Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Teoh, K; Singh, J, Medisauskaite, A, Hassard, J. Pages: 61 - 69 Abstract: ObjectivesStudies have demonstrated an association between doctors’ perceived working conditions, and their psychological well-being and patient care. However, few have examined inter-relationships among these three domains, and even fewer using longitudinal designs. Using meta-analytical structural equation modelling, we tested longitudinal relationships among doctors’ perceived working conditions, their psychological well-being and patient care. We further tested if doctors’ psychological well-being mediates the relationship between perceived working conditions and patient care.MethodsWe carried out a systematic review using Academic Search Premier, Business Source Premier, PsycInfo, PsycArticles and Medline for the 20-year period between January 2000 and the start of the pandemic (January 2020). We included studies with practising doctors as participants, and that reported a quantifiable bivariate effect size between at least two of the three constructs of interest—perceived working conditions (ie, job demands, job resource), psychological well-being (ie, emotional exhaustion, work engagement) and patient care (ie, clinical care, patient safety). We pooled relationship effect sizes using random-effects meta-analysis, before testing for indirect effects using two-stage structural equation modelling.ResultsTwenty-three samples from 11 countries representing 7275 doctors were meta-analysed. The results indicated that job resources predicted work engagement (=0.18; 95% CI 0.11 to 0.24) and emotional exhaustion (=–0.21; 95% CI –0.31 to –0.11), while job demands predicted emotional exhaustion (=0.27; 95% CI 0.17 to 0.36). Better clinical care was also associated with higher levels of job resources (=0.16; 95% CI 0.04 to 0.29), and lower levels of emotional exhaustion (=–0.21; 95% CI –0.37 to –0.12) and job demands (=–0.27; 95% CI –0.43 to –0.10). Both factors of the work environment were associated with clinical care through doctors’ emotional exhaustion, but there were insufficient studies to test the indirect effects for work engagement or patient safety.ConclusionOur results demonstrate the need for a systems perspective to address working conditions to support both doctors’ psychological well-being and patient care. Interventions should target doctors’ job resources as they are more strongly associated with psychological well-being. However, given that job demands were strongly associated with emotional exhaustion, and in turn, clinical care, there is a need to better manage doctors’ workload, conflict and pressure to support the current psychological well-being crises among this occupational group.PROSPERO registration numberCRD42020189070. PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108486 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Mason, P; Liviero, F, Paccagnella, E. R, Biasioli, M, Maestrelli, P, Frigo, A. C. Pages: 70 - 76 Abstract: ObjectivesThe aim of this study was to assess the predictors of a favourable prognosis of occupational asthma (OA) and the employment status of patients with OA at least 2 years after diagnosis.MethodsWe collected data from 204 patients who had a diagnosis of OA confirmed by a positive specific inhalation challenge. We defined OA remission as meeting the following three criteria: no asthma symptoms, no antiasthma therapy for the last year and having normal lung function at the end of follow-up. A logistic regression analysis was performed to estimate the effects of the covariates.ResultsAt 10.6±7.8-year follow-up, 60 of 204 possible patients participated in the study, and among them 17 showed OA remission. When compared with the 43 patients with persistent OA, these patients exhibited at diagnosis younger age (p=0.0039), shorter duration of symptomatic exposure (p=0.0512), better lung function expressed by higher forced vital capacity (FVC%) predicted (p=0.0164), forced expiratory volume in 1 s (FEV1) % predicted (p=0.0066) and FEV1/FVC% (p=0.0132), and less bronchial hyper-responsiveness (p=0.0118). Nevertheless, in the multivariable model, no variables were significantly associated with OA remission. At follow-up, three individuals have retired; among the remaining 57 workers, 91.2% were still employed and 43.8% of them had continued working in the same factory after ceasing exposure to the causative agent.ConclusionsThis monocentric study did not identify a strong predictor of OA remission, but documented a high employment rate and a good job preservation over a long timeframe after diagnosis of OA mainly induced by low molecular weight agents. PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108504 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Jung, A. M; Jahnke, S. A, Dennis, L. K, Bell, M. L, Burgess, J. L, Farland, L. V. Pages: 77 - 85 Abstract: ObjectivesPrevious research has suggested that women firefighters may have a greater risk of adverse reproductive outcomes compared with non-firefighting women. In this study, we investigated the association between firefighter occupational factors and risk of preterm birth.MethodsThis cross-sectional analysis of US firefighters surveyed in 2017 compared preterm birth among firefighters to non-firefighters using age-at-pregnancy-standardised prevalence ratios. Generalised estimating equations estimated relative risks and 95% CIs between firefighter occupational factors (career or volunteer, wildland status, shift schedule, fire responses, work restriction) and preterm birth risk. We adjusted for age-at-pregnancy, education, gravidity, BMI, and smoking and considered effect modification by age-at-pregnancy and career versus volunteer status.ResultsAmong 934 women who reported 1356 live births, 12% were preterm (n=161). Preterm birth prevalence among firefighters was 1.41 times greater than non-firefighters (95% CI 1.18 to 1.68). Among wildland and combination wildland/structural firefighters, volunteers had 2.82 times the risk of preterm birth (95% CI 1.19 to 6.67) compared with career firefighters. Firefighters who started restricting their work in the 2nd trimester had a nonsignificant 0.67 times lower risk of preterm birth than those who started in the 3rd trimester or did not restrict work at all (95% CI 0.43 to 1.03).ConclusionsFirefighters may have greater risk of preterm birth than non-firefighters, which could be influenced by roles in the fire service and work restrictions taken. Keywords:
Open access
PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108332 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Kurth, L; Mazurek, J. M, Blackley, D. J. Pages: 86 - 92 Abstract: ObjectivesMesothelioma is a rare, aggressive cancer caused by exposure to asbestos fibres. Mesothelioma patients who receive trimodal therapy (chemotherapy, surgical resection and radiation) survive longer than those who receive two or fewer therapy modalities. This study analyses the 2016–2019 Medicare claims data to estimate the burden of malignant mesothelioma and describe therapy patterns (when available) among continuously enrolled fee-for-service (FFS; Medicare parts A and B) beneficiaries.MethodsWe analysed claims and enrolment information from 42 529 117 FFS Medicare beneficiaries using three mesothelioma case definitions (broad, intermediate and narrow) with varying levels of diagnostic requirements. Results are presented as ranges of values for the three definitions.ResultsAmong FFS beneficiaries, 8213–19 036 beneficiaries with mesothelioma were identified depending on the case definition. The annual prevalence per 100 000 beneficiaries ranged from 8.8 in 2016 (narrow) to 31.3 in 2019 (broad) and annual incidence per 100 000 beneficiaries ranged from 4.5 in 2019 (narrow) to 12.6 in 2017 (broad). Depending on the mesothelioma case definition, 41.8%–81.5% had available therapy claim information indicating that 7.6%–11.3% received chemotherapy alone, 1.3%–1.5% received radiation alone, and 14.3%–27.0% underwent surgery only, with 4.6%–10.5% receiving all three therapy modalities.ConclusionsMesothelioma was a prevalent disease among FFS Medicare beneficiaries during 2016–2019, and a limited proportion of beneficiaries received all three therapy modalities. Medicare data build on findings from cancer registry data to enhance our understanding of the mesothelioma burden and therapy patterns. Keywords:
Editor's choice
PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108706 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Das, D; Dutta, H. K, Borbora, D, Brahma, R. C, Das, J. M. Pages: 93 - 96 Abstract: ObjectiveThe association between periconceptional parental exposure to endocrine-disrupting chemicals (EDCs) and hypospadias remains inconclusive and controversial. Therefore, we conducted a hospital-based retrospective study to assess the relationship between hypospadias risk and parental occupational exposure to potential EDCs.MethodsIncident cases (n=73) were boys between 0 and 14 years diagnosed with hypospadias with no micropenis or cryptorchidism. Controls (n=146) were an age-matched group of boys without any congenital malformations, inguinal hernia, nephrological, urological and genital disorders. Their selection was independent of exposures to EDCs. Data on parental occupation and sociodemographic variables were collected using a structured questionnaire. We evaluated parental occupational exposures using a previously validated job-exposure matrix (JEM) for EDCs.ResultsIn our case–control study, 30.1% of all pregnancies had likely exposure to potential EDCs. The most prevalent occupations conferring possible exposure were related to activities on farms. Maternal and paternal occupational exposure to potential EDCs significantly increased the risk of mild hypospadias than moderate-to-severe hypospadias (OR=6.55 vs OR=4.63). Among various categories, parental occupational exposure to pesticides was associated with at least a twofold increased risk of hypospadias. Maternal EDC exposure during the first trimester significantly increased the risk of bearing a hypospadiac child (OR=4.72 (95% CI 2.10 to 10.60)).ConclusionThis study suggests that EDCs are a risk factor for hypospadias through occupational exposure during fetal life. PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108594 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Reynolds, C. J; Sisodia, R, Barber, C, Moffatt, M, Minelli, C, De Matteis, S, Cherrie, J. W, Newman Taylor, A, Cullinan, P. Pages: 97 - 103 Abstract: BackgroundAsbestos has been hypothesised as the cause of the recent global increase in the incidence of ‘idiopathic’ pulmonary fibrosis (IPF). Establishing this has important diagnostic and therapeutic implications. The association between occupational asbestos exposure and IPF, and interaction with a common (minor allele frequency of 9% in European populations) genetic variant associated with IPF, MUC5B rs35705950, is unknown.MethodsMulticentre, incident case–control study. Cases (n=494) were men diagnosed with IPF at 21 UK hospitals. Controls (n=466) were age-matched men who attended a hospital clinic in the same period. Asbestos exposure was assessed at interview using a validated job exposure matrix and a source-receptor model. The primary outcome was the association between asbestos exposure and IPF, estimated using logistic regression adjusted for age, smoking and centre. Interaction with MUC5B rs35705950 was investigated using a genetic dominant model.Results327 (66%) cases and 293 (63%) controls ever had a high or medium asbestos exposure risk job; 8% of both cases and controls had cumulative exposure estimates ≥25 fibre ml–¹ years. Occupational asbestos exposure was not associated with IPF, adjusted OR 1.1 (95% CI 0.8 to 1.4; p=0.6) and there was no gene–environment interaction (p=0.3). Ever smoking was associated with IPF, OR 1.4 (95% CI 1 to 1.9; p=0.04) and interacted with occupational asbestos exposure, OR 1.9 (95% CI 1 to 3.6; p=0.04). In a further non-specified analysis, when stratifying for genotype there was significant interaction between smoking and work in an exposed job (p Keywords:
Open access
PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108404 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Goldfarb, D. G; Prezant, D. J, Zeig-Owens, R, Schwartz, T, Liu, Y, Kavouras, I. G. Pages: 104 - 110 Abstract: ObjectivesA refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021.MethodsThe cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R2 values were calculated.ResultsFirefighters responded to a median of 424.7 (IQR=202.3–620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4–114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6–85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R2=0.43). Incident severity explained most of the variability of particle exposures (R2=0.90).ConclusionsUsing the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes. PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108549 Issue No:Vol. 80, No. 2 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Turunen, A. W; Halonen, J, Korpela, K, Ojala, A, Pasanen, T, Siponen, T, Tiittanen, P, Tyrväinen, L, Yli-Tuomi, T, Lanki, T. Pages: 111 - 118 Abstract: BackgroundExposure to natural environments is thought to be beneficial for human health, but the evidence is inconsistent.ObjectiveTo examine whether exposure to green and blue spaces in urban environments is associated with mental and physical health in Finland.MethodsThe Helsinki Capital Region Environmental Health Survey was conducted in 2015–2016 in Helsinki, Espoo and Vantaa in Finland (n=7321). Cross-sectional associations of the amounts of residential green and blue spaces within 1 km radius around the respondent’s home (based on the Urban Atlas 2012), green and blue views from home and green space visits with self-reported use of psychotropic (anxiolytics, hypnotics and antidepressants), antihypertensive and asthma medication were examined using logistic regression models. Indicators of health behaviour, traffic-related outdoor air pollution and noise and socioeconomic status (SES) were used as covariates, the last of these also as a potential effect modifier.ResultsAmounts of residential green and blue spaces or green and blue views from home were not associated with medications. However, the frequency of green space visits was associated with lower odds of using psychotropic medication (OR=0.67, 95% CI 0.55 to 0.82 for 3–4 times/week; 0.78, 0.63 to 0.96 for ≥5 times/week) and antihypertensive (0.64, 0.52 to 0.78; 0.59, 0.48 to 0.74, respectively) and asthma (0.74, 0.58 to 0.94; 0.76, 0.59 to 0.99, respectively) medication use. The observed associations were attenuated by body mass index, but no consistent interactions with SES indicators were observed.ConclusionsFrequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive and asthma medication in urban environments. Keywords:
Open access, Press releases
PubDate: 2023-01-18T06:28:25-08:00 DOI: 10.1136/oemed-2022-108491 Issue No:Vol. 80, No. 2 (2023)
Hybrid journal (It can contain Open Access articles)
[62 journals]
