occupational

职业
  • 文章类型: Journal Article
    背景:心理弹性有助于在压力环境中适应,并且是使工人能够应对职业挑战的重要个人特征。很少有研究评估与医护人员心理弹性相关的因素。
    目的:确定一组南非医生和救护人员的心理弹性的患病率和相关因素。
    方法:这项分析性横断面研究使用了从2019年和2022年在医护人员中进行的两项研究中获得的次要数据。与弹性相关的自我报告因素,根据康纳-戴维森弹性量表-10(CD-RISC-10)测量,进行了评估。使用R统计软件进行数据分析并进行统计检验。
    结果:共有647名医护人员被纳入研究,其中医生259人,救护人员388人。总体弹性评分较低(27.6±6.6),但救护车人员的弹性评分(28.0±6.9)高于医生的弹性评分(27.1±6.0)(p=0.006)。女性(OR1.94,95CI1.03-3.72,p=0.043),工作类别(OR6.9495CI1.22-60.50,p=0.044)和加班(OR13.88,95CI1.61-368.00,p=0.044)显著增加了医生低弹性的几率.相反,工资(OR0.13,95CI0.02-0.64,p=0.024)和当前吸烟状况(OR0.16,95CI0.02-0.66,p=0.027)显著降低了医生低弹性的几率.此外,仅既往饮酒显著降低了救护人员(OR0.44,95CI0.20-0.94,p=0.038)和整体样本(OR0.52,95CI0.29-0.91,p=0.024)低弹性的几率.
    结论:南非医护人员的弹性相对较低。低韧性与个人和工作场所因素之间的紧密联系为早期干预和建立医护人员的韧性提供了途径。
    BACKGROUND: Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers.
    OBJECTIVE: To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel.
    METHODS: This analytical cross-sectional study used secondary data obtained from two studies conducted among healthcare workers in 2019 and 2022. Self-reported factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated. R statistical software was used for analysing the data and performing statistical tests.
    RESULTS: A total of 647 healthcare workers were included in the study, of which 259 were doctors and 388 were ambulance personnel. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ± 6.9) than for doctors (27.1 ± 6.0) (p = 0.006). Female gender (OR 1.94, 95%CI 1.03-3.72, p = 0.043), job category (OR 6.94 95%CI 1.22-60.50, p = 0.044) and overtime work (OR 13.88, 95%CI 1.61-368.00, p = 0.044) significantly increased the odds of low resilience for doctors. Conversely, salary (OR 0.13, 95%CI 0.02-0.64, p = 0.024) and current smoking status (OR 0.16, 95%CI 0.02-0.66, p = 0.027) significantly reduced the odds of low resilience amongst doctors. In addition, only previous alcohol use significantly reduced the odds of low resilience for ambulance personnel (OR 0.44, 95%CI 0.20-0.94, p = 0.038) and overall sample (OR 0.52, 95%CI 0.29-0.91, p = 0.024).
    CONCLUSIONS: Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience among healthcare workers.
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  • 文章类型: Journal Article
    我们的目的是探索患者血清生物标志物水平与血管严重程度之间的关系。即,雷诺现象(RP),和神经感觉表现,当前的暴露水平,和暴露的持续时间。本研究采用病例系列设计,涉及92例诊断为手臂振动损伤的患者。Jonckheere的趋势检验用于评估血清生物标志物水平与RP以及神经感觉表现之间的任何关联。按国际共识标准分级。对可能的混杂因素进行调整的广义线性模型也用于生物标志物的血清水平之间的关联;(1)RP的严重程度记录为手指漂白的程度,用Griffin评分计算,(2)振动感知阈值,(3)电流暴露的幅度为[A(8);(m/s2)]值,和(4)暴露的持续时间,以年为单位。血清血栓调节蛋白水平,vonWillebrand因子,降钙素基因相关肽(CGRP),热休克蛋白27和caspase-3与RP的严重程度呈正相关。血清CGRP水平与神经感觉成分呈正相关。对于这些生物标志物,未显示与暴露的关联。对于细胞间粘附分子1和单核细胞趋化蛋白1,未发现与严重程度或暴露无关。与内皮损伤或功能障碍相关的血清生物标志物水平,炎症,血管舒张,神经保护,细胞凋亡与手臂振动损伤的严重程度呈正相关。
    Our aim was to explore possible relationships between serum levels of biomarkers in patients with hand-arm vibration injury in relation to the severity of the vascular, i.e., Raynaud\'s phenomenon (RP), and neurosensory manifestations, the current exposure level, and the duration of exposure. This study was of case series design and involved 92 patients diagnosed with hand-arm vibration injury. Jonckheere\'s trend test was used to assess any association between serum levels of biomarkers and RP as well as neurosensory manifestations, graded by the International Consensus Criteria. Generalized linear models with adjustment for possible confounders were also used for associations between serum levels of biomarkers and; (1) severity of RP recorded as the extent of finger blanching calculated with Griffin score, (2) vibration perception thresholds, (3) magnitude of current exposure as [A(8); (m/s2)] value, and (4) the duration of exposure in years. Serum levels of thrombomodulin, von Willebrand factor, calcitonin gene related peptide (CGRP), heat shock protein 27, and caspase-3 were positively associated with severity of RP. Serum levels of CGRP were positively associated with the neurosensory component. No associations with exposure were shown for these biomarkers. For Intercellular adhesion molecule 1 and monocyte chemoattractant protein 1, no associations were found with neither severity nor exposure. Levels of serum biomarkers associated with endothelial injury or dysfunction, inflammation, vasodilation, neuroprotection, and apoptosis were positively associated with the severity of hand-arm vibration injury.
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  • 文章类型: Journal Article
    背景:在低收入和中等收入国家,职业性手和手腕受伤(OHWIs)占与工作有关的事故的25%。在哥伦比亚,2021年发生了超过50万起职业事故,尽管这一比率在2020年和2021年下降到不到5%,但至少有四分之一的事故涉及手或手腕受伤。
    目的:描述在哥伦比亚二级医院急诊室看到的工人中的OHWIs。
    方法:一项观察性研究使用来自经历OHWIs并在二级医院就诊的工人的数据进行,六月之间,2020年5月,2021年。OHWIs的总体频率,以及它们按社会人口统计的分布,临床,和职业变量,被描述。此外,性别之间的关联模式,解剖区域(手指,手,手腕),和工作类型进行了对应分析(CA)。
    结果:有2.101名工人因职业事故接受治疗,423例(20.3%)是OHWIs,主要影响男性(93.9%),中位年龄为31岁,主要在采矿业工作(75.9%)。OHWIs在右上肢更为常见(55.3%),包括不同类型的损伤,如挫伤(42.1%),裂伤(27.9%),骨折(18.7%),挤压伤(15.6%)。他们主要影响指骨(95.2%),尤其是第一个手指(25.7%)。CA显示受伤的解剖区域与工人的工作之间的关联在男性和女性中有所不同(解释方差>90%)。
    结论:昆迪纳马卡遭受职业事故的五分之一工人,哥伦比亚有一个OHWI,主要影响从事采矿的男性。这种职业特征很可能会导致长期康复,和永久性的功能限制。我们的结果可能有助于调整集群风险组的预防措施。
    BACKGROUND: Occupational hand and wrist injuries (OHWIs) account for 25% of work-related accidents in low- and middle-income countries. In Colombia, more than 500000 occupational accidents occurred in 2021, and although the rate declined to less than 5% in 2020 and 2021, at least one in four accidents involved a hand or wrist injury.
    OBJECTIVE: To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.
    METHODS: An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital, between June, 2020 and May, 2021. The overall frequency of OHWIs, as well as their distribution by sociodemographic, clinical, and occupational variables, are described. Furthermore, association patterns between sex, anatomical area (fingers, hand, wrist), and type of job were analyzed by correspondence analysis (CA).
    RESULTS: There were 2.101 workers treated for occupational accidents, 423 (20.3%) were cases of OHWIs, which mainly affected men (93.9%) with a median age of 31 years and who worked mainly in mining (75.9%). OHWIs were more common in the right upper extremity (55.3%) and comprised different types of injuries, such as contusion (42.1%), laceration (27.9%), fracture (18.7%), and crush injury (15.6%). They primarily affected the phalanges (95.2%), especially those of the first finger (25.7%). The CAs showed associations between the injured anatomical area and the worker\'s job that differed in men and women (explained variance > 90%).
    CONCLUSIONS: One out of five workers who suffered occupational accidents in Cundinamarca, Columbia had an OHWI, affecting mainly males employed in mining. This occupational profile is likely to lead to prolonged rehabilitation, and permanent functional limitations. Our results might be useful for adjusting preventive measures in cluster risk groups.
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  • 文章类型: Meta-Analysis
    职业事故,尽管不断更新安全,仍然是职业和法医领域的祸害,构成,除其他外,诉讼的主体很大一部分。人口数据可以帮助了解缺乏健康监测应用的领域。这项荟萃分析旨在分析来自工作事故研究的数据,重点关注事故发生地区与是否使用个人安全设备之间的相关性,关于现行的不同条例。对于数据的选择,根据PRISMA指南进行了系统审查,主要目标是确定特定地理区域的职业事故趋势,在对预防方面的关注方面有所不同。我们强调的数据显示,关于事故的类型,低收入国家和工业化国家之间的巨大差异(根据人类发展指数分层),对是否使用单独的安全装置完全漠不关心,揭示了这一点,尽管工作安全领域的规范不断发展,即使在今天,有关法规实际应用的调查数据,在工作事故中,被低估了,很少研究。
    Occupational accidents, despite continuous safety updates, are still a scourge in the occupational and forensic spheres, constituting, among other things, the subject of a large share of litigation. Demographic data can help to understand the areas where the application of health surveillance is lacking. This meta-analysis sets out to analyse data from studies on accidents at work, focusing on the correlation between the areas in which accidents occur and whether or not personal safety equipment is used, in relation to the different regulations in force. For the selection of the data, a systematic review was carried out according to the PRISMA guidelines, with the primary objective of identifying the trend of occupational accidents in specific geographical areas, which differ in terms of the attention paid to preventive aspects. The data we highlighted showed, regarding the type of accident, substantial differences between low-income countries and industrialised countries (stratified according to the Human Development Index) and, an overall indifference as to whether or not individual safety devices were used, revealing that, despite the continuous normative evolution in the field of safety at work, even today, the investigative data on the actual application of the regulations, during accidents at work, is underestimated and little researched.
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)大流行引发了上班族远程在家工作的增加。鉴于许多家庭现在可以作为办公室,尽管不是为了支持办公室工作而设计的,研究室内空气质量(IAQ)对在家工作的人的认知表现的影响至关重要。在这项研究中,在2021年至2022年期间,我们在美国各地的206名办公室工作人员在远程或混合远程设置下进行了为期一年的跟踪。参与者实时放置了两个,消费级室内环境监视器在他们的家庭工作站区和卧室。使用自定义的智能手机应用程序地理到他们的住宅地址,参与者对调查和定期认知功能测试做出回应,包括Stroop颜色词干扰测试,算术两位数加法/减法测试,和复合远程关联任务(cRAT)。评估的暴露包括二氧化碳(CO2)和热条件(室内热指数:温度和相对湿度的组合),在每次认知测试之前平均30分钟。在完全调整的纵向混合模型(n≤121)中,我们发现,室内热条件与认知功能结果呈非线性相关(p<0.05),当条件太热或太冷时,Stroop测试的认知表现较差,cRAT的创造性解决问题能力较差。大多数室内二氧化碳含量<640ppm,但是在Stroop上,较高的CO2和较差的认知能力之间仍然存在轻微的关联(p=0.09)。我们的发现强调了在远程工作期间需要提高家庭室内环境质量以实现最佳认知功能,对雇员和雇主都有好处。
    The coronavirus disease 2019 (COVID-19) pandemic triggered an increase in remote work-from-home for office workers. Given that many homes now function as offices despite not being designed to support office work, it is critical to research the impact of indoor air quality (IAQ) in homes on the cognitive performance of people working from home. In this study, we followed 206 office workers across the U.S. over one year under remote or hybrid-remote settings during 2021-2022. Participants placed two real-time, consumer-grade indoor environmental monitors in their home workstation area and bedroom. Using a custom smartphone application geofenced to their residential address, participants responded to surveys and periodic cognitive function tests, including the Stroop color-word interference test, Arithmetic two-digit addition/subtraction test, and Compound Remote Associates Task (cRAT). Exposures assessed included carbon dioxide (CO2) and thermal conditions (indoor heat index: a combination of temperature and relative humidity) averaged over 30 minutes prior to each cognitive test. In fully adjusted longitudinal mixed models (n≤121), we found that indoor thermal conditions at home were associated with cognitive function outcomes non-linearly (p<0.05), with poorer cognitive performance on the Stroop test and poorer creative problem-solving on the cRAT when conditions were either too warm or too cool. Most indoor CO2 levels were <640 ppm, but there was still a slight association between higher CO2 and poorer cognitive performance on Stroop (p=0.09). Our findings highlight the need to enhance home indoor environmental quality for optimal cognitive function during remote work, with benefits for both employees and employers.
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  • 文章类型: Journal Article
    背景:新冠肺炎大流行引发了工作模式的持久转变,许多员工现在在家工作(w@h)。这种转变加剧了办公室工作人员现有的高水平的职业久坐行为(SB),这是对健康和福祉的公认风险。本研究旨在使用能力-机会-动机-行为(COM-B)模型来更好地了解这两个员工的SB,和直线经理的行为,以帮助员工在w@h时降低SB,并确定如何最好地支持员工以减少SB。
    方法:三个在线焦点小组,员工年龄在18-40岁之间,以桌面为基础的角色(例如行政/销售/客户服务)(n=21),和三名直线经理(n=21)进行了调查。焦点小组促进了关于参与者当前行为的讨论,什么影响它,以及当w@h时可以做些什么来降低员工SB。在COM-B框架的指导下对焦点组数据进行了主题分析,以了解对行为的影响,并确定有希望的干预策略。
    结果:大多数参与者认识到w@h提升了员工职业SB,和直线经理报告了支持员工管理工作量的重要性,鼓励和建模休息。有能力对员工和直线经理的行为有多重影响,机会和动机都被认为是有影响力的,虽然不平等。例如,一个主要主题与员工在w@h时减少SB的身体机会有关,包括模糊的工作-生活界限。身体机会的变化也使支持员工对直线经理具有挑战性。此外,W@h环境包括独特的社交机会,对这两个群体的行为产生了负面影响,包括永远在线的期望,和社会规范。提出了在个人和组织层面降低w@h时降低SB的一系列策略。
    结论:很明显,当w@h时,SB受到一系列因素的影响,因此,多组分干预策略可能最有效地降低SB。未来的干预研究是评估和完善策略的优先事项,并告知w@h指导,以保护SB升高对继续w@h的人的短期和长期健康后果。
    BACKGROUND: The Covid-19 pandemic initiated an enduring shift in working patterns, with many employees now working at home (w@h). This shift has exacerbated existing high levels of occupational sedentary behaviour (SB) in office workers, which is a recognised risk to health and well-being. This study aimed to use the Capability-Opportunity-Motivation-Behaviour (COM-B) model to better understand both employees\' SB, and line managers behaviour to assist employees to reduce SB when w@h, and identify how employees can best be supported to reduce SB.
    METHODS: Three online focus groups with employees aged 18-40 working in desk-based roles (e.g. administrative / sales / customer services) (n = 21), and three with line managers (n = 21) were conducted. The focus groups facilitated discussion regarding participants\' current behaviour, what impacts it, and what could be done to reduce employee SB when w@h. The focus group data were thematically analysed guided by the COM-B framework to understand influences on behaviour, and to identify promising intervention strategies.
    RESULTS: Most participants recognised that w@h had elevated employee occupational SB, and line managers reported the importance of supporting employees to manage their workload, and encouraging and modelling taking breaks. There were multiple influences on both employee and line manager behaviour with capability, opportunity and motivation all perceived as influential, although not equally. For example, a major theme related to the reduced physical opportunities for employees to reduce their SB when w@h, including blurred work-life boundaries. Changes in physical opportunities also made supporting employees challenging for line managers. Additionally, the w@h environment included unique social opportunities that negatively impacted the behaviour of both groups, including an expectation to always be present online, and social norms. A range of strategies for reducing SB when w@h at both individual and organisational level were suggested.
    CONCLUSIONS: It was evident that SB when w@h is influenced by a range of factors, and therefore multi-component intervention strategies are likely to be most effective in reducing SB. Future intervention research is a priority to evaluate and refine strategies, and inform w@h guidance to protect both the short-term and long-term health consequences of elevated SB for those who continue to w@h.
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  • 文章类型: Case Reports
    虽然由于烟草和酒精消费的减少,头颈癌的总体发病率有所下降,在几个工业化国家,HPV阴性口腔鳞状细胞癌(SCC)的发病率正在上升,特别是不吸烟和不饮酒的患者。
    我们记录了一例56岁的从不吸烟患者的牙龈SCC病例,报告其饮酒量低和不寻常的职业溶剂暴露。HPV阴性病变于2018年手术切除,2019年复发手术后4年,患者仍处于完全缓解状态。2021年,该患者被转诊至职业癌症咨询。病人做了18年的丝网印刷机。他报告说,每2-3天吸嘴将有机溶剂(主要是芳烃和酮)从容器转移到较小的容器中,有规律的溶剂进入他的嘴里。
    根据文献,使用口腔虹吸溶剂的频率可能被低估。虽然我们的综述没有发现报告口腔虹吸对口腔的长期影响的研究,目前的证据支持上消化道SCC与职业暴露于有机溶剂和印刷过程呈正相关。在没有主要的非专业因素的情况下,该患者的HPV阴性牙龈SCC可能归因于常规的职业性口服溶剂暴露.虽然现有的证据仍然限于正式建立因果关系,临床医师应调查OSCC患者和溶剂暴露史患者的这一危险工作实践.
    UNASSIGNED: While overall head and neck cancer incidence decreases due to reduced tobacco and alcohol consumption, the incidence of HPV negative oral cavity squamous cell carcinoma (SCC) is raising in several industrialized countries, especially in non-smoking and non-drinking patients.
    UNASSIGNED: We document a case of gingiva SCC in a 56 years old never-smoker patient reporting low alcohol consumption and unusual occupational solvent exposure. The HPV-negative lesion was surgically removed in 2018, and the patient remains in complete remission 4 years after recurrent surgery in 2019. In 2021, the patient was referred to the occupational cancer consultation. The patient worked as screen printer for 18 years. He reported mouth siphoning every 2-3 days to transfer organic solvents (mainly aromatic hydrocarbons and ketones) from containers into smaller recipients, with regular passage of solvents into his mouth.
    UNASSIGNED: According to the literature, the frequency of solvent siphoning using mouth is likely to be underestimated. While our review did not find studies reporting longterm consequences to the oral cavity of mouth siphoning, current evidence supports a positive association of upper aero digestive tract SCC with occupational exposures to organic solvents and printing processes. In absence of major extraprofessional factors, the HPV-negative gingiva SCC of this patient might be attributable to the regular occupational oral solvent exposure. While the available evidence remains limited to formally establish a causal relationship, clinicians should investigate this hazardous work practice in patients with OSCC and history of solvent exposures.
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  • 文章类型: Journal Article
    背景:健身领域经历了显着的扩展,健身教练(FIs)发挥着举足轻重的作用。鉴于他们的职业要求,了解他们的健康状况至关重要。本研究的目的是探讨健身指导员职业健康相关问题的患病率。
    方法:涵盖社会人口统计学,职业,并管理与健康相关的项目。统计分析,包括Mann-WhitneyU和卡方检验,斯皮尔曼的rho相关性,和逻辑回归,进行了。
    结果:59个金融机构报告了与职业健康相关的问题,大多数发生在教学期间(66.1%),肌肉发达(32.2%),和膝盖(15.3%),最常见的类型和本地化。在受伤和未受伤的FIs之间观察到显着的统计学差异,包括性别(p=0.012),年作为FI(p=0.001),每周工作天数(p=0.039),和每日工作小时数(p=0.013)。在健康问题之间发现了弱负(-0.284--0.362)统计学上的显着相关性;体重;身高;主要活动;和工作场所的FI。Logistic回归确定了重要的模型,表明具有运动/体育锻炼背景并定期进行运动/体育锻炼不太可能报告滑囊炎(OR0.018;p=0.020)和髋关节损伤(OR0.026;p=0.037)。
    结论:大约三分之一的金融机构报告了与职业相关的健康问题,主要是肌肉骨骼损伤。社会人口统计学,个人,和职业因素似乎会影响这些健康问题的患病率。
    BACKGROUND: The fitness sector has experienced significant expansion, with fitness instructors (FIs) playing a pivotal role. Given the demands of their profession, understanding their health profile is crucial. This study\'s purpose is to explore the prevalence of fitness instructors\' occupational health-related problems.
    METHODS: A questionnaire covering sociodemographic, occupational, and health-related items was administered. Statistical analyses, including Mann-Whitney U and chi-square tests, Spearman\'s rho correlations, and logistic regressions, were conducted.
    RESULTS: Fifty-nine FIs reported occupational health-related problems, with the majority occurring during instruction (66.1%), being muscular (32.2%), and knee (15.3%), the most common type and localization. Significant statistical differences were observed between injured and non-injured FIs, including sex (p = 0.012), years as an FI (p = 0.001), weekly days worked (p = 0.039), and daily hours worked (p = 0.013). Weak negative (-0.284 - -0.362) statistically significant correlations were found between health problems; weight; height; main activity; and FIs in the workplace. Logistic regressions identified significant models showing that having a sport/physical exercise background and practicing it regularly were less likely to report bursitis (OR 0.018; p = 0.020) and hip injuries (OR 0.026; p = 0.037).
    CONCLUSIONS: Approximately one-third of FIs reported occupational-related health problems, predominantly musculoskeletal injuries. Sociodemographic, personal, and occupational factors appear to influence the prevalence of these health problems.
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  • 文章类型: Journal Article
    确定在工作中报告骚扰的人中,召回偏见对所观察到的精神疾病过度的贡献。
    在长达5年的时间里,每六个月联系一次1885名焊接和电气行业工人。询问他们目前是否焦虑或沮丧,以及工作是否使情况变得更糟。只有在研究结束时,我们才询问他们在工作中遇到的任何工作场所骚扰。我们从已发表的可靠性研究中得出了自我报告的欺凌行为的敏感性和特异性,并制定了先验知识,这些先验知识反映了因工作(案例)而焦虑或抑郁的人过度报告工作场所骚扰(暴露)的可能性。我们将所得的错误分类模型应用于相对风险的概率偏差分析(PBA)。
    我们观察到,PBA暗示,由于研究对象的心理状态导致的有偏见的错误分类不太可能导致整个观察到的关联。的确,结果表明,工作场所骚扰后焦虑或抑郁的风险增加一倍是合理的,未经调整的相对风险随着低估的不确定性而减弱。
    工作场所骚扰后焦虑或抑郁的风险似乎不太可能用我们提出的回忆偏见来解释。
    UNASSIGNED: To determine the contribution of recall bias to the observed excess in mental ill-health in those reporting harassment at work.
    UNASSIGNED: A prospective cohort of 1885 workers in welding and electrical trades was contacted every six months for up to 5 years, asking whether they were currently anxious or depressed and whether this was made worse by work. Only at the end of the study did we ask about any workplace harassment they had experienced at work. We elicited sensitivity and specificity of self-reported bullying from published reliability studies and formulated priors that reflect the possibility of over-reporting of workplace harassment (exposure) by those whose anxiety or depression was reported to be made worse by work (cases). We applied the resulting misclassification models to probabilistic bias analysis (PBA) of relative risks.
    UNASSIGNED: We observe that PBA implies that it is unlikely that biased misclassification due to the study subjects\' states of mind could have caused the entire observed association. Indeed, the results demonstrated that doubling of risk of anxiety or depression following workplace harassment is plausible, with the unadjusted relative risk attenuated with understated uncertainty.
    UNASSIGNED: It seems unlikely that risk of anxiety or depression following workplace harassment can be explained by the form of recall bias that we proposed.
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  • 文章类型: Journal Article
    背景:髋关节骨性关节炎(HOA)是残疾随年龄增长而增加的主要原因,在女性和各种身体要求高的职业中更为普遍。本系统综述确定并总结了女性在身体要求苛刻的职业中的职业暴露,并讨论了性别差异和后果。
    方法:在这篇系统综述中,我们在各种电子数据库中搜索了从数据库开始日期到2022年10月之间发布的报告.我们纳入了队列研究和病例对照研究,这些研究评估了暴露于身体要求苛刻的职业与HOA发展之间的关系。然后,我们评估了选定研究的方法学质量,提取的相对效果,比较女性和男性的风险,并进行荟萃分析评估体力要求高的职业的影响。所有步骤均基于PROSPERO(CRD42015016894)中公布的研究方案。
    结果:本系统综述包括6项队列研究和2项病例对照研究。这些研究表明,男女患HOA的风险大大增加。从事传统上由女性主导的职业的妇女,如清洁、销售,餐饮,对身体要求很高的育儿和美发,在同样的体力要求高的职业中,与男性相比,患HOA的风险更高。相反,在传统上以男性为主的职业中,工作活动的异质性很高,比如农业,工艺品,建筑,以及低技能职业,男性的风险更高。一个例外是健康职业,与广泛的其他技术职业组合在一起,很难得出结论。
    结论:现有研究表明,各种职业与高体力劳动和增加患HOA的风险之间存在关联。职业预防和个人健康促进战略应侧重于减少工作中繁重的体力劳动的影响。上述以及早期发现应特别提供给女性主导职业的妇女和从事基本职业的人。
    BACKGROUND: Hip osteoarthritis (HOA) is a leading cause of disability increasing with age and is more prevalent in women and in various physically demanding occupations. This systematic review identifies and summarises occupational exposures for women in physically demanding occupations and discusses sex differences and consequences.
    METHODS: In this systematic review, we searched various electronic databases for reports published between date of database inception and October 2022. We included cohort studies and case-control studies that assessed the association between exposure to physically demanding occupations and the development of HOA. We then assessed the methodological quality of selected studies, extracted relative effects, compared the risk for women and men and meta-analytically reviewed the effects of physically demanding occupations. All steps were based on a study protocol published in PROSPERO (CRD42015016894).
    RESULTS: We included six cohort studies and two case-control studies in this systematic review. These studies showed a considerably increased risk of developing HOA in both sexes. Women working in traditionally female-dominated occupations such as cleaning, sales, catering, childcare and hairdressing that are physically demanding, have a higher risk of developing HOA than men in similarly physically demanding occupations. Conversely, in traditionally male-dominated occupations with a high heterogeneity of work activities, such as agriculture, crafts, construction, as well as in low-skilled occupations, the risk was higher for men. One exception are health occupations, which are grouped together with a wide range of other technical occupations, making it difficult to draw conclusions.
    CONCLUSIONS: Existing studies indicate an association between various occupations with a high physical workload and an increased risk of developing HOA. Occupational prevention and individual health promotion strategies should focus on reducing the effects of heavy physical workloads at work. The aforementioned as well as early detection should be specifically offered to women in female-dominated occupations and to people working in elementary occupations.
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