Unraveling the occupational exposure to mycotoxins in a waste management setting: results from a case study in Norway

Introduction: Waste management represents an occupational setting where fungi are significant contaminants. This study aimed to assess the exposure of waste workers to mycotoxins through a human biomonitoring study. Methods: A total of 33 workers and 19 controls provided spot urine samples to determine 10 mycotoxins’ urinary biomarkers using liquid chromatography coupled with mass spectrometry. Risk characterization was performed using hazard quotient and margin of exposure assessments. Results: The results indicated that workers were exposed to six out of the 10 mycotoxins tested, with the following detection rates: deoxynivalenol (91%, 30/33), ochratoxin A (33%, 11/33), zearalenone (17%, 5/33), α-zearalenol (12%, 4/33), β-zearalenol (12%, 4/33), and HT-2 toxin (3%, 1/33). Within controls and outwith controls, were exposed to 5/10 and 2/10 mycotoxins, respectively. All participants exhibited hazard quotients for deoxynivalenol and zearalenone below one, indicating that the exposure is unlikely to pose a health risk. However, when considering the margin of exposure determined for ochratoxin A, 18% of the total participants presented results below 200 for non-neoplastic effects, and 100% of the total participants presented values below 10,000 for neoplastic effects, suggesting potential health concerns that require further assessment. Discussion: This study highlights the need for future research on occupational exposure to mycotoxins in waste management settings.publishedVersio

GLU24/7 study: cardiometabolic health risk factors in night shift workers – protocol for a 2-year longitudinal study in an industrial setting in Norway

Introduction Evidence links night shift work to circadian rhythm disruption, causing hormonal and metabolic alterations, as well as increased risk for cardiovascular disease (CVD). This study investigates whether night shift work affects blood glucose variability and dysregulation, potentially driven by circadian misalignment. It also examines whether such disruptions elevate inflammatory markers involved in atherosclerosis and contribute to the exacerbation of CVD risk markers. Methods and analysis The study includes 60 participants: rotating night shift workers (day, evening, and night shifts) and day workers (controls) at a pharmaceutical plant. We will assess the effects of night shift work on metabolic and cardiovascular health over three phases: an initial 6-week observational period (phase I), baseline registration of CVD risk factors (phase II), and follow-up assessment of CVD risk factors at 2 years (phase III). Phase I registrations include working hours derived from payroll data, sleep metrics by OURA ring (actigraphy, plethysmography and temperature), continuous assessments of blood glucose using continuous glucose monitor, self-reported food diary and measurements of circadian rhythm markers (monocyte mRNA expression). In phases II and III, blood CVD risk factors such as markers of inflammation, lipids, glycosylated haemoglobin, D-dimer, clinical examination of blood pressure, resting heart rate, arterial stiffness by the means of carotid to femoral pulse wave velocity, carotid intima–media thickness and maximal oxygen uptake (V̇O2max) are measured. To this end, a comprehensive set of methods will be used in a prospective manner to provide new knowledge on shift work-induced glucose regulation and CVD risk factors. Ethics and dissemination All participants provided written informed consent prior to participating in the study, which will adhere to the principles outlined in the Declaration of Helsinki. Ethical approval has been granted by the Norwegian Regional Committee for Medical Research Ethics South-East B (reference # 745702). Dissemination plans include academic and public publications, as well as collaborations with national and regional policy-makers.GLU24/7 study: cardiometabolic health risk factors in night shift workers – protocol for a 2-year longitudinal study in an industrial setting in NorwaypublishedVersio

Does Attending Work When Ill Vary Across Different Office Concepts? A Bayesian Analysis of Differences in Sickness Presenteeism using Nationally Representative Data

Several studies have examined how sickness absence varies across different office concepts, but the potential role of sickness presenteeism (i.e., attending work when faced with health complaints) is poorly understood. We discuss how different office concepts may influence the decision between attending and not attending work when faced with health complaints, and the implications this may have for how observed differences in sickness absence are interpreted. We then use data from a nationwide probability sample from Norway (N = 3112) to explore (i) differences in presenteeism among employees in different office concepts with and without assigned workstations (i.e., private, conventional shared-room, conventional open-plan, non-territorial) and (ii) whether and how perceived health status moderates these differences. Based on a frequency measure of presenteeism, we infer about likely differences in presenteeism propensity by adjusting for perceived health status and self-certified sickness absence, in addition to important demographic and occupational covariates. Results from Bayesian cumulative probit models indicated similar levels of presenteeism among employees in private and conventional shared-room and open-plan offices and lower levels among employees in non-territorial offices. Differences in presenteeism between private and non-territorial offices increased as perceived health status deteriorated. Our study represents an important step towards a complete picture of attendance patterns across different office concepts. Our findings suggest that whether you have a personalized workstation may be relevant for attending or not attending work when faced with health complaints. Future studies should take this into account when interpreting differences in sickness absence observed across office concepts.Does Attending Work When Ill Vary Across Different Office Concepts? A Bayesian Analysis of Differences in Sickness Presenteeism using Nationally Representative DatapublishedVersio

Psychosocial work exposures as risk factors for skin problems in a general working population: cross-sectional and prospective associations

Objective The potential contribution of psychosocial work exposures to skin problems is largely overlooked in the occupational health literature. To address this knowledge gap, we examined cross-sectional and prospective associations between six psychosocial work exposures (i.e., quantitative demands, job control, social support, emotional demands, role confict, and interpersonal confict) and self-reported skin problems. Methods Data came from a probability sample of the general working population in Norway surveyed in 2016 (N=7833) and 2019 (N=8038). The prospective sample comprised 3430 participants. Data were analysed with ordered logistic regression, adjusting for age, sex, occupation, and exposure to cleaning products, water, and dry indoor air. Results Cross-sectional analyses indicated statistically signifcant associations with skin problems for emotional demands, role confict, and interpersonal confict in 2016 and 2019, and for social support in 2019. In prospective analyses, emotional demands (OR 1.12, 95% CI 1.01–1.23), role confict (OR 1.14, 95% CI 1.00–1.29), and interpersonal confict (OR 1.24, 95% CI 1.01–1.52) signifcantly predicted subsequent skin problems. Interpersonal confict (OR 1.26, 95% CI 1.01–1.57) was a signifcant predictor above and beyond baseline levels of skin problems. Quantitative demands and job control was generally non-signifcant, except for a signifcant interaction in the 2019 sample. Conclusion Exposure to certain psychosocial work stressors may be a risk factor for experiencing skin problems, particularly if you are exposed to interpersonal confictPsychosocial work exposures as risk factors for skin problems in a general working population: cross-sectional and prospective associationspublishedVersio

Sick leave due to musculoskeletal disorders: A prospective cohort study

Background In Norway, home care workers experience particularly high levels of medically-certified sick leave. A substantial percentage of sick leave is due to musculoskeletal disorders, which may be attributed to risk factors at work. Due to limited knowledge of the impact of working conditions on sick leave in this sector, an improved understanding of occupation-specific risk factors is needed. Objective To examine the impact of psychosocial and mechanical work factors on subsequent sick leave due to musculoskeletal disorders. Design Prospective cohort study. Setting A probability sample of 130 Norwegian municipalities and their respective home care services. Participants 1819 home care workers. Methods Participants were surveyed on work environment factors and followed for 26 months between 2019 and 2021 using registry data on sick leave from the Norwegian Labour and Welfare Administration. Registry data comprised complete registrations of all medically-certified sick leave, including the relevant diagnostic codes of the International Classification of Primary Care system. Incidence risk ratios and 95 % confidence intervals were calculated using negative binomial regression with robust standard deviations. Population attributable risk and population preventable fractions were calculated to estimate the contribution of the significant work factors to sick leave in the sample. Results The following factors were associated with excessive risk of sick leave due to musculoskeletal disorders: Lifting or supporting the patient between bed and chair or wheelchair, heavy physical exertion without aids or assistance, heavy physical exertion despite aids or assistance, walking/standing, forward bending of the upper body, squatting/kneeling, and experiencing the work as physically demanding. Control over work pacing, fair leadership, empowering leadership, and support from immediate supervisor were associated with reduced risk of sick leave. Conclusions Preventive efforts to reduce sick leave due to musculoskeletal disorders among home care workers should adopt a multifactorial approach, including both psychosocial and mechanical work factors and the context in which they occur. There may be considerable potential for risk reduction by targeting awkward postures and heavy physical exertions, facilitating control over work pacing, and developing relationship-oriented leadership skills.publishedVersio

Field comparison of inhalable air samplers for the determination of occupational exposure to inhalable aerosols and soluble proteins in food production

This study assessed the performance of the Institute of Occupational Medicine (IOM) and Gesamtstaubprobenahme (GSP) personal inhalable aerosol samplers in measuring aerosol and soluble protein (SP) concentrations across 12 food industry environments. A total of 193 sampling pairs (GSP and IOM) were analyzed for inhalable aerosols, and 185 sampling pairs for SP. Median aerosol concentrations ranged from 0.2 mg/m³ in snacks, nuts, and chips production to 5.6 mg/m³ in spreads production. The IOM sample had a median aerosol concentration of 1.8 mg/m³, while the GSP had a slightly lower median of 1.4 mg/m³, generally collecting 17% less inhalable aerosol than the IOM in most environments. The IOM also included wall deposits in its gravimetric determinations, contributing an additional 10–30% to the overall aerosol concentrations. For SP concentrations, the IOM measured higher aerosol concentrations in environments with a particle size distribution dominated by larger particles, while the GSP showed higher SP concentrations in environments dominated by smaller, respirable particles. The Tobit mixed-effect models showed that the IOM had statistically significantly higher aerosol concentrations compared to the GSP, but significantly lower SP concentrations than the GSP. However, these differences between the samplers were relatively small, suggesting that in occupational hygiene practices, both samplers can be used.Field comparison of inhalable air samplers for the determination of occupational exposure to inhalable aerosols and soluble proteins in food productionpublishedVersio

Strengthening research preparedness for crises: lessons from Norwegian government agencies in using randomized trials and quasi-experimental methods to evaluate public policy interventions

During public health crises such as pandemics, governments must rapidly adopt and implement wide-reaching policies and programs (“public policy interventions”). A key takeaway from the coronavirus disease 2019 (COVID-19) pandemic was that although numerous randomized controlled trials (RCTs) focussed on drugs and vaccines, few policy experiments were conducted to evaluate effects of public policy interventions across various sectors on viral transmission and other consequences. Moreover, many quasi-experimental studies were of spurious quality, thus proving unhelpful for informing public policy. The pandemic highlighted the need to continuously develop competence, capacity and a robust legal–ethical foundation for impact evaluations well before crises occur. It raised a crucial question: how can governments in non-crisis times develop capabilities to generate evidence on the effects of public policy interventions, thus enabling a rapid and effective research response during public health crises? We conducted a mapping to explore how government agencies in Norway use RCTs and quasi-experimental methods to strengthen the evidence base for public policy interventions and to identify barriers and facilitators to their use. Contributing to the study were 10 government agencies across sectors such as development assistance, education, health, social welfare, statistics and taxation. Many of these agencies have conducted or commissioned RCTs or quasi-experimental studies in the past 5 years, with evaluations ranging from 1 or 2 to more than 15 per agency. The measures evaluated included organizational, educational and financial interventions and interventions for oversight and sanctions. Some agencies have internal capabilities for designing and conducting evaluations, while others commissioned such studies to universities and other research institutions. Agencies reported examples where enhanced communication among implementers, researchers, ministries and political leaders facilitated impact evaluations, and these lessons offer opportunities for cross-sector knowledge-sharing to help strengthen rigorous evaluations of public policy interventions. Despite their potential, various government agencies report that randomized and quasi-experimental studies face legal, ethical, political and practical barriers that affect their use. For instance, the urgency of politicians to implement policies at scale has led to the discontinuation of trials and hindered learning from their effects. The surveyed agencies stressed the importance of legislation providing clear guidelines on when differential treatment can be justified and when informed consent requirements can be waived, as well as faster and clearer processes for managing privacy concerns related to data access. Crucially, greater political acceptance for systematically and gradually implementing reforms, including using randomization, could strengthen evidence-informed public policy, enhancing the scaling-up of effective interventions and deprioritizing ineffective ones.Strengthening research preparedness for crises: lessons from Norwegian government agencies in using randomized trials and quasi-experimental methods to evaluate public policy interventionspublishedVersio

Education and training interventions for healthcare workers to prevent sexual harassment

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.Education and training interventions for healthcare workers to prevent sexual harassmentpublishedVersio

European harmonization of asbestos exposure assessment: comparing PCM, SEM, and TEM to derive conversion factors

After the European ban on the use of asbestos, exposure assessment of asbestos became imperative for ensuring compliance with safety standards. However, each European country has their own legislation and requirements, including measurement strategies, analytical techniques such as the microscope used as well as occupational exposure limits (OELs). The recent EU directive (EU) 2023/2668 significantly lowered the OEL for asbestos from 100,000 fibres/m³ 8-h time-weighted average to either 2,000 fibres/m³ when counting fibres between 0.2 and 3 µm in diameter, or 10,000 fibres/m³ when counting fibres thinner than 0.2 µm and dictates a transition from optical to electron microscopy analysis by the end of 2029. This change impacts Member States that rely on phase-contrast microscopy (PCM) to quantify asbestos concentrations, prompting the need for a standardized comparison between different analytical methods. Therefore, our study investigated whether conversion factors could be developed, enabling comparison of results obtained with different analytical techniques. To achieve this, a phased approach was applied, involving a survey of measurement strategies implemented by different countries in Europe, a literature search, and analysis of in-house data to explore differences between analytical techniques. Standardized conversion factors were developed via (i) direct comparison of concentrations from analysis with scanning electron microscopy (SEM), transmission electron microscopy (TEM), and/or PCM, (ii) a multiple linear regression model, and (iii) via log probability plots from raw data on fibre dimensions. Ten institutes from the ‘Partnership for European Research in Occupational Safety and Health’ (PEROSH) asbestos network participated in this study. The results showed that SEM and PCM were the most commonly used analytical techniques, with TEM also being used in 3 countries. OELs and measurement standards/protocols varied across countries, and most employed national derived standards for measurements. Conversion factors overall showed that measurements analysed by TEM resulted in higher fibre concentrations followed by PCM and SEM. Although conversion factors were developed, these were influenced by factors such as material type, applied energy, and local controls, preventing the derivation of a general conversion method.publishedVersio

Mapping dynamic working life patterns and the impact of occupational exposures. A scoping review

Background An ageing population and increasing life expectancy has intensified pressure to prolong working lives among high-income countries. Emerging research has sought to characterise dynamic working life patterns (how labour market participation changes over the working career), and how various factors, including occupational exposures, influence these patterns. This scoping review aims to systematically map the literature in this area and to identify future research needs. Methods A systematic search was carried out in PubMed, Embase, Web of Science and Scopus. Original studies were included if they included individuals from the general working-age population (defined as 18–70 years of age) or from patient-, sector-, industry-, or occupation-specific populations, and if they examined associations between at least one occupational exposure and a measure of dynamic working life patterns, grouped into either labour market participation trajectories or cumulative time spent in various labour market states. Studies were considered too heterogeneous to allow for quantitative synthesizing of results or calculation of an average measure of working life patterns across studies by exposure. Results The seventeen included original studies were heterogenous with regards to study populations, analysis methods, occupational exposures, and outcomes. Studies of biomechanical and psychosocial exposures were the most common, with indications that biomechanical factors are associated with reduced work participation. Conclusions Future studies would benefit from clearer definitions of occupational exposures and measures of dynamic working life patterns, a broader inclusion of occupational exposures, and measures of cumulative exposure.Mapping dynamic working life patterns and the impact of occupational exposures. A scoping reviewpublishedVersio