The effect of the Labour Inspection Authority's regulatory tools on compliance with regulations in the Norwegian home care services. A post-test-only control group study

Occupational Safety and Health (OSH) laws and regulations serves as fundamental pillars for OSH practices, playing a crucial role in safeguarding employee safety and wellbeing. However, little is known about the efficiency of regulatory tools intending to ensure compliance with OSH laws and regulations, especially within the health and social care sector. The current experimental study aimed to determine the effect of two specific regulatory tools on compliance. Municipal home-care services were allocated to one of three groups: (I) “Inspection”, (II) “Guidance-through-workshops”, and (III) “Control”. At 24–30 months after the interventions all groups underwent formal inspections which recorded the numbers of contraventions with regulations to determine the difference in regulatory compliance between the groups. Analyses comparing the two intervention groups with the control group showed overall increased compliance in the inspection group (I), while no significant effects were found for the guidance group (II). The inspection group underwent inspections twice, and analyses of changes from the first to the second inspection also revealed improved compliance, but only statistically significantly for requirements pertaining to the addressed psychosocial factors. Future research should investigate how labour inspections can more effectively increase compliance and how to develop guidance as a tool for improving complianceThe effect of the Labour Inspection Authority's regulatory tools on compliance with regulations in the Norwegian home care services. A post-test-only control group studypublishedVersio

Occupational exposure to diesel engine exhaust and first-time acute myocardial infarction. A nationwide register-based cohort study 1976- 2018

Aims: Exposure to air pollution including diesel engine exhaust (DEE) is associated with increased risk of acute myocardial infarction (AMI). Few studies have investigated the risk of AMI according to occupational exposure to DEE. The aim of this study was to evaluate the association between occupational exposure to DEE and the risk of first-time AMI. Methods: The study was a register-based cohort study of the Danish working population and included 903,415 individuals aged 35-50 years in 1995. Exposure estimates of DEE were assigned by linking a quantitative DEE job exposure matrix with the individual job history (1976-2017). National registers provided data on AMI throughout the follow-up period (1996-2018). The incidence rate ratios (IRR) for AMI were computed using Poisson regression while adjusting for demographics, comorbidities, socio-economic factors, ambient air pollution and occupational exposure to noise, physically demanding work, and job strain. Results: 35,511 cases of AMI occurred during the follow-up period of 19,357,326 person-years. IRRs for cumulative exposure to DEE in the fully adjusted model were 1.04 (95%CI: 1.00-1.08) for exposure levels between the 50th and 75thpercentiles and 1.08 (95%CI: 1.04-1.12) for exposure levels ≥75thpercentile. Recent exposure to DEE was associated with an increased IRR in the highest exposed quartile (IRR=1.15 (95%CI: 1.05-1.27)), but only when compared within exposed workers. Conclusion: Increasing exposure to DEE was associated with increasing IRR for first-time AMI across different exposure measures. The results indicate that AMI should be included in risk assessment of DEE when establishing occupational exposure limits.Occupational exposure to diesel engine exhaust and first-time acute myocardial infarction. A nationwide register-based cohort study 1976- 2018publishedVersio

Night shift work and indicators of cardiovascular risk. A systematic review and meta-analysis

Cardiovascular disease (CVD) is a leading cause of death worldwide, and shift workers have an increased risk of CVD. This comprehensive systematic review and meta-analysis aimed to assess the association between night shift work and cardiovascular risk indicators. A systematic literature search was performed according to the PRISMA 2020 guidelines using Medline, Embase, and Web of Science databases from inception through May 2024. Original manuscripts reporting relevant cardiovascular risk indicators and biomarkers in night shift workers were included. Risk of bias was assessed using the JBI's critical appraisal tools. When applicable, random-effect meta-analyses were performed. If suitable data were not available, a narrative synthesis was performed by combining p-values or vote-counting. Meta-regression analyses were performed to assess the contribution of sex, body mass index, and age as possible modifiers of effect. Evidence was weighed using an adapted GRADE. This study is registered in PROSPERO (CRD42022337285). Of the 8,387 studies identified, 81 were included in the synthesis, comprising 14 cohort and 67 cross-sectional studies. Moderate-confidence evidence was presented demonstrating increased inflammation, dyslipidaemia and impaired cardiac excitability among night shift workers. Dose-dependent effects were reported for these cardiovascular risk indicators, suggesting that the intensity and duration of night shift work contribute to risk of CVD. Furthermore, no association between night shift work and indicators of vascular dysfunction, deregulation of the autonomic nervous system, or altered homeostasis was observed. Considering this, regulatory and preventative initiatives are essential to reduce the cardiovascular risk among night shift workers.publishedVersio

Pulmonary hazards of nanoplastic particles: a study using polystyrene in in vitro models of the alveolar and bronchial epithelium

Background Nanoplastics (NPs) are released into the environment through the degradation of plastic objects, leading to human exposure. Due to their small size, concerns have been raised about the potential hazards to the respiratory tract, as ultrafine and nanoparticles are known to penetrate till the alveolar regions of the lungs, potentially impairing their functions. Thus, in the present study, we used model polystyrene nanoparticles doped with the f luorescent metal europium (PS-Eu) to enhance the understanding of NPs hazard and investigate adverse outcomes associated with exposure in human lungs using alveolar (A549) and bronchial (Calu-3) cell models grown in 2D and 3D submerged conditions or quasi air-liquid interface (ALI) conditions (3D). Results Briefly, after in-dept physicochemical characterization of the particles, we assessed their impact on ROS production, cell viability (AlamarBlue and lactate dehydrogenase assays) and barrier integrity (lucifer yellow assay and TEER measurement), finding no negative effects in either model. However, in alveolar cells, particles increased acidic organelle activity. Transmission electron microscopy and Raman microscopy showed, in both models, a dose- and cell-dependent particle uptake with PS-Eu accumulating in numerous and large endo-lysosomes, which, in transwells-grown A549 cells, often contained also lamellar bodies (LBs), organelles involved in surfactants storage and secretion. After extensively quantifying surfactant proteins (SP) in the pellet and supernatant fractions of treated A549 cells, we observed a significant reduction in several members of this family, including surfactant protein B, which is crucial for lamellar body formation and surface tension regulation in the lungs. In quasi-ALI Calu-3 cultures instead, PS-Eu significantly upregulated interleukin 6 (IL-6) and increased transforming growth factor beta β (TGF-β), zonula occludens 1 (ZO-1), and mucin (MUC) 5B mRNA expressions causing a moderate proinflammatory response. Conclusion Our results show that PS-Eu exposure does not induce acute cytotoxicity in these models, but affects cell-specific functions like surfactant, mucin, and cytokine production. This underscores the limitations of relying solely on standard cytotoxicity tests for particle hazard assessment and highlights the importance of investigatingPulmonary hazards of nanoplastic particles: a study using polystyrene in in vitro models of the alveolar and bronchial epitheliumpublishedVersio

Occupational exposure to respirable crystalline quartz and the risk of incident acute myocardial infarction

We aimed to investigate the association between occupational exposure to respirable crystalline quartz (RCQ) and acute myocardial infarction (AMI) in a Danish register-based cohort (DOC*X Dust, n = 903,415). Through 1976–2017, information on occupation was linked to quantitative exposure estimates of RCQ, obtained from the job-exposure matrix of SYN-JEM. The follow-up period (1996–2018) counted 19,357,326 person-years, where 35,511 first-time AMIs occurred, according to register-based hospital contacts. Incidence rate ratios (IRRs) for AMI based on cumulative, recent, and maximum exposure were computed using Poisson regression adjusted for socio-economic factors, comorbidities, air pollution, and other occupational exposures such as noise, physically demanding work, exposure to diesel exhaust, and job strain. For cumulative exposure, the IRR for AMI in the unadjusted model was highest in the two lowest exposed quartiles (IRR for Q1 = 1.19 (95%CI: 1.13–1.25), IRR for Q2 = 1.12 (95%CI: 1.06, 1.17)). However, in the fully adjusted model, these associations were no longer significant and even inverse for exposed above 25th percentile. The lowest IRR was observed in the highest RCQ exposure quartile (IRR = 0.87, (95%CI: 0.83–0.92)). In general, the RCQ exposure levels in the DOC*X Dust cohort were presumed to be lower than in countries that – contrary to Denmark – have an active mining industry. In conclusion, no increased risk of AMI due to RCQ exposure was observed, but cautious interpretation is warranted because of potential bias from the healthy worker survivor effect.publishedVersio

Hybrid work and mental distress. A cross‑sectional study of 24,763 ofce workers in the Norwegian public sector

Objective Few studies have investigated the relationship between post-pandemic hybrid work-from-home (WFH), mental health, and work-life balance. We examined the association between hybrid WFH, mental distress, availability demands, work-life conflict, and life-work conflict. Methods Data from 24,763 office workers in the public sector in Norway were analyzed by linear and logistic regressions. Results Employees practicing flexible hybrid WFH (i.e., when needed/desired) were less likely to report mental distress (measured by the Hopkins Symptom-Checklist; HSCL-5) than those not practicing WFH. WFH being self-chosen was associated with less distress. Flexible WFH was also associated with availability demands, work-life conflict, and life-work conflict, which were, in turn, linked to distress. The risk of distress increased with the number of weekly days of flexible WFH. Workers with fixed agreements to regularly WFH did not report significantly less distress than those with no WFH. However, fixed WFH was associated with lower availability demands, not with work-life conflict, and was more often self-chosen than flexible WFH. Conclusion Flexible WFH may alleviate distress but may also indicate attempts to cope with taxing availability demands, and may even introduce stressors that could reverse beneficial effects. Our results should motivate nuanced, multifactorial assessments of WFH in organizational practice and research.publishedVersio

Arbeidsmiljøets påvirkning på kvinners arbeidshelse og arbeidstilknytning.En kunnskapsoppsummering

Rapporten gir en oversikt over vitenskapelige artikler publisert siden 2010 om hvordan arbeidsmiljøfaktorer påvirker kvinners arbeidshelse og arbeidstilknytning i en nordisk kontekst. Rapporten begrenser inklusjonskriteriene til fagfellevurderte vitenskapelige artikler med longitudinelle studier fra nordiske land med populasjoner bestående av enten bare kvinner, hovedsakelig kvinner eller ansatte i kvinnedominerte yrker. Funnene må derfor tolkes innenfor disse rammene, og rapporten gir ikke noen uttømmende oversikt over all relevant kunnskap knyttet til kvinners arbeidshelse eller arbeidstilknytning. Totalt ble 327 artikler inkludert. 243 handlet om påvirkning av arbeidsmiljøfaktorer på arbeidshelse og 94 om påvirkning av arbeidsmiljøfaktorer på arbeidstilknytning. Psykososiale arbeidsmiljøfaktorer er studert i flest artikler (148 artikler), etterfulgt av mekaniske/ ergonomiske (96 artikler), organisatoriske (69 artikler) og kjemiske/biologiske (44 artikler). Færrest antall artikler studerte fysiske arbeidsmiljøfaktorer (23 artikler). Sju artikler har sett på flere arbeidsmiljøfaktorer samtidig. Av de inkluderte studiene var 0 fra Island, 41 fra Norge, 58 fra Finland, 92 fra Sverige og 119 fra Danmark, og 17 artikler kombinerte data fra flere land i Norden.publishedVersio

DNA metabarcoding and its potential in microbial risk assessment in waste sorting plants

Exposure to hazardous microorganisms during waste handling is a potential health concern. Molecular biological techniques provide means of profiling the microbial community at high taxonomic resolution, allow the identification of critical human pathogens on the species level and thereby aid the risk assessment of work tasks. The present study used high-throughput sequencing to characterise the microbiome in personal full-shift air samples collected at contemporary waste sorting plants (WSPs) and identified large variations in community composition within (alpha diversity) and between (beta diversity) WSPs. Seasonality did not contribute to differences in the community composition. Cladosporium sp. was dominant among fungi, whereas Aerococcus sp. was dominant among bacteria. The personal air-samples contained potential human pathogens, such as Aspergillus sp., Fusarium sp. and Enterobacteriaceae, that encompass strains with the potential to develop drug-resistance. This study provided characterization of the microbial community composition of personal bioaerosol samples and provided evidence for the occurrence of potential human pathogens in contemporary waste sorting plants. Furthermore, this study highlighted the potential of microbial metabarcoding to detect critical human pathogens that may be encountered in working environments.DNA metabarcoding and its potential in microbial risk assessment in waste sorting plantspublishedVersio

Contact Urticaria and Related Conditions. Clinical Review

Contact urticaria (CoU) is an immediate contact reaction occurring within minutes to an hour after exposure to specific pro-teins or chemicals. CoU is categorised into non-immunologic (NI- CoU) and immunologic (I- CoU) types, with I- CoU potentiallyleading to anaphylaxis. Both forms of CoU can be associated with protein contact dermatitis and the CoU syndrome. Patientswith I- CoU may also have other type I (immediate) allergic diseases, such as allergic conjunctivitis, rhinitis, asthma or foodallergy. This review provides a detailed overview of CoU and related conditions, focusing on triggers, diagnostic methods andmanagement strategies. NI- CoU is typically triggered by low molecular weight chemicals, while I- CoU involves IgE-mediatedhypersensitivity to both high molecular weight proteins and low molecular weight chemicals. Early diagnosis is crucial, thoughCoU is often underrecognized. The diagnostic approach includes a thorough medical history, physical examination, evaluationof photographs, (non)invasive skin tests and in vitro assessments. Management strategies prioritise trigger avoidance and phar-macological treatments when avoidance is not fully possible. For I- CoU, second-generation H 1-antihistamines are the first-linetreatment. Severe cases of I- CoU may benefit from anti-IgE therapy (omalizumab). Patients at risk of anaphylaxis should carryan adrenaline auto-injector and wear a medical alert bracelet.Contact Urticaria and Related Conditions. Clinical ReviewpublishedVersio

Pepper mild mottle virus as a potential indicator of occupational exposure to airborne viruses in wastewater treatment plants

Wastewater is a known carrier for human pathogenic viruses, with seasonal variations in concentrations, and wastewater treatment plant (WWTP) workers are a potentially overlooked occupational group regarding exposure to secondary aerosolized viruses. Exposure assessment of airborne pathogens is complicated by a lack of universal markers of viruses, no standardized sampling protocol, and challenges in detecting extremely low-abundant targets. In this study, we evaluate the risk of workers’ exposure to 4 pathogens, Adenovirus, Norovirus GI and GII, and Influenza A and the Pepper mild mottle virus (PMMoV) as an indicator for aerosolized viruses from wastewater, in 3 WWTPs in the Oslo region, Norway. We collected personal and stationary air samples in summer and winter and used digital droplet PCR (ddPCR) to enable the detection of low-abundant targets. Pathogenic viruses were detected in 22% of all samples, with similar detection rates in personal and stationary samples, with a maximum concentration of 762 genome copies/m3 air. PMMoV was detected in 69% of all samples, with concentrations ranging from 28 to 9703 genome copies/m3 air. The pathogens and PMMoV were most frequently detected at the grids, biological cleansing, sedimentation basins, and sludge treatment/de-watering stations, and were associated with tasks such as flushing, cleaning, and maintenance of the same workstations. Overall, the concentration of pathogens and PMMoV in the air was low, but there is a potential for high point exposure which may pose a risk to workers’ health and is increased by the nature of the workers’ tasks. PMMoV may be a promising tool for assessing the overall potential for viruses with human waste origin aerosolized from sewage. To strengthen this indicator-based approach to occupational exposure assessment, we recommend validating PMMoV along with other potential indicators. Validation should include evaluating the correlation between these indicators and pathogens in both wastewater and bioaerosols.publishedVersio