Brage (Statens arbeidsmiljøinstitutt)
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European harmonization of asbestos exposure assessment: comparing PCM, SEM, and TEM to derive conversion factors
Full text linkAfter 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
Minimering av støv og vibrasjoner. Prosjekt i IA-bransjeprogram for Bygg og anlegg: Utvikling og testing av tekniske hjelpemidler som reduserer helseskadelig kvartsstøv og vibrasjoner ved fjellboring
Full text linkProsjektet «Minimering av støv og vibrasjoner» har hatt som mål å utvikle og teste tekniske hjelpemidler for å redusere eksponeringen for kvartsstøv og mekaniske vibrasjoner ved fjellboring. Arbeidet er et samarbeid mellom Statens Arbeidsmiljøinstitutt (STAMI), IA-bransjeprogram for bygg og anlegg, RISE Institute, og flere entreprenører og byggherrer. Gjennom prosjektet ble det utviklet og testet flere prototyper, inkludert vibrasjonsdempende håndtak, fjærdempere, vektlodd med integrert demping og en spesialtilpasset støvsuger for fjellbor. Målinger viste at vibrasjonsnivået ble redusert med 50–80 %, og at støvsugeren effektivt ledet bort steinstøv fra arbeidstakernes pustesone. Dette bidrar til å redusere risikoen for yrkessykdommer som hånd-arm vibrasjonssyndrom (HAVS) og lungesykdommer forårsaket av kvartsstøv. Tilbakemeldinger fra arbeidstakere som testet utstyret var overveiende positive. Samtlige opplevde redusert vibrasjonsnivå, og flertallet rapporterte om mindre støv i pustesonen. Noen opplevde at det krevde tilvenning og justering av arbeidsteknikk, men de fleste ønsket å fortsette å bruke utstyret. Prototypene har allerede blitt kommersialisert gjennom TM Verkstad, og verktøyprodusenter vurderer videreutvikling av teknologien, inkludert implementering av avansert demping i nye borhammerdesign. Prosjektet har også bidratt til økt bevissthet blant byggherrer og entreprenører, og det pågår initiativ for å innlemme krav til støv- og vibrasjonsdemping i anbudsprosesser. På lengre sikt kan tiltakene bidra til redusert sykefravær, færre tilfeller av yrkessykdom, mindre belastningsskader og et tryggere arbeidsmiljø i bygg- og anleggsbransjen.publishedVersio
Occupational exposure to respirable crystalline quartz and the risk of incident acute myocardial infarction
Full text linkWe 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
Arbeidsmiljøets påvirkning på kvinners arbeidshelse og arbeidstilknytning.En kunnskapsoppsummering
Full text linkRapporten 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
Cohort Profile: The Nor-Work Cohort
Full text linkThe Nor-Work cohort was established in 2018 to identify differences in health, labour force participation, and related outcomes, and to study how these outcomes are associated with other factors, including occupation and occupational exposures. The dynamic cohort consists of individuals born between 1930 and 1992 who have ever lived and/or worked in Norway and who have a Norwegian personal identification number (N = 5 799 138). Data are available from 1960 to 2022, though exact time periods vary between data sources. Nor-Work contains data from several national administrative registers, which allows for prospective follow-up. The register-based nature means individuals cannot opt out, and thus there is no attrition. The cohort is mainly intended for occupational epidemiological research, and contains information on employment, occupation and industry, diagnoses from specialist healthcare and health registries, health-related benefits and their diagnoses (sickness absence, disability benefits), as well as demographic and socioeconomic factors. Occupation is registered from 2003; prior to this, self-reported occupation is available from the censuses in 1960, 1970, and 1980, and for a subset of the population in 1990. For the years in which occupational data are missing, imputed occupation is available.Cohort Profile: The Nor-Work CohortpublishedVersio
Inflammatory responses of inhalable aerosols from powder food industry in THP-1 cells
Full text linkBackground Occupational exposure to inhalable aerosols and airborne particles in the food production industry is associated with an increased risk of respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). This study aims to investigate the inflammatory potential of inhalable aerosols collected from various food production environments and work tasks by assessing the concentrations of cytokines using an in vitro assay. Methods The inflammatory response, as measured by the production of inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin 1β (IL-1β), IL-2, IL-4, IL-6, IL-8, IL-10, and IL-12, was determined using human macrophages derived from THP-1 monocytic cells. These cells were exposed to inhalable aerosol samples from 12 dry powder food processing plants. Cytokine concentrations were quantified using a Luminex assay. Results This study identified statistically significant variations in in vitro cytokine responses across different production types and work tasks, emphasizing the diverse inflammatory potential of workplace aerosols. Furthermore, a dose-dependent relationship was observed for TNF-α, IL-8, IL-2, and IL-1β, suggesting that aerosol mass plays a role in immune activation. After normalizing cytokine concentrations to aerosol mass, variations in the intrinsic potential of aerosols were observed, indicating that aerosols generated during dry powder food production have differing capacities to induce an inflammatory response. Conclusions This study has demonstrated that the inflammatory potential of inhalable aerosols collected from various food production environments can be assessed by measuring cytokine concentrations using an in vitro assay. Although cytokine concentrations were generally low, weighing and mixing food ingredients, and environments like coffee, spice, and powdered consumer product production, and bakeries exhibited elevated concentrations of inflammatory cytokines, potentially indicating a higher risk for workers in these settings.publishedVersio
The prevalence of childhood bullying and violence victimization and subsequent risk of adult revictimization in the Norwegian population: A cross-sectional study
Full text linkRevictimization research has largely ignored bullying victimization, and knowledge of the association between childhood bullying and adulthood revictimization is scarce. Research is also needed to explore whether bullying exposure in combination with childhood violence exacerbates the risk of revictimization. This study sought to address these research gaps in a national probability sample of Norwegian adults (N = 4,299, age range: 18–74 years). One in five (n = 838) reported that they had experienced bullying in childhood or adolescence. Approximately half of these individuals (49.0%, n = 459) reported new victimization in adulthood, including controlling behavior from a partner, rape, and/or severe physical violence. Regression analyses confirmed that survivors of bullying had significantly higher odds of experiencing victimization in adulthood compared to individuals who did not experience any form of childhood victimization, aOR = 1.52, 95% CI [1.24, 1.87], p < .001, highlighting the unique association between bullying and adult revictimization in this population-based sample. This risk was exacerbated for individuals who had experienced both childhood violence and bullying (n = 879, 8.9%), with four-fold higher odds of experiencing new victimization as an adult, compared to those who did not experience childhood violence or bullying, aOR = 4.16, 95% CI [3.23, 5.35], p < .001. Bullying and violence have typically been studied in separate research fields and traditions. These findings call for integrated research and prevention efforts at both the individual and contextual levels to address multiple forms of violence and prevent repeated violence exposure throughout the lifespan.The prevalence of childhood bullying and violence victimization and subsequent risk of adult revictimization in the Norwegian population: A cross-sectional studypublishedVersio
Strengthening research preparedness for crises: lessons from Norwegian government agencies in using randomized trials and quasi-experimental methods to evaluate public policy interventions
Full text linkDuring 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
Sick leave due to musculoskeletal disorders: A prospective cohort study
Full text linkBackground 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
Full text linkThis 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