[Neuropsychiatric disease in workers exposed to solvents--a case control study].
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Biomedical subjects
Publications and source records attributed to C Hogstedt.
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Published reports give justification for the belief that long-term exposure to solvents might induce chronic but nonspecific neuropsychiatric conditions. This case-referent study of data from a regional Swedish pension fund register indicated a risk ration of 1.8 in regard to nonspecific neuropsychiatric disorders among workers such as painters, varnishers and carpetlayers who are exposed to solvents as compared to workers not so exposed. Moreover a dose-response relationship seems to exist between exposure in terms of occupational years and neuropsychiatric conditions, the result being that persons affected are considered eligible for disability pensions.
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Alcohol and tobacco habits have been identified as strong risk factors for esophageal cancer. Increased risks of esophageal cancer have also been reported to be associated with occupational exposure to asbestos and various metals, among vulcanization workers, asphalt workers, and workers in the petrochemical industry. Mortality and cancer incidence were investigated in a series of studies of workers exposed to combustion by-products, i.e., chimney sweeps, waste incinerator workers, gas workers, and bus garage workers exposed to diesel exhausts. The SMRs for esophageal cancer ranged from 150-386 in these cohorts, and a combined SMR of 289 (95% C.I. 174-452) was obtained. Available data on smoking habits and indirect indicators of alcohol consumption show that the excess cannot be attributed solely to these factors. It seems likely that occupational exposure to combustion products is associated with an increased risk of esophageal cancer.
To investigate if participation in sports increases the risk of developing osteoarthrosis of the hip, we did a case-control study on the sports activities of 233 men (up to age 49) who were recent recipients of a prosthesis because of severe idiopathic osteoarthrosis of the hip and 302 men randomly selected from the general population. Assessments of sports, job history, and health status were made by an interview. Men with high exposure to sports of all kinds combined (in hours) had a relative risk to develop osteoarthrosis of the hip of 4.5 compared to those with low exposure. Track and field sports and racket sports seemed to be the most hazardous to the hip joint. Men who had been exposed to high physical loads both from their occupation and sports had a relative risk of 8.5 to develop osteoarthrosis of the hip compared to those with low physical load in both activities. Potential confounding factors, such as age, body mass index, and smoking, were considered. Long-term exposure to sports among men seems to be a risk factor for developing severe osteoarthrosis of the hip; this is increased when combined with heavy load from occupation.
This paper summarizes experiences from long-term ongoing cooperation between Swedish research institutions and institutions at the National Universities in Nicaragua and Costa Rica. 24 researchers and teachers from the Central American institutions and ten Swedish research students have been trained. In addition to three full doctoral and three licentiate (two-year PhD program) theses, the two programs have so far published 15 articles in English-language, international, refereed journals and about three times as many abstracts for conferences in more than ten countries. A "sandwich" model for training is recommended, where the southern researchers come to the wealthier partner for collaborative analyses and write-ups of the publications, while spending 50-75% of their time in their home countries for data collection. Such collaboration should be planned for a time span of at least eight years and include substantial numbers of researchers and students. Means to minimize the risk of brain drain are suggested. The collaboration has been important for the globalization of the research cultures at the participating institutions and has trained international experts.
To evaluate time trends of occupational pesticide-related injuries in Costa Rica, a survey was carried out three times over a ten-year period at a national reporting system for occupational accidents and diseases among wage-earning workers. The sample comprised the accidents reported during the months of June of the years 1982, 1987, and 1992. The overall incidence rates were 1.8, 2.7, and 2.5 per 1,000 agricultural workers, respectively. Rates among female workers increased (3.1, 3.7, 5.4) and were elevated as compared with male workers (1.7, 2.6, 2.3). The trend for topical lesions was upgoing (1.2, 1.4, 2.1), consistent with an increased use of fungicides and lack of safety measures for pesticides with low acute toxicity. Systemic poisonings peaked in 1987 (0.6, 1.2, 0.5), declining in 1992 with increased use of biologic pest control and pyrethroid insecticides less toxic than cholinesterase inhibitors, and improved safety during nematocide applications on banana plantations. In 1992, despite the largest decline of systemic poisonings in the banana-producing Atlantic Region, poisonings as well as topical injuries were still four times more frequent in this region than in the rest of the country. Restriction of highly toxic pesticides together with implementation of occupational safety measures can reduce systemic poisonings in developing countries. Such policies need to be extended to other pesticides to prevent less life threatening but often disabling skin and eye injuries.
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