Occupational and Environmental Medicine最新文献

{"title":"Atopy, asthma symptoms and eosinophilic airway inflammation in British woodworkers.","authors":"Ruth Eleanor Wiggans, Jade Sumner, Edward W Robinson, Charlotte Young, Andrew Simpson, Timothy Yates, David Fishwick, Christopher M Barber","doi":"10.1136/oemed-2025-110183","DOIUrl":"10.1136/oemed-2025-110183","url":null,"abstract":"<p><strong>Objectives: </strong>Despite reducing exposures to wood dust, woodworkers remain at increased risk of asthma. There have been no recent studies of wood dust exposure, respiratory symptoms or asthma in British woodworkers. This cross-sectional study examined factors associated with asthma in British woodworkers across exposure groups.</p><p><strong>Methods: </strong>Participants answered a reporter-delivered work and respiratory questionnaire, and underwent fractional exhaled nitric oxide (FE_NO), spirometry and specific IgE measurements. Wood dust exposure was assigned through a job-exposure matrix. Multiple regression evaluated associations between asthma and factors including exposure, atopy and current asthma symptoms (CAS).</p><p><strong>Results: </strong>A total of 269 woodworkers participated. Median wood dust exposure was 2.00 mg/m³ (IQR 1.14 mg/m³). CAS, work-related respiratory symptoms (WRRS) and eosinophilic airway inflammation (FE_NO>40 ppb) were common, present in 46%, 11% and 19% of the cohort, respectively. Atopic woodworkers were more likely to have nasal symptoms (OR 2.13, 95% CI 1.18 to 3.85, p<0.05), WRRS (OR 2.78, 95% CI 1.11 to 6.92, p<0.05), asthma (OR 3.40, 95% CI 1.49 to 7.81, p<0.01) and FE_NO>40 ppb (OR 2.00, 95% CI 1.03 to 3.88, p<0.05). No effect was seen for airflow obstruction. Symptomatic workers were more likely to have WRRS and asthma (OR 4.29, 95% CI 2.12 to 8.69, p<0.001) but not FE_NO>40 ppb or airflow obstruction. A dose-response effect with wood dust exposure was not seen.</p><p><strong>Conclusions: </strong>Asthma symptoms were prevalent among British woodworkers, even at low exposure levels. Atopy was associated with asthma, particularly among symptomatic woodworkers. Further studies should phenotype woodworkers at risk of asthma and inform approaches to reduce risk.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"527-533"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between combat injury, pain, mobility and post-service employment: the ADVANCE study.","authors":"Howard Burdett, Susie Schofield, Daniel Mark Dyball, Alexander Bennett, Christopher Boos, Anthony Bull, Nicola T Fear","doi":"10.1136/oemed-2025-110328","DOIUrl":"10.1136/oemed-2025-110328","url":null,"abstract":"<p><strong>Objectives: </strong>Over 600 UK Armed Forces personnel and civilians were seriously injured in the conflict in Afghanistan. We examined whether combat injury, and limb loss specifically, reduced the likelihood of employment after leaving the UK Armed Forces and to what extent this was mediated by pain and mobility.</p><p><strong>Methods: </strong>Combat-injured participants who were aeromedically evacuated to a UK hospital while on deployment to Afghanistan and subsequently left the UK Armed Forces (n=406) and a comparison group of uninjured personnel who had left the military (n=107) were drawn from an existing cohort (the ADVANCE study). Current employment was determined by self-report questionnaire, and pain and mobility mediating variables were taken from the EuroQol EQ-5D 5-Level measure.</p><p><strong>Results: </strong>21.2% of the injured group were not in paid employment, compared with 14.3% of the uninjured comparison group; this difference was not statistically significant. Unmediated analyses showed that although those with amputation injuries had an increased risk of being unemployed compared with the comparison group, this was not statistically significant. For those who were injured without limb loss, compared with the comparison group, there were indirect effects on employment through both mobility (adjusted risk ratio (aRR) 1.32, 95% CI 1.11 to 1.69) and pain (aRR 1.10, 95% CI 1.01 to 1.31).</p><p><strong>Conclusions: </strong>In this severely injured cohort, combat injury does not result in a significantly reduced rate of post-military employment. Any potential relationship between injury and employment for those injured without limb loss compared with the uninjured is due in part to the mediating effects of mobility and pain.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"521-526"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges with, and potential solutions for, mediation analyses.","authors":"Peter M Smith","doi":"10.1136/oemed-2025-110670","DOIUrl":"10.1136/oemed-2025-110670","url":null,"abstract":"","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"519-520"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of World Trade Center dust exposure on upper-aero digestive tract disorders and sinonasal surgery: findings from patients seen in the Department of Otolaryngology - Head and Neck Surgery at Mount Sinai Hospital.","authors":"Horacio M Romero Castillo, Alicia Yang, Kalena Liu, Madeleine Schaberg, Mathilda Monaghan, Maaike van Gerwen","doi":"10.1136/oemed-2025-110133","DOIUrl":"10.1136/oemed-2025-110133","url":null,"abstract":"<p><strong>Objective: </strong>We assessed upper-aero digestive tract disorders in World Trade Center (WTC) patients seen in the Otolaryngology - Head and Neck Surgery Department of a large New York City hospital system and the association between WTC exposure and sinonasal surgery for chronic rhinosinusitis (CRS).</p><p><strong>Methods: </strong>Retrospective review of medical records of all WTC patients seen between July 2002 and December 2023. Primary exposure was measured by arrival date and exposure length to the disaster site. Primary outcomes were upper-aero digestive tract disorders and sinonasal surgery.</p><p><strong>Results: </strong>3118 WTC patients were reviewed. Of these, 1162 (37.3%) had CRS. CRS patients were more likely female (p=0.03) and had higher proportion of comorbid obstructive sleep apnoea (OSA) (p<0.0001), allergic rhinitis (p<0.0001) and gastro-oesophageal reflux disease (p<0.0001). 355 (31.0%) CRS patients underwent sinonasal surgery. Relative to the medically managed patients, surgical CRS patients were younger at time of 9/11 (p=0.006), had a higher proportion of comorbid OSA (p=0.02) and earlier exposure (arrival date 11 September-13 September prior to rainfall) (p=0.001). CRS patients with early exposure demonstrated significantly greater odds of undergoing sinonasal surgery compared with those with late exposure (adjusted OR 1.61; 95% CI 1.2 to 2.3).</p><p><strong>Conclusions: </strong>Earlier arrival at WTC site increased the risk of needing surgery for responders with CRS. Higher levels of irritant exposure prior to rainfall on 14 September 2001 may have caused significant epithelial injury to the sinonasal mucosa of WTC patients, leading to an elevated prevalence of CRS requiring surgical intervention.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"534-539"},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021.","authors":"Dario Consonni, Enrica Migliore, Manuela Gangemi, Domenica Cavone, Luigi Vimercati, Sara Piro, Lucia Giovannetti, Valentina Zabeo, Vera Comiati, Stefania Curti, Stefano Mattioli, Maria Teresa Landi, Carmela Gioscia, Silvia Eccher, Stefano Murano, Flavia D'Agostin, Carlo Genova, Riccardo Perduri, Iolanda Grappasonni, Fabrizio Stracci, Ilaria Cozzi, Tommaso Staniscia, Franco Calista, Italo Francesco Angelillo, Rocco Galasso, Federico Tallarigo, Giuseppe Cascone, Massimo Melis, Susan Peters, Hans Kromhout, Alessandra Binazzi, Alessandro Marinaccio, Carolina Mensi","doi":"10.1136/oemed-2025-110414","DOIUrl":"10.1136/oemed-2025-110414","url":null,"abstract":"<p><strong>Objectives: </strong>Using a case-control design, we examined the association between occupational asbestos exposure and risk of peritoneal mesothelioma in the general population in Italy.</p><p><strong>Methods: </strong>From the National Mesothelioma Registry, we selected cases (2000-2021) with life-time occupational history. Controls were 3045 from three case-control studies (region-sex-age-matched, performed in six regions), one in 2002-2004 (2116 population controls) and two in 2012-2016 (718 population and 211 hospital controls). For all subjects, exposure assignment was based on a quantitative job-exposure matrix (SYN-JEM). Qualitative expert-based evaluation was available for all cases, but only in 2012-2016 for 929 controls. We estimated ORs and 90% CIs using logistic regression models adjusted for residence, gender, period and age.</p><p><strong>Results: </strong>In complete analyses (1591 cases, all years/regions), the OR for ever exposure was 3.66 (CI 3.21 to 4.18, 45.4% cases and 27.8% controls exposed). Among the exposed, median cumulative exposure (fibres/mL-years) was 1.4 (max 20.0) in cases and 1.1 (max 10.9) in controls. The OR was 1.55 (1.48 to 1.62) per log₁₀-transformed cumulative exposure. In analyses restricted to 290 cases (same years/regions of controls), ORs were 3.35 (2.57 to 4.37, 43.8% cases exposed) for ever exposure and 1.52 (1.39 to 1.65) for cumulative exposure. ORs for ever asbestos exposure using expert-based evaluation were particularly high, 4.32 (3.50 to 5.34, 53.9% cases and 26.4% controls exposed) in complete analyses (778 cases) and 6.35 (4.58 to 8.81, 57.1% cases exposed) in restricted analyses (245 cases), but are known to be more prone to bias.</p><p><strong>Conclusions: </strong>Peritoneal mesothelioma showed clear associations with asbestos exposure using different exposure assessment methods.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"495-503"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational risk assessment: lessons from the MSHA Silica Rule.","authors":"Ellen A Eisen, Sadie Costello, Gregory Wagner","doi":"10.1136/oemed-2025-110557","DOIUrl":"10.1136/oemed-2025-110557","url":null,"abstract":"","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"467-468"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between maternal occupation as a cleaner/maid/janitor during early pregnancy and selected birth defects in the National Birth Defects Prevention Study.","authors":"Yining Yang, Michele L Herdt, Akiko S Hosler, Tania A Desrosiers, Meredith M Howley","doi":"10.1136/oemed-2025-110511","DOIUrl":"10.1136/oemed-2025-110511","url":null,"abstract":"<p><strong>Objectives: </strong>Cleaning work involves potential exposures to physical, chemical, biological and psychosocial hazards, which might increase the risk of birth defects. Yet, there is limited research focused on maternal occupation in cleaning jobs and the risk of birth defects. We investigated the association between maternal occupation in cleaning-related jobs during early pregnancy and selected birth defects in the National Birth Defects Prevention Study, a case-control study from 1997 to 2011.</p><p><strong>Methods: </strong>Mothers self-reported job details, which were classified by occupational epidemiologists into cleaner or non-cleaner occupations. Cases were live births or stillbirths with at least one of 19 eligible birth defects ascertained from state surveillance systems, while controls were randomly selected live births without structural defects. We estimated adjusted ORs with 95% CIs from multivariable logistic regression for associations between maternal cleaning occupations and birth defects, controlling for eight covariates identified a priori.</p><p><strong>Results: </strong>Of the 28 936 mothers, 1109 (868 cases/241 controls) were assigned a primary occupational code as a cleaner during early pregnancy. In total, 9 of the 19 included birth defects had elevated ORs (>1.5), ranging from 1.58 for anophthalmia/microphthalmia to 2.65 for oesophageal atresia/stenosis; six had CIs that excluded the null (anencephaly, glaucoma, anotia/microtia, cleft lip and palate, oesophageal atresia/stenosis, small intestinal atresia/stenosis).</p><p><strong>Conclusions: </strong>We observed that maternal occupation in cleaning-related jobs was associated with several specific birth defects in various body systems. Future studies should explore specific chemical and physical exposures under these cleaning occupations and the association with birth defects.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"504-511"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose occupational ionising radiation exposure and gastrointestinal cancer mortality among US radiologic technologists, 1983-2021.","authors":"Jim Z Mai, Raquel Velazquez-Kronen, Martha S Linet, Jo L Freudenheim, Jean Wactawski-Wende, Taeeun Kwon, Choonsik Lee, Dale L Preston, Bruce H Alexander, Elizabeth K Cahoon, Cari M Kitahara","doi":"10.1136/oemed-2025-110223","DOIUrl":"10.1136/oemed-2025-110223","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the relationship between cumulative occupational ionising radiation exposure and gastrointestinal cancer mortality in a cohort of US radiologic technologists (USRT).</p><p><strong>Methods: </strong>Among 106 072 USRT cohort participants who were cancer-free at completion of the baseline questionnaire (1983-1998, representing completion of the first (1983-1989) or second questionnaire (1994-1998) as baseline), protracted low- to moderate-dose occupational ionising radiation exposure was evaluated in relation to gastrointestinal cancer mortality over the follow-up period (through 2021). Poisson regression was used to calculate linear excess relative rates (ERR) of gastrointestinal cancer mortality per 100 mGy colon-absorbed dose (mean=15 mGy; range 0-754 mGy), lagged 10 years, adjusting the baseline mortality rate for attained age, sex, birth cohort, race and other potential confounders (alcohol consumption, smoking, body mass index, non-steroidal anti-inflammatory drug (NSAID) use).</p><p><strong>Results: </strong>Over follow-up (mean=31.4 years), 570 pancreatic, 504 colon, 171 liver, 131 oesophageal, 106 stomach and 73 rectal cancer deaths were identified. In the full cohort, no significant dose-response relationships were observed for pancreatic, colon, liver, oesophageal or rectal cancer mortality. A non-significant positive association for stomach cancer mortality was observed in a model minimally adjusted for attained age, sex and birth cohort; however, this association was attenuated after additionally adjusting for race and NSAID use (ERR/100mGy=1.56; 95% CI <0 to 159). Evidence for effect modification for stomach cancer mortality was observed by birth year (<i>P</i>-interaction=0.002) and year first worked (0.004), although based on small number of deaths, most positive associations within categories were not statistically significant.</p><p><strong>Conclusions: </strong>In this nationwide cohort of radiologic technologists, cumulative occupational ionising radiation exposure was not clearly associated with mortality from specific gastrointestinal cancers. Studies with cancer incidence follow-up and pooled analyses of ionising radiation-exposed populations may provide more comprehensive and robust dose-response estimates for specific gastrointestinal cancers.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"485-493"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrazine use and markers of kidney function and nephrotoxicity among male farmers in the Biomarkers of Exposure and Effect in Agriculture Study.","authors":"Gabriella Andreotti, Joseph J Shearer, Dale P Sandler, Anna M Lukkari, Richard V Remigio, Christine G Parks, Vicky C Chang, Venkata Sabbisetti, Laura E Beane Freeman, Amy B Karger, Jonathan N Hofmann","doi":"10.1136/oemed-2025-110386","DOIUrl":"10.1136/oemed-2025-110386","url":null,"abstract":"<p><strong>Objective: </strong>Atrazine, an herbicide widely used in US agriculture, has been associated with kidney cancer and non-malignant kidney disease. However, the potential mechanisms underlying these associations remain unclear. We evaluated atrazine use and biomarkers of kidney function and nephrotoxicity among male farmers in the Biomarkers of Exposure and Effect in Agriculture Study.</p><p><strong>Methods: </strong>Our investigation included three groups of farmers defined based on atrazine use: (1) both recent (last 3 months) and past use (continuous users; n=83); (2) high lifetime use (≥178.5 lifetime days) but no recent use (former high users; n=88) and (3) never/low lifetime use (<50 lifetime days) and no recent use (never/low users; n=75). Biomarkers were measured in serum (creatinine, cystatin C, urea nitrogen, uric acid) and urine (kidney injury molecule-1 (KIM-1), albumin, creatinine). The 2021 CKD-EPI creatinine-cystatin C equation was used to calculate estimated glomerular filtration rate (eGFRcr-cys). We estimated the percentage difference (95% CI) in each marker across groups using multivariable linear regression.</p><p><strong>Results: </strong>Compared with farmers with never/low atrazine use, continuous users had statistically significantly lower eGFRcr-cys (-9.4%; 95% CI -16.1% to -2.2%) and higher serum creatinine (9.4%; 95% CI: 1.6% to 17.9%) and cystatin C (10.8%; 95% CI 2.0% to 20.4%); no associations with these markers were observed for the former high users. We also observed higher uric acid for both former high and continuous users and lower urea nitrogen for former high users, although these associations were not statistically significant. Urine albumin-creatinine ratio and KIM-1 levels did not differ across groups.</p><p><strong>Conclusions: </strong>Our findings add to the evidence that continued atrazine use is associated with diminished kidney function.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"469-475"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12767703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cause-specific mortality among banana plantation workers in the French West Indies.","authors":"Danièle Luce, Juliette Gambaretti, Léah Michineau, Luc Multigner, Christine Barul","doi":"10.1136/oemed-2025-110304","DOIUrl":"10.1136/oemed-2025-110304","url":null,"abstract":"<p><strong>Objective: </strong>To describe cause-specific mortality patterns of banana plantation workers in the French West Indies.</p><p><strong>Methods: </strong>The study included 11 221 farmers and farm workers who had work in banana cultivation in the French West Indies (Guadeloupe or Martinique) between 1973 and 1993, followed up from January 1981 to December 2017. We calculated standardised mortality ratios (SMRs), causal mortality ratios (CMRs) and relative standardised mortality ratios (rSMRs) using regional reference rates.</p><p><strong>Results: </strong>SMR analyses showed mortality deficits in the overall mortality and for almost all causes of deaths. In contrast, analyses using CMRs revealed a significant excess in the overall mortality. The CMRs were significantly elevated for all cancers combined and for stomach cancer, colorectal cancer, prostate cancer and haematopoietic malignancies, as well as for several non-cancer causes of death, including diabetes mellitus, Parkinson's disease, Alzheimer's disease, non-ischaemic heart diseases, pneumonia and diseases of the skin and subcutaneous tissue. rSMRs were in general consistent with CMRs with regards to the direction of the association, although rSMRs were lower and in some instances not statistically significant.</p><p><strong>Conclusion: </strong>The CMR approach showed an elevated mortality for several causes of death, for which work in banana farming and/or exposure to pesticides are plausible explanations.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"512-518"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}