Lung function decline in 4-monthly repeated spirometric measurements: Due to silt aerosol exposure or decreasing effort?

Background: Workers on dredgers and lighters on rivers are exposed to the inhalation of aerosols and dusts. Objective: The aim of this study was to investigate effects of river silt aerosol and dust exposure on the respiratory health of dredging employees. Methods: Six era mi nations were performed over a period of 2 years at 4-monthly intervals in 54 seamen with higher silt aerosol exposure and 36 controls of the same employer. Results: No significant differences could be observed between the groups at any time of the study but there was an unexpected significant decrease in the age-corrected expiratory vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and midexpiratory flow rate (MMEF25/75) over the six series in both groups. This may indicate a loss of effort of the participants in re-examinations since biological and technical influences were highly unlikely to be the cause of these findings. Conclusions: Ignoring this possible decline of effort in frequently repeated measurements may result in overestimating potential effects of occupational exposure. Copyright (C) 2000 S. Karger AG, Basel

An international prospective general population-based study of respiratory work disability

Background: Previous cross-sectional studies have shown that job change due to breathing problems at the workplace (respiratory work disability) is common among adults of working age. That research indicated that occupational exposure to gases, dust and fumes was associated with job change due to breathing problems, although causal inferences have been tempered by the cross-sectional nature of previously available data. There is a need for general population-based prospective studies to assess the incidence of respiratory work disability and to delineate better the roles of potential predictors of respiratory work disability.Methods: A prospective general population cohort study was performed in 25 centres in 11 European countries and one centre in the USA. A longitudinal analysis was undertaken of the European Community Respiratory Health Survey including all participants employed at any point since the baseline survey, 6659 subjects randomly sampled and 779 subjects comprising all subjects reporting physician-diagnosed asthma. The main outcome measure was new-onset respiratory work disability, defined as a reported job change during follow-up attributed to breathing problems. Exposure to dusts (biological or mineral), gases or fumes during follow-up was recorded using a job-exposure matrix. Cox proportional hazard regression modelling was used to analyse such exposure as a predictor of time until job change due to breathing problems.Results: The incidence rate of respiratory work disability was 1.2/1000 person-years of observation in the random sample (95% CI 1.0 to 1.5) and 5.7/1000 person-years in the asthma cohort (95% CI 4.1 to 7.8). In the random population sample, as well as in the asthma cohort, high occupational exposure to biological dust, mineral dust or gases or fumes predicted increased risk of respiratory work disability. In the random sample, sex was not associated with increased risk of work disability while, in the asthma cohort, female sex was associated with an increased disability risk (hazard ratio 2.8, 95% CI 1.3 to 5.9).Conclusions: Respiratory work disability is common overall. It is associated with workplace exposures that could be controlled through preventive measures

Mediating role of perceived social support in the relationship between unemployment and mental distress among healthcare graduates during the COVID-19 era

Objective: This study investigates the mediating role of perceived social support in the relationship be ween unemployment and mental distress among young healthcare graduates in Bolivia during the COVID-19 pandemic. Methods: A cross-sectional analysis within a cohort study was conducted using data from 109 healthcare graduates from Bolivia collected through an online survey in 2022. The survey measured employment status, mental distress with the 12-item General Health Questionnaire (GHQ-12), and perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS). Mediation analysis was performed in R to examine the mediating effect of perceived social support on the relationship between unemployment and mental distress. Results: More than two-thirds of participants reported mental distress. Consistent with the main effect model, employment was directly associated with lower levels of mental distress, and perceived social support was positively related to better mental health. However, perceived social support did not statistically significant mediate the impact of unemployment on mental distress, with only 2.1% of the effect being mediated through perceived social support. Conclusion: Despite the beneficial effect of perceived social support on mental health, it did not signifcantly mediate the relationship between unemployment and mental distress among Bolivian healthcare graduates during COVID-19. The findings highlight the need for targeted mental health support that go beyond social support for unemployed healthcare graduates during crises

Childhood Asthma and Allergies in Urban, Semiurban, and Rural Residential Sectors in Chile

While rural living protects from asthma and allergies in many countries, results are conflicting in Latin America. We studied the prevalence of asthma and asthma symptoms in children from urban, semiurban, and rural sectors in south Chile. A cross-sectional questionnaire study was conducted in semiurban and rural sectors in the province of Valdivia (n = 559) using the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. Results were compared to prevalence in urban Valdivia (n = 3105) by using data from ISAAC III study. Odds ratios (+95% confidence intervals) were calculated. No statistical significant differences were found for asthma ever and eczema symptoms stratified by residential sector, but a gradient could be shown for current asthma and rhinoconjunctivitis symptoms with urban living having highest and rural living having lowest prevalence. Rural living was inversely associated in a statistical significant way with current asthma (OR: 0.4; 95% CI: 0.2-0.9) and rhinoconjunctivitis symptoms (OR: 0.3; 95% CI: 0.2-0.7) in logistic regression analyses. Rural living seems to protect from asthma and respiratory allergies also in Chile, a South American country facing epidemiological transition. These data would be improved by clinical studies of allergic symptoms observed in studied sectors

Precarious employment and migrant workers' mental health: a protocol for a systematic review of observational studies

Background: Precarious employment has become an urgent public health issue at a global scale with potential consequences for quality of life and health of employees, especially in vulnerable groups such as migrants. The primary aim of this systematic review is thus to analyze and summarize existing research on the association between precarious employment and migrant workers' mental health. Methods: We will search PubMed/MEDLINE, PsycINFO, Web of Science (from January 1970 onwards) for original articles on observational studies (e.g., cohort, case-control and cross-sectional, and qualitative) published in English, German, Turkish, and Spanish. The primary outcome will be depression and anxiety disorders. Secondary outcomes will be burnout, sleeping problems, and occupational stress. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. A narrative synthesis will summarize and explain the characteristics and findings of the studies. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion: This systematic review will analyze the ways in which precarious employment affects migrant workers' mental health and the process that underlies this relationship. The results from the systematic review outlined in this protocol will be of interest to labor and health professionals, policy makers, labor unions, and non-governmental organizations. Our findings may encourage and impel related policy makers to establish human-focused, safe and healthy work environments, and workplace conditions

Associations between effort-reward imbalance and health indicators among school teachers in Chuquisaca, Bolivia: a cross-sectional study

Objective To assess the association between effort-reward imbalance (ERI) and health indicators among Bolivian school teachers. Design School-based cross-sectional study. Setting Sixty randomly selected schools from rural (33) and urban (27) schools in Chuquisaca, Bolivia. Participants A total of 1062 school teachers were invited to participate, of which 597 answered the questionnaire (response 56.2%). Exposure measure Psychosocial factors at work were explored through the short version of the Effort-Reward Questionnaire. Primary and secondary outcome measures Health outcomes included self-rated overall health, mental distress (12-item General Health Questionnaire >= 5) and the 7-day prevalence of low back pain (LBP) as well as neck or shoulder pain (Nordic Questionnaire). Crude and adjusted ORs and their 95% CIs for each health outcome were calculated using logistic regression models. Results The median value for the effort-reward ratio was 0.91 (range: 0.3-2.3) with higher values for teachers from rural versus urban schools. Overall, about 43% of the teachers reported their overall health as fair or poor;45% suffered mental distress, 17% reported LBP and 29% neck or shoulder pain. Prevalences were higher for teachers employed at rural schools compared with those at urban schools. After adjusting for potential confounders and school location, ERI was statistically significantly associated with fair/poor self-rated health (adjusted OR 1.7, 95% CI 1.0 to 2.9);mental distress (1.9;95% CI 1.2 to 3.1) and LBP (2.3;95% CI 1.3 to 4.1). Conclusion Our results indicate the urgent need to improve psychosocial working conditions among Bolivian school teachers, in order to promote their health and wellbeing

Prevalence of asthma, rhinitis and eczema symptoms in rural and urban school-aged children from Oropeza Province - Bolivia: a cross-sectional study

Background: Asthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia. Methods: The Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models. Results: Median age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0). Conclusion: Overall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies