Active commuting and cardiovascular risk among health care workers.

BACKGROUND: Although the benefit of physical activity on cardiovascular health has been well demonstrated, being physically active can be difficult for health care workers. Active commuting such as walking or cycling may be a good way to promote physical activity. AIMS: To investigate the relationship between active commuting and cardiovascular disease risk factors in health care workers. METHODS: A cross-sectional study of health care workers conducted in Chiang Mai University Hospital, Thailand. Information on demographics and lifestyle, including active commuting, was obtained from questionnaires. Results were analysed with multiple logistic regression, adjusting for other physical activity and possible confounders. RESULTS: Among 3204 participants, fewer than half engaged in active commuting. After adjustment for poss ible confounders, low active commuting was associated with increased risk of hypertension [adjusted odds ratio (aOR) 1.3, 95% confidence interval (CI) 1.1-1.7]. High active commuting was associated with central obesity (aOR 1.4, 95% CI 1.0-1.8). Compared with non-active commuters, younger active commuters (aged under 40) had reduced prevalence of hypertension (aOR 0.4, 95% CI 0.2-1.0), while older active commuters (aged 40 or over) demonstrated increased hypertension (aOR 1.6, 95% CI 1.1-2.3) and central obesity (aOR 1.5, 95% CI 1.1-2.1). CONCLUSIONS: We found conflicting evidence on the relationship between active commuting and cardiovascular risk factors. Reverse causation may explain the association between active commuting and hypertension and central obesity and should be investigated further.

Development of an occupational airborne chemical exposure matrix.

BACKGROUND: Population-based studies of the occupational contribution to chronic obstructive pulmonary disease generally rely on self-reported exposures to vapours, gases, dusts and fumes (VGDF), which are susceptible to misclassification. AIMS: To develop an airborne chemical job exposure matrix (ACE JEM) for use with the UK Standard Occupational Classification (SOC 2000) system. METHODS: We developed the ACE JEM in stages: (i) agreement of definitions, (ii) a binary assignation of exposed/not exposed to VGDF, fibres or mists (VGDFFiM), for each of the individual 353 SOC codes and (iii) assignation of levels of exposure (L; low, medium and high) and (iv) the proportion of workers (P) likely to be exposed in each code. We then expanded the estimated exposures to include biological dusts, mineral dusts, metals, diesel fumes and asthmagens. RESULTS: We assigned 186 (53%) of all SOC codes as exposed to at least one category of VGDFFiM, with 23% assigned as having medium or high exposure. We assigned over 68% of all codes as not being exposed to fibres, gases or mists. The most common exposure was to dusts (22% of codes with >50% exposed); 12% of codes were assigned exposure to fibres. We assigned higher percentages of the codes as exposed to diesel fumes (14%) compared with metals (8%). CONCLUSIONS: We developed an expert-derived JEM, using a strict set of a priori defined rules. The ACE JEM could also be applied to studies to assess risks of diseases where the main route of occupational exposure is via inhalation.

Anterior cruciate ligament reconstruction and service in the British Army.

BACKGROUND: In 2005, British Army recruiting policy was revised to permit applicants with a history of anterior cruciate ligament reconstruction (ACLR) to be accepted for an initial period of engagement. AIMS: To determine whether personnel with an ACLR history are more likely to be medically discharged due to further injuries and complications than those without. METHODS: A retrospective study of personnel commissioned or enlisted into the British Army between January 2006 and July 2009. ACLR cases were identified from personnel and medical records and were age and sex matched to randomly selected controls. Reasons for discharge were identified. RESULTS: A total of 69 cases and 140 controls were included. A significant increase in risk of medical discharge was found in those with ACLR (incidence risk ratio was 3.04; 95% confidence interval 1.24-7.45). Sixty-one per cent of cases experienced complications linked to their previous surgery. CONCLUSIONS: The current British Army policy on recruitment of those with a history of ACLR should be reviewed in terms of fitness for service and risk of foreseeable harm in these individuals.

Voice disorders in Nigerian primary school teachers.

BACKGROUND: The prolonged use or abuse of voice may lead to vocal fatigue and vocal fold tissue damage. School teachers routinely use their voices intensively at work and are therefore at a higher risk of dysphonia. AIMS: To determine the prevalence of voice disorders among primary school teachers in Lagos, Nigeria, and to explore associated risk factors. METHODS: Teaching and non-teaching staff from 19 public and private primary schools completed a self-administered questionnaire to obtain information on personal lifestyles, work experience and environment, and voice disorder symptoms. Dysphonia was defined as the presence of at least one of the following: hoarseness, repetitive throat clearing, tired voice or straining to speak. RESULTS: A total of 341 teaching and 155 non-teaching staff participated. The prevalence of dysphonia in teachers was 42% compared with 18% in non-teaching staff. A significantly higher proportion of the teachers reported that voice symptoms had affected their ability to communicate effectively. School type (public/private) did not predict the presence of dysphonia. Statistically significant associations were found for regular caffeinated drink intake (odds ratio [OR] = 3.07; 95% confidence interval [CI]: 1.51-6.62), frequent upper respiratory tract infection (OR = 3.60; 95% CI: 1.39-9.33) and raised voice while teaching (OR = 10.1; 95% CI: 5.07-20.2). CONCLUSIONS: Nigerian primary school teachers were at risk for dysphonia. Important environment and personal factors were upper respiratory infection, the need to frequently raise the voice when teaching and regular intake of caffeinated drinks. Dysphonia was not associated with age or years of teaching.

Risks of cataract in Nigerian metal arc welders.

BACKGROUND: Occupational exposure to ultraviolet (UV) radiation from welding is considered a risk factor for cataract and other eye disorders, but the evidence for such effects is limited. AIMS: To identify any increased risk of developing cataract from metal arc welding and to investigate the associated risk factors. METHODS: A cross-sectional study was carried out on male welders and control subjects (not engaged in welding) from five fabrication and construction companies in Port Harcourt, Nigeria. A questionnaire was used to gather information regarding their demography and lifestyle, along with their occupational, medical and ocular histories. Cataract was identified by external examination and ophthalmoscopy. RESULTS: A total of 117 welders and 105 controls participated. There was no statistically significant increase in the risk of cataract in welders after adjusting for age, smoking status, family history of cataract, outdoor work and history of eye injury. There was a strong association between work-related eye-injury history and cataract. Only 60% of welders were wearing eye protection when the eye injury occurred. The majority of the eye injuries (72%) occurred during welding and grinding operations. CONCLUSIONS: The findings of this study suggest that the main occupational risk factor for cataract was a history of eye injuries. The role of UV (or optical) radiation appeared to be less important than impact eye injuries associated with welding-allied processes. It is therefore important that welders are provided with different types of eye protection and are informed about which type should be used, and when, so that they can be protected against optical and impact injuries.

Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study.

There is some evidence that chronic obstructive pulmonary disease (COPD) and metabolic syndrome may be related, perhaps through systemic inflammation, which is common to both. However, the association between the two conditions has not yet been clearly shown. The present study involved 7,358 adults aged > or =50 yrs from a population-based survey who underwent spirometry, a structured interview and measurement of fasting metabolic marker levels. Airflow obstruction (forced expiratory volume in 1 s/forced vital capacity ratio of less than the lower limit of normal) was present in 6.7%, and the International Diabetes Federation metabolic syndrome criteria were met by 20.0%. The risk of metabolic syndrome was higher in those with airflow obstruction than in those without (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.12-1.92), after controlling for potential confounders. Of the five components of metabolic syndrome, only central obesity was significantly associated with airflow obstruction (OR 1.43; 95% CI 1.09-1.88) after adjusting for body mass index. A similar association was observed in both never and current smokers. In this Chinese sample, airflow obstruction was associated with metabolic syndrome, and, in particular, its central obesity component. This may help explain the increased risk of cardiovascular diseases in COPD, and so could guide future clinical practice.