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Harris S.A.,Population Studies and Surveillance | Harris S.A.,University of Toronto | Harris S.A.,Occupational Cancer Research Center
American Journal of Infection Control | Year: 2010

Background: Little is known about compliance with universal precautions (CUP) or occupational exposures to blood and body fluids among Emergency Medical Services (EMS) providers. The objective of this study was to obtain estimates of CUP and knowledge of universal precautions (KUP), occupational exposures, and needle and lancet sticks in the prehospital environment. Methods: A convenience sample of workers (n=311, 51% response) from 17 agencies in Virginia that provided emergency ground transportation (volunteer, commercial, government rescue squads, and fire departments) completed a questionnaire on certification and training, KUP, CUP, exposures and needlesticks, risk perceptions, and demographic variables. Results: Nearly all EMS providers reported exposures and were concerned about risk of HIV and hepatitis. Providers reported inconsistent CUP when treating patients or using needles, including failure to wear gloves (17%) and to appropriately dispose of contaminated materials (79%), including needles (87%), at all times. Certification type (advanced and basic) was related to both KUP and CUP. Of those respondents reporting current sharps use, 40% recapped needles. A lancet stick was reported by 1.4% (n=5), and 4.5% reported a needlestick (n=14). Conclusion: EMS providers working in the prehospital environment experience significant exposures but are not consistently using universal precautions. © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Source

Wong I.S.,University of British Columbia | Ostry A.S.,University of Victoria | Demers P.A.,Occupational Cancer Research Center | Davies H.W.,University of British Columbia
Journal of Occupational and Environmental Hygiene | Year: 2012

This pilot study is one of the first to examine the impact of job strain and shift work on both the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis using two salivary stress biomarkers and two subclinical heart disease indicators. This study also tested the feasibility of a rigorous biological sampling protocol in a busy workplace setting. Paramedics (n=21) self-collected five salivary samples over 1 rest and 2 workdays. Samples were analyzed for α-amylase and cortisol diurnal slopes and daily production. Heart rate variability (HRV) was logged over 2 workdays with the Polar RS800 Heart Rate monitors. Endothelial functioning was measured using fingertip peripheral arterial tonometry. Job strain was ascertained using a paramedic-specific survey. The effects of job strain and shift work were examined by comparing paramedic types (dispatchers vs. ambulance attendants) and shift types (daytime vs. rotating day/night). Over 90% of all expected samples were collected and fell within expected normal ranges. Workday samples were significantly different from rest day samples. Dispatchers reported higher job strain than ambulance paramedics and exhibited reduced daily α-amylase production, elevated daily cortisol production, and reduced endothelial function. In comparison with daytime-only workers, rotating shift workers reported higher job strain, exhibited flatter α-amylase and cortisol diurnal slopes, reduced daily α-amylase production, elevated daily cortisol production, and reduced HRV and endothelial functioning. Despite non-statistically significant differences between group comparisons, the consistency of the overall trend in subjective and objective measures suggests that exposure to work stressors may lead to dysregulation in neuroendocrine activity and, over the long-term, to early signs of heart disease. Results suggest that further study is warranted in this population. Power calculations based on effect sizes in the shift type comparison suggest a study size of n=250 may result in significant differences at p=0.05. High compliance among paramedics to complete the intensive protocol suggests this study will be feasible in a larger population. © 2012 JOEH, LLC. Source

Constanza Camargo M.,University of Illinois at Chicago | Stayner L.T.,University of Illinois at Chicago | Straif K.,International Agency for Research on Cancer | Reina M.,University of Illinois at Chicago | And 3 more authors.
Environmental Health Perspectives | Year: 2011

Objective: A recent Monographs Working Group of the International Agency for Research on Cancer (IARC) concluded that there is sufficient evidence for a causal association between exposure to asbestos and ovarian cancer. We performed a meta-analysis to quantitatively evaluate this association. Data sources: Searches of PubMed and unpublished data yielded a total of 18 cohort studies of women occupationally exposed to asbestos. Data extraction: Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. Data synthesis: All but one study reported standardized mortality ratios (SMRs) comparing observed numbers of deaths with expected numbers for the general population; the exception was a study that reported standardized incidence ratios. For simplicity, we refer to all effect estimates as SMRs. The overall pooled SMR estimate for ovarian cancer was 1.77 (95% confidence interval, 1.37-2.28), with a moderate degree of heterogeneity among the studies (I2 = 35.3%, p = 0.061). Effect estimates were stronger for cohorts compensated for asbestosis, cohorts with estimated lung cancer SMRs > 2.0, and studies conducted in Europe compared with other geographic regions. Effect estimates were similar for studies with and without pathologic confirmation, and we found no evidence of publication bias (Egger's test p-value = 0.162). Conclusions: Our study supports the IARC conclusion that exposure to asbestos is associated with increased risk of ovarian cancer. Source

Harris M.A.,University of British Columbia | Harris M.A.,Occupational Cancer Research Center | Tsui J.K.,University of British Columbia | Tsui J.K.,Pacific Parkinsons Research Center | And 3 more authors.
Movement Disorders | Year: 2012

The ultimate causes of idiopathic Parkinson's disease (PD) are not fully known, but environmental and occupational causes are suspected. Postencephalitic parkinsonism has been linked to influenza, and other viral infections have also been suspected to relate to PD. We estimated the relationship between PD and both infections and possible vectors of infection (i.e., animal and human) in a population-based, case-control study in British Columbia, Canada. We recruited 403 cases detected by their use of antiparkinsonian medications and 405 controls from the registrants of the provincial universal health insurance plan. Severe influenza was associated with PD (odds ratio [OR]: 2.01; 95% confidence interval [CI]: 1.16-3.48), although this effect was attenuated when reports were restricted to those occurring 10 or more years before diagnosis. Childhood illnesses were inversely associated with PD, particularly red measles (OR: 0.65; 95% CI: 0.48-0.90). Several animal exposures were associated with PD, with statistically significant effects for cats (OR: 2.06; 95% CI: 1.09-3.92) and cattle (OR: 2.23; 95% CI: 1.22-4.09). Influenza infection may be associated with PD. The inverse relationships with childhood infections may suggest an increased risk with subclinical or asymptomatic childhood infections. Occupational exposure to animals may increase risk through transmission of infections or may indicate exposure to another agent of interest (e.g., bacterial endotoxin). © 2012 Movement Disorder Society. Source

Wong I.S.,University of British Columbia | McLeod C.B.,University of British Columbia | Demers P.A.,Occupational Cancer Research Center
Scandinavian Journal of Work, Environment and Health | Year: 2011

Objective The aim of this study was to examine the risk of work injury across shift work types in a representative sample of Canadian workers. Methods We used the Survey of Labour and Income Dynamics to investigate trends in work injury by shift type between 1996-2006. Work injury was defined by receipt of workers' compensation. Logistic regression was used to estimate the risk between shift type and worker injury after adjusting for potential confounders. Results The rate of work injury decreased overall between 1996-2006, but did not decline for night shift workers. Night shift work was associated with work injury for women [odds ratio (OR) 2.04, 95% confidence interval (95% CI) 1.13-3.69] and men (OR 1.91, 95% CI 1.21-3.03), while rotating shift work was associated with work injury for women (OR 2.29, 95% CI 1.37-3.82). The excess risk of work injury attributed to shift work was 14.4% for women and 8.2% for men based on population attributable fraction estimates. Conclusions Rotating and night shift workers appear to have a higher risk of work injury, particularly among women. Regulatory agencies and employers need to identify and mitigate factors that give rise to increased work injury among these types of shift workers. Source

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