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Ecotoxicology and Environmental Safety Feb 2024Although previous studies have shown an association between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although previous studies have shown an association between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children, the results have been inconsistent. We summarize studies on the association between prenatal PFAS exposure and neurodevelopment in children in order to better understand the relationship.
OBJECTIVE
We conducted a meta-analysis of prenatal PFAS exposure and developmental outcomes associated with intellectual, executive function and behavioral difficulty in children to explore the relationship between prenatal exposure to perfluorinated and polyfluoroalkyl substances (PFAS) and neurodevelopmental disorders in children.
METHODS
We searched for articles published up to August 3, 2023, included and quantified original studies on PFAS and child Intelligence Quotient (IQ), executive function and behavioral difficulty during pregnancy, and systematically summarized articles that could not be quantified.
CONCLUSION
There is evidence of sex-specific relationship between PFAS exposure and children's PIQ. We found that PFOS [β = -1.56, 95% CI = -2.96, - 0.07; exposure = per 1 ln (ng/ml) increase], PFOA [β = -1.87, 95% CI = -3.29, - 0.46; exposure = per 1 ln (ng/ml) increase], PFHxS [β = -2.02, 95% CI = -3.23, - 0.81; exposure = per 1 ln (ng/ml) increase] decreased performance IQ in boys, but PFOS [β = 1.56, 95% CI = 0.06, 3.06; exposure = per 1 ln (ng/ml) increase] increased performance IQ in girls. PFAS are associated with executive function impairments in children, but not related to behavioral difficulty in children.
Topics: Male; Female; Pregnancy; Humans; Child; Prenatal Exposure Delayed Effects; Fluorocarbons; Intelligence Tests; Environmental Pollutants; Alkanesulfonic Acids
PubMed: 38211513
DOI: 10.1016/j.ecoenv.2024.115939 -
Applied Ergonomics May 2024This systematic review summarizes the evidence on associations between physical and psychosocial work-related exposures and the development of carpal tunnel syndrome... (Review)
Review
This systematic review summarizes the evidence on associations between physical and psychosocial work-related exposures and the development of carpal tunnel syndrome (CTS). Relevant databases were searched up to January 2020 for cohort studies reporting associations between work-related physical or psychosocial risk factors and the incidence of CTS. Two independent reviewers selected eligible studies, extracted relevant data, and assessed risk of bias (RoB). We identified fourteen articles for inclusion which reported data from nine cohort studies. Eight reported associations between physical exposure and the incidence of CTS and five reported associations between psychosocial exposures and the incidence of CTS. Quality items were generally rated as unclear or low RoB. Work-related physical exposure factors including high levels of repetition, velocity, and a combination of multiple physical exposures were associated with an increased risk of developing CTS. No other consistent associations were observed for physical or psychosocial exposures at work and CTS incidence.
Topics: Humans; Carpal Tunnel Syndrome; Prospective Studies; Incidence; Risk Factors; Cohort Studies
PubMed: 38199092
DOI: 10.1016/j.apergo.2023.104211 -
International Journal of Hygiene and... Mar 2024In 2012, the International Agency for Research on Cancer (IARC) concluded that diesel engine emissions (DEE) emissions cause cancer in humans. However, there is still... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In 2012, the International Agency for Research on Cancer (IARC) concluded that diesel engine emissions (DEE) emissions cause cancer in humans. However, there is still controversy surrounding this conclusion, due to several studies since the IARC decision citing a lack of evidence of a dose-response relationship.
OBJECTIVES
Through a systematic review, we aimed to evaluate all evidence on the association between occupational DEE and lung cancer to investigate whether there is an increased risk of lung cancer for workers exposed to DEE and if so, to describe the dose-response relationship.
METHODS
We registered the review protocol with PROSPERO and searched for observational studies in relevant literature databases. Two independent reviewers screened the studies' titles/abstracts and full texts, and extracted and assessed their quality. Studies with no direct DEE measurement but with information on length of exposure for high-risk occupations were assigned exposure values based on the DEE Job-Exposure-Matrix (DEE-JEM). After assessing quality and informativeness, we selected appropriate studies for the dose-response meta-analysis.
RESULTS
Sixty-five reports (from thirty-seven studies) were included in the review; one had a low risk of bias (RoB) (RR per 10 μg/m-years: 1.014 [95%CI 1.007-1.021]). There was an increased, statistically significant risk of lung cancer with increasing DEE exposure for all studies (RR per 10 μg/m-years = 1.013 [95%CI 1.004-1.021]) as well as for studies with a low RoB in the exposure category (RR per 10 μg/m-years = 1.008 [95% CI1.001-1.015]). We obtained a doubling dose of 555 μg/m-years for all studies and 880 μg/m-years for studies with high quality in the exposure assessment.
DISCUSSION
We found a linear positive dose-response relationship for studies with high quality in the exposure domain, even though all studies had an overall high risk of bias. Current threshold levels for DEE exposure at the workplace should be reconsidered.
Topics: Humans; Air Pollutants, Occupational; Lung Neoplasms; Vehicle Emissions; Occupational Exposure; Case-Control Studies
PubMed: 38194821
DOI: 10.1016/j.ijheh.2023.114299 -
PLoS Neglected Tropical Diseases Jan 2024Currently, vaccination of livestock with attenuated strains of Brucella remains an essential measure for controlling brucellosis, although these vaccines may be...
BACKGROUND
Currently, vaccination of livestock with attenuated strains of Brucella remains an essential measure for controlling brucellosis, although these vaccines may be dangerous to humans. The aim of this study was to review the risk posed to humans by occupational exposure to vaccine strains and the measures that should be implemented to minimize this risk.
METHODS
This article reviewed the scientific literature indexed in PubMed up to September 30, 2023, following "the PRISMA guidelines". Special emphasis was placed on the vaccine strain used and the route of exposure. Non-occupational exposure to vaccine strains, intentional human inoculation, publications on exposure to wild strains, and secondary scientific sources were excluded from the study.
RESULTS
Nineteen primary reports were found and classified in three subgroups: safety accidents in vaccine factories that led to an outbreak (n = 2), survellaince studies on vaccine manufacturing workers with a serologic diagnosis of Brucella infection (n = 3), and publications of infection by vaccine strains during their administration, including case reports, records of occupational accidents and investigations of outbreaks in vaccination campaigns (n = 14). Although accidental exposure during vaccine manufacturing were uncommon, they could provoke large outbreaks through airborne spread with risk of spread to the neighboring population. Besides, despite strict protection measures, a percentage of vaccine manufacturing workers developed positive Brucella serology without clinical infection. The most frequent type of exposure with symptomatic infection was needle injury during vaccine administration. Prolonged contact with the pathogen, lack of information and a low adherence to personal protective equipment (PPE) use in the work environment were commonly associated with infection.
CONCLUSIONS
Brucella vaccines pose occupational risk of contagion to humans from their production to their administration to livestock, although morbidity is low and deaths were not reported. Recommended protective measures and active surveillance of exposed workers appeared to reduce this risk. It would be advisable to carry out observational studies and/or systematic registries using solid diagnostic criteria.
Topics: Animals; Humans; Brucella Vaccine; Brucellosis; Brucella; Vaccination; Occupational Exposure; Livestock; Vaccines, Attenuated
PubMed: 38190394
DOI: 10.1371/journal.pntd.0011889 -
Frontiers in Public Health 2023Sanitary workers are exposed to a variety of occupational hazards in a variety of working environments, which can result in occupational-related outcomes. As a result,...
INTRODUCTION
Sanitary workers are exposed to a variety of occupational hazards in a variety of working environments, which can result in occupational-related outcomes. As a result, the goal of this review was to identify occupational health and safety outcomes among sanitary workers worldwide.
METHODS
PRISMA was used as flow diagram and PICOS was used review questions. The studies published in English were searched from databases and others methods ranging from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords used: (Occupation *OR Job *OR Work) AND (Occupational related respiratory Symptoms *OR Disease) AND [Solid waste collectors (SWCs) *OR Street sweepers (SS) *OR Sewage workers and waste treatment (STWs)] AND (Countries).
RESULTS
A total of 228 studies were identified from 23 countries across the world. Studies were found via PubMed ( = 40), Medline ( = 25), Embase ( = 11) and Global Health ( = 66) and Google scholar ( = 63) and from previous ( = 23). From 8,962 of eligible sanitary workers, about 4,742 (54%), 1714 (19%) and 1,441 (16%) were sewage, sweepers and solid waste workers, respectively. A total study ( = 51) were eligible for occupational health and safety outcomes. Of these, respiratory problems accounted 27 (52%) and Gastroenteritis 14 (27%).
CONCLUSION
Despite a large number of studies to date provides sanitary employees all over the world face occupational-related risks, hence more research is needed to enhance and quantify illness burden among sanitary workers.
Topics: Humans; Occupational Health; Occupational Diseases; Solid Waste; Sanitation; Sewage; Occupational Exposure
PubMed: 38174086
DOI: 10.3389/fpubh.2023.1304977 -
Heliyon Jan 2024Leptospirosis is a neglected emerging zoonotic disease with a profound public health impact worldwide with higher burden of disease in resource-poor countries. The...
BACKGROUND
Leptospirosis is a neglected emerging zoonotic disease with a profound public health impact worldwide with higher burden of disease in resource-poor countries. The environmental and occupational exposures contribute to human and animal transmission, but the interaction was less explored. A deeper understanding of the critical environmental and occupational drivers in different contexts will provide useful information for disease control and prevention measures.
OBJECTIVE
This review aimed to summarize the potential environmental and occupational risk factors associated with leptospirosis infection.
METHODS
Four databases (Scopus, Web of Science, Ovid MEDLINE, EBSCOhost) were searched for articles published from 2012 to 2021. Eligible articles were assessed using a checklist for assessing the quality of the studies. The quality of the articles was assessed based on the laboratory diagnosis approach and statistical analysis method.
RESULTS
A total of 32 studies were included in this systematic review. Water-related risk factors such as natural water as the primary water source (AOR 1.8-18.28), water-related recreational activities (AOR 2.36-10.45), flood exposure (AOR 1.54-6.04), contact with mud (AOR 1.57-4.58) and stagnant water (AOR 2.79-6.42) were associated with increased risk of leptospirosis. Infrastructural deficiencies such as un-plastered house walls and thatched houses presented a higher risk (AOR 2.71-5.17). Living in low-lying areas (AOR 1.58-3.74), on clay loam soil (OR 2.72), agricultural land (OR 2.09), and near rubber tree plantations (AOR 11.65) is associated with higher risk of leptospirosis. Contact with rats (AOR 1.4-3.5), livestock (AOR 1.3-10.4), and pigs (AOR 1.54-7.9) is associated with an increased risk of leptospirosis. Outdoor workers (AOR 1.95-3.95) and slaughterhouse workers (AOR 5.1-7.5) have higher risk of leptospirosis.
CONCLUSION
The environmental and occupational components related to water, infrastructure, landscape, agriculture, and exposed animals play an essential role in leptospirosis transmission. The magnitude of those risk factors differs with geographical region, climate factor, urbanization and population growth, and the country's socioeconomic status.
PubMed: 38173528
DOI: 10.1016/j.heliyon.2023.e23473 -
European Journal of Epidemiology Jan 2024Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC).... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC). However, previous reviews have several deficits with regard to included and excluded studies/risk estimates and the assessment of risk of selection bias (RoSB). Our aim was to review epidemiologic studies with a focus on these deficits and to use meta-(regression) analyses to summarize risk estimates.
METHODS
We systematically searched PubMed (including MEDLINE) and Embase for epidemiologic studies. Study evaluation considered four main aspects of risk of bias assessments, i.e. Selection of subjects (selection bias); Exposure variables; Outcome variables; Data analysis.
RESULTS
Of 56 identified references, 32 were used for meta-(regression) analyses. The overall pooled risk estimate for BCC comparing high/present vs. low/absent occupational solar exposure was 1.20 (95% CI 1.02-1.43); among studies without major deficits regarding data analysis, it was 1.10 (95% CI 0.91-1.33). Studies with low and high RoSB had pooled risk estimates of 0.83 (95% CI 0.73-0.93) and 1.95 (95% CI 1.42-2.67), respectively. The definitions of exposure and outcome variables were not correlated with study risk estimates. Studies with low RoSB in populations with the same latitude or lower than Germany had a pooled risk estimate of 1.01 (95% CI 0.88-1.15).
CONCLUSION
Due to the different associations between occupational solar exposure and BCC among studies with low and high RoSB, we reason that the current epidemiologic evidence base does not permit the conclusion that regular outdoor workers have an increased risk of BCC.
Topics: Humans; Carcinoma, Basal Cell; Germany; Occupational Exposure; Selection Bias; Skin Neoplasms
PubMed: 38170370
DOI: 10.1007/s10654-023-01061-w -
International Journal of Environmental... Dec 2023Language development starts during the fetal period when the brain is sensitive to endocrine disruptions from environmental contaminants. This systematic review aims to... (Review)
Review
Language development starts during the fetal period when the brain is sensitive to endocrine disruptions from environmental contaminants. This systematic review aims to systematically summarize the existing literature on early-life exposure to PFAS and children's language and communication development, which is an indicator of neurocognitive development. A structured literature search was conducted using three databases, PubMed, Scopus, and CINAHL, last updated in April 2023. The population was defined as children and young adults. PFAS exposure was assessed pre- or postnatally. The outcome was defined as a language and communication ability assessed with validated instruments, parental self-reports, or clinical language disorder diagnoses. In total, 15 studies were identified for subsequent analyses. Thirteen were performed in background-exposed populations and two in highly exposed populations. There were some indications of potential adverse effects; however, these were not consistent across child sex, age of assessment, or PFAS exposure levels. No systematic effect of early-life PFAS exposure on language and communication development was found. These inconclusive findings may partly be explained by the use of general test instruments with limited validity as to children's language and communication development. Further studies over a wider exposure range using specific language test instruments are needed.
Topics: Child; Female; Young Adult; Humans; Child Language; Prenatal Exposure Delayed Effects; Fluorocarbons; Language Development; Communication; Environmental Pollutants; Alkanesulfonic Acids
PubMed: 38131721
DOI: 10.3390/ijerph20247170 -
Environment International Jan 2024Applications emitting radiofrequency electromagnetic fields (RF-EMF; 100 kHz to 300 GHz) are widely used for communication (e.g. mobile phones), in medicine... (Meta-Analysis)
Meta-Analysis
The effects of radiofrequency electromagnetic fields exposure on tinnitus, migraine and non-specific symptoms in the general and working population: A systematic review and meta-analysis on human observational studies.
BACKGROUND
Applications emitting radiofrequency electromagnetic fields (RF-EMF; 100 kHz to 300 GHz) are widely used for communication (e.g. mobile phones), in medicine (diathermy) and in industry (RF heaters).
OBJECTIVES
The objective is to systematically review the effects of longer-term or repeated local and whole human body radiofrequency electromagnetic field (RF-EMF) exposure on the occurrence of symptoms. Primary hypotheses were tinnitus, migraine and headaches in relation to RF-EMF exposure of the brain, sleep disturbances and composite symptom scores in relation to whole-body RF-EMF exposure.
METHODS
Eligibility criteria: We included case-control and prospective cohort studies in the general population or workers estimating local or whole-body RF-EMF exposure for at least one week.
INFORMATION SOURCES
We conducted a systematic literature search in various databases including Web of Science and Medline. Risk of bias: We used the Risk of Bias (RoB) tool developed by OHAT adapted to the topic of this review.
SYNTHESIS OF RESULTS
We synthesized studies using random effects meta-analysis.
RESULTS
Included studies: We included 13 papers from eight distinct cohort and one case-control studies with a total of 486,558 participants conducted exclusively in Europe. Tinnitus is addressed in three papers, migraine in one, headaches in six, sleep disturbances in five, and composite symptom scores in five papers. Only one study addressed occupational exposure.
SYNTHESIS OF RESULTS
For all five priority hypotheses, available research suggests that RF-EMF exposure below guideline values does not cause symptoms, but the evidence is very uncertain. The very low certainty evidence is due the low number of studies, possible risk of bias in some studies, inconsistencies, indirectness, and imprecision. In terms of non-priority hypotheses numerous exposure-outcome combinations were addressed in the 13 eligible papers without indication for an association related to a specific symptom or exposure source.
DISCUSSION
Limitations of evidence: This review topic includes various challenges related to confounding control and exposure assessment. Many of these aspects are inherently present and not easy to be solved in future research. Since near-field exposure from wireless communication devices is related to lifestyle, a particular challenge is to differentiate between potential biophysical effects and other potential effects from extensive use of wireless communication devices that may compete with healthy behaviour such as sleeping or physical activity. Future research needs novel and innovative methods to differentiate between these two hypothetical mechanisms.
INTERPRETATION
This is currently the best available evidence to underpin safety of RF-EMF. There is no indication that RF-EMF below guideline values causes symptoms. However, inherent limitations of the research results in substantial uncertainty.
OTHER
Funding: This review was partially funded by the WHO radioprotection programme.
REGISTRATION
The protocol for this review has been registered in Prospero (reg no CRD42021239432) and published in Environment International (Röösli et al., 2021).
Topics: Humans; Electromagnetic Fields; Environmental Exposure; Prospective Studies; Tinnitus; Migraine Disorders; Cell Phone; Headache; Radio Waves
PubMed: 38104437
DOI: 10.1016/j.envint.2023.108338 -
Frontiers in Public Health 2023The inclusion of all relevant exposure routes in the exposure assessment is essential for the protection of workers. However, under European chemical regulations but... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The inclusion of all relevant exposure routes in the exposure assessment is essential for the protection of workers. However, under European chemical regulations but also for workplace risk assessments according to occupational safety and health (OSH) requirements, the quantitative assessment of oral exposure is usually neglected assuming good occupational hygiene. In contrast, several studies point to the importance of unintentional ingestion in the workplace. To our knowledge, there is no systematic analysis of the extent of this exposure route.
METHODS
Therefore, the aim of this study was to assess systematically the current knowledge on the relevance of occupational oral exposure using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. Five electronic databases and nine institutional websites were searched for all publications on the relevance. The data were extracted into a concept matrix. In the subsequent meta-analysis, the identified conclusions on the relevance were analyzed. In addition, the measurement methods or modeling approaches that were described for occupational oral exposure were determined as well as the potentially relevant workplaces and substances.
RESULTS
In total, 147 studies were included in this analysis that contain a general or several, differentiated assessments of the relevance of occupational oral exposure. Nine of these studies assessed this exposure route as irrelevant. However, 123 studies considered oral exposure as potentially contributing and 80 studies explicitly identified it as relevant. 78 and 94 of the publications described modeling and measurement approaches, respectively. The workplaces frequently identified as potentially or explicitly relevant were other indoor, other industrial or recycling workplaces. Analogously, metals, dust and powders or pesticides were the most frequently investigated substance groups.
DISCUSSION
As several studies assessed occupational oral exposure as relevant in the context of different workplaces and substances, further investigation of this exposure route is needed. This systematic review and meta-analysis serve as a basis for further development of feasible assessment methods for this route of exposure.
Topics: Humans; Occupational Exposure; Risk Assessment; Workplace; Pesticides
PubMed: 38098819
DOI: 10.3389/fpubh.2023.1298744