Ramazzini; Blog on work and health by Annet Lenderink


Occupational diseases surveillance in France

The French national occupational disease surveillance and prevention network (RNV3P) includes the 30 occupational disease consultation centres in university hospitals to which patients are referred for potentially work-related diseases, and an occupational health service.

Analysis of  data from 2001 to 2007 (58 777 occupational health reports) showed that referrals increased significantly for asbestos-related diseases, mood disorders and adjustment disorders related to psychological and organisational demands, and for elbow and shoulder disorders related to manual handling.

Referrals significantly decreased for asthma and for rhinitis related to exposure to organic dusts (vegetable or animal) or chemicals, except for cosmetics and cleaning products.

Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P)
Vincent Bonneterre et al. Occup Environ Med 2010;67:178-186 Read the rest of this entry »

Filed under: New occupational risks, Occupational diseases, Occupational medicine, Reporting OD's, , ,

Not so easy to diagnose carpal tunnel syndrome

To evaluate the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) a cohort of 1108 newly employed workers in several industries was studied. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. To diagnose CTS both median nerve conduction abnormality and symptoms classified as “classic” or “probable” on a hand diagram were required. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The post-test probability of positive testing was <50% for all strategies tested. In this study it turned out that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. Researchers suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test

Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research
 Descatha, A, Dale, A-M, Franzblau, A, Coomes, J, Evanoff, B
Occup Environ Med 2010;67:133-135 doi:10.1136/oem.2009.047431 Read the rest of this entry »

Filed under: Musculoskeletal problems, Occupational injury, Occupational medicine, ,

Working night shifts may be bad for the heart

This study in Austria among 30 healthy physicians was performed to evaluate the effects of a 24 h (h) physicians on-call duty (OCD) (‘night shift’) on 24 h electrocardiogram (ECG), heart rate variability, blood pressure (BP), and various biochemical serum and urine ‘stress markers’ compared with a ‘regular’ day at work. Twenty-four hours ECG showed a higher rate of ventricular premature beats (VPB) during early morning hours.  During OCD, BP monitoring revealed a greater diastolic BP throughout 24 h as well as during night-time and a higher rate of systolic BP during sleep time. Tumour necrosis factor alpha concentrations increased significantly during night shift and urinary noradrenaline excretion was greater during OCD when compared with control day. The researchers conclude that there is an association of OCD with an increased risk profile for cardiovascular disease.

Arrhythmias and increased neuro-endocrine stress response during physicians’ night shifts: a randomized cross-over trial
Markus Rauchenzauner, Florian Ernst, Florian Hintringer, Hanno Ulmer, Christoph F. Ebenbichler, Marie-Therese Kasseroler and Michael Joannidis
European Heart Journal 2009 30(21):2606-2613; doi:10.1093/eurheartj/ehp268 online publish-ahead-of-print 14 July 2009

Read the rest of this entry »

Filed under: cardio vascular, Occupational medicine, Psychosocial exposure, , ,

Does occupational diving cause permanent injuries to the ears or vestibular organs?

Permanent injuries to the vestibular end organs may occur in diving due to decompression illness (DCI) or barotraumas. A cohort of 67 men aged 28 ± 5 years (mean ± SD) were followed for 6 years after completing a basic course for working divers. At follow-up, none of the divers had experienced inner ear barotraumas or inner ear DCI. Two cases of untreated probable DCI were diagnosed retrospectively in 27 232 dives. Middle ear barotrauma was reported by 36%. Transient dizziness during or shortly after a dive was reported by 63 and 15%, respectively. This study found no evidence of long-term vestibular effects.

Vestibular effects of diving — a 6-year prospective study
Goplen, F. K., Gronning, M., Aasen, T., Nordahl, S. H. G.
Occupational Medicine 2010 60(1):43-48; doi:10.1093/occmed/kqp148 Read the rest of this entry »

Filed under: Occupational exposure, Occupational medicine, Physical load, ,

Hand lacerations important health risk in commercial fishermen

In this study 210 fishermen were interviewed. Over their careers, 56 subjects (27%) had been returned to shore as an emergency for medical reasons. Most emergency evacuations were for acute injuries, and only 5 were for illness. Fifty-five fishermen had suffered injuries in the past year, including 12 that had caused loss of more than 3 days from work. Subjects15 reported 15 hand lacerations, of which 4 were self-stitched, while others had been bound with ‘gaffer’ tape.  The researchers conclude that prevention of hand lacerations should be a high priority, with first-aid training and equipment for fishing crews to improve their care when prevention fails.

Occupational health needs of commercial fishermen in South West England
Grimsmo-Powney, H., Harris, E. C., Reading, I., Coggon, D. 
Occupational Medicine 2010 60(1):49-53; doi:10.1093/occmed/kqp137 Read the rest of this entry »

Filed under: Accidents, Occupational exposure, Occupational medicine, , ,

Positive illness perceptions associated with earlier return to work

A patient’s perception of their illness can influence their coping ability, compliance with treatment and functional recovery. This study compares perceptions of illness, fitness to return to work and time to return to work among employees with those of their occupational physicians (OPs). 84 employees and 9 OPs filled in several questionnaires including the Brief Illness Perception Questionnaire. Employees had more negative perceptions (longer duration, more symptoms and concersn) about their illness than OPs. Positive perceptions (shorter lasting illness, more treatable, less symptoms and concern) were associated with an earlier return to work. Unhelpful negative beliefs about illness need to be addressed by OPs.

Perceptions of illness and their impact on sickness absence
Prosenjit Giri, Jon Poole, Peter Nightingale and Alastair Robertson
Occupational Medicine 2009 59(8):550-555; doi:10.1093/occmed/kqp123 Read the rest of this entry »

Filed under: Health, Occupational medicine, RTW (Return to Work), Well-being,

Intervention to improve reporting occupational diseases in the Netherlands



After 2 years of research an writing and the interesting process of submitting and revising my first scientific article, I am proud to announce that it is online now. You can read the full article, because it is open access. The subject is the reporting of occupational diseases by Dutch OPs and the effect of a relatively small intervention trying to improve that. 

Annet F. Lenderink · Dick Spreeuwers · Jac J. L. van der Klink · Frank J. H. van Dijk Int Arch Occup Environ Health DOI 10.1007/s00420-009-0468-8

Filed under: Occupational diseases, Occupational medicine, Reporting OD's

Work is good for your health and well-being

Although this blog may seem mainly occupied with dangers and risks of work and working, I am convinced that work is essentially good for us in many ways. Working is better for our health than being without employment. One of the important studies into this subject came from Gordon Waddell and Kim Burton: IS WORK GOOD FOR YOUR HEALTH AND WELL-BEING? (2006). You can read the review online, but here is their main conclusion:

“There is a strong evidence base showing that work is generally good for physical and mental health and well-being. Worklessness is associated with poorer physical and mental health and well-being. Work can be therapeutic and can reverse the adverse health effects of unemployment. That is true for healthy people of working age, for many disabled people, for most people with common health problems and for social security beneficiaries.
The provisosare that account must be taken of the nature and quality of work and its social context; jobs should be safe and accommodating. Overall, the beneficial effects of work outweigh the risks of work, and are greater than the harmful effects of long-term unemployment or prolonged sickness absence. Work is generally good for health and well-being.”

Filed under: Health, Occupational medicine, Well-being, ,

Work-related major depression

Is there something like occupational depression?

Jens Peter Bonde, Department of Occupational Medicine, Aarhus University Hospital reviewed the literature on psychosocial factors at work and the risk of depression:

Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence Bonde, J P E Occupational and Environmental Medicine 2008;65:438-445

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Filed under: Occupational medicine

Assessment of work-related musculoskeletal disorder

From the informative website of the Brtitish HSE, aimed at the food and drink manufacture, but also useable in other work situations in my opinion.

Work related musculoskeletal disorders, usually upper limb, neck and back problems – are a significant problem in food and drink manufacture. A Quick Exposure Check (QEC) is a practical tool for individual physical work activities to be assessed in collaboration with the worker. It has been designed to be quick (3 pages), easy to use and does not require extensive training before use.

More detailed guidance on work related upper limb disorders (WRULDs) can be found in HSE publication:

Filed under: Occupational medicine, ,


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Annet Lenderink

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Diepenveen, Netherlands

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