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Toxics Apr 2024Biomonitoring of human populations exposed to chemical substances that can act as potential mutagens or carcinogens, may enable the detection of damage and early disease... (Review)
Review
Biomonitoring of human populations exposed to chemical substances that can act as potential mutagens or carcinogens, may enable the detection of damage and early disease prevention. In recent years, the comet assay has become an important tool for assessing DNA damage, both in environmental and occupational exposure contexts. To evidence the role of the comet assay in human biomonitoring, we have analysed original research studies of environmental or occupational exposure that used the comet assay in their assessments, following the PRISMA-ScR method (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews). Groups of chemicals were designated according to a broad classification, and the results obtained from over 300 original studies (n = 123 on air pollutants, n = 14 on anaesthetics, n = 18 on antineoplastic drugs, n = 57 on heavy metals, n = 59 on pesticides, and n = 49 on solvents) showed overall higher values of DNA strand breaks in the exposed subjects in comparison with the unexposed. In summary, our systematic scoping review strengthens the relevance of the use of the comet assay in assessing DNA damage in human biomonitoring studies.
PubMed: 38668493
DOI: 10.3390/toxics12040270 -
The International Journal of Behavioral... Apr 2024Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to... (Meta-Analysis)
Meta-Analysis Review
Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies.
BACKGROUND AND OBJECTIVE
Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD).
METHODS
PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model.
RESULTS
A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77-0.86), CHD (HR = 0.83; 0.79-0.88), and stroke (HR = 0.83; 0.79-0.88), but not AF (HR = 0.98; 0.92-1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF.
CONCLUSIONS
Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.
Topics: Humans; Leisure Activities; Cardiovascular Diseases; Exercise; Incidence; Prospective Studies; Risk Factors
PubMed: 38659024
DOI: 10.1186/s12966-024-01593-8 -
Environment International May 2024Potential effect of greenspace exposure on human microbiota have been explored by a number of observational and interventional studies, but the results remained mixed....
BACKGROUND
Potential effect of greenspace exposure on human microbiota have been explored by a number of observational and interventional studies, but the results remained mixed. We comprehensively synthesized these studies by performing a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS
Comprehensive literature searches in three international databases (PubMed, Embase, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Biology Medicine disc) were conducted from inception to November 1, 2023. Observational and interventional studies that evaluated associations between greenspace exposure and human microbiota at different anatomical sites were included. Studies were assessed using the National Toxicology Program's office of Health Assessment and Translation risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Two authors independently performed study selection, data extraction, and risk of bias assessment, and evidence grading. Study results were synthesized descriptively.
RESULTS
Twenty studies, including 11 observational studies and 9 interventional studies, were finally included into the systematic review. The microbiota of the included studies was from gut (n = 13), skin (n = 10), oral cavity (n = 5), nasal cavity (n = 5) and eyes (n = 1). The majority of studies reported the associations of greenspace exposure with increased diversity (e.g., richness and Shannon index) and/or altered overall composition of human gut (n = 12) and skin microbiota (n = 8), with increases in the relative abundance of probiotics (e.g., Ruminococcaceae) and decreases in the relative abundance of pathogens (e.g., Streptococcus and Escherichia/Shigella). Due to limited number of studies, evidence concerning greenspace and oral, nasal, and ocular microbiota were still inconclusive.
CONCLUSION
The current evidence suggests that greenspace exposure may diversify gut and skin microbiota and alter their composition to healthier profiles. These findings would be helpful in uncovering the potential mechanisms underlying greenspace and human health and in promoting a healthier profile of human microbiota.
Topics: Humans; Microbiota; Environmental Exposure
PubMed: 38653130
DOI: 10.1016/j.envint.2024.108662 -
The Science of the Total Environment Jun 2024In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and... (Review)
Review
In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and recommended the identification and control of "lead hot spots". In the present study, an evaluation of progress toward reducing BLL in the region was carried out. A systematic review of the latest literature on lead exposure in the LAC region held on the PubMed, Web of Science and LILACS databases (January 2014 to March 2022) was conducted using the PRISMA methodology. Only original papers published in peer-reviewed English, Spanish, or Portuguese journals were eligible. A total of 558 papers were retrieved, 77 of which met the selection criteria and 31 (40.25 %) were carried out in Mexico. The prevalence of children with BLL above 10 μg. dL was 22.08 % in the previous review versus 6.78 % in the current study. In the present review, the prevalence of children with BLL above 5 μg. dL was 29.62 %, and only one study reported a BLL prevalence rate between 3.3 and 5 μg. dL. The highest BLLs were associated with well-known sources or occupational exposures. The number of countries (n = 13) that published data on BLL in children was lower compared to the previous review (n = 16). Most studies were conducted in areas with known lead exposure sources, similar to the earlier review. The percentage of children at risk of lead poisoning in the region remains unknown because few studies have published data on environmental exposure levels and most samples were relatively small. The recommendation to identify and control sources of lead exposure was maintained, while further suggestions for establishing a systematic public health surveillance system for lead were proposed to help reduce the knowledge gap and inform public health policy-making in LAC.
Topics: Lead; Latin America; Humans; Caribbean Region; Child; Environmental Exposure; Child, Preschool; Environmental Pollutants; Prevalence; Infant
PubMed: 38604359
DOI: 10.1016/j.scitotenv.2024.172372 -
Archives of Toxicology Jul 2024Benzene is used worldwide as a major raw material in a number of industrial processes and also a potent airborne pollutant emitted from traffic exhaust fume. The present... (Review)
Review
Benzene is used worldwide as a major raw material in a number of industrial processes and also a potent airborne pollutant emitted from traffic exhaust fume. The present systematic review aimed to identify potential associations between genetic polymorphisms and occupational benzene-induced genotoxicity. For this purpose, a total of 22 selected studies were carefully analysed. Our results revealed a positive relation between gene polymorphism and genotoxicity in individuals exposed to benzene, since 17 studies (out of 22) observed positive relations between genotoxicity and polymorphisms in xenobiotics metabolizing genes influencing, therefore, individuals' susceptibility to genomic damage induced by benzene. In other words, individuals with some genotypes may show increase or decrease DNA damage and/or higher or lower DNA-repair potential. As for the quality assessment, 17 studies (out of 22) were categorized as Strong or Moderate and, therefore, we consider our findings to be trustworthy. Taken together, such findings are consistent with the notion that benzene induces genotoxicity in mammalian cells being strongly dependent on the genetic polymorphism. Certainly, such findings are important for clarifying the role of biomarkers related to genotoxicity in human biomonitoring studies.
Topics: Humans; Benzene; Occupational Exposure; Polymorphism, Genetic; DNA Damage; Air Pollutants, Occupational; Mutagens
PubMed: 38600397
DOI: 10.1007/s00204-024-03744-z -
The Cochrane Database of Systematic... Apr 2024Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) experience no or mild symptoms, some individuals can develop severe...
BACKGROUND
Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment. This is the first update of a Cochrane review published 6 May 2022, with one new study added.
OBJECTIVES
To assess the benefits and harms of interventions in non-healthcare-related workplaces aimed at reducing the risk of SARS-CoV-2 infection compared to other interventions or no intervention.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science Core Collections, Cochrane COVID-19 Study Register, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and medRxiv to 13 April 2023.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) and non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by coworkers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls (i.e. elimination; engineering controls; administrative controls; personal protective equipment).
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess risk of bias, and GRADE methods to evaluate the certainty of evidence for each outcome.
MAIN RESULTS
We identified 2 studies including a total of 16,014 participants. Elimination-of-exposure interventions We included one study examining an intervention that focused on elimination of hazards, which was an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) working at 86 schools were assigned to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic polymerase chain reaction (PCR)-positive SARS-CoV-2 infection (rate ratio (RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study; very low-certainty evidence). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-CoV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study; very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 working days) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 working days) in the intervention group (RR 0.83, 95% CI 0.55 to 1.25). We downgraded the certainty of the evidence to low due to imprecision. Uptake of the intervention was 71% in the intervention group, but not reported for the control intervention. The trial did not measure our other outcomes of SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, or hospitalisation. We found seven ongoing studies using elimination-of-hazard strategies, six RCTs and one non-randomised trial. Administrative control interventions We found one ongoing RCT that aims to evaluate the efficacy of the Bacillus Calmette-Guérin (BCG) vaccine in preventing COVID-19 infection and reducing disease severity. Combinations of eligible interventions We included one non-randomised study examining a combination of elimination of hazards, administrative controls, and personal protective equipment. The study was conducted in two large retail companies in Italy in 2020. The study compared a safety operating protocol, measurement of body temperature and oxygen saturation upon entry, and a SARS-CoV-2 test strategy with a minimum activity protocol. Both groups received protective equipment. All employees working at the companies during the study period were included: 1987 in the intervention company and 1798 in the control company. The study did not report an outcome of interest for this systematic review. Other intervention categories We did not find any studies in this category.
AUTHORS' CONCLUSIONS
We are uncertain whether a test-based attendance policy affects rates of PCR-positive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. A test-based attendance policy may result in little to no difference in absenteeism rates compared to standard 10-day self-isolation. The non-randomised study included in our updated search did not report any outcome of interest for this Cochrane review. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus become an important absolute effect from the enterprise or societal perspective. The included RCT did not report on any of our other primary outcomes (i.e. SARS-CoV-2-related mortality and adverse events). We identified no completed studies on any other interventions specified in this review; however, eight eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.
Topics: Humans; COVID-19; Delivery of Health Care; Pandemics; Workplace
PubMed: 38597249
DOI: 10.1002/14651858.CD015112.pub3 -
Applied Ergonomics Jul 2024This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and...
This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
Topics: Humans; Occupational Diseases; Occupational Exposure; Risk Factors; Rotator Cuff Injuries; Vibration; Tendinopathy; Shoulder Pain
PubMed: 38579494
DOI: 10.1016/j.apergo.2024.104277 -
Applied Ergonomics Jul 2024Whole-body vibration (WBV) is prevalent in labour-related activities and can have adverse effects on the health and performance of the individuals exposed. However,...
Whole-body vibration (WBV) is prevalent in labour-related activities and can have adverse effects on the health and performance of the individuals exposed. However, evidence regarding the extent to which human functionality is affected following occupational WBV exposure has not been collated. The current systematic review sought to synthesize existing literature and assess the strength and direction of evidence regarding the acute after-effects of occupational WBV exposure on cognition, visual function, postural stability, and motor control. We conducted a comprehensive search of AMED, CINAHL, MEDLINE, PubMED, Psychology and Behavioural Sciences Collection, SPORTDiscus, APA PsychInfo, Cochrane Library, EMBASE, HMIC, Global Health, ProQuest Central, Scopus, Web of Science, and the US National Technical Information Service on April 26, 2023. Studies that quantified vibration exposure and measured acute changes in cognition, visual function, postural stability, and motor control from baseline to post-vibration were considered without date restriction. Out of the 2663 studies identified, 32 were eligible for inclusion. Based on the Risk of Bias in Non-Randomized Studies of Exposure (ROBINS-E) tool, the studies demonstrated low (66%), moderate (25%) and high risk of bias (9%). The findings indicate that after exposure to WBV, postural stability either deteriorates or remains unchanged. Inconsistent effects of WBV on cognition were reported, while visual function and motor control showed no pronounced changes following WBV. This might be attributed to assessment limitations such as learning effects in neuropsychological and motor tasks, and non-functional measures of vision employed. There was a lack of consistency in the characterization of vibration exposure and the assessment of associated effects on functional performance. Current evidence is therefore insufficient to provide definitive guidance for updating occupational health and safety regulations regarding WBV. However, this review highlights the potential for WBV to jeopardize post-exposure human performance and, consequently, safety. The completion of the review was supported by a UKRI EPSRC training grant. The review has been registered on PROSPERO (ref CRD42023391075).
Topics: Humans; Cognition; Occupational Exposure; Postural Balance; Vibration; Vision, Ocular
PubMed: 38565009
DOI: 10.1016/j.apergo.2024.104264 -
Annals of Work Exposures and Health Jun 2024This paper describes an evaluation and analysis of an updated version of ECEL v3.0-an integrated risk management measure (RMM) library developed as part of a CEFIC LRI... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
This paper describes an evaluation and analysis of an updated version of ECEL v3.0-an integrated risk management measure (RMM) library developed as part of a CEFIC LRI initiative. The occupational module contains extensive data on the quantitative effectiveness of RMMs to control inhalation and dermal exposure in the workplace. The objective was to investigate the effectiveness and variability in effectiveness of RMM and to explore the difference between optimal and non-optimal RMM applications in the workplace.
METHODS
A new database structure and interface were developed and the content of the database was updated with a systematic literature review and integration with other databases (totalling 3373 records from 548 studies). To analyse the data, Bayesian linear mixed models were constructed with the study as a random effect and various study characteristics and RMM categories as fixed effects individually in separate models. A multivariate mixed model was used on a stratified dataset to test (amongst others) the conditions of RMM use.
RESULTS
Analyses of the data indicated effectiveness values for each RMM category (for example ~87% for technical emission controls compared with ~60% for technical dispersion controls). Substantial variability in effectiveness was observed within and between different types of RMM. Seven study characteristics (covariables) were included in the analyses, which indicated a pronounced difference in as-built (optimal/experimental) and as-used (workplace) conditions of RMM use (93.3% and 74.6%, respectively).
CONCLUSIONS
This library provides a reliable evidence base to derive base estimates of RMM effectiveness-beneficial for both registrant and downstream users. It stresses the importance of optimal use of RMMs in the workplace (technical design/functioning, use, and maintenance). Various challenges are foreseen to further update ECEL to improve guidance, for deriving improved estimates and ensure user-friendliness of the library.
Topics: Humans; Occupational Exposure; Workplace; Risk Management; Bayes Theorem; Inhalation Exposure; Databases, Factual
PubMed: 38563681
DOI: 10.1093/annweh/wxae021 -
VASA. Zeitschrift Fur Gefasskrankheiten May 2024Forced postures are common in the workplace. Work in the primary economic sector is characterised by a high degree of physical activity and movement; however, activities... (Review)
Review
Forced postures are common in the workplace. Work in the primary economic sector is characterised by a high degree of physical activity and movement; however, activities in the secondary and tertiary sectors commonly require workers to stand or sit. An expansion of the tertiary sector in recent decades has meant that people in industrialised and emerging economies primarily sit or stand at work. The aim of the systematic review was to identify occupational factors relating to the presence of chronic venous disease (CVD), to place these in the context of developments in the workplace, and to determine whether measures are in place to prevent CVD. We performed a systematic literature review to analyse studies assessing work-related risk factors for CVD. We searched for publications in the PubMed database, the clinic library of BG Hospital Bergmannstrost Halle, and the registry of the German Statutory Accident Insurance. Using occupation-specific keyword combinations, we identified 27,522 publications. The publications underwent an automatic and manual filtering process according to the PRISMA guidelines and 81 publications qualified for the review. Ultimately 25 studies were included in the systematic review. All of the subjects of the studies worked in the secondary and tertiary sectors. No studies looked at the relationship between venous disorders and primary sector occupations. Standing at work for more than four hours a day, repeated heavy lifting, and cumulative time working in a sitting or standing position are risk factors for the development of CVD. Sitting is less of a risk factor than standing or walking. Occupational history and the patient's activity profile are important diagnostic tools which can help confirm a diagnosis and justify treatment when findings are inconsistent. Compression therapy is the primary form of secondary and tertiary prevention. There continues to be a lack of primary preventive measures related to workplace design.
Topics: Humans; Risk Factors; Occupational Diseases; Occupational Health; Posture; Vascular Diseases; Risk Assessment; Male; Female; Job Description; Occupational Exposure; Standing Position; Chronic Disease
PubMed: 38536202
DOI: 10.1024/0301-1526/a001116