at task post-call. Alpha band power is increased in the frontal and reduced in other regions. Correlation with Stroop Test results indicated that those who have higher alpha, beta, and lower relative theta powers at the frontal region at post-call rest have higher percentage of correct congruent trials.

Conclusion: The results objectively imply that these fatigue doctors are under more strain while carrying out a task and corresponds to the implicated regions of brain stimulated by the task accordingly.

Objectives: This study aimed to characterize injuries and illnesses among construction workers in the State of Oregon in the US and examine the association between injury frequency and severity with hour of work by using Workers’ Compensation (WC) accepted disabling claims data in the construction industry from 2007 to 2013.

Methods: Injury frequency, rate, medical cost, and lost work days were analyzed by year, demographics, employment, injury nature, and temporal factors including hour of work. Multiple linear regression models were used to quantify adjusted associations between hour of work and medical cost and lost work days (indicating injury severity).

Results: There were a total of 12 222 disabling claims in the Oregon construction industry. The average annual injury rate was 2.21 per 100 workers. Both the count and rate of disabling claims decreased during the study period. Male workers and young workers had higher injury rates, while medical cost and lost work days increased for older workers. Injuries occurring at night were more severe. The distribution of claims frequency by hour of work was bimodal, with peaks in the 4th and 8th hour. Compared with the first hour of work, the 5th and 13th hours corresponded to significantly more severe injuries and illnesses.

Conclusions: This study identified the burden and distribution of work-related injuries and illnesses in the Oregon construction industry. Continued intervention efforts should target certain subpopulations (eg, young workers) and certain working time periods (eg, mid- and end-shift) to protect construction workers’ safety and health.

Objectives: Migraine is a chronic neurological disorder characterized by recurrent attacks of headache, mainly affecting the working age population with a great socioeconomic impact. The etiology of migraine is still uncertain, and various individual and/or environmental risk factors have been suggested as triggers of the attacks, including irregularities in the sleep-wake rhythm. In this perspective, it is possible that shift and night work, affecting circadian rhythms, may play a key function in the disease pathogenesis. Therefore, aim of this review was to provide an overview on the possible association between shift works and migraine development or clinical outcomes.

Methods: A systematic review of literature studies available in Pubmed, Scopus, and ISI Web of Science databases, addressing the possible shift work-migraine relationship was performed.

Results: Conflicting data emerged from the revised studies. Some results supported a positive association between migraine prevalence and shift works, according to peculiar job tasks, seniority in shift works, specific work schedules, and number of night shifts performed in a month. However, other investigations failed to confirm such findings.

Conclusions: The limited number of available studies, their cross-sectional nature, the different criteria employed for migraine diagnosis, and the various shift work schedules analyzed, together with exposure to other confounding factors on workplace do not allow to extrapolate definite conclusions on shift work-migraine relationship. From an occupational health perspective, further studies appear necessary to better understand such exposure-disease association and possibly define risk assessment and management strategies to protect the health of susceptible and/or migraine affected workers.

Objective: In this study, in order to investigate the usefulness of intratracheal instillation in assessing the pulmonary toxicity of nanomaterials, intratracheal instillation of nickel oxide-nanoparticles (NiO-NP) was performed.

Methods: In this study, rats were administered test materials by intratracheal instillation at five different research institutions in order to assess the validity of using intratracheal instillation for hazard identification of nanomaterials. Eight-week-old male SD rats were administered NiO-NP dispersed in deionized water by a single intratracheal instillation at doses of 0 (vehicle control), 0.2, 0.67, and 2 mg/kg BW. Three days after instillation, histopathological examination of the lungs was performed.

Results: NiO-NP was distributed in the vicinity of hilus of the lung and in the alveoli around the bronchioles. Histopathological changes such as degeneration/necrosis of macrophages, inflammation, and proliferation of type II pneumocyte in the lung were observed, and their severity corresponded with increasing dose. The histopathological observations of pulmonary toxicity were almost similar at each institution.

Conclusion: The similarity of the histopathological changes observed by five independent groups indicates that intratracheal instillation can be a useful screening method to detect the pulmonary toxicity of nanomaterials.

Objectives: Very few longitudinal studies have investigated the question of whether differences in company size may give rise to health inequalities. The aim of this study was to examine the relationship between company size of the longest-held job and mortality in older Japanese adults.

Methods: This study used longitudinal data from the Japan Gerontological Evaluation Study. Surveys were sent to functionally independent individuals aged 65 or older who were randomly sampled from 13 municipalities in Japan. Respondents were followed for a maximum of 6.6 years. The Cox proportional hazards model was used to calculate mortality hazard ratios (HRs) for men and for women. Analysis was carried out on 35 418 participants (197 514 person-years).

Results: A total of 3935 deaths occurred during the 6-year follow-up period. Among men, in Model 1 that adjusted for age, educational attainment, type of longest-held job, and municipalities, mortality HRs decreased significantly with increasing size of company (P for trend = .002). Compared to companies with 1-9 employees, the mortality HR (0.78, 95% confidence interval: 0.68-0.90) was significantly lower for companies with 10 000 or more employees. However, there were no significant differences among women (P for trend = .41).

Conclusions: In men, mortality in old age may decrease with increasing size of company of the longest-held job. To reduce health inequalities in old age due to differences in size of company, studies should be conducted to determine the underlying mechanisms and moderating factors and those findings should be reflected in labor policies and occupational health systems.

Objectives: Chromogranin A (CgA) is regarded as an indicator of sympathetic tone and adrenomedullary system activity. Catestatin is one of CgA-derived fragments through proteolytic processing. Many studies have confirmed the correlation between anxiety/depression and the salivary CgA level. The study was to investigate the associations between anxiety/depression and plasma CgA/catestatin levels in healthy workers without cardiovascular disease.

Methods: The study included 263 healthy workers (175 men and 88 women). The symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS). Plasma CgA and catestatin levels were measured by ELISA kits.

Results: In bivariate correlation analysis, anxiety and depression were positively associated with plasma CgA level, respectively (r = 0.298, P < .001; r = 0.304, P < .001), but not significantly associated with plasma catestatin level.

The anxiety group had significantly higher plasma CgA level than that in the no-anxiety group (median 158.60 vs 70.90, P < .001). The similar results were found for depression scales. The depression group had significantly higher plasma CgA level (median 145.60 vs 82.40, P < .001).

In the multiple linear regression model, after adjusting for age, gender, and BMI, anxiety was positively correlated with plasma CgA level (β = 0.359, P < .001), while anxiety was negatively correlated with plasma catestatin level (β = −0.128, P = .044), depression was also positively correlated with plasma CgA level (β = 0.343, P < .001).

Conclusions: Plasma CgA was associated with anxiety and depression in healthy workers. It can be considered as the blood indicator for the evaluation of anxiety and depression.

Objectives: The problem of spinal pain among nurses and lack of compliance with workplace ergonomy is increasing. The study aimed to assess the pressure pain threshold (PPT) at the cervical and lumbar spine in nursing staff.

Methods: The sample of this prospective and observational study consisted of 30 female nurses with a mean age of 38.6 ± 11.1 years. The standardized Oswestry (ODI) and the Neck Disability Index (NDI) were used, as well as the Authors’ Designed Questionnaire (ADQ) was used to assess compliance with ergonomic principles. The PPT analysis using a computerized pressure algometer (CPA) was performed to examine the level of PPT.

Results: A mild disability was found in 56% of nurses (NDI and ODI). A value of <4 kg/cm² (CPA), indicating musculoskeletal overload was observed in 57% of subjects. Also, 60% of nurses work with a lying patient; 73.4% grabs the patient's armpits while transferring in bed; 16.7% never adjusts the height of the bed, and only 13.4% choose specialist footwear for work. There is a correlation between PPT values for trapezius and erector spinae muscles on the same side of the body in nurses with mild and moderate disability (P < .05).

Conclusions: Pain complaints are associated with lower PPT of trapezius and erector spinae muscles and asymmetry of muscle tension. Also, it was noted that the lack of implementation of ergonomic principles by nursing staff affects their degree of disability.

Objective: Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers.

Methods: A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m².

Results: The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m² and 0.2% had BMI ≥40 kg/m². Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered.

Conclusions: These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population.

Objectives: At the Fukushima Daiichi Nuclear Power Plant, run by the Tokyo Electric Power Company, new procedures were introduced as part of the fitness for duty program in July 2016. These were designed to ensure that treatment and further investigations identified as necessary during health examinations were carried out. This study aimed to assess the effectiveness of the initiative by testing whether workers who needed further health examinations obtained them promptly, and whether the number with unmet health needs decreased and the number of workers being treated increased.

Methods: The primary contractors reported aggregated quarterly results of health examinations of both their own and their subcontractors’ employees, and follow-up visits to medical institutions were also reported over the next two quarters. The study used data for the period from July 2016 to December 2018. Incident rate ratios were estimated using a multilevel Poisson regression model, including the logarithm of the number of workers who took health examination for each primary contractor company as offset. The linear trend was assessed by treating the number of periods as a continuous variable.

Results: The incident rate ratio for workers who needed treatment having a follow-up examination promptly showed a significant decrease over time. The incident rate ratio for those with unmet needs decreased, and those being treated increased over time.

Conclusions: The findings showed that the initiative was effective, with the number of early visits for further health examinations increasing and a decrease in the number of people with unmet health needs.

Objectives: Using annual health check-up data, the aim of this study was to identify target populations for lifestyle interventions to effectively prevent diabetes in a real-world setting.

Methods: The Japan Diabetes Outcome Intervention Trial-1, a prospective, cluster-randomized controlled trial, was launched to test if year-long telephone-delivered lifestyle support by health professionals can prevent the development of type 2 diabetes (T2D) in people with impaired fasting glucose (IFG) identified at health check-ups. A total of 2607 participants aged 20-65 years with IFG were randomized to an intervention arm (n = 1240) or a control arm (n = 1367). We performed subgroup analysis to examine the effects of the intervention on the incidence of T2D in participants with body mass index (BMI) ≥25, metabolic syndrome (MetS), and non-alcoholic or alcoholic elevated liver enzymes at the baseline. Cox regression analysis adjusted for sex was used to calculate the hazard ratios (HRs).

Results: In addition to IFG, the presence of BMI ≥25, MetS, and elevated liver enzymes increased the incidence of diabetes by two- or three-fold. During a median follow-up period of 4.9 years, only the non-alcoholic elevated liver enzyme group showed a low incidence rate owing to lifestyle interventions (adjusted HR: 0.42, 95% confidence interval: 0.18-0.98).

Conclusion: The results suggest that people who have IFG and non-alcoholic elevated liver enzymes are a good target population for lifestyle interventions to effectively reduce the incidence of diabetes in a real-world setting.

Objectives: The purpose of this research was to develop and validate an analytical method for rapid determination of the exposure of workers to ortho-phthalaldehyde (OPA) at the ceiling threshold concentration.

Methods: A 2,4-dinitrophenylhydrazine (DNPH)-silica cartridge was chosen as a sampler. OPA collected by the DNPH-silica cartridge was subsequently extracted with 5 mL of acetonitrile. A 50-µL aliquot of phosphoric acid/acetonitrile solution (2%, v/v) was added to 950 µL of the extraction solution and allowed to stand for 30 minutes at room temperature. This solution was then analyzed by high-performance liquid chromatography tandem mass spectrometry. The basic characteristics of the proposed method, such as recovery, repeatability, limit of quantification, and storage stability of the samples, were examined.

Results: The overall recoveries of OPA from OPA-spiked DNPH-silica cartridges were 93.6%-100.1% with relative standard deviations, representing the repeatability, of 1.5%-10.8%. The limit of quantification was 0.165 ng/sample. The recovery of OPA from DNPH-silica cartridges after 5 days of storage in a refrigerator exceeded 95%.

Conclusions: The proposed method enabled the determination of the OPA concentration corresponding to the Threshold Limit Value-Ceiling of 0.1 ppb recommended by the American Conference of Governmental Industrial Hygienists, with a minimum sampling time of 18 seconds (corresponding to a sampling volume of 300 mL at 25°C and 1 atm). Thus, this method will be useful for estimating worker exposures to OPA.

Objective: To investigate the association between dental consultation and oral health status among male Japanese employees.

Methods: The participants were 3351 male employees who received a workplace oral health examination conducted at the ages of 35, 40, 45, 50, 55, and 59 years before retirement in conjunction with an annual health checkup. Data on dental expenditures were collected from health insurance claims. The number of dental visits and dental care expenses, alone or in combination, were used as indices of the dental consultation status for the analyses. The effects of dental consultation status on oral health status (number of total teeth, number of decayed teeth, and periodontal status) were analyzed using multivariate multinomial logistic regression analyses adjusted for confounders.

Results: Multivariate analyses revealed that the odds ratio (OR) for 20-27 teeth (losing 1-8 teeth) was significantly higher (OR 1.4, 95% confidence interval (CI) 1.1-1.7) in those who had a high number of dental visits and high dental care expenses than in those who did not have a dental visit. By contrast, the ORs for ≤19 teeth (losing ≥9 teeth), having ≥3 decayed teeth, or having a periodontal pocket ≥6 mm were significantly lower (OR 0.2, 95% CI 0.1-0.6; OR 0.5, 95% CI 0.3-0.6; OR 0.7, 95% CI 0.5-1.0, respectively) in those who had fewer dental visits and lower dental care expenses.

Conclusions: These results imply that the dental consultation status is associated with oral health status among male employees.

Objectives: Historically, little was known about the effects of low blood lead level (BLL < 10 μg/dL) on hypertension (HTN). The purpose of this study was to assess the effects of low BLL on blood pressure (BP) and HTN in lead-exposed male workers in the Republic of Korea.

Methods: From the year 2000 to 2004, 12,060 male workers underwent an Annual Specialised Medical Check-up for lead; 7,341 subjects had a peak BLL < 10 μg/dL and were selected for the study. The quartiles of peak BLL in lead-exposed workers were as follows: first (0.01-3.68 μg/dL), second (3.69-5.19 μg/dL), third (5.20-6.86 μg/dL), and fourth (6.87-10.00 μg/dL). To examine the relationship between BLL and pre-HTN (systolic BP [SBP] ≥120-140 mmHg; diastolic BP [DBP] ≥80-90 mmHg) and between BLL and HTN (SBP ≥ 140 mmHg; DBP ≥ 90 mmHg), the quartiles of BLL were used as independent variables in multiple logistic regression analysis.

Results: In multiple linear regression analyses, SBP (β 0.04, P < .01) and DBP (β 0.06, P < .01) increased in line with a 1 μg/dL increase in BLL. The odds ratio (OR) of HTN in the fourth versus first BLL quartile (1.54; 95% confidence interval [CI]: 1.26, 1.89) was statistically significant.

Conclusion: SBP and DBP were statistically significantly associated with peak BLL. A BLL ≥ 6.87 μg/dL was associated with HTN; thus, even in workers with low BLLs (<10 μg/dL), management of BP is likely to be necessary. Modulation of the current safety standards for BLLs in workers will be needed.

Objective: This study aimed to evaluate the efficacy of increased daily walking steps on the 6-month incidence of neck pain among office workers.

Methods: Healthy office workers with high risk of neck pain were recruited into a 6-month prospective cluster-randomized controlled trial. Participants were randomly assigned at the cluster level, into either intervention (n = 50) or control (n = 41) groups. Participants in the intervention group were instructed to increase their daily walking steps to a designated level for a duration of 6 months. Participants in the control group received no intervention. The outcome measures included the 6-month incidence of neck pain as well as its pain intensity and disability level. Analyses were performed using multivariable logistic regression model.

Results: Of the participants in the intervention and control groups, 22% and 34% reported a 6-month incidence of neck pain, respectively. After adjusting for confounders, a significant preventive effect of walking intervention was found (adjusted odd ratio 0.22, 95% confidence interval 0.06-0.75). No significant difference in pain intensity and disability level was found between those in the intervention and control groups.

Conclusion: An intervention to increase daily walking steps reduced onset neck pain in high-risk office workers. However, the walking interventions did not decrease pain intensity and disability in those increasing the number of daily walking steps compared to the control group.

Objectives: Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses.

Methods: The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait.

Results: We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045).

Conclusions: Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses’ work productivity.

Objectives: Osteoarthritis (OA) is a common disorder which affects the joints. As relationships between occupational factors and lower limb OA have been widely studied in systematic reviews, the aim of this umbrella review was to synthesize their key findings in the risk factors for development of lower limb OA.

Methods: A systematic search was conducted using the databases PUBMED, Cumulative Index of Nursing and Allied Health Literature, and Elton B Stevens Company to identify reviews examining associations between lower limb OA and occupational tasks. These reviews were rated for their methodological quality before key data were extracted and synthesized.

Results: Sixteen reviews were found, seven pertained to the knee, four to the hip, two to a variety of joints, and three to both the hip and knee. One was deemed to be of high methodological quality, one of critically low methodological quality, and the others of moderate methodological quality. The reviews found moderate to good evidence for heavy occupational lifting to be associated with an increased risk of OA at the knee and the hip. Kneeling, squatting, and climbing, previous injuries to joints, being overweight and obese were also predictive of lower limb OA.

Conclusion: Occupations which involve heavy physical workloads increase the risk of developing lower limb OA. Heavy lifting, squatting, knee bending, kneeling, and climbing may all increase the risk of developing OA in both the knees and hips. Efforts to reduce exposure to these tasks, reducing joint injuries, optimizing bodyweight may reduce the risks of lower limb OA for occupations which are physically demanding.

Objectives: Ultraviolet radiation (UVR) emitted during arc welding frequently causes keratoconjunctivitis and skin erythema. The extent of the hazard of UVR varies depending on the welding process and conditions. Therefore, it is important to identify the levels of UVR present under different conditions. The purpose of this study was to investigate the degree of hazard of UVR emitted by the different types of arc welding of cast iron frequently used in industry.

Methods: In this study, we experimentally measured the UVR emitted during gas tungsten arc welding (GTAW), shielded metal arc welding (SMAW), and gas metal arc welding (GMAW) of cast iron. The degree of hazard of UVR was quantitatively evaluated in accordance with the guidelines of the American Conference of Governmental Industrial Hygienists.

Results: Effective irradiances measured in this study were in the range 0.045-2.2 mW/cm² at a distance of 500 mm from the welding arc. The maximum allowable exposure times corresponding to these levels were only 1.4-67 s/day.

Conclusions: UVR emitted during arc welding of cast iron has the following characteristics: (a) It is more hazardous at higher welding currents. (b) The magnitude of the hazard, which depends on the welding process, increases in the order of GMAW > SMAW > GTAW. (c) It is influenced by the filler material used; that is, the components contained in the filler material affect the hazard of UVR. The effect is Fe > Ni, Cr

Objectives: Practitioners and organizational leaders are calling for practical ways to explain and monitor factors that affect workplace health and productivity. This article builds on the well-established Job Demands-Resources (JD-R) model and proposes an empirically tested ratio that aggregates indicators of job resources and demands. In this study, we calculate a ratio of generalizable job resources and demands derived from the JD-R model and then translate the ratio into the language of company stakeholders.

Methods: We calculated a ratio based on measures applied in a large stress management intervention study (n = 2983) and report the findings from cross-sectional analysis with health and productivity outcomes from same-source and separate-source data.

Results: Findings showed a strong and unambiguous increase in health and productivity measures with each step of increase in the ratio. Loss in explained variance due to aggregation of two factors into a single ratio is small for measures which are known to be predicted by both factors simultaneously.

Conclusions: A translation and visualization of the ratio that is accessible to practitioners and organizational leaders is presented and its use in companies discussed.

Objectives: With the increasing demand for the detection of occupational hazard factors in workplaces, the national standard determination method for ammonia (sampling with absorbing solution-analysis with Nessler reagent spectrophotometry) in the air of workplace presents many drawbacks during application in China. This review summarized the improvement and the alternate methods of the current sampling and analysis procedures for ammonia, aiming to provide reference to establish an appropriate method for the determination of ammonia in workplace air.

Methods: Scientific publications in English and Chinese and the standard methods of the Deutsche Forschungsgemeinschaft (DFG) in Germany, the National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) in the United States, and Ministry of Health in China for airborne ammonia collection and analysis in the workplace were reviewed.

Results: The measures to improve the current sampling and analysis procedures for ammonia in China were firstly summarized. For sampling, the decrease of absorbing solution concentration and the methanesulfonic acid solution as the alternate sampling solution were suggested. For analysis, the anti-interference measures and the optimum reaction condition between ammonia and Nessler reagent were discussed. The alternate methods including sampling conducted using solid sorbent tubes and analysis performed by ion chromatography were then considered for the determination of ammonia.

Conclusions: The methods-sampling with acid-treated solid sorbent tubes and analysis with ion chromatography-were more suitable for the determination of ammonia in workplace air. However, some details about ammonia sampling and analysis still need further investigation.

Objectives: We aimed to compare the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with risk of cardiovascular disease (CVD) among middle-aged working Japanese men.

Methods: A nested case-control study was performed among middle-aged male employees who underwent periodic health checkup. A total of 241 CVD cases were identified and matched individually on age, gender, and worksite with 1205 controls. Data on BMI, WC, WHtR, smoking, hypertension, diabetes, and dyslipidemia collected at 4 years before the event/index date were retrieved. Associations between BMI, WC, WHtR, and CVD risk were assessed by using conditional logistic regression models.

Results: The strength of the association of BMI, WC, and WHtR with CVD risk was similar. The smoking-adjusted odds ratio (95% confidence interval) for CVD was 1.60 (1.38-1.85), 1.53 (1.33-1.78), and 1.56 (1.35-1.81) for a 1 SD unit increase in BMI, WC, and WHtR respectively. After further adjustment for hypertension, diabetes, and dyslipidemia, these associations were attenuated but remained statistically significant.

Conclusions: Measures of general (BMI) and abdominal (WC and WHtR) obesity were similarly associated with CVD in middle-aged Japanese men.

Objectives: Musculoskeletal disorders, mainly carpal tunnel syndrome, represent a leading cause of compensation claims of workers worldwide. Despite this, and the fact that occupational exposures to biomechanical factors and neurotoxic chemicals have been individually associated with peripheral nerve damage, the prevalence of occupational co-exposure to biomechanical factors and neurotoxic chemicals has rarely been explored. Therefore, our aim was to assess the prevalence of occupational co-exposure to biomechanical factors and neurotoxic chemicals in a national representative sample of the French working population.

Methods: The study was based on the French representative cross-sectional survey SUMER 2010. A total of 47 983 employees who had worked in their current job for at least one year were included. Occupational exposure to biomechanical factors and neurotoxic chemicals within the previous week of work were assessed using a questionnaire during face-to-face interviews with occupational physicians.

Results: Approximately 5% of male employees and 1% of female employees were co-exposed to biomechanical factors and neurotoxic chemicals. This prevalence was up to 10% among male blue-collar workers and 13%, 8%, and 6%, respectively, among male employees in the construction, agriculture, and industry sectors. Male employees under 30 years old, in apprenticeships, and working in small companies were more co-exposed to biomechanical factors and neurotoxic chemicals than their counterparts.

Conclusions: Occupational co-exposure to biomechanical factors and neurotoxic chemicals was observed in a significant proportion of French male employees, suggesting that further studies are required to investigate its potential adverse effects on peripheral neuropathies.

Objectives: Neck pain ranks 4th highest in terms of disability as measured by years lived with disabilities. This study was conducted to determine whether Tasuki-style posture supporter improves neck pain compared to waiting-list.

Methods: This trial was an individually-randomized, open-label, waiting-list-controlled study. Adults (20 years or older) with non-specific chronic neck pain who reported 10 points or more on modified Neck Disability Index (mNDI: range, 0-50; higher points indicate worse condition) were enrolled. Participants were randomly assigned 1:1 to the intervention group or waiting-list. Prespecified primary outcome was the change in mNDI at 1 week. The principle of intention-to-treat analyses (as randomized) was applied. This trial was prospectively registered with UMIN (UMIN000034825).

Results: In total, 50 participants (mean age, 40.9 [standard deviation (SD) = 9.6]; 32 participants [64%] were female, mean mNDI, 14.3 [SD = 2.9]) were enrolled. Of these participants, 26 (52%) were randomly assigned to the intervention group and 24 (48%) to the waiting-list. Attrition rate was low in both groups (1/50). The mean mNDI change score at 1 week was more favorable for Tasuki than waiting-list (between-group difference, −3.5 points (95% confidence interval (CI), −5.3 to −1.8); P = .0002). More participants (58%) had moderate benefit (at least 30% improvement) with Tasuki than waiting-list (13%) (relative risk 4.6 (95% CI 1.5 to 14); risk difference 0.45 (0.22 to 0.68)).

Conclusion: This trial suggests that wearing Tasuki might moderately improve neck pain. With its low-cost, low-risk, and easy-to-use nature, Tasuki could be an option for those who suffer from neck pain.

Objective: The present study aimed to estimate cumulative incidence of overweight and obesity and describe 5-year longitudinal changes in body mass index (BMI) in a large occupational cohort in Japan.

Methods: Participants were 55 229 Japanese employees, who were aged 20-59 years and attended at all subsequent annual health check-ups between 2009 and 2014. Mixed model analysis was performed to examine the effects of age and cohort by gender on BMI change, with age as a random variable. Cumulative incidence of overweight (23.0≤ BMI <27.5 kg/m²) and obesity (BMI ≥27.5 kg/m²) was calculated. Logistic regression analysis was used to estimate odds ratios for the incidence of overweight and obesity according to age group.

Results: The incidence of overweight and obesity was approximately double in men (28.3% and 6.7%, respectively) compared to women (14.3% and 3.9%, respectively). The incidence of obesity decreased with age in men, but did not differ according to age in women (P for trend: .02 and .89, respectively). Among overweight participants, the incidence of obesity was higher in women (18.9%) than men (14.5%) and decreased with advancing age (P for trend: <.001 in men and .003 in women). Mean BMI was higher in men than women in all age groups throughout the period. Younger cohorts tended to have a higher BMI change compared with older cohorts.

Conclusions: In this Japanese occupational cohort, transition from overweight to obesity is higher in women than men, and the more recent cohorts had a higher change in mean BMI than the older cohorts.

Objectives: The purpose of the study was to examine hearing thresholds among dental personnel. The secondary aim was to evaluate sound levels among dental equipment that dental personnel are exposed to.

Methods: Two hundred forty-four dentists, dental technicians, dental assistants, and dental students participated. Sixty-two participated as a control group. Audiological thresholds for the test groups were compared to the control group. All participants were from Jordan University Hospital. Participants completed a questionnaire in addition to their audiometric testing. Otoscopy, tympanometry, and pure tone audiometry were included in their assessment. Three-factor ANOVA and t tests were utilized to assess the statistical differences of hearing thresholds among the groups and between the two ears. Pearson correlation test was used to assess the effect of age, experience, and duration of exposure on the degree of hearing loss in the test groups for both ears.

Results: The authors reported statistically significant differences among hearing thresholds between the control group and others. Left hearing thresholds were noted to be significantly poorer in the left versus right ear at 1000, 2000, 4000, and 8000 Hz in dental assistants. The authors also reported a significant relationship between the degree of hearing impairment among dental assistants and the daily duration of exposure to dental occupational noise, followed by age.

Conclusion: Hearing impairment was higher among dental professionals than the control group and especially among dental assistants and technicians. The authors recommended screening guidelines and adapting hearing protection methods for dental professionals and particularly for dental assistants and technicians.

Objective: Poultry farm workers are exposed to barn air and suffer from various respiratory disorders. Due to frequent prevalence of endotoxin in the farm settings workers can get co-exposed to barn air and endotoxin. The study was aimed to explore the pulmonary damage following long-term multiple exposures to poultry barn air with or without endotoxin.

Methods: We studied the pulmonary expression of Toll-like receptor 4 (TLR4) and Interleukin-1β (IL-1β) by exposing Swiss albino mice to poultry barn air for 6 days (Monday-Saturday) in a week for 5 and 10 weeks. At the end of exposure, animals were challenged with lipopolysaccharide (LPS) or normal saline solution @80 μg/mouse intranasally. Histopathology, bronchoalveolar lavage (BAL) fluid and blood analysis were used to characterize lung damage. mRNA and protein expression of TLR4 and IL-1β were evaluated using quantitative polymerase chain reaction (qPCR) and immunohistochemistry, respectively.

Results: Histopathology along with TLC and DLC of blood and BAL fluid revealed lung damage following multiple exposures and damage was severe in combination with LPS. Exposures altered mRNA and protein expression of TLR-4 and IL-1β and the expression was more marked following 30 days of exposure. Further LPS co-challenge showed a synergistic effect on the expression of TLR4 and IL-1β.

Conclusions: The data suggest that long-term exposures with or without LPS caused lung damage and altered the pulmonary expression of TLR4 and IL-1β.

Objectives: The current research aimed to study the relationship between health-related quality of life (poor perceived health/unhealthy days) and workers' pain.

Methods: This cross-sectional study was conducted among 1360 Japanese workers of a Japanese company in Kyushu. Health-related quality of life was measured by HRQOL-4 tool developed by Centers for Disease Control and Prevention of the USA. Pain was assessed by numeric rating scale with 0-10 points. Regression analysis was conducted to identify the relationship between health-related quality of life and pain.

Results: Participants who reported pain had significantly greater odds of having poor health compared to those with no pain (AOR = 3.99, 95% CI = 3.82-4.18, P < .0001). In general, participants who had a higher frequency and intensity of pain had significantly greater odds of having poor health compared to those with no pain. Compared to those with no pain, participants with pain had an average of 2.85 (95% CI = 2.07-3.63, P < .0001), 2.25 (95% CI = 1.52-2.99, P < .0001), 4.41 (95% CI = 3.39-5, P < .0001), and 1.9 (95% CI = 1.30-2.50, P < .0001) more physically unhealthy days, mentally unhealthy days, total unhealthy days, and days with activity limitation, respectively. Headache causes many more unhealthy days and more poor health than any other pain, including back pain, shoulder/neck pain, and joint pain.

Conclusion: Poor health status and the number of unhealthy days among Japanese workers are strongly associated with the presence of pain and increases with the intensity and frequency of pain.

Objective: Recent attention has been focused on sedentary behavior (SB) affecting health outcomes, but the characteristics of indicators reflecting SB remain to be identified. This cross-sectional study aims to identify the characteristics of indicators of SB, focusing on the examination of correlations, reliability, and validity of sedentary variables assessed by the smartphone app.

Method: Objectively measured data of SB of eligible 46 Japanese workers obtained from smartphones were used. We assessed the characteristics of current indicators being used with a 10-minute or 30-minute thresholds, in addition to the conventional indicators of total sedentary time, mean sedentary bout duration, and total number of sedentary bouts. They were evaluated from three perspectives: (a) association among the indicators, (b) reliability of the indicators, and (c) criterion validity.

Results: Total sedentary time under 10 minutes (U10) and U30 had negative associations with Total sedentary time (r = −.47 and −.21 respectively). The correlation between Mean sedentary bout duration and Total number of sedentary bouts was −.84, whereas between Mean sedentary bout duration 10, 30 and Total number of sedentary bouts were −.54 and −.21, respectively. The intraclass correlation coefficients of almost all indicators were around .80. Mean sedentary bout duration, Mean sedentary bout duration 10, Total number of sedentary bouts, Total sedentary time 30, U30 and U10 have significant differences between three BMI groups.

Conclusion: This study comprehensively revealed the rationale of advantage in the current indicator being used with a 10-minute or 30-minute threshold, rather than the conventional total amount of SB.

Objectives: The increasing number of working elderly people has enhanced the importance of workplace health promotion activities. We investigated the association between the health status of workers approximately 60 years of age and the risk of all-cause mortality after compulsory retirement in Japan.

Methods: The 2026 participants (1299 males and 727 females) had retired from a metal-products factory at ≥60 years of age. Baseline health examinations were conducted at 60 years of age and included questions about medical history and lifestyle factors; the participants also underwent a physical examination. The participants were followed up annually by mail for an average of 7.4 years. The association between health status at age 60 years and the risk of all-cause mortality was assessed by Cox proportional hazards regression analysis.

Results: During the study, 71 deaths were reported. The age- and sex-adjusted hazard ratio (HR [95% confidence interval]) for all-cause mortality was higher for males (HR, 3.41 [1.73-6.69]) compared with females, participants with a low body mass index (<18.5 kg/m²; HR 3.84 [1.91-7.73]) compared with normal body weight, smokers (HR, 2.63 [1.51-4.58]) compared with nonsmokers, and those with three or more of four metabolic abnormalities (obesity, high blood pressure, dyslipidemia, and glucose intolerance) (HR 2.29 [1.04-5.02]) compared with no metabolic abnormalities. The associations were unaffected by adjustment for these factors.

Conclusion: Maintenance of an appropriate body weight, smoking cessation, and elimination of metabolic syndrome are required for older workers to prevent early death after retirement.

Objectives: Early retirement due to disability is a problem in Finland. That causes pension costs that are heavy for the society. This study was designed to find out whether a quality network can support the reduction in incident disability pensions and promote a shift from full to partial disability pensions.

Methods: The study population (N = 41 472 in 2016) consisted of municipal employees whose occupational health care (OHC) was provided by the members of the Finnish Occupational Health Quality Network (OQN). The comparison population consisted of all municipality employees whose OHC was provided by non-members of the OQN (N = 340 479 in 2016). The outcomes were measured by comparing the trends in incident disability pensions of full and partial permanent pension and full and partial provisional pension, partial/full pension indexes from 2011 to 2016 according to the principles of Benchmarking Controlled Trials. Linear regression models were used to explore the dynamics of different pension forms. Regression coefficients were calculated to show the average change per year.

Results: The incidence of permanent disability pensions decreased faster in the study population (P for trend .03) and the study group showed a stronger shift from full to partial permanent pensions (P for trend <.001).

Conclusion: Quality networking between OHC units including common goal setting, systematic quality improvement, and repeated quality measurements decreased new permanent disability pensions and increased partial permanent pensions. Such changes are important while thriving for increased work participation.

Objectives: The aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff.

Methods: The 22-items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross-sectional survey. The internal consistency reliability was estimated using Cronbach's α. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work.

Results: In total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's α values demonstrated acceptable internal consistency in two scales (supervisor support α = .87; coworker support α = .86), while Cronbach's α was below the acceptable threshold of 0.70 for job control (α = .45) and job demand (α = .50). EFA assuming a four-factor structure showed a factor structure that was almost identical to the original JCQ, with two items loading on other scales. The subscales of depression, anxiety, and stress response of DASS 21 and the subscales of JCQ were significantly correlated, as expected.

Conclusion: The results suggest that the JCQ in Vietnamese can be used with some reliability and validity for examining psychosocial work environment among nurses. Further studies should be done to confirm and expand our findings in a variety of occupational groups and in other Asian low- and middle-income countries.