Idiopathic Pulmonary Fibrosis: What do we Know about the Role of Occupational and Environmental Determinants? A Systematic Literature Review and Meta-Analysis.

The objectives of this systematic review of original articles published up until August 2021 and meta-analyses were to identify the links between occupational and non-occupational environmental exposures, types of occupations and idiopathic pulmonary fibrosis (IPF). Sixteen selected case-control studies were qualified as good level with Newcastle-Ottawa quality assessment scale. Sensitivity analyses highlighted the role of choice of control group, tobacco adjustment and diagnostic tools. Significantly increased risks of IPF were observed (OR (95%CI): for metals (1.42(1.05-1.92)), wood (OR:1.32(1.02-1.71)), and general dust (OR:1.32(1.08-1.63)) exposures. Subgroup analyses found a significantly elevated risk for: hardwood (OR:1.75 (1.13-2.70)), organic dusts (OR:1.72 (1.20-2.46)) and pesticides (OR:2.30 (1.30-4.08)), while no significant change was noted for softwoods and solvents. Smoking adjustments: general dust (1.45 (1.04-2.03)/organic dust (2.5 (1.49-4.22)/metals (1.87 (1.16-3)/wood dust OR: 1.16 (0.86-1.61)/pesticide exposure 2.4 (0.84-6.9) were calculated. Among agricultural workers, the risk was also increased (OR:2.06 (1.02-4.16)). Few environmental data were available and no significant associations detected. Thus, these meta-analyses highlighted the role of some occupational exposures in IPF occurrence. A more accurate and thorough assessment of exposures over the entire working life as well as on the duration and intensity of exposure and complex of multi-pollutant exposure is needed in future research and clinical practice.

Job stress and occupational status in a French cohort.

BACKGROUND: The goal of this study was to examine a large, varied occupational French cohort for possible relationships between various dimensions of occupational stress, on the one hand, and the occupational status and socio-demographic characteristics of workers on the other. METHODS: Data was taken from the first, cross-sectional phase of the VISAT study (aging, health, and work), which took place in 1996. Participants were randomly drawn from the patient lists of about one hundred occupational physicians in three regions of southern France. The current study concerned 2,768 wage earners born in 1944, 1954, or 1964. The material consisted of 59 questions aimed at assessing a broad set of working conditions, some of which were proxy measures of the dimensions described in the Karasek and Siegrist models. RESULTS: From a principal component analysis, three main factors were extracted that accounted for 40% of the total variance. The first factor (a=0.79) included items that referred to the decision latitude in the Karasek model and items that referred to the reward dimension in the Siegrist model. The second factor (a=0.77) was made up of items tapping physical stressors, while the third factor (a=0.71) pooled items that corresponded fairly well to psychological demands in the Karasek model. Highly significant relationships (p<10(-4)) were found between the mean factor scores and both occupational status and educational level, with a lower occupational status and educational level being associated with greater lack of job control and rewards, higher physical stress, but lower psychological demands. Less job control and fewer rewards were also found to be greater in older workers (p<10(-3)) and females (p<10(-4)). CONCLUSION: Our results thus confirm the existence of a strong association, in a French cohort, between occupational status and dimensions of job stress known to be associated with adverse health outcomes.

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust.

BACKGROUND: characterize To the effects of high asbestos exposure during annual periods of insulation. METHOD: 170 ex-workers underwent clinical examination, spirometry, standard chest X-rays and high-resolution computed tomography (HRCT). Asbestos exposure was retrospectively assessed for latency, duration, and intensity. RESULTS: Sixty-six percent of these workers were annually exposed to high concentrations of asbestos dust. Respiratory symptoms were mild. One hundred and nineteen subjects had pleural or pulmonary changes on HRCT, compatible with asbestos exposure. Localized pleural thickening was found in 113 subjects (66.5%); pulmonary nodules or lines in 35 (20.6%). The presence of pleural plaques was linked to intensity of asbestos exposure (P <.01), and length of employment (P <.05). Parenchymal lesions were related to intensity (P <.05) and duration of exposure (P <.05). Lung function of subjects with X-ray changes was not significantly altered. CONCLUSIONS: Annual asbestos exposure led to a high prevalence of pleural plaques and to mild parenchymal anomalies.

[Cardiovascular risk factors and shift work in men living in Haute-Garonne, France]. / Facteurs de risque cardiovasculaire et travail posté chez l'homme en Haute-Garonne.

OBJECTIVE: The goal of this study was to examine the relationship between shift work and cardiovascular risk factors in a cross sectional survey. MATERIAL AND METHODS: 2 610 men of the PRIME study, aged 50-60 years, residing in Haute-Garonne (France) and selected from health centers and various firms were screened. White-collar workers, retired and disabled men at the time of the study were excluded so the analysis was performed on a sample of 1,341 subjects. Work was categorized as day work (n = 1,161) and three types of shift work: 2 x 8 (n = 108), 3 x 8 (n = 41) and night (n = 31). A comparison of cardiovascular risk factors was performed in the different types of work. RESULTS: Univariate analysis showed that systolic blood pressure was significantly higher among 2 x 8 workers (132.7 +/- 17.4 mmHg) than in other shift workers and day workers (126.9 +/- 15.1 mmHg). The same difference was observed for diastolic blood pressure. Plasma triglycerides were significantly higher among night workers (1.60 +/- 0.76 g/l) than among day workers (1.29 +/- 0.81 g/L). Logistic regression analysis showed that the risk of hypertension, defined as systolic (> or = 140 mmHg) and diastolic (> or = 90 mmHg) blood pressure and/or antihypertensive drug, was 2 times higher among 2 x 8 shift workers (OR: 2.14, 95% CI [1.42-3.23]) than among day workers after adjustment for BMI, alcohol and tobacco consumption and plasma triglyceride levels. The same result (OR: 1.99, 95% CI [1.28-3.12] was obtained with a different definition of hypertension (systolic > or = 160 mmHg and/or diastolic > or = 95 mmHg blood pressure and/or antihypertensive drug). Among night workers the risk of triglycerides > 2 g/L was higher (OR: 2.52, 95% CI [1.06-6.01] than among day workers. The risk of both hypertension (140/90 mmHg) and hypertriglyceridemia in comparison to day workers was (OR: 2.01, 95% CI [1.33-3.03]) and (OR: 2.44, 95% CI [1.14-5.21]) for 2 x 8 shift workers and night shift workers respectively. CONCLUSION: The results of this study, putting into evidence a relationship between shift work, hypertension and high level of triglycerides, justify a careful screening by occupational physicians of cardiovascular risk factors among shift workers.