Per Sabro Nielsen

Hospitalization for lifestyle related diseases in long haul drivers compared with other truck drivers and the working population at large

Personal lifestyle and working conditions are closely linked for long haul truck drivers. We compare lifestyle related diseases in long haul drivers with other drivers of goods and the working population at large. Standardized hospital treatment ratios (SHR) for lifestyle related diseases were compared for long haul truck drivers and other truck drivers to the working population at large. The follow up group comprised of 2,175 long haul drivers and 15,060 other truck drivers. An increased risk was found for lifestyle related diseases among truck drivers except for alcohol related diseases. We identified a strong association between hospital treatment for obesity and working as a driver and an association between diabetes and working as a driver. No major differences in lifestyle related diseases were found in long haul drivers compared to other truck drivers with the exception of a significant lower risk for alcohol-related diseases and a possibly higher risk for lung cancer in long haul drivers. It is concluded that diseases related to excess caloric intake or lack of exercise may be a problem for truck drivers. This risk is preventable and of importance both in occupational medicine as in public health.

Hospital contacts for injuries and musculoskeletal diseases among seamen and fishermen: a population-based cohort study.

BackgroundWe studied musculoskeletal diseases (MSD) and injuries among fishermen and seamen with focus on low back disorders, carpal tunnel syndrome (CTS), rotator cuff syndrome and arthrosis.MethodsCohorts of all male Danish seamen (officers and non-officers) and fishermen employed 1994 and 1999 with at least six months employment history were linked to the Occupational Hospitalisation Register. We calculated standardised incidence ratios (SIR) for the two time periods, using rates for the entire Danish workforce as a reference.ResultsAmong fishermen, we found high SIRs for knee arthrosis, thoraco-lumbar disc disorders, injuries and statistically significant SIRs above 200 were seen for both rotator cuff syndrome and CTS. The SIR was augmented for injuries and reduced for hip arthrosis between the two time periods. The SIRs for injuries and CTS were high for non-officers. A sub-analysis revealed that the highest risk for CTS was found among male non-officers working as deck crew, SIR 233 (95% CI: 166–317) based on 40 cases. Among officers, the SIRs for injuries and MSDs were low. The number of employed Danish fishermen declined with 25% 1994–1999 to 3470. Short-term employments were common. None of the SIRs increased with increasing length of employment.ConclusionBoth fishermen and non-officers have high SIRs for injuries and fishermen also for MSD. Only the SIR for injuries among fishermen was augmented between 1994 and 1999. Our findings suggest an association between the incidence of rotator cuff syndrome and CTS and work within fishery. Long-term cumulative effects of employment were not shown for any of the disease outcomes. Other conditions may play a role.

Cancer incidence among Danish seafarers: a population based cohort study

Aims: Seafarers aboard oil and chemical tankers may be exposed to many chemicals, including substances like benzene that are known to be carcinogenic. Other seafarers are exposed to engine exhaust, different oil products, and chemicals used aboard and some years ago asbestos was also used extensively in ships. The aim of this study was to study cancer morbidity among Danish seafarers in relation to type of ship and job title. Methods: A cohort of all Danish seafarers during 1986–1999 (33 340 men; 11 291 women) registered by the Danish Maritime Authority with an employment history was linked with the nationwide Danish Cancer Registry and followed up for cancer until the end of 2002. The number of person years at risk was 517 518. Standardised incidence ratios (SIR) were estimated by use of the corresponding national rates. Results: The SIR of all cancers combined was higher than expected: 1.26 (95% CI 1.19 to 1.32) for men and 1.07 (95% CI 0.95 to 1.20) for women. This was mainly due to an excess of cancer of the larynx, lung, tongue, mouth, pharynx, oesophagus, pancreas, kidney, urinary bladder, colon, and bone as well as skin melanomas among men (the three latter borderline significantly increased), and an excess of cancer of the lung, rectum, and cervix uteri among women. The differences in risk pattern for lung cancer between the different job categories among men ranged in terms of SIR from 1.2 (95% CI 0.9 to 1.7) (engine officers) to 2.3 (1.6 to 3.3) (engine room crew), and 4.1 (2.1 to 7.4) among maintenance crew. Non-officers had a 1.5 times higher lung cancer risk than officers. No increased occurrence of all lymphatic and haematopoietic malignancies combined was found for employees on tankers, but the number of cases was limited to a total of 7. Conclusions: Danish seafarers, especially men, face an increased overall cancer risk, in particular a risk for lung cancer and other tobacco associated cancers.

Hospital contacts for noise-related hearing loss among Danish seafarers and fishermen: A population-based cohort study

AIMS Noise-induced hearing loss (NIHL) is a leading occupational disease and some seafarers and fishermen may be at high risk. We present here standardized hospital contact ratios (SHCRs) for hearing loss among Danish seafarers and fishermen. MATERIALS AND METHODS Cohorts of all Danish seafarers registered by the Danish Maritime Authority (DMA) and fishermen retrieved from a 1989-1998 pension registry were linked to the nationwide Occupational Hospitalisation Registry (OHR) with follow-up for NIHL from 1994 to 2003, using rates specific for age and calendar time for the entire Danish workforce as a reference. RESULTS We found high SHCRs for NIHL: 165 [95% confidence interval (CI) 131-206] among officers, 113 (79-157) for nonofficers and 119 (85-162) for fishermen. The increased SHCR for hearing impairment among seafarers was solely found in engine room personnel (SHCR = 222; 95% CI 178-277). Compared to other seafarers, the engine room personnel had a relative risk ratio of 2.39 (95% CI: 1.74-3.26). Short-term employment is common in many trades. No duration response pattern was observed which may suggest a secondary healthy worker effect. CONCLUSIONS These findings indicate that hearing problems are frequent among men who work in the engine rooms on ships. Long-term cumulative effects of employment were not shown.

Comparative synchronous fluorescence spectrophotometry and 32P-postlabelling analysis of PAH-DNA adducts in human lung and the relationship to TP53 mutations

Polycyclic aromatic hydrocarbon (PAH)-DNA adducts were studied in human lung from 39 lung cancer patients by synchronous fluorescence spectrophotometric (SFS) and 32P-postlabeling assays. Regression analysis of the samples failed to detect any correlation between benzo[a]pyrene-diolepoxide (BPDE)-DNA adducts detected by SFS and the BPDE co-migrating spot detected by 32P-postlabeling. We have also analyzed the relationship between adduct levels and TP53 mutations. By postlabeling diagonal radioactive zone (DRZ) adducts were detected in 37 of 39 (95%) lung tissues from lung cancer patients and the adduct level ranged from 6.81 to 108.50 adducts/10(8) nucleotide. Thirty-three of 39 (85%) had detectable levels of BPDE-DNA adducts (> 1 adduct/10(9) nucleotide). Current heavy smokers (> 20 cigarettes/day) have significantly higher DRZ adduct levels compared to individuals smoking less than 20 cigarettes/day. By SFS combined with immunoaffinity column (IAC), 11 of 39 (28%) samples had detectable adduct levels, and 6 of 11 (55%) were detectable by SFS following purification of benzo[a]pyrene (BP)-tetrols by high pressure liquid chromatography (HPLC). Six of 33 (18%) samples were positive for BPDE-DNA adducts by both postlabeling and HPLC/SFS. No correlation was observed between the SFS and 32P-postlabeling assays for the detection of BPDE-DNA adducts. However, there was a good correlation between adduct levels detected by IAC/SFS and HPLC/SFS. We found a weak association between total PAH-DNA adduct levels in lung tissue and TP53 mutations.