Documents Pearce, Neil 17 results

"Objective This study aimed to understand whether the proportionate mortality of COVID-19 for various occupational groups has varied over the pandemic.

Methods We used the Office for National Statistics (ONS) mortality data for England and Wales. The deaths (20–64 years) were classified as either COVID-19-related using ICD-10 codes (U07.1, U07.2), or from other causes. Occupational data recorded at the time of death was coded using the SOC10 coding system into 13 groups. Three time periods (TP) were used: (i) January 2020 to September 2020; (ii) October 2020–May 2021; and (iii) June 2021–October 2021. We analyzed the data with logistic regression and compared odds of death by COVID-19 to other causes, adjusting for age, sex, deprivation, region, urban/rural and population density.

Results Healthcare professionals and associates had a higher proportionate odds of COVID-19 death in TP1 compared to non-essential workers but were not observed to have increased odds thereafter. Medical support staff had increased odds of death from COVID-19 during both TP1 and TP2, but this had reduced by TP3. This latter pattern was also seen for social care, food retail and distribution, and bus and coach drivers. Taxi and cab drivers were the only group that had higher odds of death from COVID-19 compared to other causes throughout the whole period under study [TP1: odds ratio (OR) 2.42, 95% confidence interval (CI) 1.99–2.93; TP2: OR 3.15, 95% CI 2.63–3.78; TP3: OR 1.7, 95% CI 1.26–2.29].

Conclusion Differences in the odds of death from COVID-19 between occupational groups has declined over the course of the pandemic, although some occupations have remained relatively high throughout."

"Introduction: This study examines the prevalence of a range of occupational risk factors reported by a random sample of the New Zealand working population.
Methods: Men and women aged 20–64 were selected from the New Zealand Electoral Roll and invited to take part in a telephone interview, which collected information on lifetime work history, current workplace exposures and organizational factors, and various health conditions. The prevalences of occupational risk factors in each occupational and industry group are reported.
Results: Three thousand and three interviews were completed (37% of the eligible sample and 55% of those that could be contacted). Trades workers reported the highest prevalences of exposure to dust (75%) and oils and solvents (59%). Agriculture and fishery workers reported the highest prevalences of exposure to pesticides (63%) and acids or alkalis (25%). Plant and machine operators and assemblers reported the highest prevalences of exposure to smoke/fume/gas (43%), working night shift in the previous 4 weeks (18%), and working irregular hours (33%). In the high exposure occupational and industry groups, males reported a higher prevalence of exposure than females. Lifting, exposure to loud noise, and the use of personal protective equipment were reported by >50% of the manual occupational groups.
Conclusions: This study indicates that occupational exposure to risk factors for work-related disease and injury remains common in the New Zealand working population. While these occupational exposures are disproportionately experienced by workers in certain industries, they also occur in occupational groups not traditionally associated with hazardous exposures or occupational disease."

"We are all living in the era of globalization and, like it or not, it is going to change the way we practise epidemiology, the kinds of questions we ask and the methods we use to answer them. However, the methods, and ways of thinking about the health of populations, that will be required for epidemiology in the 21st century are in some instances quite different from the standard epidemiological techniques that are taught in most textbooks and courses today. As we develop epidemiological methods for addressing the scientific and public health problems of the 21st century, it is important that we consider, once again, the distinction between the analysis of variance and the analysis of causes. This has primarily been considered with respect to genetic research, and also with regard to the problems of making comparisons between different populations and environments at the same point in time. It has not been considered in depth with regard to the issues of conducting epidemiological research in a world that is changing over time. In this article, I first consider the statistical and scientific issues involved in the distinction between the analysis of variance and the analysis of causes. I then discuss some examples of the implications of this distinction for the theory and practice of epidemiology in a changing world, particularly with regard to risk factors that become ubiquitous over time. Sometimes the most important causes of disease are invisible because they are everywhere."

"Negli ultimi decenni, l'influenza della grande industria sull'epidemiologia si è rafforzata e si è diffusa, soprattutto nei settori con maggiori contenziosi come la farmacoepidemiologia e l'epidemiologia occupazionale. Per ogni epidemiologo indipendente che studia gli effetti collaterali dei farmaci e quelli avversi delle sostanze di uso industriale, vi sono molti altri epidemiologi assunti dall'industria per attaccare la ricerca e derubricarla a «scienza spazzatura». Talora, si è arrivati a tentare di bloccare la pubblicazione dei risultati di studi epidemiologici. In alcune circostanze gli accademici hanno accettato finanziamenti industriali di cui non si è dato atto nelle pubblicazioni, indicando soltanto le istituzioni accademiche di appartenenza dei consulenti dell'industria. Questo comportamento è una grave minaccia per l'integrità dell'epidemiologia e per la sua sopravvivenza come disciplina scientifica. Il problema non è facilmente risolvibile. Comunque, in risposta a comportamenti non etici di molti consulenti finanziati dall'industria, da vent'anni a questa parte si è sviluppata una ricca discussione sull'etica in epidemiologia. Associazioni di professionisti, come la International Epidemiological Association, possono avere un ruolo importante nel sostenere gli epidemiologi e nell'incoraggiarli ad affermare, in alternativa alla produzione di semplici liste di cose «da non fare», alcuni principi positivi di come la scienza dovrebbe funzionare, e come dovrebbe essere applicata per prendere decisioni in salute pubblica."

"BACKGROUND:
To examine the association between occupation and leukaemia.
METHODS:
We interviewed 225 cases (aged 20-75 years) notified to the New Zealand Cancer Registry during 2003-04, and 471 controls randomly selected from the Electoral Roll collecting demographic details, information on potential confounders and a comprehensive employment history. Associations between occupation and leukaemia were analysed using logistic regression adjusted for gender, age, ethnicity and smoking.
RESULTS:
Elevated odds ratios (ORs) were observed in agricultural sectors including horticulture/fruit growing (OR: 2.62, 95% confidence interval (CI): 1.51, 4.55), plant nurseries (OR: 7.51, 95% CI: 1.85, 30.38) and vegetable growing (OR: 3.14, 95% CI: 1.18, 8.40); and appeared greater in women (ORs: 4.71, 7.75 and 7.98, respectively). Elevated ORs were also observed in market farmers/crop growers (OR: 1.84, 95% CI: 1.12, 3.02), field crop/vegetable growers (OR: 3.98, 95% CI: 1.46, 10.85), market gardeners (OR: 5.50, 95% CI: 1.59, 19.02), and nursery growers/workers (OR: 4.23, 95% CI: 1.34, 13.35); also greater in women (ORs: 3.48, 7.62, 15.74 and 11.70, respectively). These elevated ORs were predominantly for chronic lymphocytic leukaemia (CLL). Several associations persisted after semi-Bayes adjustment. Elevated ORs were observed in rubber/plastics products machine operators (OR: 3.76, 95% CI: 1.08, 13.08), predominantly in plastic product manufacturing. CLL was also elevated in tailors and dressmakers (OR: 7.01, 95% CI: 1.78, 27.68), cleaners (OR: 2.04, 95% CI: 1.00, 4.14) and builder's labourers (OR: 4.03, 95% CI: 1.30, 12.53).
CONCLUSIONS:
These findings suggest increased leukaemia risks associated with certain agricultural, manufacturing, construction and service occupations in New Zealand."

"Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e. self-reported reduced activities and absenteeism). The 12-month period prevalence of reduced activities and absenteeism were 18% and 9%, respectively. Lifting (OR 1.79 95% CI 1.16–2.77) increased the risk of reduced activities. Working in awkward/tiring positions (OR 2.11 95% CI 1.20–3.70) and in a cold/damp environment (OR 2.18 95% CI 1.11–4.28) increased the risk of absenteeism. Among those with LBS, reduced activities increased with working in a hot/warm environment (OR 2.14 95% CI 1.22–3.76) and absenteeism was increased with work in awkward/tiring positions (OR 2.06 95% CI 1.13–3.77), tight deadlines (OR 1.89 95% CI 1.02–3.50), and a hot/warm environment (OR 3.35 95% CI 1.68–6.68). Interventions to reduce the consequences of LBS should aim to reduce awkward/tiring positions, lifting and work in a cold/damp environment. For individuals with LBS, additional focus should be to reduce tight deadlines, and work in hot/warm environments."

"Background Sawmill workers have an increased risk of developing occupational asthma and other respiratory symptoms. Wood dust and microorganisms have both been suggested to play a role, but few studies have measured microbial exposure levels in sawmills. Methods The preliminary study reported in this paper assessed airborne dust, bacterial endotoxin and (1,3)-glucan levels in 37 samples from two New Zealand sawmills. Results Nearly one-third of the measured dust levels exceeded 1 mg/m3 and only one sample exceeded the legal limit of 5 mg/m3. Endotoxin levels were clearly elevated with 50% of all measured exposures above 50 EU/m3 (range: 7-588 EU/m3). (1,3)-glucan levels were comparable with levels measured in other industries where workers are exposed to organic dust. Workers in the planing department had the highest mean exposures to dust, endotoxin and (1,3)-glucan. Dust levels were only weakly correlated with endotoxin and (1,3)-glucan levels. Conclusions Endotoxin exposures in sawmill workers are at levels sufficient to potentially contribute to the development of respiratory symptoms. Moreover, measurement of dust exposure is a poor proxy for (1,3)-glucan and endotoxin exposure in sawmill workers."

Aims To examine the prevalence of symptoms of asthma and allergy in different farming groups in New Zealand. Methods A postal questionnaire was sent to a random sample of 2,500 farmers throughout New Zealand. Results The response rate was 77% (1,706 of 2,203 eligibles). The 12-month period prevalence of current asthma was 11.8% overall, compared with 15% in the general population. Asthma prevalence was higher for horse breeders/groomers (16.5%), pig farmers (18.2%), poultry farmers (17.4%), and those working with oats (17.4%). Asthma was also significantly elevated among those working with cleaning powders (14.7%). Women were more likely to report current asthma than were men (OR 1.8, 95% CI 1.3-2.5). Hay fever was significantly higher in deer and crop farmers, and farmers working with horses and goats; eczema was higher for goat and deer farmers. Conclusions The lower overall prevalence of asthma in farmers may be due to the healthy worker effect. Among farmers, the types of farming associated with an elevated prevalence of asthma and allergy in New Zealand are deer and goat farming, working with horses, poultry, pigs, and crop farming. Females reported more current asthma than males.

"BackgroundThere are many proven and suspected occupational causes of lung cancer, which will become relatively more important over time, as smoking prevalence decreases.MethodsWe interviewed 457 cases aged 20–75 years notified to the New Zealand Cancer Registry during 2007–2008, and 792 population controls. We collected information on demographic details, potential confounders, and employment history. Associations were estimated using logistic regression adjusted for gender, age, ethnicity, smoking, and socio-economic status.ResultsAmong occupations of a priori interest, elevated odds ratios (ORs) were observed for sawmill, wood panel and related wood-processing plant operators (OR 4.63; 95% CI 1.05–20.29), butchers (OR 8.77, 95% CI 1.06–72.55), rubber and plastics products machine operators (4.27; 1.16–15.66), heavy truck drivers (2.24; 1.19–4.21) and workers in petroleum, coal, chemical and associated product manufacturing (1.80; 1.11–2.90); non-significantly elevated risks were also observed for loggers (4.67; 0.81–27.03), welders and flame-cutters (2.50; 0.86–7.25), pressers (5.74; 0.96–34.42), and electric and electronic equipment assemblers (3.61; 0.96–13.57). Several occupations and industries not of a priori interest also showed increased risks, including nursing associate professionals (5.45; 2.29–12.99), enrolled nurses (7.95; 3.10–20.42), care givers (3.47; 1.40–8.59), plant and machine operators and assemblers (1.61; 1.20–2.16), stationary machine operators and assemblers (1.67; 1.22–2.28), food and related products processing machine operators (1.98; 1.23–3.19), laborers and related elementary service workers (1.45; 1.05–2.00), manufacturing (1.34; 1.02–1.77), car retailing (3.08; 1.36–6.94), and road freight transport (3.02; 1.45–6.27).ConclusionsCertain occupations and industries have increased lung cancer risks in New Zealand, including wood workers, metal workers, meat workers, textile workers and drivers."