Journal of Occupational Health
Online ISSN : 1348-9585
Print ISSN : 1341-9145
ISSN-L : 1341-9145
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Showing 1-50 articles out of 92 articles from the selected issue
Original Articles
  • Hiroshi Murayama, Kumiko Nonaka, Masami Hasebe, Yoshinori Fujiwara
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12177
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objective: Despite the potential of the social capital approach in preventing burnout, there is sparse evidence of its contextual effect. This study aimed to reveal the contextual association of workplace and community social capital on burnout among professionals of health and welfare services for seniors in Japan.

    Methods: We collected data from a cross-sectional questionnaire survey for all health and welfare professionals working in Community Comprehensive Support Centers (CCSCs) in the central Tokyo area in 2015. We assessed burnout using the Japanese version of the Maslach Burnout Inventory, which consists of three subscales: emotional exhaustion, depersonalization, and reduced personal accomplishment. We prepared social capital items regarding workplace (the CCSC the participants belonged to) and community (the current catchment area of the CCSC). We aggregated individual responses of workplace and community social capital within each CCSC to create group-level workplace and community social capital indicators.

    Results: Among the 1771 questionnaires distributed, we analyzed 1110 from 211 CCSCs. Multilevel analysis showed that higher group-level workplace social capital was significantly associated with lower scores of all three subscales after adjusting for covariates. Moreover, we found a significant association between greater group-level community social capital and lower scores of depersonalization and reduced personal accomplishment.

    Conclusion: Working in workplaces and communities with higher social capital is related to lower burnout. The findings suggest that strategies to enhance the social capital of their workplace and community would be beneficial in the prevention of burnout among professionals in the field of health and social welfare.

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Review Articles
  • Jaspinder Sanghera, Nikhil Pattani, Yousuf Hashmi, Kate F. Varley, Man ...
    Type: REVIEW ARTICLE
    2020 Volume 62 Issue 1 e12175
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The SARS-CoV-2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and formulate recommendations for future action.

    Methods: A systematic review was performed between 31st December 2019 and 17th June 2020 through Ovid Medline and Embase databases (PROSPERO ID CRD42020181204). Studies were included for review if they investigated the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and used validated psychiatric scoring tools. Prevalence of ICD-10 classified psychiatric disorders was the primary outcome measure.

    Results: The initial search returned 436 articles. Forty-four studies were included in final analysis, with a total of 69,499 subjects. Prevalence ranges of six mental health outcomes were identified: depression 13.5%-44.7%; anxiety 12.3%-35.6%; acute stress reaction 5.2%-32.9%; post-traumatic stress disorder 7.4%-37.4%; insomnia 33.8%-36.1%; and occupational burnout 3.1%-43.0%. Direct exposure to SARS-CoV-2 patients was the most common risk factor identified for all mental health outcomes except occupational burnout. Nurses, frontline HCWs, and HCWs with low social support and fewer years of working experience reported the worst outcomes.

    Conclusion: The SARS-CoV-2 pandemic has significantly impacted the mental health of HCWs. Frontline staff demonstrate worse mental health outcomes. Hospitals should be staffed to meet service provision requirements and to mitigate the impact onmental health. This can be improved with access to rapid-response psychiatric teams and should be continually monitored throughout the pandemic and beyond its conclusion.

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Original Articles
  • Ziyang Song, Edwin J. Boezeman, Karen Nieuwenhuijsen, Xiaodong Li, Ang ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12174
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: To investigate the association of subjective fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning, among young construction project management professionals (CPMPs).

    Methods: The research had a cross-sectional design. Dutch young CPMPs (142 participants, age range: 20 to 30 years of age) completed a questionnaire containing general questions recording their demographic characteristics, and instruments recording the following concepts: perceived person-organization fit, perceived person-job fit (including demands-abilities fit and needs-supplies fit), distress, emotional exhaustion, work engagement, and work functioning. Correlation analysis and multiple regression analysis were used to examine the association of fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning.

    Results: The correlation analysis indicated that person-organization fit, needs-supplies fit, distress, emotional exhaustion, and work engagement correlated significantly with work functioning problems of young CPMPs. The multiple regression analyses corroborated that needs-supplies fit, distress, and emotional exhaustion related significantly to the work functioning problems of young CPMPs, with the standardized regression coefficients (β) of −0.28, 0.52, and 0.38 (P < .01), respectively. Other than would be expected, the multiple regression analyses also made clear that work engagement does not significantly relate to work functioning problems beyond distress and emotional exhaustion.

    Conclusions: Incongruence between personal needs and job supplies, psychological distress, and emotional exhaustion are central correlates of the work functioning problems of young CPMPs. Occupational health professionals can use these insights to help young CPMPs at work.

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  • Sheari Suri, Somayeh F. Dehghan, Ali S. Sahlabadi, Soheila K. Ardakani ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12173
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Background and Aims: Today, human beings are exposed to the ELF magnetic field of electrical equipment and power lines, which can damage Leydig cells and alter the secretion of reproductive hormones. The purpose of this study was to investigate the relationship between exposure to ELF magnetic field and the level of some reproductive hormones in male power plant workers.

    Materials and Methods: The present cross-sectional study was carried out among all male employees of different units of the selected power plant around Tehran, Iran. All participants were asked to complete demographic data sheets and General Health questionnaire, on condition of consent and meeting the inclusion criteria. Time-weighted average (TWA) exposure to magnetic field of 122 men was measured by IEEE Std C95.3.1 method using TES 1393 Gauss meter. Based on the exposure level, subjects were divided into three groups. Serum Levels of Free Testosterone, Luteinizing Hormone (LH), and Follicle stimulating hormone (FSH) in participants were determined. Data analysis was performed using ANOVA, Kruskal-Wallis tests, and the relationships between variables were assessed by linear regression and correlation using SPSS v.25 software.

    Results: There was no significant statistical correlation between the level of ELF exposure and serum levels of free testosterone, LH, and FSH, (r = 0.158). Serum levels of LH decreased significantly with age and duration of work experience (P < .05, r = −.25, P = .005, r = −.203, P = .025).

    Conclusion: There was no relationship between exposure to magnetic field in power plants and reproductive hormone levels, although it is impossible to make definitive comments without using more accurate methods to estimate male fertility.

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Opinions
Original Articles
  • Chad Aldridge, Victor Tringali, Robert Rhodes, Kohl Kershisnik, Debra ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12171
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Like the concept of work ability in occupational health, gait speed is a measure of general fitness and can predict functional decline and morbidity. This is especially important when our care-takers, i.e. nurses, show decline in fitness and become care-receivers. The study aims to describe the demographics of hospital nurses in the context of gait speed and work ability as well as to determine the association between them.

    Methods: Three-hundred and twelve inpatient nurses and nursing assistants were sampled from a level 1 trauma and teaching hospital from several service lines and acuity levels. Spearman correlation tests were utilized to determine the relationship of gait speed and ratings of item 1 on the Work Ability Index (WAI) as well as Cochran-Armitage test for linear trend of gait speed.

    Results: Maximum gait speed has a significant positive association with work ability with a Rho coefficient of 0.217 (P < .0001). Additionally, the linear trend test of gait speed tertiles was significant (P < .001) for work ability categories of Moderate to Poor (0-7) and Good to Excellent (8-10).

    Conclusions: Gait speed is correlated with the item 1 self-rating of the WAI in hospital nursing staff. The 10-m walk test is a practical and easy measure that can be utilized in occupational health. More research is required to validate gait speed in other occupational health populations and investigate gait speed changes and its interaction with the work environment longitudinally.

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Editorial
Opinions
Original Articles
  • Ken-ichiro Nishi, Chikara Kadoya, Akira Ogami, Takako Oyabu, Yasuo Mor ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12162
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objective: Nickel oxide nanoparticles (NiONPs) are representative metal oxide NPs and are categorized as an insoluble nickel compound. Our previous studies suggested that NiONPs have more pulmonary toxicity than micron-sized NiO because they may dissolve slowly and produce many more Ni ions. We confirmed the hypothesis that the slow dissolution of NiONPs induces a change in inflammatory response over time.

    Method: We reanalyzed our previous data on intratracheally instilled NiONP to rats and focused on Ni retention in the lungs and the lung weight ratio for each rat to the mean of control rat lungs. We also measured the solubility of NiONPs and micron-sized NiO samples by means of an artificial lysosomal fluid (ALF, pH 4.5).

    Results: The in vivo test of instilled NiONPs resulted in the biomarkers reaching their peak values at 1 week or 1 month, and not at 3 days, after instillation. We found that as the NiO mass in the lung increased, the lung weight ratios tended to increase. The relationships shifted to more toxic at 3 days to 1 month (P < .01). Compared to the dissolution of NiONPs in the ALF that took roughly 1 week, the dissolution of NiONPs in vivo was take about 1 month or more.

    Conclusion: When intratracheally instilled NiONPs dissolve slowly in the phagolysosomes of alveolar macrophages (AM), the resulting Ni ions cause the AM to transform into foamy cells at 1 month, and the inflammatory response persists even at 3 months after instillation.

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  • Farooq Ahmad Chaudhary, Basaruddin Ahmad, Paras Ahmad, Muhammad Danial ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12168
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objective: The aim of the study was to evaluate the oral healthcare workers' concerns, perceived impact, and preparedness in COVID-19 pandemic.

    Methods: This cross-sectional study was carried out at 10 different dental hospitals in Pakistan from March to June 2020. A 35 items valid and reliable questionnaire was used to assess the concerns, perceived impact, and preparedness of oral healthcare workers (OHCW) in COVID-19 pandemic. Chi-squared test and logistic regression were used for analysis.

    Results: A total of 583 OHCW participated in this study. The odds of having the awareness about the risk of exposure and fear of getting infected, were greater in the clinical than non-clinical OHCW (OR: 52.6; OR: 15.9). For social network concerns, the clinical OHCW were more likely to be concerned about their colleagues (OR: 6.0). The clinical OHCW have greater odds of worrying about telling the family/friends about the risk exposed to (OR: 2.55), being avoided because of the job (OR: 3.20) and more likely to be feeling stressed (OR: 4.31). Less than 50% of the participants felt that their institutions are well prepared and only 12.6% had attended an infection control training session. Most participants practiced self-preparation such as buying masks and disinfection (94.3%, 98.3%).

    Conclusion: The majority of OHCW felt concerned about their risk of exposure to infection and falling ill from exposure and infecting friends/family. There is a need for training of infection control and PPE and minimizing fear and psychological impact on OHCW should be the priority in any preparedness and planning for combating COVID-19.

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  • Koki Kimura, Tomohisa Nagata, Makoto Ohtani, Masako Nagata, Shigeyuki ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12167
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The objective of this study was to estimate a risk of cardiovascular and cerebrovascular diseases for each worker and to determine whether this risk is associated with the incidence and costs of presenteeism, absenteeism, and medical/drug treatments.

    Methods: Established risk equations were used to estimate the 10-year probability of developing coronary artery disease and ischemic stroke in male workers aged 40-65 years who were recruited from four pharmaceutical companies in Japan. The incidence of presenteeism was defined as existence of presenteeism for the past a month, and the incidence of absenteeism was defined as existence of sick-leave for the past three months by a self-administered questionnaire. Each cost was calculated based on the human capital method. Data on medical/drug treatments were collected from health insurance claims.

    Results: The risks were calculated for 6047 workers. Individuals at moderate and high risk of coronary artery disease had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Workers at moderate and high risk of ischemic stroke also had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Mean costs for absenteeism and medical/drug treatments increased with the risk of developing coronary artery disease or ischemic stroke, while costs for presenteeism did not.

    Conclusions: To prevent the costs of presenteeism, workers not only at high risk but also at low and moderate risk of developing cardiovascular and cerebrovascular diseases should receive health care services.

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Case Studies
  • Makiko Nakano, Miyuki Hirata, Makoto Hamasaki, Akiyo Tanaka, Asahi Nag ...
    Type: Case Study
    2020 Volume 62 Issue 1 e12165
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Background: A male worker with indium-tin oxide (ITO)-induced pneumoconiosis underwent bilateral lung transplantation (LT).

    Methods: Post-LT histopathological investigations of the isolated lungs and hilar lymph nodes were performed and indium concentration in serum (In-S) and serum Krebs von den Lungen-6 (KL-6) were tracked for 122 weeks.

    Results: He has attained the ultimate treatment goal of > 2-year survival. The main histopathological characteristics were pan-lobular emphysematous change, interstitial fibrosis, and lymphocytic infiltration in the peribronchiolar/perivascular portions, and numerous cholesterol clefts and giant cells containing brown particles. These findings support the conclusion that the lung injury was caused by the inhalation of ITO. Metal element mapping and indium in the isolated lungs revealed that inhaled ITO particles in humans migrate to the lymph nodes. In-S remained at remarkably high levels (≥30 ng/mL) and showed wide fluctuation with bimodality until 46 weeks after LT, but KL-6 remained in the normal range for almost the entire period. The indium concentration in the donor's resection lung at 10 weeks after LT was 143.5 ng/g wet-weight, which was only one one-thousandth of the recipient's lung (161 µg/g wet-weight). After 48 weeks of LT, the recipient's In-S had gradually decreased; the biological half-life was 1.2 years. These results clearly suggest that indium remaining in the recipient's tissues did not adversely influence the transplant donor's lungs.

    Conclusions: The transplanted donor's lungs were not influenced by indium in the recipient's organs. Bilateral LT is thus an effective treatment option in severe indium lung disease cases.

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Original Articles
  • Qiuliang Xu, Fang Yu, Fei Li, Hua Zhou, Kang Zheng, Meibian Zhang
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12164
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Methodological studies on occupational health risk assessment (OHRA) models are rarely reported. This study aimed to explore the quantitative differences between common OHRA models.

    Methods: The risk ratios (RRs) in five typical industries (leather, wooden furniture manufacturing, printing and dyeing, printing, and garment manufacturing) were investigated using six OHRA models, namely the models from the US Environmental Protection Agency (EPA), Singapore, the Control of Substances Hazardous to Health (COSHH), Australia, Romania, and International Council on Mining and Metals (ICMM). The consistency, correlation, and reliability were evaluated for quantitative differences between the models.

    Results: The order of the RRs obtained from the EPA, Singaporean, and COSHH models in the five industries was consistent with the order of the inherent risk levels in those industries. The EPA and Singaporean models could effectively distinguish the inherent risk levels of risk factors like xylene and ethyl acetate. The order of RR between the six models was: RR EPA > RR COSHH > RR Singaporean > RR Australian > RR Romanian and RR ICMM (P < .05). The EPA model had the weakest correlations with other models. The Singaporean model had positive correlations in RRs with the other models (P < 0.01).

    Conclusions: The EPA and Singaporean models exhibited good reliability since they could distinguish the inherent risk of the industry or risk factor and tended to get higher risk levels. The EPA model was independent and the Singaporean model had a good correlation with other models. More studies on OHRA methodology are needed.

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  • Thanh Hai Nguyen, Duc Luan Hoang, Thi Giang Hoang, Minh Khue Pham, Van ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12161
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Background: Nurses are one of the population groups with the highest prevalence of musculoskeletal disorders (MSDs). At many sites, musculoskeletal symptoms (MS) represent a major health-care burden, adversely affecting nurses' quality of life and giving rise to mental health issues.

    Objectives: This study measured the prevalence of multi-body-site (two or more anatomical sites) musculoskeletal symptoms (MMS), and the association between MMS, a number of demographic and work characteristics, psychological distress, and the quality of life among district hospital nurses.

    Material and Methods: A cross-sectional study was performed with 1179 nurses in Haiphong City using three questionnaires: the Modified Nordic; Quality of Life Enjoyment and Satisfaction Short Form (Q-LES-Q-SF); and the Kessler Psychological Distress Questionnaire (K6).

    Results: Women have a higher MMS prevalence than men (57.1% in women vs 37.6% in men, P < .001). Having a higher number of anatomical sites of MS appears to be associated with a worse quality of life among nurses. Linear regression analysis found a number of other factors negatively associated with the nurses' quality of life: gender (female), age (50-60 years old vs 19-29 years old), and psychological distress.

    Conclusions: This study shows a high prevalence of MMS and the relationship between, on the one hand, MMS, gender, age, as well as psychological distress and, on the other hand, the quality of life among nurses in Vietnam. Further in-depth studies are needed to investigate the causal relationships between these indicators.

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  • Huan M. Tran, Hanh T. M. Bui, Somkiat Thoumsang, Ngoc T. B. Ngo, Nhan ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12160
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Nail workers are exposed to many hazardous chemicals. Despite many warnings about health problems among nail workers in other countries, data concerning exposure to chemical hazards among nail workers is still limited in Vietnam. In this study, we aimed to identify exposure to volatile organic compounds and their relationship with occupational symptoms among Vietnamese female nail salon workers.

    Methods: A cross-sectional study was conducted in Danang, Vietnam, from January 2019 to September 2019. Total 42 personal passive samplers were collected to evaluate 12 substances from 21 nail workers (15 salons) twice a week. We chose one representative worker from each of the nine salons with less than six workers and two representative workers from each of the six salons with over five workers for personal sampling based on the principle of similar exposure groups. We interviewed a total of 100 nail workers in 15 salons and 100 office workers in offices adjacent to the salons to compare occupational symptoms among them.

    Results: The commonly detected compounds in nail salons were acetone (97.6%), butyl acetate (83.3%), and ethyl acetate and ethyl methacrylate (78%). The concentration of total target VOCs was related to the number of serviced customers, the concentration of CO2, and general ventilation used. The subjective symptoms were significantly higher for the nail workers than for the comparison subjects, that is, headache, nausea, nose irritation, skin irritation, shortness of breath, and confusion. Among 100 nail workers, nose irritation was significantly higher for nail workers who were exposed to acetone at levels exceeding the Vietnam occupational exposure limit (VOEL) adjusted with the Brief-Scala model.

    Conclusions: Exposure to VOCs such as acetone in nail salons results in occupational symptoms among workers.

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  • Ana Zaira da Silva, Rosa Maria Salani Mota, Raimunda Hermelinda Maia M ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12163
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: To estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons.

    Methods: Cross-sectional, analytical study conducted in 15 female prisons in all five Brazilian regions between January 2014 and December 2015. The study population consisted of correctional officers with at least 6 months in the position. The sampling included 40% of FCO present in the prison during data collection, yielding 295 FCOs. Data were collected via Audio Computer-Assisted Self-Interview. A physical examination of participants was conducted including blood pressure, weight, and waist and hip circumference. The Odds Ratio and confidence intervals for independent factors were estimated.

    Results: Hypertension prevalence in correctional officers was 37.9%, (95% CI 32.1-44.0). Hypertension was associated with obesity (95% CI = 1.884-9.947), cardiovascular disease (95% CI = 3.348-16.724), and participation in the specific training course for the relevant position (95% CI = 1.413-9.564).

    Conclusions: While findings, except for the last factor, are not novel, this is the first such study conducted in Brazil. Hypertension prevalence among this pool of all female correctional officers is higher than in the average population, and FCOs associate this with the prison environment. Current training does not appear to address this problem. Especially since prison populations are growing in Brazil, this problem needs to be addressed for the health of the FCOs and the prisoners in their care.

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  • Chloé Charlotte Schröder, Hans Martin Hasselhorn, Jean-Baptist du Prel ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12166
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The aim of this study was to investigate the subjective employment perspective in higher working age for different employee groups with migrant background (EMB) and without (non-EMB), meaning willing, being able, and planning to work until the individual state pension age (iSPA).

    Methods: A representative sample of socially insured employees born in 1959 or 1965 was surveyed in 2011, 2014, and 2018 with computer-assisted personal interviews. The current cross-sectional analysis is based on data from the third study wave (n = 3286) of the lidA cohort study. EMB were differentiated via generation (first generation, G1, vs second generation, G2) or nationality (German vs foreign). Applying bivariate statistics with the tests of independence and block-wise logistic regressions, group differences were investigated. Sex, age, educational level, net household income, health, and work factors were considered as covariates.

    Results: When comparing subgroups of EMB, significant differences appeared in bivariate analyses for willing and planning to work. G1 were to a higher degree planning to work longer than G2 and those with foreign nationality were more willing and planning than those with German nationality. Multivariate analyses revealed significant differences of G1 and non-EMB for planning, being significant in the fully adjusted model, but not for willing.

    Conclusion: The findings underline the need for differentiation of migrant groups in social research and policy. When it comes to extended working lives, the first-generation migrant group, as well as foreigners may constitute risk groups and require increased attention from a work, health, and economic point of view.

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  • Naoto Ito, Ayana Ogasawara, Mika Kawasumi, Koji Mori, Tomohisa Nagata, ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12147
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: To elucidate the factors that influence occupational physicians’ decision to issue an employer warning.

    Methods: The interview was conducted with 10 Japan Society for Occupational Health certified occupational physicians (COPs) and certified senior occupational physicians (CSOPs) to create nine fictive scenarios in which an occupational physician may need to consider issuing a warning. Sixteen CSOPs assessed the seriousness of the problem in each of nine scenarios where they may need to consider issuing an employer warning. Next, using a survey questionnaire, 597 COPs and CSOPs were asked to rate how likely they were to issue a warning in each of the nine scenarios, and answer items on their characteristics and number of previously issued warnings. A multilevel logistic regression analysis nested for various scenarios was used to assess the odds ratio (OR) of being likely to issue a warning.

    Results: Valid questionnaires were obtained from 117 participants (19.6%). The ORs and 95% confidence intervals (CIs) were as follows: mean score of seriousness of the problem, 5.90 (4.50-7.75); years of experience as occupational physician, 1.04 (1.02-1.06); women, 1.75 (1.20-2.54); being a part-time occupational physician without in-house experience, 2.08 (1.31-3.29); and having previously issued two or more times warnings, 1.99 (1.29-3.06), compared with those who had never issued a warning.

    Conclusions: Occupational physicians’ likelihood to issue a warning was associated with the seriousness of the problem as assessed in various scenarios, years of experience as occupational physician, gender, employment type, experience as in-house occupational physician, and number of past warnings.

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  • Wei-Ting Lin, Chia-Chen Hsieh, Fong-Ching Chang, Chao-Ling Wang, Chia- ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12140
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Work is often a barrier for women to continue breastfeeding after they have given birth. Breastfeeding support is an important part of workplace health promotion. We investigated the implementation of breastfeeding promotion and gender equality polices in workplaces with the Taiwan Badge of Accredited Healthy Workplace.

    Methods: Our samples consisted of 1648 corporations with the badge of Accredited Healthy Workplace issued by the Bureau of Health Promotion from 2007 to 2008. Concomitantly, 2000 corporations without accreditation were randomly selected from the National Business Directory as the control group. Data were collected from self-administered questionnaires. Logistic regression was used to examine the association with breast-feeding promotion and other variables in Taiwanese workplaces.

    Results: Members of accredited group of 1089/1648 (66.1%) and the control group of 526/2000 (26.3%) responded to the questionnaire. The accredited companies had more mother-friendly settings, including breastfeeding policies and documents, appropriate breastmilk preserving equipment and settings in the workplace. In the accredited group, breastfeeding rate of mothers returning to work after giving birth was 64.3% in 2008 (1 year after giving birth) and 60.4% in 2009 (1 year after giving birth), while the rate of the control group was 59.1% in 2008 and 51% in 2009.

    Conclusion: Accredited corporations are better at breastfeeding support than those of the control group. This might be related to the company size, location, and the implementation of tobacco control and/or occupational health promotion policies, which may increase awareness of healthy workplaces and influence maternal protection positively.

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  • Kojiro Yamamoto, Takeshi Ebara, Fumiko Matsuda, Tsuyoshi Matsukawa, Na ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12159
    Published: 2020
    Released: November 25, 2020
    JOURNALS OPEN ACCESS

    Objective: To examine whether the self-monitoring interventions of a mobile health app reduce sedentary behavior in the short and long terms.

    Method: We designed a double-blind randomized control trial. Participants were selected from among the staff of a medical institution and registrants of an online research firm. Forty-nine participants were randomly assigned to either a control group (n = 25) or an intervention group (n = 24). The control group was given only the latest information about sedentary behavior, and the intervention was provided real-time feedback for self-monitoring in addition to the information. These interventions provided for 5 weeks (to measure the short-term effect) and 13 weeks (to measure the long-term effect) via the smartphone app. Measurements were as follows: subjective total sedentary time (SST), objective total sedentary time (OST), mean sedentary bout duration (MSB), and the number of sedentary breaks (SB). Only SST was measured by self-report based on the standardized International Physical Activity Questionnaire and others were measured with the smartphone.

    Results: No significant results were observed in the short term. In the long term, while no significant results were also observed in objective sedentary behavior (OST, MSB, SB), the significant differences were observed in subjective sedentary behavior (SST, βint − βctrl between baseline and 9/13 weeks; 1.73 and 1.50 h/d, respectively).

    Conclusions: Real-time feedback for self-monitoring with smartphone did not significantly affect objective sedentary behavior. However, providing only information about sedentary behavior to users with smartphones may make misperception on the amount of their subjective sedentary behavior.

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  • Thuy Thi Thu Tran, Kazuhiro Watanabe, Kotaro Imamura, Huong Thanh Nguy ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12157
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The present study investigated the reliability and validity of a newly developed Vietnamese version of the 9-item Utrecht Work Engagement Scale (UWES-9-V) in a sample of hospital nurses in Hanoi, Vietnam.

    Methods: The UWES-9 was translated into Vietnamese following a standard procedure. A survey was conducted of 949 registered nurses in a large tertiary general hospital in Hanoi, Vietnam, in 2018, using a self-administered questionnaire including the Vietnamese UWES-9, other scales measuring health status, work performance, job demand, job control, and workplace social support, and questions pertaining to demographic variables. Cronbach’s alpha and interclass correlation coefficients (ICC) were calculated to assess reliability. Explanatory and confirmatory factor analyses were conducted to assess factorial validity. Convergent validity was tested based on associations between the UWES-9-V and subscales and other scales.

    Results: The Cronbach’s alpha coefficients of the UWES-9-V and the Vigor, Absorption, and Dedication subscales were 0.93, 0.86, 0.77, and 0.90, respectively. ICC of the UWES-9-V in a subsample after 3 months was 0.48. Confirmatory factor analyses indicated an acceptable fit of both one-factor and three-factor structures, with the three-factor model having the better fit. The UWES-9-V and its subscales correlated with depression, anxiety and stress, health-related quality of life and health condition, job performance, and psychosocial work environment.

    Conclusions: The study findings suggest that the UWES-9-V is a reliable and valid instrument to measure work engagement among hospital nurses in Vietnam, a low- and middle-income country. Future studies should confirm the validity and reliability of the UWES-9-V among various occupations.

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  • Ji-Hwan Kim, Jaehong Yoon, Jinwook Bahk, Seung-Sup Kim
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12143
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objective: This study examined whether perceived job insecurity was associated with absenteeism and presenteeism, and how these associations varied when the differential cutoff was applied to define absenteeism and presenteeism.

    Methods: We analyzed a nationally representative dataset of 19 720 full-time waged workers from the 4th Korean Working Conditions Survey (2014). As an independent variable, perceived job insecurity was assessed. As dependent variables, absenteeism and presenteeism were measured. Seven differential cutoffs (from “1 day” to “7 days”) were used when defining absenteeism and presenteeism. A Poisson regression model with a robust error variance was applied for the analysis.

    Results: When “1 day” was cutoff to define absenteeism and presenteeism, job insecurity was not associated with both absenteeism (PR: 1.07, 95% CI: 0.97, 1.16) and presenteeism (PR: 1.05, 95% CI: 1.00, 1.10). When the higher cutoff was used, the association between job insecurity and absenteeism was attenuated and remained statistically nonsignificant. However, statistically significant associations between job insecurity and presenteeism were observed when the differential cutoff was used: “2 days” (PR: 1.07, 95% CI: 1.01, 1.13), “3 days” (PR: 1.14, 95% CI: 1.06, 1.22), “4 days” (PR: 1.15, 95% CI: 1.05, 1.26), “5 days” (PR: 1.18, 95% CI: 1.06, 1.30), “6 days” (PR: 1.17, 95% CI: 1.02, 1.33), and “7 days” (PR: 1.17, 95% CI: 1.02, 1.34).

    Conclusion: This study found that perceived job insecurity was associated with presenteeism, but not absenteeism. Furthermore, the association differed by cutoff applied to define presenteeism among full-time waged workers in South Korea.

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Review Articles
  • Leonard Joseph, Miles Standen, Aatit Paungmali, Raija Kuisma, Patrapor ...
    Type: REVIEW ARTICLE
    2020 Volume 62 Issue 1 e12150
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Professional drivers are at high risk of developing musculoskeletal pain (MSP) due to risk factors such as prolonged sitting, whole body vibration, awkward posture, and repetitive actions. This review investigates the reported prevalence of MSP among professional drivers.

    Methods: An electronic search of Medline (1946 + via OvidSP), Embase (1974 + OvidSP), CINAHL (1982+), AMED, PubMed, and Web of Science from 1990 to July 2019 was performed. Methodological quality of studies was assessed using three quality assessment tools for cross-sectional, case-control, and prospective cohort studies. The prevalence of MSP was reported using descriptive analysis.

    Results: A total of 56 studies conducted in 23 different countries across a total of 14 types of occupational transport were reviewed. Data of a total pooled population of 18 882 professional drivers were analyzed for MSP. The prevalence of MSP ranged between 43.1% and 93%. The low back was the most frequently reported body region for MSP with a meta-prevalence rate of 53% (N = 9998). Neck, shoulder, and upper back were the other common regions with high prevalence.

    Conclusion: There is a high prevalence of MSP in professional drivers and low back was the most frequently reported body region, followed by neck, upper back, shoulder, knee, hip/thigh, wrist, ankle, and elbow. MSP is complicated in nature and therefore in-depth exploration of causal relationships between MSP and risk factors is necessary so that appropriate healthcare programs can be initiated to prevent and treat MSP effectively.

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Original Articles
  • Na Zhao, Xiangrong Song, Hisao Naito, Hongling Li, Yongshun Huang, Lil ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12142
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Occupational exposure to trichloroethylene (TCE) induces trichloroethylene hypersensitivity syndrome (TCEHS), which causes hypersensitivity dermatitis and hepatitis. However, whether TCE itself or its two metabolites, trichloroethanol (TCEOH) and trichloroacetic acid (TCA), are involved in TCEHS remains unclear. Therefore, in this study we explored the allergens causing TCEHS and characterized TCEHS-related liver injury in guinea pigs.

    Method: The guinea pig maximization test was performed using TCE, TCEOH, and TCA as candidate allergens. Skin inflammation was scored, and liver function and histopathological changes were evaluated by biochemical tests and hematoxylin and eosin staining, respectively.

    Results: The sensitization rates for TCE, TCEOH, and TCA were 90.0%, 50.0%, and 0.0%, respectively. In the TCE and TCEOH experimental groups, the skin showed varying degrees of erythema with eosinophil granulocyte infiltration in the dermis. Additionally, serum alanine aminotransferase and γ-glutamyl transpeptidase levels increased significantly, and histological analysis revealed focal hepatocellular necrosis with inflammatory cell infiltration in the liver.

    Conclusions: TCE is the main cause of allergy and TCEOH is a secondary factor for allergy in guinea pigs. TCE and TCEOH can cause immune-mediated skin sensitization complicated by focal hepatic necrosis.

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Recommendation
Editorial
Original Articles
  • Ro-Ting Lin, Ying-Wen Liang, Masaya Takahashi, Hisashi Eguchi, Akizumi ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12148
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Overwork has been recognized as a risk factor for cerebrovascular and cardiovascular disease (CCVD). To our best knowledge, Japan is the first country in the world to implement an independent act (the 2014 Act) for the prevention of overwork-related disease, which was promoted through application of preventive measures, such as reductions in working hours. We assessed changes in working hours and overwork-related CCVD before and after introduction of the 2014 Act.

    Methods: We calculated the overwork-related CCVD incidence rate and average monthly working hours for 10 industry groups in Japan with data from 2012 to 2018. We applied a causal mediation analysis to estimate the total effect of implementing the 2014 Act on the overwork-related CCVD and the effect mediated by working hours.

    Results: An average of 271 for every 48 million employees developed overwork-related CCVD per year. After introducing the 2014 Act, the incidence rate ratio of overwork-related CCVD was 0.881-fold lower (95% CI 0.780-0.995) compared with before the policy change. The 2014 Act contributed to a decrease of 26% (78 cases per year; 95% CI 29-173) of the overwork-related CCVD incidence per year. Approximately 41% (32 cases per year) of this effect could be explained by reduced working hours.

    Conclusions: Our study highlights the impact of the 2014 Act in Japan on the reduction in working hours, which further contributes to the reduction in overwork-related CCVD. Policymakers should consider adopting our innovative approach to assess the mediation effect underlying the implementation of new policies.

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  • Byung-Yoon Chun, Chiang-Soon Song
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12153
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Presenteeism is undoubtedly a widespread phenomenon in organizations. Research on presenteeism has been conducted for decades in the broader workforce (eg, nurses, doctors, teachers, police officers). Occupational stress and turnover intention in occupational therapy have been extensively studied. However, the effect of presenteeism on the relationship between occupational stress and resultant turnover intention among occupational therapists is unclear. This study aims to explore the mediating effect of presenteeism and moderating effect of perceived organizational support in the relationship between occupational stress and turnover intention among occupational therapists in Korea.

    Methods: We conducted an individual and cross-sectional analysis of 257 occupational therapists from various health care institutions in Korea. Data were collected and hypotheses were tested via Process macro. Quantitative analyses were conducted with SPSS 26 and LISREL 8.54.

    Results: Occupational stress was strongly related to presenteeism, which in turn predicted turnover intention. Presenteeism played a mediating role between occupational stress and turnover intention. Moreover, occupational therapists’ perception of organizational support acted as an important mechanism through which presenteeism mediated the relationship between occupational stress and turnover intention.

    Conclusions: This study highlights the need to maximize employee productivity and retain talent by providing managers with insight into the mechanism of presenteeism in relation to occupational stress and turnover intention among occupational therapists in Korea.

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  • Shoko Nogami, Naw Awn J-P, Munenobu Nogami, Tomomi Matsui, Nlandu Roge ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12141
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The Asian Intensive Reader of Pneumoconiosis (AIR Pneumo) is a training program designed to improve diagnostic skills for chest radiographies (CXRs) in accordance with the ILO/ICRP 2000. The purpose was to determine the prevalence of occupational environmental pulmonary disease findings in construction workers on thin-slice computed tomography (thin-slice CT), and to compare the diagnostic performance with CXR evaluated by AIR Pneumo-trained physicians.

    Methods: Ninety-seven male construction workers underwent low-dose thin-slice CT and CXR on the same day. NIOSH B reader and a board-certified radiologist each interpreted the thin-slice CTs independently. The concordant findings on thin-slice CT were established as the reference standard and were statistically compared with CXRs. Four physicians interpreted CXRs independently according to the ILO/ICRP 2000.

    Results: Of the 97 cases, nine showed irregular or linear opacities, and 44 had pleural plaques on thin-slice CT. Five, four, three, and two of nine cases with irregular opacity were detected by the four readers on CXRs, respectively. Sixteen, 14, 9, and 5 of the 44 cases with pleural plaques were detected by the four readers, respectively. Specificities for irregular opacities ranged from 94% to 100%, and those for pleural plaques were from 86% to 96%.

    Conclusions: Thin-slice CT-detected irregular opacity was found in 9.3%, whereas pleural plaque was found in 45.4% among the construction workers. Chest radiography showed acceptable performance in classifying pneumoconiotic opacities according to ILO/ICRP 2000 by the AIR Pneumo and/or NIOSH-certified physicians.

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  • Sunisa Chaiklieng, Thawatchai Dacherngkhao, Pornnapa Suggaravetsiri, V ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12137
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objective: This cross-sectional study aimed to assess fire risk in fire hazardous zones (FHZ) at the dispenser areas of gasoline stations.

    Methods: There were 47 stations chosen for fire risk assessment and two zones around the dispenser area of each station were assessed. The assessments were carried out by applying the matrix (3 × 4) of fire risk assessment by multipliers of opportunities level of hazard occurrence and the subsequent severity of the incident.

    Results: Across the 47 gasoline stations studied, there was an average of 23 ± 12 nozzles and none had vapor recovery systems (VRS) on dispenser nozzles. The average daily amount of gasoline sold was 3382 L. Each gasoline station had an average of 10 ± 5 workers/station; they all worked within a 1.5 meter radius of the dispenser (FHZ-I); and they used cellphones >4 hours/day. The average level of flammable gas was in the range 1.3%-7.4% LEL-UEL (6.2% ± 5.2%). The fire risk was found to be an intolerable risk in FHZ-I at 40 stations (85.1%) and FHZ-II at 10 stations (21.3%). A total of 18 stations were ranked as having a substantial risk, whereas 19 stations also had a moderate risk in FHZ-II; those levels correlated with the station locations and the quantity of fuel sold.

    Conclusion: It suggests that high risk must be controlled by using preventive and safety actions: eliminating fire ignition sources, such as by cellphone prohibition, and inspection of electrostatic discharges, engineering control with grounding when refuelling, signposting of hazardous zones, and VRS installation on dispenser nozzles.

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Brief Reports
  • Odgerel Chimed-Ochir, Yuko Mine, Makoto Okawara, Koki Ibayashi, Fuyu M ...
    Type: BRIEF REPORT
    2020 Volume 62 Issue 1 e12152
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Background: We set out to investigate the reliability and validity of the Japanese version of the CDC core healthy day measures assessing health-related quality of life (CDC HRQOL-4) in Japanese workers.

    Methods: This cross-sectional study was conducted among 1360 Japanese workers of one Japanese company located in Kyushu. Cronbach's alpha was calculated to evaluate the internal consistency of CDC HRQOL-4 items. The concurrent validity was tested by assessing whether the CDC HRQOL-4 items correlated well with the corresponding domains of the SF-8 and the overall WFun score. The construct validity was tested by assessing the ability of the CDC HRQOL-4 to discriminate groups with and without any current disease, pain, mental problem, and sleeping disorder.

    Results: Cronbach's alpha for three of the four CDC HRQOL-4 items was 0.80, which is greater than the minimal standard (0.70) recommended for internal consistency reliability. Correlation coefficients ranging from 0.25 to 0.67 were obtained between CDC HRQOL-4 items and the SF-8 domains and WFun score. Workers with any current disease, mental problem, pain or sleeping disorder reported higher numbers of unhealthy days, and a higher odd of poor health than those without such problems. Japanese version of the CDC HRQOL-4 shows a good concurrent validity with the SF-8 and the WFun tool and good construct validity among Japanese workers in the current study.

    Conclusions: Japanese version of the CDC HRQOL-4 is a reliable and valid instrument that may be used to assess overall health and physically and mentally unhealthy days in Japanese workers.

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Original Articles
  • Mohammad Ali, Gias U. Ahsan, Ahmed Hossain
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12131
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objective: Low back pain (LBP) is one of the common health problems among full-time office employees that causes absenteeism from work. The aim of the study is to identify the association between occupational factors and LBP among full-time bank employees in Dhaka City.

    Materials and Methods: We conducted a cross-sectional study involving 593 full-time bank employees who were engaged in sedentary works. The 1-month complaint of LBP was measured using a subscale of subjective health complaints inventory. Multivariable logistic models were performed to identify variables related to LBP, and a random forest technique was performed to determine the top five important variables.

    Results: The 1-month prevalence for LBP was found to be 36.6% among the bank employees, and the prevalence was the highest (64.3%) for the 51- to 59-year-old age group. The regression analysis indicates that respondents from both agegroups, 41-50 years (OR = 2.00, 95% confidence interval [CI] = 1.10-3.69) and 51-59 years age groups (OR = 5.14, 95% CI = 2.05-13.64), are significantly associated with LBP. Furthermore, obesity (OR = 2.06, 95% CI = 1.01-4.21), and prolong working hours (>9 hours) (OR = 1.42, 95% CI = 1.01-2.0) are positively associated with LBP. The top five important variables for LBP identified by random forest technique are: age, length of employment, prolong office hours, presence of chronic illness, and physical activity.

    Conclusion: LBP is highly prevalent in full-time bank employees. The occupational factors, including the length of employment (>10 years) and long working hours, play a significant role in developing LBP among bank employees. Moreover, several factors, including age, chronic illness, obesity, and physical activity, should be taken into account in the prevention of LBP in bank employees.

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  • Yukiko Fueta, Susumu Ueno, Toru Ishidao, Yasuhiro Yoshida, Yasunari Ka ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12135
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Although 1-Bromopropane (1-BP) exposure has been reported to cause neurotoxicity in adult humans and animals, its effects on the development of the central nervous system remain unclear. Recently, we reported delayed developmental neurotoxicity (DNT) upon 1-BP exposure in rats. Here we aimed to study the effect of prenatal 1-BP exposure on the hippocampal excitability in the juvenile offspring.

    Methods: Pregnant Wistar rats were exposed to vaporized 1-BP for 20 days (6 h/d) with concentrations of 0 (control), 400, or 700 ppm. Hippocampal slices were prepared from male offspring during postnatal days (PNDs) 13, 14, and 15. Field excitatory postsynaptic potential (fEPSP) and population spike (PS) were recorded simultaneously from the CA1 region.

    Results: In the exposed groups, the stimulation/response relationships of fEPSP slope and PS amplitude were enhanced more than in the control group at PND 14. Analysis of fEPSP-spike coupling demonstrated increased values of Top and Eslope50 in the exposed groups. Real-time PCR analysis showed a significant increase in the mRNA levels of the adult type Nav1.1 Na+ channel subunit and the GluR1 glutamate receptor subunit in the hippocampus of the 700 ppm group at PND 14.

    Conclusions: Our results provide evidence that prenatal exposure to 1-BP accelerates developmental enhancement of hippocampal excitability in the pups before eye-opening. The current study suggests that our evaluation method of DNT is applicable to the industrial chemical 1-BP.

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  • Akito Takeuchi, Sadao Nakamura, Akira Namera, Tomoaki Kondo, Hiroyuki ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12144
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The aim of this study was to develop and validate a simple and reliable gas chromatography-mass spectrometry (GC-MS) method to simultaneously determine urinary 1-naphthol (1-NAP) and 2-naphthol (2-NAP) for biological monitoring of occupational exposure to naphthalene.

    Methods: NAPs were derivatized in situ with acetic anhydride after enzymatic hydrolysis, extracted with n-hexane, and analyzed using GC-MS. Validation of the proposed method was conducted in accordance with US Food and Drug Administration guidance. A final validation was performed by analyzing a ClinChek®-Control for phenolic compounds.

    Results: The linearity of calibration curves was indicated by a high correlation coefficient (>0.999) in the concentration range 1-100 μg/L for each NAP. The limits of detection and quantification for each NAP were 0.30 and 1.00 μg/L, respectively. The recovery was 90.8%-98.1%. The intraday and interday accuracies, expressed as the deviation from the nominal value, were 92.2%-99.9% and 93.4%-99.9%, respectively. The intraday and interday precision, expressed as the relative standard deviation, was 0.3%-3.9% and 0.4%-4.1%, respectively. The ClinChek® values obtained using our method were sufficiently accurate.

    Conclusions: The proposed method is simple, reliable, and appropriate for routine analyses, and is useful for biological monitoring of naphthalene exposure in occupational health practice.

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Editorial
Original Articles
  • Shinobu Yamamoto, Yuriko Hachiya, Eri Yuasa, Akito Takeuchi, Toru Ishi ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12139
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: The present study aimed to develop a method for measuring the ceiling level of ortho-phthalaldehyde (OPA) exposure and evaluate the ceiling levels of OPA exposure among health care workers who handle disinfectant solutions containing OPA for the disinfection of endoscopes.

    Methods: The study consisted of a preliminary survey and main survey. In the preliminary survey, processes involving high-concentration exposure to OPA were identified by video-exposure monitoring (VEM). In the main survey, the ceiling levels of OPA exposure for high-concentration exposure processes identified from the results of the preliminary survey were determined using a measuring method combining sampling using a 2,4-dinitrophenylhydrazine-silica cartridge and analysis by high-performance liquid chromatography tandem mass spectrometry.

    Results: In the preliminary survey, seven processes involving high-concentration exposure to OPA were identified by VEM. The duration of each process was short, lasting from 20 seconds to a few minutes. In the main survey, the OPA concentrations for the identified high-concentration exposure processes ranged from 1.18 to 4.49 ppb, which markedly exceeded the threshold limit value ceiling (TLV-C) of 0.1 ppb recommended by the American Conference of Governmental Industrial Hygienists.

    Conclusions: The method for measuring the ceiling level of OPA exposure was established using VEM and the highly sensitive method of chemical analysis; and we successfully evaluated the ceiling levels of OPA exposure among health care workers engaged in endoscope disinfection. This approach can also be applied to other chemical substances with recommended TLV-Cs, and important information for reducing exposure can thus be obtained.

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Review Articles
  • Hamad S. Al Amer
    Type: REVIEW ARTICLE
    2020 Volume 62 Issue 1 e12155
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    Objectives: Low back pain (LBP) has a major impact on health workers, and its prevalence and risk factors among them in Saudi Arabia have been investigated previously. However, the results have never been comprehensively reviewed. Therefore, the aim of this study was to perform a systematic review and meta-analysis of the available literature to identify the prevalence and risk factors of LBP among health workers in Saudi Arabia.

    Methods: MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Saudi peer-reviewed journals were searched for relevant literature. After quality assessment of the eligible articles, 18 studies targeting seven occupational categories, with a total number of 5345 health workers, were analyzed.

    Results: Pooled prevalence rates of 40.8% (n = 7 studies), 65.0% (n = 13 studies), and 81.4% (n = 2 studies) were obtained for week, year, and career, respectively, across all professional groups. Nurses and physical therapists were more susceptible to LBP, in that order, than the other categories considering week and career periods. Age, body mass index, and female gender were the most commonly reported individual risk factors. Occupational risk factors mainly included work-related activities requiring back bending and twisting, lifting and pulling objects, and manual patient-handling.

    Conclusions: The results of this review indicate that LBP is highly prevalent among health workers in Saudi Arabia when compared with international rates. Proper prophylactic measures are necessary to reduce LBP and minimize its consequences. Further high-quality research is needed in different Saudi regions to achieve a broader understanding of LBP prevalence and causes.

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Original Articles
  • Sihao Lin, Zhenyi Wu, Wenjuan Tang, Guoxi Xu, Xianzhe Zeng
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12154
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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  • Hoichi Amano, Yoshiharu Fukuda, Megu Y. Baden, Ichiro Kawachi
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12149
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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  • Taisuke Tomonaga, Hiroto Izumi, Yukiko Yoshiura, Takashi Marui, Ke-Yon ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12146
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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  • Kota Fukai, Tomohisa Nagata, Koji Mori, Makoto Ohtani, Kenji Fujimoto, ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12138
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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  • Majid Bagheri Hosseinabadi, Narges Khanjani, Mohammad Hossein Ebrahimi ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12136
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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  • Maarit Malin, Nina Jaakkola, Ritva Luukkonen, Antero Heloma, Anne Lamm ...
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12145
    Published: 2020
    Released: September 25, 2020
    JOURNALS OPEN ACCESS

    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.

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Opinions
Original Articles
  • Fatma Uzuntarla, Serhat Kucukali, Yasin Uzuntarla
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12129
    Published: 2020
    Released: July 25, 2020
    JOURNALS OPEN ACCESS

    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.

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Review Articles
  • Maxwell O. Akanbi, Cassandra B. Iroz, Linda C. O'Dwyer, Adovich S. Riv ...
    Type: REVIEW ARTICLE
    2020 Volume 62 Issue 1 e12133
    Published: 2020
    Released: July 25, 2020
    JOURNALS OPEN ACCESS

    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.

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Brief Reports
  • Natsu Sasaki, Reiko Kuroda, Kanami Tsuno, Norito Kawakami
    Type: BRIEF REPORT
    2020 Volume 62 Issue 1 e12134
    Published: 2020
    Released: July 25, 2020
    JOURNALS OPEN ACCESS

    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.

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Letters To The Editor
Original Articles
  • Hoda Jradi, Hajjah Alanazi, Yousef Mohammad
    Type: ORIGINAL ARTICLE
    2020 Volume 62 Issue 1 e12126
    Published: 2020
    Released: July 25, 2020
    JOURNALS OPEN ACCESS

    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.

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