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Swiss Medical Weekly Feb 2020Systemic sclerosis is a rare autoimmune disease characterised by a multifactorial aetiology involving a gene–environment interaction. Despite the growing... (Review)
Review
Systemic sclerosis is a rare autoimmune disease characterised by a multifactorial aetiology involving a gene–environment interaction. Despite the growing epidemiological arguments for odds ratio (OR) data showing an association with occupational exposure, systemic sclerosis is not currently included in the list of recognised occupational diseases in Switzerland, unlike other northern European countries. Future recognition will be conditional on the demonstration of a strong association between the disease and occupational exposure in the scientific literature. The present article’s main goal is to present five cases of systemic sclerosis investigated for possible occupational aetiologies during occupational pathology consultations at the Institute for Work and Health, in Lausanne. The occupational aetiologies of these cases are discussed against the background of a literature review of publications from the past 20 years in order to determine whether recognition as an occupational disease is possible within Switzerland’s legal framework. Epidemiological studies of systemic sclerosis have identified strong associations with occupational factors such as exposure to silica and solvents, with ORs >2, and weaker associations with epoxy resins and welding fumes. Other occupational exposures are also known to induce systemic sclerosis-like diseases, such as vinyl chloride disease and toxic oil syndrome. All five patients had been exposed to either silica, solvents, or both. Given their exposure and the data in the literature, four patients had their cases declared to their accident insurance companies and two of them were recognised as suffering from an occupational disease by the Swiss National Accident Insurance Fund. Our literature review enabled us to design a short questionnaire to help general practitioners and rheumatologists to identify those patients with systemic sclerosis who are likely to have their illness recognised as an occupational disease.
Topics: Adult; Causality; Female; Humans; Male; Middle Aged; Occupational Diseases; Occupational Medicine; Scleroderma, Systemic; Silicon Dioxide; Solvents; Switzerland
PubMed: 32083706
DOI: 10.4414/smw.2020.20193 -
British Medical Journal Aug 1951
Topics: Humans; Occupational Health; Occupational Medicine; Physicians
PubMed: 14858882
DOI: 10.1136/bmj.2.4729.448 -
Public Health Reports (Washington, D.C.... Dec 1957
Topics: Humans; Occupational Health; Occupational Medicine
PubMed: 13485304
DOI: No ID Found -
International Journal of Environmental... Mar 2020Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to...
Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer.
Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician's role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.
Topics: European Union; Humans; Neoplasms; Occupational Diseases; Occupational Medicine; Workplace
PubMed: 32231054
DOI: 10.3390/ijerph17072279 -
Journal of Occupational and... Dec 2013New rapid growth economies, urbanization, health systems crises, and "big data" are causing fundamental changes in social structures and systems, including health. These... (Review)
Review
New rapid growth economies, urbanization, health systems crises, and "big data" are causing fundamental changes in social structures and systems, including health. These forces for change have significant consequences for occupational and environmental medicine and will challenge the specialty to think beyond workers and workplaces as the principal locus of innovation for health and performance. These trends are placing great emphasis on upstream strategies for addressing the complex systems dynamics of the social determinants of health. The need to engage systems in communities for healthier workforces is a shift in orientation from worker and workplace centric to citizen and community centric. This change for occupational and environmental medicine requires extending systems approaches in the workplace to communities that are systems of systems and that require different skills, data, tools, and partnerships.
Topics: Community Participation; Databases, Factual; Delivery of Health Care; Economic Development; Environmental Medicine; Humans; Occupational Health; Occupational Medicine; Public-Private Sector Partnerships; Urbanization
PubMed: 24284749
DOI: 10.1097/JOM.0000000000000033 -
Environmental Health : a Global Access... Sep 2020Climate change is set to exacerbate occupational heat strain, the combined effect of environmental and internal heat stress on the body, threatening human health and... (Review)
Review
BACKGROUND
Climate change is set to exacerbate occupational heat strain, the combined effect of environmental and internal heat stress on the body, threatening human health and wellbeing. Therefore, identifying effective, affordable, feasible and sustainable solutions to mitigate the negative effects on worker health and productivity, is an increasingly urgent need.
OBJECTIVES
To systematically identify and evaluate methods that mitigate occupational heat strain in order to provide scientific-based guidance for practitioners.
METHODS
An umbrella review was conducted in biomedical databases employing the following eligibility criteria: 1) ambient temperatures > 28 °C or hypohydrated participants, 2) healthy adults, 3) reported psychophysiological (thermal comfort, heart rate or core temperature) and/or performance (physical or cognitive) outcomes, 4) written in English, and 5) published before November 6, 2019. A second search for original research articles was performed to identify interventions of relevance but lacking systematic reviews. All identified interventions were independently evaluated by all co-authors on four point scales for effectiveness, cost, feasibility and environmental impact.
RESULTS
Following screening, 36 systematic reviews fulfilled the inclusion criteria. The most effective solutions at mitigating occupational heat strain were wearing specialized cooling garments, (physiological) heat acclimation, improving aerobic fitness, cold water immersion, and applying ventilation. Although air-conditioning and cooling garments in ideal settings provide best scores for effectiveness, the limited applicability in certain industrial settings, high economic cost and high environmental impact are drawbacks for these solutions. However, (physiological) acclimatization, planned breaks, shading and optimized clothing properties are attractive alternative solutions when economic and ecological sustainability aspects are included in the overall evaluation.
DISCUSSION
Choosing the most effective solution or combinations of methods to mitigate occupational heat strain will be scenario-specific. However, this paper provides a framework for integrating effectiveness, cost, feasibility (indoors and outdoor) and ecologic sustainability to provide occupational health and safety professionals with evidence-based guidelines.
Topics: Climate Change; Global Health; Heat Stress Disorders; Humans; Occupational Health; Occupational Medicine; Stress, Physiological
PubMed: 32887627
DOI: 10.1186/s12940-020-00641-7 -
Occupational and Environmental Medicine Aug 1995
Topics: Health Services Administration; Humans; Occupational Health; Occupational Medicine; United Kingdom
PubMed: 7663632
DOI: 10.1136/oem.52.8.497-a -
Journal of Exposure Science &... 2015Exposure science is a holistic concept without prejudice to exposure source. Traditionally, measurements aimed at mitigating environmental exposures have not included... (Review)
Review
Exposure science is a holistic concept without prejudice to exposure source. Traditionally, measurements aimed at mitigating environmental exposures have not included exposures in the workplace, instead considering such exposures to be an internal affair between workers and their employers. Similarly, occupational (or industrial) hygiene has not typically accounted for environmental contributions to poor health at work. Many persons spend a significant amount of their lifetime in the workplace, where they maybe exposed to more numerous chemicals at higher levels than elsewhere in their environment. In addition, workplace chemical exposures and other exogenous stressors may increase epigenetic and germline modifications that are passed on to future generations. We provide a brief history of the development of exposure science from its roots in the assessment of workplace exposures, including an appendix where we detail current resources for education and training in exposure science offered through occupational hygiene organizations. We describe existing successful collaborations between occupational and environmental practitioners in the field of exposure science, which may serve as a model for future interactions. Finally, we provide an integrated vision for the field of exposure science, emphasizing interagency collaboration, the need for complete exposure information in epidemiological studies, and the importance of integrating occupational, environmental, and residential assessments. Our goal is to encourage communication and spur additional collaboration between the fields of occupational and environmental exposure assessment. Providing a more comprehensive approach to exposure science is critical to the study of the "exposome", which conceptualizes the totality of exposures throughout a person's life, not only chemical, but also from diet, stress, drugs, infection, and so on, and the individual response.
Topics: Environmental Exposure; Environmental Medicine; Environmental Monitoring; Humans; Interdisciplinary Communication; Occupational Exposure; Occupational Medicine; Risk Assessment; Risk Factors; United States
PubMed: 25670022
DOI: 10.1038/jes.2014.91 -
Annals of the Academy of Medicine,... Jul 2005We describe how the curriculum of community, occupational and family medicine (COFM) has evolved in response to social and educational forces and local health needs....
INTRODUCTION
We describe how the curriculum of community, occupational and family medicine (COFM) has evolved in response to social and educational forces and local health needs. Challenges in the teaching of the curriculum are also discussed.
CURRICULUM
The COFM Department aims to produce medical undergraduates and graduates with the skills to critically appraise evidence, prevent and manage diseases, and promote health in the community and primary healthcare setting. Its teaching programmes consist of the medical undergraduate programme and the Master of Medicine programmes in Occupational Medicine, Public Health and Family Medicine. The undergraduate modules consist of evidence-based medicine, public health in the community, disease prevention and control, occupational medicine practice, health promotion and behaviour, and communication with patients. The university's first completely online module on SARS was jointly implemented by the Department and the Centre for Instructional Technology for the entire student population last year. The COFM curriculum has shifted from giving students factual information through lectures to developing students' critical thinking and problem-solving skills through small group teaching, case studies and community health projects. Innovative assessment methods such as open-book examinations; objective structured communication stations with simulated patients; and evaluation of students' participation in group work are used to assess students' skills in problem-solving, communication and teamwork respectively.
CONCLUSION
While the Department has made significant progress in developing a relevant and updated curriculum based on appropriate learning and assessment approaches, it will strive to do more to develop students' critical thinking skills by using newer approaches.
Topics: Community Medicine; Education, Medical; Family Practice; History, 20th Century; History, 21st Century; Humans; Occupational Medicine; Public Health; Schools, Medical; Singapore
PubMed: 16010387
DOI: No ID Found -
Postgraduate Medical Journal Feb 1989
Topics: Humans; Occupational Health Services; Occupational Medicine
PubMed: 2780464
DOI: 10.1136/pgmj.65.760.65