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| 2. |
- Neitzel, R. L., et al.
(författare)
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Comparison of Multiple Measures of Noise Exposure in Paper Mills
- 2016
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Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 60:5, s. 581-596
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Tidskriftsartikel (refereegranskat)abstract
- Noise exposures are associated with a host of adverse health effects, yet these exposures remain inadequately characterized in many industrial operations, including paper mills. We assessed noise at four paper mills using three measures: (i) personal noise dosimetry, (ii) area noise measurements, and (iii) questionnaire items addressing several different aspects of perceived noise exposure. We assessed exposures to noise characterized using the three measures and compared the relationships between them. We also estimated the validity of each of the three measures using a novel application of the Method of Triads, which does not appear to have been used previously in the occupational health literature. We collected 209 valid dosimetry measurements and collected perceived noise exposure survey items from 170 workers, along with 100 area measurements. We identified exposures in excess of 85 dBA at all mills. The dosimetry and area noise measurements assigned to individual subjects generally showed good agreement, but for some operations within mill, large differences between the two measures were observed, and a substantial fraction of paired measures differed by > 5 dB. Perceived noise exposures varied greatly between the mills, particularly for an item related to difficulty speaking in noise. One perceived noise exposure item related to difficulty hearing due to noise showed strong and significant correlations with both dosimetry and area measurements. The Method of Triads analysis showed that dosimetry measures had the highest estimated validity coefficient (0.70), and that the best performing perceived exposure measure had validity that exceeded that of area measurements (0.48 versus 0.40, respectively). Workers in Swedish pulp mills have the potential for exposures to high levels of noise. Our results suggest that, while dosimetry remains the preferred approach to exposure assessment, perceived noise exposures can be used to evaluate potential exposures to noise in epidemiological studies.
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| 3. |
- Neitzel, R. L., et al.
(författare)
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Development of a Job Exposure Matrix for Noise in the Swedish Soft Tissue Paper Industry
- 2018
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Ingår i: Annals of Work Exposures and Health. - : Oxford University Press (OUP). - 2398-7308 .- 2398-7316. ; 62:2, s. 195-209
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Noise exposure is a common occupational hazard, but has not been sufficiently characterized in paper mills. We developed a job-exposure matrix (JEM) for noise exposure for use in estimating exposures among Swedish soft tissue paper mill workers.& para;& para;Methods: We used a combination of area and personal dosimetry noise exposure measurements made at four soft tissue paper mills by industry and research staff between 1977 and 2013 to estimate noise exposures by department, location, and job title. We then utilized these estimates, in conjunction with information on process and facility changes and use of hearing protection collected via focus groups, to create a seven-category, semi-quantitative JEM for all departments, locations, and job titles spanning the years 1940-2010.& para;& para;Results: The results of the 1157 area and personal dosimetry noise measurements indicated that noise levels have generally declined in Swedish paper mills over time, though these changes have been neither uniform nor monotonic within or across the four mills. Focus group results indicated that use of hearing protection has generally increased over time. The noise JEM totals 1917 cells, with each cell representing a unique combination of operation, job title, and single year. We estimated that -50% of workers at the four mills assessed were exposed at or above the Swedish 8-h average noise exposure limit of an 85 dBA at the conclusion of the study period in 2010.& para;& para;Conclusions: Our results highlight the continuing need for hearing loss prevention and noise control efforts at these and similar mills, and the completed JEM now represents a tool for use in epidemiological studies of noise-related health outcomes.
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| 4. |
- Olin, Anna-Carin, 1960, et al.
(författare)
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Prevalence of asthma and exhaled nitric oxide are increased in bleachery workers exposed to ozone.
- 2004
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 23:1, s. 87-92
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to determine whether exposure to high peaks of ozone resulted in an increased prevalence of asthma or respiratory symptoms among bleachery workers and whether nitric oxide (NO) was elevated in the exhaled air of these workers. Bleachery workers (n=228) from three Swedish pulp mills who had been exposed to ozone, together with 63 unexposed control subjects, were investigated by means of spirometry, Phadiatop, exhaled and nasal NO and answers to a questionnaire concerning respiratory symptoms and exposure. Exposure to an ozone peak that gave rise to respiratory symptoms was defined as a "gassing". Bleachery workers reporting four or more gassings involving ozone had an increased prevalence of adult-onset asthma, wheeze, and current asthma symptoms. They also had a higher median concentration of exhaled NO in comparison with those who reported no such gassings (19.2 versus 15.7 parts per billion). No such associations were found in respect of nasal NO. The results from this study show that bleachery workers who have been repeatedly exposed to ozone gassings have an increased prevalence of adult-onset asthma. The results also indicate exhaled nitric oxide may be a marker of airway inflammation in bleachery workers who have been exposed to high peaks of ozone.
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| 5. |
- Abrahamsen, R., et al.
(författare)
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Association of respiratory symptoms and asthma with occupational exposures: findings from a population-based cross-sectional survey in Telemark, Norway
- 2017
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to estimate the prevalence of respiratory symptoms and physiciandiagnosed asthma and assess the impact of current occupational exposure. Design: Cross-sectional analyses of the prevalence of self-reported respiratory health and association with current occupational exposure in a random sample of the general population in Telemark County, Norway. Settings: In 2013, a self-administered questionnaire was mailed to a random sample of the general population, aged 16-50, in Telemark, Norway. The overall response rate was 33%, comprising 16 099 responders. Outcome measures: The prevalence for respiratory symptoms and asthma, and OR of respiratory symptoms and asthma for occupational groups and exposures were calculated. Occupational exposures were assessed using self-reported exposure and an asthma-specific job-exposure matrix (JEM). Results: The prevalence of physician-diagnosed asthma was 11.5%. For the occupational groups, the category with agriculture/fishery workers and craft/related trade workers was associated with wheezing and asthma attack in the past 12 months, showing OR 1.3 (1.1 to 1.6) and 1.9 (1.2 to 2.8), respectively. The group including technicians and associated professionals was also associated with wheezing OR 1.2 (1.0 to 1.3) and asthma attack OR 1.4 (1.1 to 1.9). The JEM data show that exposure to flour was associated with wheezing OR 3.2 (1.4 to 7.3) and woken with dyspnoea OR 3.5 (1.3 to 9.5), whereas exposures to diisocyanates, welding/soldering fumes and exposure to vehicle/motor exhaust were associated with dyspnoea OR 2.9 (1.5 to 5.7), 3.2 (1.6 to 6.4) and 1.4 (1.0 to 1.8), respectively. Conclusions: The observed prevalence of physiciandiagnosed asthma was 11.5%. The 'manual' occupations were associated with respiratory symptoms. Occupational exposure to flour, diisocyanates, welding/soldering fumes and vehicle/motor exhaust was associated with respiratory symptoms in the past 12 months and use of asthma medication. However, prospective data are needed to confirm the observed associations.
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| 6. |
- Andersson, Eva, 1955, et al.
(författare)
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A case-referent study of cancer mortality among sulfate mill workers in Sweden.
- 2001
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Ingår i: Occupational and environmental medicine. - 1351-0711. ; 58:5, s. 321-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate whether workers in Swedish sulfate mills have an increased risk of death from certain malignancies that have previously been linked to the pulping process. METHODS: Subjects of the study (n=2480) were men aged 40-75 at death during 1960-89 in the parishes surrounding four sulfate mills. Exposure assessment was based on information from the personnel files in the mills- 35% of the subjects were recognised there, and work categories were created. RESULTS: Among all sulfate mill workers, the odds ratio (OR) (90% confidence interval (90% CI)) for death from lung cancer was 1.6 (1.1 to 2.3), pleural mesotheliomas 9.5 (1.9 to 48), brain tumours 2.6 (1.2 to 5.3), and liver or biliary tract cancer 2.3 (1.0 to 5.2). There was an increased mortality from leukaemia among workers in the soda recovery plant (5.9 (2.6 to 13)) and bleaching plant and digester house (2.8 (1.0 to 7.5)). CONCLUSIONS: Sulfate mill workers were at increased risk of dying from lung cancer and pleural mesotheliomas, probably due to exposure to asbestos. Increased risks of brain tumours and cancers of the liver or biliary tract were also found but the aetiology is not obvious.
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| 7. |
- Andersson, Eva, 1955, et al.
(författare)
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Adult-onset asthma and wheeze among irritant-exposed bleachery workers.
- 2003
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Ingår i: American journal of industrial medicine. - : Wiley. - 0271-3586. ; 43:5, s. 532-538
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Tidskriftsartikel (refereegranskat)abstract
- Background Whether new-onset asthma is associated with irritant exposure is unclear. The aim was to investigate if occupational exposure to irritant gases, especially repeated peak exposure (gassings), increased the risk of obstructive airways disease. Methods Data on airway symptoms and exposure among bleachery (n = 101) and paper department workers (n = 314) were collected by a questionnaire. Incidence rates and hazard ratios (HR) (Cox regression) were calculated. Non-responders were interviewed by telephone. Results The incidence rate for adult-onset physician-diagnosed asthma among bleachery workers reporting gassings giving rise to respiratory symptoms was 7.6/103 person-years and for those without gassings 2.2/103 person-years, compared to 1.0/103 person-years for paper workers. In a Cox regression model for asthma (n = 12), stratified for sex, HR for gassings were 5.6 (95% confidence intervals (CI) 1.6–20), for hay fever 3.0 (95% CI 0.8–11), and for ever smoking 0.7 (95% CI 0.2–2.4). The same model for adult-onset wheeze gave HR of 5.2 (95% CI 2.2–12), 1.7 (95% CI 0.6–5.4), and 1.1 (95% CI 0.5–2.7), respectively. Conclusions Repeated peak exposure to irritant gases, here studied as gassings in the pulp industry, increased the risk for both adult-onset asthma and wheeze.
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| 8. |
- Andersson, Eva, 1955
(författare)
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Asthma and cancer among pulp and paper mill workers
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There were two main aims of this thesis. One was to study if repeated high exposures to irritant gases give rise to new-onset asthma, and the other was to study if exposure in pulp and paper mills were associated with cancer.Two studies were case-referent studies of male mortality in parishes surrounding three sulfite (N=780) and four sulfate mills (N=2480). An increased mortality from asthma was found among workers in sulfite mills, possibly as a result of accidental exposure to sulfur dioxide. Brain tumor mortality was two to three times higher than expected among both sulfite and sulfate mill workers. In sulfate mills, the excess mortality was seen among workers from maintenance departments, wood rooms and saw mills. The workers from the sulfate mills had an increased mortality from lung cancer and pleural mesotheliomas, probably caused by asbestos exposure. Stomach cancer mortality was not increased in any of the studies.One study investigated glioma incidence between 1971 and 1990 among men in different occupations in Swedish pulp and paper mills from census and cancer incidence data in the Cancer Environment Register 6070. All gainfully employed Swedish men were used as a reference group. Standardized incidence ratios were calculated using 5-year birth cohorts stratified by calendar period and region. A 50% excess incidence of gliomas was found among maintenance workers in the pulp and paper industry and among process workers in pulp mills. Process workers in paper mills showed a lower incidence than expected. The reasons for these findings are not obvious.In a historical cohort study, 101 bleachery workers and 314 paper department workers were investigated by questionnaires with items on airway symptoms and exposure to irritant gases. About 50% of the irritant gas-exposed workers had experienced high exposures giving respiratory symptoms (gassings). Incidence rates of adult-onset physician-diagnosed asthma and adult-onset wheeze were calculated and Cox regression analyses were performed. The incidence of asthma was significantly increased among bleachery workers during mill working years compared to paper workers (5.4 and 1.0 cases per 1000 person-years, respectively), especially among workers who reported gassings. The incidence of new-onset wheeze was also increased among the workers with gassings. Both for asthma and wheeze, the risk estimate was five times higher for those reporting gassings, stratified for sex, and controlled for hay fever and smoking.It was shown that repeated high exposure to irritant gases gave rise to new-onset asthma among bleachery workers. Such exposure should be prevented. It was also found that glioma incidence was increased in some occupations in pulp and paper mills. Mortality from lung cancer and pleural mesotheliomas was increased, probably caused by asbestos exposure.
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| 9. |
- Andersson, Eva, 1955, et al.
(författare)
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Cancer mortality in a Swedish cohort of pulp and paper mill workers.
- 2010
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 83:2, s. 123-32
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study cancer mortality among Swedish pulp and paper mill workers by main mill pulping process and department, and to present the Swedish part of an international exposure measurements database. METHODS: A cohort of 18,163 male and 2,290 female workers at four sulfate and four sulfite mills, enrolled from 1939 to 1999, was followed up for mortality during 1952-2001. Standardized mortality ratios (SMRs) relative to the general Swedish population were calculated. RESULTS: There were 1,340 malignant cases out of 5,898 deaths. Total cancer mortality was not increased in either sulfate or sulfite mill workers, or by gender. Lung cancer mortality was increased among female workers (SMR 1.70, 95% CI 1.04-2.63), especially in paper production, but not among male workers (SMR 0.91, 95% CI 0.79-1.04). Exposure to wood dust and sulfur dioxide frequently exceeded occupational exposure limits. CONCLUSIONS: Female paper production workers had an increased mortality from lung cancer.
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| 10. |
- Andersson, Eva, 1955, et al.
(författare)
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Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases
- 2007
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:6, s. 470-478
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.Methods The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98–1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90–0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12–1.32) and SMR 1.11 (95% CI 1.02–1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07–1.54), paper production (SMR 1.26, 95% CI 1.06–1.49), and maintenance (SMR 1.16, 95% CI 1.02–1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).
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