Christer Hogstedt - Academia.edu (original) (raw)
Papers by Christer Hogstedt
Occupational and Environmental Medicine, Oct 14, 2019
Scandinavian Journal of Work, Environment & Health, Dec 1, 1997
Objectives A cross-sectional study was conducted to evaluate the relationship between respiratory... more Objectives A cross-sectional study was conducted to evaluate the relationship between respiratory health and paraquat exposure. Methods The study population was selected from among workers at 15 Nicaraguan banana plantations which relied on paraquat for the control of weeds. All the workers were interviewed after they received their job assignment for the day of the survey, and all who reported never having applied paraquat and all who reported more than 2 years of cumulative exposure as applicators of paraquat with knapsack sprayers were invited for medical evaluation. One hundred and thirty-four exposed workers and 152 unexposed workers were administered a questionnaire interview asking about exposure and respiratory symptoms, and they underwent spirometric testing of forced expiratory volume in 1 s (FEV, ,) and forced vital capacity (FVC). Results In the exposed group 53% reported having experienced a skin rash or burn resulting from paraquat exposure, 25% reported epistaxis, 58% nail damage, and 42% paraquat splashed in the eyes. There was a consistent dose-response relationship between intensity of exposure (as indicated by a history of skin rash or burn) and the prevalence of dyspnea. This relationship was more marked for more severe dyspnea. There was a 3-fold increase in episodic wheezing accompanied by shortness of breath among the more intensely exposed workers. There was no relationship between exposure and FEV, , or FVC. COIICIUS~O~S The high prevalence of respiratory symptoms associated with exposure, in the absence of spirometric abnormalities associated with exposure, could be a result of unmeasured gas exchange abnormalities among workers with long-term exposure to paraquat.
Scandinavian Journal of Work, Environment & Health, Mar 1, 1980
Herbicide exposure and tumor mortality. An updated epidemiologic investigation on Swedish railroa... more Herbicide exposure and tumor mortality. An updated epidemiologic investigation on Swedish railroad workers.
Occupational and Environmental Medicine, Nov 1, 1979
Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising... more Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising hospital equipment, is mutagenic in several organisms; carcinogenicity has been suspected although this has not been supported by clinical data. Ethylene oxide has been produced by a Swedish company since the beginning of the 1940s. This paper describes a cohort study of the mortality and the cancer incidence among full-time exposed workers in ethylene oxide production, a group of maintenance workers with intermittent exposure and a group of unexposed controls. Investigation of the production processes in the building at different times has shown that workers were exposed to ethylene dichloride, ethylene chlorohydrin, ethylene, and small amounts of bis-(2-chloroethyl) ether as well as to ethylene oxide and traces of other chemicals. The full-time exposed cohort shows a considerable excess mortality deriving mainly from increased mortality from tumours and also from diseases of the circulatory system. The cancer incidence study, including living persons with malignancies, showed a significant excess in the full-time cohort. Of the 16 patients with tumours in the two more exposed cohorts there were three cases of leukaemia, six of tumours in the alimentary tract and four of urogenital malignancy. The excess mortality and cancer incidence cannot be attributed to any particular chemical in the production process, but ethylene oxide and ethylene dichloride are the prime suspects.
Scandinavian journal of work, environment & health, 1982
A cohort study on mortality among all members of the Swedish Chimney Sweeps Union who were active... more A cohort study on mortality among all members of the Swedish Chimney Sweeps Union who were active in 1950 or later and have been members for at least 10 a has been performed; 2,071 chimney sweeps fulfilled the criteria and the loss in the follow-up was less than 1 %. The observed numbers of death before the age of 80 were compared with sex-, calendar year-, and age class specific expectancy values from the national statistics of 1951-1979. Two hundred and thirty deaths were observed versus 197.6 expected. This result was due to a significant excess of deaths from tumors, particularly lung and esophageal cancer, and from nonmalignant chronic respiratory diseases. The multifold increased risk from these diseases could hardly be explained by extreme smoking or alcohol habits but rather by exposure to polycyclic aromatic hydrocarbons, nitrogen compounds, arsenic, and asbestos in combination with exposure to sulfur dioxide. The excess mortality had occurred in spite of favorable selectio...
Scandinavian Journal of Work, Environment & Health, 1990
Oral Presentation, Aug 1, 2017
Epidemiology, Sep 1, 2001
The aim of this study was to assess the influence of work-related physical and psychosocial facto... more The aim of this study was to assess the influence of work-related physical and psychosocial factors on seeking care for neck or shoulder disorders among men and women in a general working population. The study population comprised gainfully employed (>17 hours per week) men and women in the municipality of Norrtälje, altogether 392 cases and 1,511 controls. Cases were defined as persons seeking care because of neck or shoulder disorders by any caregiver in the region. The study began in 1994 and continued to 1997. We assessed physical and psychosocial exposures by questionnaires and interviews. The pattern of seeking care for neck or shoulder disorders differed between men and women. Among men, work with vibrating tools [relative risk (RR) = 1.6], not having a fixed salary (RR = 1.9), and low demands in relation to competence (RR = 1.5) were the strongest risk indicators obtained in analyses stratified for age and previous symptoms. Among women, repetitive hand or finger movements (RR = 1.6), constrained sitting (RR = 1.6), not having a fixed salary (RR = 2.0), and solitary work (RR = 1.8) were the strongest risk indicators. A large proportion of the general population was exposed to several of these moderately harmful conditions, and their concomitant effect may explain the high incidence of neck and shoulder disorders in the general working population.
Elsevier eBooks, 1988
Abstract The British MRC questionnaire was distributed to 377 male subjects participating in a he... more Abstract The British MRC questionnaire was distributed to 377 male subjects participating in a health examination. Most of the subjects had been exposed to asbestos cement dust. Test scores from the questionnaire were compared with ventilatory function tests and with the diagnosis of chronic bronchitis. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV,) were recorded and the airways disorders were classified by lung specialists. The sensitivity of the questionnaire using two or more symptoms as indicative of chronic bronchitis was moderate, i.e., the questionnaire identified correctly 67 % of the individuals with decreased FVC as well as 72 % with decreased FEV1. In addition, it identified correctly 66 % of individuals with chronic bronchitis. Only every third subject reporting two or more symptoms had impaired lung function or chronic bronchitis. The validity of the MRC questionnaire appeared to be relatively low. However, it may reflect exposure to dust and can therefore be recommended for screening purposes.
Archivos de prevención de riesgos laborales, 2005
Spine, Feb 1, 2000
and the MUSIC-Norrtälje Study Group Study Design. A population-based case referent study. Objecti... more and the MUSIC-Norrtälje Study Group Study Design. A population-based case referent study. Objectives. To determine whether current and past physical and psychosocial occupational factors are associated with care-seeking for low back pain in working men and women. Summary of Background Data. The importance of physical and psychosocial workloads as causal factors of low back pain has mostly been investigated in special occupational groups and with a crosssectional design, which makes generalizability and interpretations more difficult. Methods. The study comprised 2118 working men and women 20 to 59 years old (695 cases, and 1423 referents). Cases were defined as persons seeking care by any caregiver for low back pain. The exposure assessments were made through questionnaires and interviews about current and past physical and psychosocial loads during work and leisure time. Results. In a logistic regression analysis, physical load from forward bending in men (RR ϭ 1.8) and high physical load, in general, in women (RR ϭ 2.0) showed increased relative risks. Psychosocial factors alone seemed to be of less importance in women, but "poor job satisfaction" and "mostly routine work without possibilities of learning" increased the risk in men. Combined current and past exposures further increased the risks. A combination of high physical and psychosocial loads increased the risk substantially, but few were exposed to such loads. Adjustment for lifestyle and other loads outside work did not change the results. Conclusion. Current and past physical and psychosocial occupational factors, both separately and combined, seem to be gender-specific, and to have a moderate impact on care-seeking for low back pain in a general working population.
International Journal of Occupational and Environmental Health, Jul 1, 2011
In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched... more In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.
Occupational and Environmental Medicine, Aug 1, 1992
The hypothesis that manual work and exposure to vibration are antecedents to the development of o... more The hypothesis that manual work and exposure to vibration are antecedents to the development of osteoarthrosis was assessed employing a cross sectional study design. The frequency of osteoarthrosis in the acromioclavicular joint was studied in three groups of workers in the construction industry. Two groups were manual workers (54 bricklayers and 55 rock blasters); the third group consisted of98 foremen. The radiographic appearance of the right and left acromioclavicular joints was classified into one of five grades of osteoarthrosis. A protocol was developed to assess exposure on the basis of job title, years of manual work, total weight lifted during working life, and total hours of exposure to vibrating tools. Odds ratios for job titles (manual worker v foreman) and for years of manual work as indicators of exposure were of similar magnitude of around 2 5. Construction workers who had lifted more than 709 tonnes had an increased risk of developing severe osteoarthrosis of the right acromioclavicular joint, odds ratio: 2-62 (95% confidence interval (95% CI), 1-13-6-06). The odds ratio for the left side was
Scandinavian Journal of Work, Environment & Health, Feb 1, 1993
Three categories of co nstructio n industry workers (54 bricklayers, 55 rockblasters, and 98 fore... more Three categories of co nstructio n industry workers (54 bricklayers, 55 rockblasters, and 98 foremen) were compared in a cro ss-sectional study. In a structured interview they reported exposure to loads lifted, vibration, and years of manual work. They were also subjected to a cli nica l invest igation including medical history and a detailed shoulder examination. Among the rockbl aster s 33% had signs of tendinitis in the left and 40% in the right shoulder. Among the brickl ayers and foremen 8-17% had signs of shoulder tendinitis. In a multipl e logistic regression being a rockblaster co mpared with being a foreman showed an odds ratio (OR) of 3.33 for left-sided and 1.7 1 for right-si ded shoulder tendinitis. Vibration exposure yielded an OR of 1.84 and 1.66 for the left and right sides , respectively. Vibration exposur e or work as a rockblaster seemed to be risk indicato rs for tendin itis of the shoulders .
International Journal of Occupational and Environmental Health, Apr 1, 2003
The CAREX data system converts national workforce volumes and proportions of workers exposed to w... more The CAREX data system converts national workforce volumes and proportions of workers exposed to workplace carcinogens into numbers of exposed in 55 industrial categories. CAREX was adapted for Costa Rica for 27 carcinogens and seven groups of pesticides. Widespread workplace carcinogens in the 1.3 million workforce of Costa Rica are solar radiation (333,000 workers), diesel engine exhaust (278,000), environmental tobacco smoke (71,000), hexavalent chromium compounds (55,000), benzene (52,000), wood dust (32,000), silica dust (27,000), lead and inorganic lead compounds (19,000), and polycyclic aromatic compounds (17,000). The most ubiquitous pesticides were paraquat and diquat (175,000), mancozeb, maneb, and zineb (49,000), chlorothalonil (38,000), benomyl (19,000), and chloro-phenoxy herbicides (11,000). Among women, formal-dehyde, radon, and methylene chloride overrode pesticides, chromium, wood dust, and silica dust in numbers of exposed. High-risk sectors included agriculture, construction, personal and household services, land and water transport and allied services, pottery and similar industries, woodworks, mining, forestry and logging, fishing, manufacturing of electrical machinery, and bar and restaurant personnel.
International Journal of Occupational and Environmental Health, Apr 1, 2002
The 12.4 million economically active population (EAP) of the seven Central American countries inc... more The 12.4 million economically active population (EAP) of the seven Central American countries includes a large informal sector. Social security covers only 14-60%. No surveillance of occupational safety and health (OSH) hazards or accidents exists. Extrapolating the incidence of occupational accidents among insured Costa Rican workers to the Central American EAP yields two million accidents yearly, still a gross underestimate. Occupational diseases are underreported, misdiagnosed, and not recognized as such. A number of regional OSH programs aim at modernization of the labor administrations and address the formal sector, in particular textile maquila, in connection with free trade agreements. The weak role of the ministries of health is expected to strengthen under the Pan American Health Organization OSH program. Employers largely influence new policies. Workers' influence on OSH policies has been weak, with only about 10% unionization rate and scarce resources and OSH knowledge. Informal workers, however, are getting organized. OSH research is underdeveloped and not linked to policy making. Construction, agriculture, and general un/underemployment are considered priorities for intervention. The informal sector needs to be included in national and regional OSH policies. Regional collaboration and international development support are of strategic importance to achieve sustainable improvement in OSH.
American Journal of Industrial Medicine, Sep 1, 1999
... Additional Information. How to Cite. Vingård, E., Alfredsson, L., Hagberg, M., Josephson, M.,... more ... Additional Information. How to Cite. Vingård, E., Alfredsson, L., Hagberg, M., Josephson, M., Kilbom, Å., Theorell, T., Waldenström, M., Hjelm, EW, Wiktorin, C., Hogstedt, C. (1999), Age and gender differences in exposure patterns and low back pain in the MUSIC-Norrtälje study. ...
Annals of Occupational Hygiene, Aug 1, 1995
Different ways to describe historic libre exposure from asbestos-containing friction materials we... more Different ways to describe historic libre exposure from asbestos-containing friction materials were studied and compared for a group of 103 car and bus mechanics with more than 20 years employment and 15 years of asbestos exposure. A model was constructed to calculate cumulative asbestos exposure from friction materials including duration, intensity and exposure last year. The model is a combination of an additive and a multiplicative model, where an asbestos index was constructed that takes both near field and far field exposure into consideration. The model was based upon data from the international literature and cluantitative asbestos measurements performed 19761988 in Swedish car repair workshops. The fibres were counted by phase-contrast microscopy with fibre criteria of length > 5 pm and aspect ratio 2 3: 1. The mechanics' fibre exposure at 398 repair workshops during a period of 48 years were calculated using the model. The mean cumulative exposure was estimated to be 2.6 f ml-' *year. The annual cumulative exposure was highest for truck mechanics in the early 1960s. The car mechanics had a time-weighted average fibre exposure range of O.llXl.41 f ml-' (mean 0.21 f ml-') in 1965 compared to 0.003Xt.08 f ml-' (mean 0.021 f ml-') in 1985. In order to validate the model, the mechanics' fibre exposure estimated using the model were compared with representative asbestos exposure measurements for car mechanics during the 1960s and the 1970s (correlation coefficient-0.69). Five lung physiological variables (FVC, TLC, FEV, , TL,, and CV%) were used to study exposureeresponse relationships. None of the exposure parameters suggested any significant relationship between cxposurc and decrease in lung function.
Occupational and Environmental Medicine, Apr 17, 2013
Previous studies of chimney sweeps have shown an excess mortality from cardiovascular diseases, a... more Previous studies of chimney sweeps have shown an excess mortality from cardiovascular diseases, although the extent of confounding from tobacco smoking is uncertain. The present study used referents of similar socioeconomic background as the chimney sweeps in order to reduce confounding, included both lethal and surviving cases of myocardial infarction, and investigated dose-response in terms of duration of employment. A cohort of 4436 male chimney sweeps was identified from nationwide trade union records from 1918 to 2006. Myocardial infarctions during 1991-2005 were identified from the Swedish nationwide register of first-time myocardial infarctions. Standardised incidence ratios (SIRs) were estimated using skilled manual workers in the service sector in Sweden to calculate expected numbers. There was a strong and statistically significant excess of myocardial infarction among the chimney sweeps, SIR 1.39 (95% CI 1.24 to 1.55). The excess was observed among both short- and long-term employed. While the excess of myocardial infarction among the short-term employed may be due to tobacco and, possibly, alcohol use, it is likely that the excess noted among the long-term employed was caused by the high exposure to combustion products, particles or metals still occurring among chimney sweeps. Preventive measures to reduce hazardous occupational exposures as well as smoking and alcohol use among chimney sweeps are urgently needed.
Occupational and Environmental Medicine, Oct 14, 2019
Scandinavian Journal of Work, Environment & Health, Dec 1, 1997
Objectives A cross-sectional study was conducted to evaluate the relationship between respiratory... more Objectives A cross-sectional study was conducted to evaluate the relationship between respiratory health and paraquat exposure. Methods The study population was selected from among workers at 15 Nicaraguan banana plantations which relied on paraquat for the control of weeds. All the workers were interviewed after they received their job assignment for the day of the survey, and all who reported never having applied paraquat and all who reported more than 2 years of cumulative exposure as applicators of paraquat with knapsack sprayers were invited for medical evaluation. One hundred and thirty-four exposed workers and 152 unexposed workers were administered a questionnaire interview asking about exposure and respiratory symptoms, and they underwent spirometric testing of forced expiratory volume in 1 s (FEV, ,) and forced vital capacity (FVC). Results In the exposed group 53% reported having experienced a skin rash or burn resulting from paraquat exposure, 25% reported epistaxis, 58% nail damage, and 42% paraquat splashed in the eyes. There was a consistent dose-response relationship between intensity of exposure (as indicated by a history of skin rash or burn) and the prevalence of dyspnea. This relationship was more marked for more severe dyspnea. There was a 3-fold increase in episodic wheezing accompanied by shortness of breath among the more intensely exposed workers. There was no relationship between exposure and FEV, , or FVC. COIICIUS~O~S The high prevalence of respiratory symptoms associated with exposure, in the absence of spirometric abnormalities associated with exposure, could be a result of unmeasured gas exchange abnormalities among workers with long-term exposure to paraquat.
Scandinavian Journal of Work, Environment & Health, Mar 1, 1980
Herbicide exposure and tumor mortality. An updated epidemiologic investigation on Swedish railroa... more Herbicide exposure and tumor mortality. An updated epidemiologic investigation on Swedish railroad workers.
Occupational and Environmental Medicine, Nov 1, 1979
Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising... more Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising hospital equipment, is mutagenic in several organisms; carcinogenicity has been suspected although this has not been supported by clinical data. Ethylene oxide has been produced by a Swedish company since the beginning of the 1940s. This paper describes a cohort study of the mortality and the cancer incidence among full-time exposed workers in ethylene oxide production, a group of maintenance workers with intermittent exposure and a group of unexposed controls. Investigation of the production processes in the building at different times has shown that workers were exposed to ethylene dichloride, ethylene chlorohydrin, ethylene, and small amounts of bis-(2-chloroethyl) ether as well as to ethylene oxide and traces of other chemicals. The full-time exposed cohort shows a considerable excess mortality deriving mainly from increased mortality from tumours and also from diseases of the circulatory system. The cancer incidence study, including living persons with malignancies, showed a significant excess in the full-time cohort. Of the 16 patients with tumours in the two more exposed cohorts there were three cases of leukaemia, six of tumours in the alimentary tract and four of urogenital malignancy. The excess mortality and cancer incidence cannot be attributed to any particular chemical in the production process, but ethylene oxide and ethylene dichloride are the prime suspects.
Scandinavian journal of work, environment & health, 1982
A cohort study on mortality among all members of the Swedish Chimney Sweeps Union who were active... more A cohort study on mortality among all members of the Swedish Chimney Sweeps Union who were active in 1950 or later and have been members for at least 10 a has been performed; 2,071 chimney sweeps fulfilled the criteria and the loss in the follow-up was less than 1 %. The observed numbers of death before the age of 80 were compared with sex-, calendar year-, and age class specific expectancy values from the national statistics of 1951-1979. Two hundred and thirty deaths were observed versus 197.6 expected. This result was due to a significant excess of deaths from tumors, particularly lung and esophageal cancer, and from nonmalignant chronic respiratory diseases. The multifold increased risk from these diseases could hardly be explained by extreme smoking or alcohol habits but rather by exposure to polycyclic aromatic hydrocarbons, nitrogen compounds, arsenic, and asbestos in combination with exposure to sulfur dioxide. The excess mortality had occurred in spite of favorable selectio...
Scandinavian Journal of Work, Environment & Health, 1990
Oral Presentation, Aug 1, 2017
Epidemiology, Sep 1, 2001
The aim of this study was to assess the influence of work-related physical and psychosocial facto... more The aim of this study was to assess the influence of work-related physical and psychosocial factors on seeking care for neck or shoulder disorders among men and women in a general working population. The study population comprised gainfully employed (>17 hours per week) men and women in the municipality of Norrtälje, altogether 392 cases and 1,511 controls. Cases were defined as persons seeking care because of neck or shoulder disorders by any caregiver in the region. The study began in 1994 and continued to 1997. We assessed physical and psychosocial exposures by questionnaires and interviews. The pattern of seeking care for neck or shoulder disorders differed between men and women. Among men, work with vibrating tools [relative risk (RR) = 1.6], not having a fixed salary (RR = 1.9), and low demands in relation to competence (RR = 1.5) were the strongest risk indicators obtained in analyses stratified for age and previous symptoms. Among women, repetitive hand or finger movements (RR = 1.6), constrained sitting (RR = 1.6), not having a fixed salary (RR = 2.0), and solitary work (RR = 1.8) were the strongest risk indicators. A large proportion of the general population was exposed to several of these moderately harmful conditions, and their concomitant effect may explain the high incidence of neck and shoulder disorders in the general working population.
Elsevier eBooks, 1988
Abstract The British MRC questionnaire was distributed to 377 male subjects participating in a he... more Abstract The British MRC questionnaire was distributed to 377 male subjects participating in a health examination. Most of the subjects had been exposed to asbestos cement dust. Test scores from the questionnaire were compared with ventilatory function tests and with the diagnosis of chronic bronchitis. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV,) were recorded and the airways disorders were classified by lung specialists. The sensitivity of the questionnaire using two or more symptoms as indicative of chronic bronchitis was moderate, i.e., the questionnaire identified correctly 67 % of the individuals with decreased FVC as well as 72 % with decreased FEV1. In addition, it identified correctly 66 % of individuals with chronic bronchitis. Only every third subject reporting two or more symptoms had impaired lung function or chronic bronchitis. The validity of the MRC questionnaire appeared to be relatively low. However, it may reflect exposure to dust and can therefore be recommended for screening purposes.
Archivos de prevención de riesgos laborales, 2005
Spine, Feb 1, 2000
and the MUSIC-Norrtälje Study Group Study Design. A population-based case referent study. Objecti... more and the MUSIC-Norrtälje Study Group Study Design. A population-based case referent study. Objectives. To determine whether current and past physical and psychosocial occupational factors are associated with care-seeking for low back pain in working men and women. Summary of Background Data. The importance of physical and psychosocial workloads as causal factors of low back pain has mostly been investigated in special occupational groups and with a crosssectional design, which makes generalizability and interpretations more difficult. Methods. The study comprised 2118 working men and women 20 to 59 years old (695 cases, and 1423 referents). Cases were defined as persons seeking care by any caregiver for low back pain. The exposure assessments were made through questionnaires and interviews about current and past physical and psychosocial loads during work and leisure time. Results. In a logistic regression analysis, physical load from forward bending in men (RR ϭ 1.8) and high physical load, in general, in women (RR ϭ 2.0) showed increased relative risks. Psychosocial factors alone seemed to be of less importance in women, but "poor job satisfaction" and "mostly routine work without possibilities of learning" increased the risk in men. Combined current and past exposures further increased the risks. A combination of high physical and psychosocial loads increased the risk substantially, but few were exposed to such loads. Adjustment for lifestyle and other loads outside work did not change the results. Conclusion. Current and past physical and psychosocial occupational factors, both separately and combined, seem to be gender-specific, and to have a moderate impact on care-seeking for low back pain in a general working population.
International Journal of Occupational and Environmental Health, Jul 1, 2011
In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched... more In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.
Occupational and Environmental Medicine, Aug 1, 1992
The hypothesis that manual work and exposure to vibration are antecedents to the development of o... more The hypothesis that manual work and exposure to vibration are antecedents to the development of osteoarthrosis was assessed employing a cross sectional study design. The frequency of osteoarthrosis in the acromioclavicular joint was studied in three groups of workers in the construction industry. Two groups were manual workers (54 bricklayers and 55 rock blasters); the third group consisted of98 foremen. The radiographic appearance of the right and left acromioclavicular joints was classified into one of five grades of osteoarthrosis. A protocol was developed to assess exposure on the basis of job title, years of manual work, total weight lifted during working life, and total hours of exposure to vibrating tools. Odds ratios for job titles (manual worker v foreman) and for years of manual work as indicators of exposure were of similar magnitude of around 2 5. Construction workers who had lifted more than 709 tonnes had an increased risk of developing severe osteoarthrosis of the right acromioclavicular joint, odds ratio: 2-62 (95% confidence interval (95% CI), 1-13-6-06). The odds ratio for the left side was
Scandinavian Journal of Work, Environment & Health, Feb 1, 1993
Three categories of co nstructio n industry workers (54 bricklayers, 55 rockblasters, and 98 fore... more Three categories of co nstructio n industry workers (54 bricklayers, 55 rockblasters, and 98 foremen) were compared in a cro ss-sectional study. In a structured interview they reported exposure to loads lifted, vibration, and years of manual work. They were also subjected to a cli nica l invest igation including medical history and a detailed shoulder examination. Among the rockbl aster s 33% had signs of tendinitis in the left and 40% in the right shoulder. Among the brickl ayers and foremen 8-17% had signs of shoulder tendinitis. In a multipl e logistic regression being a rockblaster co mpared with being a foreman showed an odds ratio (OR) of 3.33 for left-sided and 1.7 1 for right-si ded shoulder tendinitis. Vibration exposure yielded an OR of 1.84 and 1.66 for the left and right sides , respectively. Vibration exposur e or work as a rockblaster seemed to be risk indicato rs for tendin itis of the shoulders .
International Journal of Occupational and Environmental Health, Apr 1, 2003
The CAREX data system converts national workforce volumes and proportions of workers exposed to w... more The CAREX data system converts national workforce volumes and proportions of workers exposed to workplace carcinogens into numbers of exposed in 55 industrial categories. CAREX was adapted for Costa Rica for 27 carcinogens and seven groups of pesticides. Widespread workplace carcinogens in the 1.3 million workforce of Costa Rica are solar radiation (333,000 workers), diesel engine exhaust (278,000), environmental tobacco smoke (71,000), hexavalent chromium compounds (55,000), benzene (52,000), wood dust (32,000), silica dust (27,000), lead and inorganic lead compounds (19,000), and polycyclic aromatic compounds (17,000). The most ubiquitous pesticides were paraquat and diquat (175,000), mancozeb, maneb, and zineb (49,000), chlorothalonil (38,000), benomyl (19,000), and chloro-phenoxy herbicides (11,000). Among women, formal-dehyde, radon, and methylene chloride overrode pesticides, chromium, wood dust, and silica dust in numbers of exposed. High-risk sectors included agriculture, construction, personal and household services, land and water transport and allied services, pottery and similar industries, woodworks, mining, forestry and logging, fishing, manufacturing of electrical machinery, and bar and restaurant personnel.
International Journal of Occupational and Environmental Health, Apr 1, 2002
The 12.4 million economically active population (EAP) of the seven Central American countries inc... more The 12.4 million economically active population (EAP) of the seven Central American countries includes a large informal sector. Social security covers only 14-60%. No surveillance of occupational safety and health (OSH) hazards or accidents exists. Extrapolating the incidence of occupational accidents among insured Costa Rican workers to the Central American EAP yields two million accidents yearly, still a gross underestimate. Occupational diseases are underreported, misdiagnosed, and not recognized as such. A number of regional OSH programs aim at modernization of the labor administrations and address the formal sector, in particular textile maquila, in connection with free trade agreements. The weak role of the ministries of health is expected to strengthen under the Pan American Health Organization OSH program. Employers largely influence new policies. Workers' influence on OSH policies has been weak, with only about 10% unionization rate and scarce resources and OSH knowledge. Informal workers, however, are getting organized. OSH research is underdeveloped and not linked to policy making. Construction, agriculture, and general un/underemployment are considered priorities for intervention. The informal sector needs to be included in national and regional OSH policies. Regional collaboration and international development support are of strategic importance to achieve sustainable improvement in OSH.
American Journal of Industrial Medicine, Sep 1, 1999
... Additional Information. How to Cite. Vingård, E., Alfredsson, L., Hagberg, M., Josephson, M.,... more ... Additional Information. How to Cite. Vingård, E., Alfredsson, L., Hagberg, M., Josephson, M., Kilbom, Å., Theorell, T., Waldenström, M., Hjelm, EW, Wiktorin, C., Hogstedt, C. (1999), Age and gender differences in exposure patterns and low back pain in the MUSIC-Norrtälje study. ...
Annals of Occupational Hygiene, Aug 1, 1995
Different ways to describe historic libre exposure from asbestos-containing friction materials we... more Different ways to describe historic libre exposure from asbestos-containing friction materials were studied and compared for a group of 103 car and bus mechanics with more than 20 years employment and 15 years of asbestos exposure. A model was constructed to calculate cumulative asbestos exposure from friction materials including duration, intensity and exposure last year. The model is a combination of an additive and a multiplicative model, where an asbestos index was constructed that takes both near field and far field exposure into consideration. The model was based upon data from the international literature and cluantitative asbestos measurements performed 19761988 in Swedish car repair workshops. The fibres were counted by phase-contrast microscopy with fibre criteria of length > 5 pm and aspect ratio 2 3: 1. The mechanics' fibre exposure at 398 repair workshops during a period of 48 years were calculated using the model. The mean cumulative exposure was estimated to be 2.6 f ml-' *year. The annual cumulative exposure was highest for truck mechanics in the early 1960s. The car mechanics had a time-weighted average fibre exposure range of O.llXl.41 f ml-' (mean 0.21 f ml-') in 1965 compared to 0.003Xt.08 f ml-' (mean 0.021 f ml-') in 1985. In order to validate the model, the mechanics' fibre exposure estimated using the model were compared with representative asbestos exposure measurements for car mechanics during the 1960s and the 1970s (correlation coefficient-0.69). Five lung physiological variables (FVC, TLC, FEV, , TL,, and CV%) were used to study exposureeresponse relationships. None of the exposure parameters suggested any significant relationship between cxposurc and decrease in lung function.
Occupational and Environmental Medicine, Apr 17, 2013
Previous studies of chimney sweeps have shown an excess mortality from cardiovascular diseases, a... more Previous studies of chimney sweeps have shown an excess mortality from cardiovascular diseases, although the extent of confounding from tobacco smoking is uncertain. The present study used referents of similar socioeconomic background as the chimney sweeps in order to reduce confounding, included both lethal and surviving cases of myocardial infarction, and investigated dose-response in terms of duration of employment. A cohort of 4436 male chimney sweeps was identified from nationwide trade union records from 1918 to 2006. Myocardial infarctions during 1991-2005 were identified from the Swedish nationwide register of first-time myocardial infarctions. Standardised incidence ratios (SIRs) were estimated using skilled manual workers in the service sector in Sweden to calculate expected numbers. There was a strong and statistically significant excess of myocardial infarction among the chimney sweeps, SIR 1.39 (95% CI 1.24 to 1.55). The excess was observed among both short- and long-term employed. While the excess of myocardial infarction among the short-term employed may be due to tobacco and, possibly, alcohol use, it is likely that the excess noted among the long-term employed was caused by the high exposure to combustion products, particles or metals still occurring among chimney sweeps. Preventive measures to reduce hazardous occupational exposures as well as smoking and alcohol use among chimney sweeps are urgently needed.