Documents Järvholm, Bengt 14 results

"Objective
This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers' health in relation to scientific knowledge.
Methods
The findings are based on a narrative literature review.
Results
Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today.
Conclusions
The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method."

"In many developed countries, policies are enacted to increase labor force participation among older workers and to extend the age of statutory retirement in response to the ageing of society. Within Europe, the employment rate among 55–65-year olds has increased in the past decade, but there are large differences among countries, for example, reported participation among men varies from 41% in France to 73% in Sweden (1). Hence, in most countries, it will already be a large societal challenge to support workers to maintain their ability to work until the age of 65. The increase in the statutory retirement age to 67 years and beyond will require additional societal efforts to ensure that older workers can continue to contribute to a productive workforce. ..."

"Objectives The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs. Methods The occurrence of disability pension was prospectively studied between 1980–2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits. Results The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension [relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96–2.39] compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly due to musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups.Conclusion Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important."

"Objectives The objective of this study was to estimate the mortality from cancer, cardiovascular, and respiratory diseases attributable to occupational exposure in Sweden.Methods Estimates were calculated for men and women separately, and we considered only deaths between 25–74 years of age. We considered cancer exposures/sites classified as I or 2a according to the International Agency for Research on Cancer (IARC). Acute myocardial infarction was the only included cardiovascular disease. Respiratory diseases comprised chronic obstructive pulmonary disease (COPD) asthma, pneumoconiosis and alveolitis. All deaths of pneumoconiosis and alveolitis were considered work-related. Estimates were based on the Swedish mortality in 2007. Results In total, we estimate that there are about 800 work-related deaths per year in the studied causes. The majority are due to acute myocardial infarction, with 126 deaths among women and 337 deaths among men attributable to job strain, shift work, exhaust gases, combustion products, or environmental tobacco smoke (ETS). There are 99 respiratory disease-related deaths, the vast majority from COPD (N=92). In total, 270 cancer deaths are estimated to be work-related. For men, half of the cases are attributed to asbestos exposure. Conclusions Our results indicate that preventive measures to decrease occupational mortality should consider factors associated with myocardial infarction such as job strain, shift work and exhaust gases from vehicles and combustion products. Exposures to factors associated with COPD, such as dust, also seem important to prevent."

"Measures to decrease early retirement are underway in many countries to increase the working population and lower costs. Sick leave is the normal pathway to early retirement and methods to enable persons on sick leave to return to work (RTW) earlier and at a higher rate are in focus. Using the term “RTW”, a search in PubMed resulted in about 300 papers, of which more than half have been published after 2008 and 20% during the last year alone. RTW has been the focus of many papers recently submitted to and published in the Scandinavian Journal of Work, Environment and Health. In this issue, Aust and coworkers describe a large randomized Danish study to investigate if support by a trained staff will increase RTW. It is probably the largest ongoing RTW evaluation at the moment. The design is similar to studies of pharmaceutical drugs in phase III, involving a multicenter approach, evaluation committee, cost–benefit analyses, trial registration, and a huge budget. In contrast to most previous studies, it does not focus on a single diagnosis but on estimated prognosis. Established after a literature review, the intervention method is described as “biopsychosocial”. Compared to most other studies in this area, the Aust et al study has a high power. A recent systematic review of community and work-based measures to reduce sick leave among persons with musculoskeletal disorders found that the published literature consisted of rather small studies of limited quality. Furthermore, the effect was overestimated through biased publishing of positive studies."

"The construction industry is a complex work environment. The work sites are temporary and rapidly changing. Asbestos has been widely used in construction industry, but the risks were primarily detected in specialized trades, such as insulation workers and plumbers. Today, the majority of cases related to asbestos exposure will occur in other occupational groups in the construction industry. In a large cohort of Swedish construction workers, insulators and plumbers constituted 37% of all cases of pleural mesothelioma between 1975 and 1984 while they constituted 21% of the cases between 1998 and 2002. It is estimated that 25–40% of all male cases of pleural mesothelioma in Sweden are caused by asbestos exposure in the construction trades. There are many other known carcinogens occurring in the construction industry, including PAHs, diesel exhausts, silica, asphalt fumes, solvents, etc., but it is difficult to estimate exposures and thus the size of the risk. The risk of cancer is less easy to detect with traditional epidemiological methods in the construction industry than in other industrial sectors. It is not sufficient to rely upon broad epidemiological data to estimate the risk of cancer due chemicals in the construction industry. Thus, a strategy to decrease exposure, e.g., to dust, seems a feasible way to reduce the risk."

"Objectives: To study cancer morbidity patterns in concrete workers.

Methods: A cohort of 33,503 concrete workers was enrolled in the study from 1971-86. The average duration of follow up was 19.4 years (582,225 person-years). The workers' cancer morbidity was compared with the morbidity of the general population.

Results: A total of 3572 incident cancers were observed. Significantly increased standardised incidence ratios (SIRs) were found for all malignant neoplasms (SIR 107; 95% confidence interval (95%CI) 103 to 110), cancer of the lip (SIR 179; 95%CI 134 to 234), cancer of the stomach (SIR 139; 95%CI 122 to 158), cancer of the lung (SIR 125; 95%CI 114 to 137), and cancer of the prostate (SIR 108; 95%CI 101 to 116). Reduced risk was found for cancer of the large intestine (SIR 80; 95%CI 69 to 93) and cancer of the testis (SIR 50; 95%CI 26 to 87). Smoking was more prevalent among the concrete workers than in the general population (50% v 35%).

Conclusion: The study has shown a slightly increased overall risk of cancer among concrete workers. The increased risk of lung cancer could entirely be due to differences in smoking habits between concrete workers and the general population. There is a possibility that the smoking also has contributed to the increased risks of stomach cancer and lip cancer, but occupational factors may have contributed to these cancer sites."