The latest medical research on Occupational & Environmental Medicine

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about occupational & environmental medicine gathered by our medical AI research bot.

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Exposure to cholinesterase inhibiting insecticides and blood glucose level in a population of Ugandan smallholder farmers.

Occupational and Environmental Medicine

The risk of diabetes mellitus may be elevated among persons exposed to some pesticides, including cholinesterase-inhibiting insecticides (organophosphates and carbamates). The objective of this study was to investigate how acetylcholinesterase activity was associated with mean blood glucose levels among smallholder farmers in Uganda.

We conducted a short-term follow-up study among 364 smallholder farmers in Uganda. Participants were examined three times from September 2018 to February 2019. At each visit, we measured glycosylated haemoglobin A (HbA1c) as a measure of long-term average blood glucose levels. Exposure to organophosphate and carbamate insecticides was quantified using erythrocyte acetylcholinesterase normalised by haemoglobin (AChE/Hb). For a subgroup of participants, fasting plasma glucose (FPG) was also available. We analysed HbA1c and FPG versus AChE/Hb in linear mixed and fixed effect models adjusting for age, sex, physical activity level, and consumption of fruits and vegetables, alcohol and tobacco.

Contrary to our hypothesis, our mixed effect models showed significant correlation between low AChE/Hb and low HbA1c. Adjusted mean HbA1c was 0.74 (95% CI 0.17 to 1.31) mmol/mol lower for subjects with AChE/Hb=24.3 U/g (35th percentile) compared with subjects with AChE/Hb=25.8 U/g (50th percentile). Similar results were demonstrated for FPG. Fixed effect models showed less clear correlations for between-phase changes in AChE/Hb and HbA1c.

Our results do not clearly support a causal link between exposure to cholinesterase-inhibiting insecticides and elevated blood glucose levels (expressed as HbA1c and FPG), but results should be interpreted with caution due to the risk of reverse causality.

Modeling Spatial Risk of Diarrheal Disease Associated with Household Proximity to Untreated Wastewater Used for Irrigation in the Mezquital Valley, Mexico.

Environmental Health Perspectives

Reusing wastewater for irrigation is a longstanding practice that enhances crop yields and improves climate resilience. Without treatment, however, wastewater contains harmful pathogens and chemicals. Reuse of untreated wastewater has been shown to be harmful to the health of nearby communities, but the routes of exposure are unknown and do not appear to be occupational. Some routes occur throughout entire communities, such as food contamination. Other routes may be spatially dependent, such as spread by domestic animals or through aerosolization.

To examine whether those wastewater exposure routes with a spatial dependency affect health, we estimated the risks of diarrheal disease in children under age 5 associated with living near wastewater canals, while adjusting for potential individual- and household-level confounders.

We conducted three surveys over 1 y in the Mezquital Valley, Mexico, to measure diarrhea in children. The distance between each participating household and a wastewater canal was measured using GPS coordinates. The association between proximity and diarrhea was estimated with a multilevel logistic regression model accounting for spatial autocorrelation.

A total of 564 households completed one to three surveys, resulting in 1,856 survey observations of 646 children. Children living 100 m from a canal had 45% lower odds of diarrhea than those living within 10 m of a canal, and children living 1000 m away had 70% lower odds of diarrhea [ 100 m vs. 10 m adjusted odds ratio ( OR ) = 0.55 , 95% credible interval (CI): 0.33, 0.91; 1000 m vs. 10 m adjusted OR = 0.30 , 95% CI: 0.11, 0.82].

The estimated decline in diarrheal prevalence with household distance from a canal persisted after controlling for occupational exposure. Identifying the specific routes of exposure that drive this relationship will help identify which interventions, such as upstream treatment, can reduce health risks for entire communities where wastewater exposure occurs. https://doi.org/10.1289/EHP6443.

Comments on a recent case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis.

Scandinavian Journal of Work, Environment

As the first case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis (mTVT), the paper by Marinaccio et al ...

Minimization of bias in measures of gestational weight gain.

Obesity Reviews

Gestational weight gain (GWG) is an important predictor of adverse pregnancy outcomes including gestational diabetes, preterm birth, delivery by ca...

Prenatal Exposures to Perfluoroalkyl Acids and Associations with Markers of Adiposity and Plasma Lipids in Infancy: An Odense Child Cohort Study.

Environmental Health Perspectives

Perfluoroalkyl acids (PFAA) are repellants that cross the placental barrier, enabling interference with fetal programming. Maternal PFAA concentrations have been associated with offspring obesity and dyslipidemia in childhood and adulthood, but this association has not been studied in infancy.

We investigated associations between maternal PFAA concentrations and repeated markers of adiposity and lipid metabolism in infancy.

In the prospective Odense Child Cohort, maternal pregnancy serum concentrations of five PFAA: Perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were measured in 649 women. Offspring were examined at birth ( n = 613 ) and at 3 months ( n = 602 ) and 18 months ( n = 503 ) of age. Total cholesterol, LDL, HDL, and triglyceride were evaluated at 3 months ( n = 262 ) and 18 months ( n = 198 ) of age. Mixed effects linear regression models estimated associations between PFAA and standardized (SDS) body mass index (BMI), ponderal index, and waist circumference. Associations between PFAA and body fat% (BF%) and plasma lipids SDS at 3 months and 18 months of age were investigated with linear regression models.

PFNA and PFDA were associated with higher BMI SDS [adjusted β = 0.26 ; 95% confidence interval (CI): 0.03, 0.49 and β = 0.58 ; 95% CI: - 0.03 , 1.19, respectively, for 1 -ng / mL increases] and ponderal index SDS ( β = 0.36 ; 95% CI: 0.13, 0.59 and β = 1.02 ; 95% CI: 0.40, 1.64, respectively) at 3 and 18 months of age (pooled) in girls. Corresponding estimates for boys were closer to the null but not significantly different from estimates for girls. In boys and girls (combined), PFNA and PFDA were associated with BF% at age 3 months (for 1 -ng / mL PFDA, β = 0.40 ; 95% CI: 0.04, 0.75), and PFDA was associated with total cholesterol SDS at 18 months ( β = 1.06 ; 95% CI: 0.08, 2.03) ( n = 83 ).

Prenatal PFAA were positively associated with longitudinal markers of adiposity and higher total cholesterol in infancy. These findings deserve attention in light of rising rates of childhood overweight conditions and dyslipidemia. https://doi.org/10.1289/EHP5184.

Who sells tobacco, who stops? A comparison across different tobacco retailing schemes.

Tobacco Control

Licensing of tobacco retailers has been proposed as a mechanism to encourage retailers to stop selling tobacco. However, previous studies of tobacco licensing and/or of retailers who have stopped selling have been restricted to one legislative environment. This study examines patterns of tobacco retailing across three legislative environments with three different licensing schemes (an annual fee-based licence, a zero-cost, one-off notification scheme and no notification/licensing scheme).

A telephone survey was conducted of 2928 potential tobacco retailers who could personally choose whether or not to sell tobacco (rather than the decision being made at a head office).

Unexpectedly, the annual licence fee to sell tobacco was not significantly associated with a lower rate of selling tobacco or a higher rate of stopping. After allowing for other factors, probability of selling, stopping selling and reported importance of tobacco sales varied across outlet types (p<0.001 for all three outcomes), and according to the remoteness of the retailer (p<0.001, p trend=0.041 and p=0.025 respectively).

A fee of $A286 was not associated with a lower rate of selling, or a higher rate of stopping. The effect of licensing on retailer numbers will presumably be greater for higher licence fees, but will also depend on the perceived importance of tobacco sales to the retailer. In turn, importance of tobacco sales appears to depend on market factors, including proximity to major urban centres and low-cost competitors. A higher licence fee is likely to have a larger effect on discouraging retailers from selling.

Association between access to full-service restaurants and childhood obesity.

Obesity Reviews

The lack of access to full-service restaurants (FSRs) is generally thought to be a risk factor for childhood obesity, as it could discourage health...

Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years.

Occupational and Environmental Medicine

To investigate temporal trends in the 'healthy soldier effect' (HSE) among 28 300 Royal Norwegian Navy servicemen who served during 1950-2004.

Standardised mortality ratios (SMRs) for all causes, diseases and external causes were calculated from national rates for the entire study period (1951-2017), and for seven successive follow-up periods after the first recorded day of Naval service, for the overall cohort and for two subgroups: land-based personnel and vessel crews. Poisson regression, expressed as rate ratios, was used to compare all-cause mortality between the subgroups.

In the overall cohort, SMRs for all-cause mortality increased steadily during the first six 10-year follow-up periods, from 0.52 to 0.94, which was still lower than national rates. After 60 years, the lower mortality compared with national rates was no longer statistically significant (SMR=0.93). Low non-neoplastic disease mortality contributed most to the longevity of the HSE. For neoplastic diseases, there was a mortality deficit only for the first and third 10-year follow-up periods. External-cause mortality rose to national rates after 40 years. An HSE was present among vessel crews, but their total mortality rate was 24% higher than that among land-based personnel, who also showed a longer-lasting HSE.

The HSE eroded gradually over time but was still present at 60 years of follow-up for all-cause mortality. The effect was strongest and most long-lived for non-neoplastic disease, lasted up to 40 years for external causes, and was relatively short for cancers. Land-based personnel showed stronger and longer-lasting HSE than vessel crews.

Association between federal and California state policy violation among vape shops and neighbourhood composition in Southern California.

Tobacco Control

Past studies have documented disparities in regulation compliance among tobacco retailers with respect to ethnic diversity in neighbourhoods. This study investigated the association between compliance with the Food and Drug Administration (FDA) and California state rules and neighbourhood ethnic composition of a vape shop location.

We recruited 122 vape shops located in 'ethnic enclave' neighbourhoods in Southern California. Trained teams of data collectors visited each of the consented vape shops and coded items in the shops that were visible and on display. Location data for the percentages of ethnic composition for a given city were obtained from the U.S. Census Bureau, American FactFinder. Multilevel logistic regression models examined the relationship between the city-level neighbourhood ethnic composition and vape shop rule violation status: not displaying Ask4ID sign and offering free samples.

Vape shops located in neighbourhoods/communities with more white residents were significantly less likely to not display Ask4ID sign (p=0.03) and less likely to offer free sampling (p=0.009), controlling for other neighbourhood ethnic characteristics.

Greater enforcement for proper signage display is needed for vape shops located in racial/ethnic minority locations to ensure that minors are discouraged from purchasing e-products.

Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study.

Environmental Health Perspectives

Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers.

We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers.

During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with < 1 % loss.

During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference p -values = 0.001 , 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26).

Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907.

Occupational radiation exposure and morbidity of circulatory disease among diagnostic medical radiation workers in South Korea.

Occupational and Environmental Medicine

We investigated the association between low-dose external occupational radiation exposure and circulatory disease morbidity among diagnostic medical radiation workers.

A cohort of 11 500 diagnostic medical radiation workers was linked with the National Dosimetry Registry data and the National Health Insurance Service data. Relative risks (RRs) were calculated to explore the association between occupational factors and circulatory disease morbidity, and excess relative risks per 100 milligray (ERR/100 mGy) were estimated to quantify the radiation dose-response relationship.

Overall, there were 2270 cases of circulatory diseases during 93 696 person-years of observation (average follow-up=8.1 years). RRs for hypertension were significantly increased for individuals who started working before 2000 compared with those who started in 2005 and later. ERR/100 mGy for all circulatory diseases was 0.14 (95% CI -0.57 to 0.99). Radiation risks of cerebrovascular diseases and ischaemic heart disease were non-significantly increased with estimates of individual cumulative doses to the heart (ERR/100 mGy=3.10 (-0.75 to 11.59) and 1.22 (-0.71 to 4.73), respectively). However, ERR estimates were generally more strongly positive for female versus male workers and for younger workers versus more than 50-year-old workers.

This study provides little evidence in support of a positive association between occupational radiation exposure and the overall risk of circulatory disease over a short follow-up period among medical radiation workers in South Korea. However, significantly increased RR with earlier year first worked, elevated ERR in female workers and young workers should be further followed up.