Unequal excess mortality during the Spanish Flu pandemic in the Netherlands

A century after the Spanish Flu, the COVID-19 pandemic has brought renewed attention to socioeconomic and occupational differences in mortality in the earlier pandemic. The magnitude of these differences and the pathways between occupation and increased mortality remain unclear, however. In this paper, we explore the relation between occupational characteristics and excess mortality among men during the Spanish Flu pandemic in the Netherlands. By creating a new occupational coding for exposure to disease at work, we separate social status and occupational conditions for viral transmission. We use a new data set based on men’s death certificates to calculate excess mortality rates by region, age group, and occupational group. Using OLS regression models, we estimate whether social position, regular interaction in the workplace, and working in an enclosed space affected excess mortality among men in the Netherlands in the autumn of 1918. We find some evidence that men with occupations that featured high levels of social contact had higher mortality in this period. Above all, however, we find a strong socioeconomic gradient to excess mortality among men during the Spanish Flu pandemic, even after accounting for exposure in the workplace.     

Occupational Electromagnetic Fields exposure in Magnetic Resonance Imaging systems – Preliminary results for the RF harmonic content

PurposeEuropean legislation concerning the protection of workers from exposure to Electromagnetic Fields (EMF) was recently (26.6.2013) completed by Directive 2013/35/ΕU. This Directive is a specific one of the framework Directive 89/391/EEC and part of the overall legislation for Occupational Health and Safety (OHS). Magnetic Resonance Imaging (MRI) systems have played a key role, both in the postponement of the former 2004/40 EMF Directive and in the formation of the latest limits adopted by the new Directive. On the other hand, MRI systems are associated with the exposure of personnel to EMF of various frequencies and modulations, arousing peculiar safety issues. Therefore, we will try to acquire the highly important knowledge of the exact occupational exposure levels, in all working scenarios and practices.MethodsDifferent MRI systems (1.5 and 3 T) have been chosen for a variety of measurements in order to assess occupational exposure compared to the limits (ALs) of the Directive and to the main OHS principles. Gradient function of MRI systems results in low frequency exposure, while high frequency exposure comes from the application of the RF excitation frequency.ResultsIn most of the cases the RMS and peak value measurements do not exceed the corresponding ALs, apart from a few specific hot spots, manageable through OHS principles.DiscussionComplete occupational exposure results can form the basis for dealing with multiple exposures present in MRI systems. Peculiar RF harmonic components, of no safety concern, were detected. Their origin is under examination.     

Urinary homovanillic acid (HVA) and vanillymandelic acid (VMA) in workers exposed to manganese dust

The neurotoxicity of manganese (Mn) is well known, however, the neurochemical effect caused by this metal is less well investigated. In this study, urinary homovanillic acid (HVA) and vanillymandelic acid (VMA), two end products of catecholamine metabolism, were measured in 39 workers chronically exposed to Mn in a manganese smelting plant. The average duration of Mn exposure was 17.4 yr. Nineteen nonexposed workers were also studied. Concentrations of Mn in serum (MnS) and in urine (MnU) were measured by Zeeman graphite furnace atomic absorption spectrophotometry (ZAAS), and HVA and VMA determined by high performance liquid chromatography (HPLC). For Mn-exposed workers, the concentration of MnS was nearly 2.8 times (1.61 ± 0.16 mg/L vs 0.56 ± 0.16 mg/L) and MnU about 4.5 times higher (7.62 ± 0.17 mg/L vs 1.69 ± 0.16 mg/L) than the nonexposed. Although the geometric mean concentration of HVA in exposed workers was similar to that of the nonexposed (3.09 ± 1.39 mg/g ere. vs 2.99 ± 1.40 mg/g cre.), the VMA concentration was significantly higher (3.02 ± 1.43 mg/g cre. vs 2.49 ± 1.58 mg/g cre.,p = 0.033). Multiple regression analysis showed that although there were no correlations between any of these parameters with the duration of exposure to Mn, both HVA and VMA showed significant correlations with increase in MnS and MnU. These data provide evidence that exposure to Mn was associated with measurable increase in catecholamine metabolites. This finding is compatible with recent observations in laboratory animals that Mn interferes with neurochemical metabolism.     

Large tables

The traditional exploration of large contingency tables leads to multiple comparisons with the inherent generation of chance associations. To allow for this, a simple empirical Bayesian approach is used here to derive estimates of association 'shrunk' towards a global mean. Estimates are displayed on ordered normal plots, to allow visual detection of outliers, with the addition of 'guide rails', derived from simulation, to facilitate their detection. The methods, and the interpretation of results, are illustrated using a large table of occupations for cancer registrations in England and Wales for 1971-90.     

Dysregulation of Autonomic Control of Cardiac Function in Workers at am Broadcasting Stations (0.738–1.503 MHz)

Ninety-three adult males working at AM broadcasting stations (0.738–1.503 MHz) or radio line stations volunteered for cardiological examinations. The examinations included routine electrocardiogram (ECG) at rest, analysis of heart rate variability (HRV), Holter 24-h ECG, and 24-h ambulatory blood pressure (ABP). Results of cardiological examinations were correlated with individual exposure to EM fields (maximum exposure levels during working shift, daily exposure dose, and cumulative lifetime exposure). Of the 93 subjects qualified for the study, 71 (76.3%) experienced occupational RF exposure, while the remaining 22 (23.7%) had no history of regular EM exposure. ECG abnormalities or pathological changes were recorded quite frequently (50–70%) in both exposed and control populations. There was no correlation with exposure levels. We found measurable effects in the HRV and ABP parameters in the EM-exposed population, but none could be assigned clinical significance. The results suggest that exposure of workers to EM fields can cause slight disturbances in autonomic cardiac regulation and slight dysregulation of circadian rhythms in workers exposed to EM fields exceeding 100–150 V/m.     

解剖学工作者的职业病在工作环境中举证责任倒置的探讨

甲醛可引起机体一系列异常反应,针对解剖工作者所处的工作环境,可以通过改善工作环境、使用检测仪器和定期进行体检来预防甲醛对机体的危害,在防治职业病的发生的基础上,认识到职业病在工作环境中的举证责任倒置问题,可以对疾病进行早发现和早治疗,并对职业病的法律维权有所帮助。     

Evaluación de los parámetros de hipoacusia laboral en trabajadores activos y su relación con los niveles de glucemia basal

IntroductionHearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account.ObjectivesTo explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels.MethodsAn observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. Results were categorized by baseline blood glucose levels: G1 (< 100 mg/dl), G2 (100-125 mg/dl), and G3 (> 125 mg/dl).ResultsBased on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group (P = .038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p = .002), ELI (OR: .407; p = .007), and the monaural test in the left ear (OR: 4.77 × 10-5; p = .006).ConclusionsDespite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels.     

Occupational exposure to anaesthetic gases and urinary excretion of D-glucaric acid

In order to ascertain whether the urinary excretion of D-glucaric acid (DGA) might be a suitable biomarker of effect in monitoring workers exposed to anaesthetic gases, we measured DGA before and after an operating session (and, in some workers, before and after a 2-week vacation) in 229 workers of surgical units and in 229 controls. In the former, we also measured urinary levels of nitrous oxide (N₂O) and isofiurane after at least 4 h of exposure. For all subjects, information on age, smoking habits, daily intake of alcohol, coffee, and drugs, history of liver or kidney disease was collected. Study subjects were ranked according to: exposure (class 0: subjects not exposed; class 1: N₂     

医务人员职业暴露危险因素分析及对策

为了探讨医务人员职业暴露危险因素及防护对策,对长江大学附属一医院2008年1月1日—2009年12月31日上报的职业暴露依据科室分布、感染途径及暴露原因进行了分析。结果显示,该医院共发生医务人员职业暴露94例,其中,护士62例,医生25例,其它人员7例,护士高于医生;35岁以下年轻护士及医生占88例,35岁以上者6例;大学本科以下学历60例,中级职称以下人员75例。因此需对医务人员加强培训,提高自我保护意识,规范操作,加强管理,注重预防。     

Sleep Parameters among Offshore Workers: An Initial Assessment in the Campos Basin,Rio De Janeiro,Brazil

Shift work has potentially adverse effects on health, particularly on sleep. The purpose of the present study was to assess sleep parameters among personnel working in oil and gas offshore installations in the Campos Basin, Rio de Janeiro, Brazil. One hundred and seventy-nine subjects were asked to complete a sleep questionnaire with multiple-choice answers. Offshore workers were divided into two groups according to their work schedule: (1) fixed daytime workers (n = 86; age: 35.8 ± 9.6 yrs) and (2) shift (n = 87) or night (n = 6) workers (total n = 93; age: 37.7 ± 9.7 yrs). Shift/night workers reported poor sleep more frequently than the daytime workers (20.4% vs. 1.2%, p < 0.01), as well as habitual difficulty in falling asleep (15.1% vs. 4.7%, p < 0.01), long latency of sleep onset (28% vs. 7%, p < 0.01), fragmented sleep (45.2% vs. 16.3%, p < 0.01), short sleep episodes (44.1% vs. 16.3%, p < 0.01), irregular bedtimes (29.0% vs. 12.8%, p < 0.01), and feeling tired upon awakening (15.1% vs. 3.5%, p < 0.01). Habitual napping and loud snoring were reported twice as often in shift/night than in day workers (p < 0.01). Nightmares, somnambulism, and unpleasant feeling in the legs were equality reported by both groups (p > 0.05). Few offshore workers had sought medical help for their sleep problems. A higher number of shift/night workers reported feelings of sadness compared with day workers (26.9% vs. 9.3%, p < 0.01). The findings of this study show that subjective reports of sleep-related problems are quite common among Brazilian offshore shift workers. Reliance on self-reported sleep problems and a cross-sectional design are the main limitations of our study.