Occupational and Environmental Medicine最新文献

{"title":"Magnetic fields from indoor transformer stations and risk of cancer in adults: a cohort study.","authors":"Jukka Juutilainen, Muhammad Waseem Khan, Jonne Naarala, Päivi Roivainen","doi":"10.1136/oemed-2024-109466","DOIUrl":"10.1136/oemed-2024-109466","url":null,"abstract":"<p><strong>Objectives: </strong>Studies assessing the association of adult cancers with extremely low frequency (ELF) magnetic fields (MF) have provided inconclusive results, probably affected by limitations such as low exposure levels, confounding and various forms of bias. This study investigated the association between residential ELF MF exposure and adult cancer using a design that avoids the main limitations of previous studies.</p><p><strong>Methods: </strong>Persons who have lived in buildings with indoor transformer stations during the period 1971-2016 formed the study cohort. Their MF exposure was assessed based on the location of their apartment in relation to the transformer room. Information on their cancer diagnoses was obtained from the Finnish Cancer Registry. SIR with 95% CI was calculated to investigate the association of MF exposure with overall cancer and specific cancers.</p><p><strong>Results: </strong>The SIR for all primary sites was 1.01 (95% CI 0.93 to 1.09). An increased risk of digestive organ cancers was observed among the exposed persons, with a SIR of 1.23 (95% CI 1.03 to 1.46). The highest SIR was observed for gallbladder cancer (3.92, 95% CI 1.44 to 8.69). Increased risk of testicular cancer was observed among men exposed to MF during childhood, but this is likely to be due to confounding associated with living on the lowest floors. No other significant associations were observed for other primary cancer sites studied.</p><p><strong>Conclusions: </strong>Overall cancer risk was not affected by residential MF exposure. The increased risk of digestive organ cancers among MF-exposed persons is a novel finding requiring confirmation in further studies.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"574-579"},"PeriodicalIF":3.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668325","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":"Mediating effect of working conditions on the association between education and early labour market exit: a cohort study of Swedish men.","authors":"Emma Carlsson, Tomas Hemmingsson, Melody Almroth, Daniel Falkstedt, Katarina Kjellberg, Emelie Thern","doi":"10.1136/oemed-2024-109594","DOIUrl":"10.1136/oemed-2024-109594","url":null,"abstract":"<p><strong>Objectives: </strong>It is not fully known what explains educational inequalities in early labour market exits. This study aims to examine the mediating effect of exposure to unfavourable working conditions, measured by low job control and high physical workload, on the association between education and early labour market exit among men.</p><p><strong>Methods: </strong>This register-based study included all men born 1951-1953, who underwent Swedish military conscription in late adolescence and had a registered educational level in 2005 (n=115 998). These men were followed from ages 53-55 to 64 regarding early labour market exit (disability pension, long-term sickness absence, long-term unemployment, early old-age retirement with and without income). Mediation analysis was used to examine the role of job control and physical workload in explaining the educational differences in early exit. Factors measured in childhood and late adolescence were included as confounders.</p><p><strong>Results: </strong>The proportion mediated by job control was around 17% and for physical workload around 22% for the least educated men for exit through disability pension, long-term sickness absence and long-term unemployment. For early old-age retirement with and without income, working conditions were not mediating factors, except for job control mediating up to 18% for exit through early old-age retirement with income.</p><p><strong>Conclusions: </strong>Job control and physical workload seem to be important factors explaining the educational differences in most early exit routes, also after accounting for early life factors. These results indicate the importance of improving working conditions to decrease inequalities in early labour market exit and prolong working life.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"547-555"},"PeriodicalIF":3.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716659","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":"Military and occupational exposures among Veterans in the Million Veteran Program by survey self-report: a descriptive study.","authors":"Joanne E Sordillo, Andrew Dey, Yuk-Lam Ho, Nicole Kosik, Kelly Harrington, Lauren Costa, Sumitra Muralidhar, Elizabeth Hauser, John Michael Gaziano, Kelly Cho, Stacey Whitbourne","doi":"10.1136/oemed-2024-109544","DOIUrl":"10.1136/oemed-2024-109544","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to characterise self-reported military and occupational exposures including Agent Orange, chemical/biological warfare agents, solvents, fuels, pesticides, metals and burn pits among Veterans in the Department of Veterans Affairs Million Veteran Program (MVP).</p><p><strong>Methods: </strong>MVP is an ongoing longitudinal cohort and mega-biobank of over one million US Veterans. Over 500 000 MVP participants reported military exposures on the baseline survey, and over 300 000 reported occupational exposures on the lifestyle survey. We determined frequencies of selected self-reported occupational exposures by service era, specific deployment operation (1990-1991 Gulf War, Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF)), service in a combat zone and occupational categories. We also explored differences in self-reported exposures by sex and race.</p><p><strong>Results: </strong>Agent Orange exposure was mainly reported by Vietnam-era Veterans. Gulf War and OEF/OIF Veterans deployed to a combat zone were more likely to report exposures to burn pits, chemical/biological weapons, anthrax vaccination and pyridostigmine bromide pill intake as compared with non-combat deployers and those not deployed. Occupational categories related to combat (infantry, combat engineer and helicopter pilot) often had the highest percentages of self-reported exposures, whereas those in healthcare-related occupations (dentists, physicians and occupational therapists) tended to report exposures much less often. Self-reported exposures also varied by race and sex.</p><p><strong>Conclusions: </strong>Our results demonstrate that the distribution of self-reported exposures varied by service era, demographics, deployment, combat experience and military occupation in MVP. Overall, the pattern of findings was consistent with previous population-based studies of US military Veterans.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"522-528"},"PeriodicalIF":3.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351083","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":"Career duration and later-life health conditions among former professional American-style football players.","authors":"Rachel Grashow, Can Ozan Tan, Julius Dewayne Thomas, Heather DiGregorio, Hang Lee, Ran S Rotem, Dean Marengi, Douglas P Terry, Shawn R Eagle, Grant L Iverson, Alicia J Whittington, Ross D Zafonte, Marc G Weisskopf, Aaron L Baggish","doi":"10.1136/oemed-2024-109571","DOIUrl":"10.1136/oemed-2024-109571","url":null,"abstract":"<p><strong>Objectives: </strong>Career duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.</p><p><strong>Methods: </strong>We conducted a survey-based cross-sectional cohort study of former professional ASF players. Flexible regression methods measured associations between self-reported career duration and four self-reported health conditions: pain, arthritis, mood and cognitive symptoms. We also measured associations between career duration and four self-reported ASF exposures: prior concussion signs and symptoms (CSS), performance enhancing drugs, intracareer surgeries and average snaps per game. Models were adjusted for age and race.</p><p><strong>Results: </strong>Among 4189 former players (52±14 years of age, 39% black, 34% lineman position), the average career length was 6.7±3.9 professional seasons (range=1-20+). We observed inverted U-shaped relationships between career duration and outcomes (all p<0.001), indicating that adverse health effects were more common among men with intermediate career durations than those with shorter or longer careers. Similar findings were observed for play-related exposures (eg, CSS and snaps).</p><p><strong>Conclusions: </strong>Relationships between ASF career duration and subsequent health status are non-linear. Attenuation of the associations among longer career players may reflect selection effects and suggest career length may serve as a poor proxy for true causal factors. Findings highlight the need for cautious use of career duration as a proxy exposure metric in studies of former athletes.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"498-506"},"PeriodicalIF":3.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471224","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":"Risk of opioid-related harms by occupation within a large cohort of formerly injured workers in Ontario, Canada: findings from the Occupational Disease Surveillance System.","authors":"Nancy Carnide, Jeavana Sritharan, Chaojie Song, Fateme Kooshki, Paul A Demers","doi":"10.1136/oemed-2024-109458","DOIUrl":"10.1136/oemed-2024-109458","url":null,"abstract":"<p><strong>Objective: </strong>Working-age individuals have been disproportionately affected by the opioid crisis, prompting interest in the potential role of occupation as a contributor. This study aimed to estimate the risk of opioid-related poisonings and mental and behavioural disorders by occupation and industry within a cohort of 1.7 million formerly injured workers.</p><p><strong>Methods: </strong>Workers were identified in the Occupational Disease Surveillance System, a system linking workers' compensation data (1983-2019) to emergency department and hospitalisation records (2006-2020) in Ontario, Canada. Cox proportional hazards models were used to estimate HRs and 95% CIs for hospital encounters for opioid-related poisonings and mental and behavioural disorders by occupation and industry compared with all other workers, adjusted for age, sex and birth year.</p><p><strong>Results: </strong>In total, 13 702 opioid-related poisoning (p) events (n=10 064 workers) and 19 629 opioid-related mental and behavioural (mb) disorder events (n=11 755 workers) were observed. Elevated risks were identified among workers in forestry and logging (HR_p=1.45, 95% CI 1.09 to 1.94; HR_mb=1.70, 95% CI 1.34 to 2.16); processing (minerals, metals, clay, chemical) (HR_p=1.27, 95% CI 1.14 to 1.42; HR_mb=1.26, 95% CI 1.14 to 1.39); processing (food, wood, textile) (HR_p=1.12, 95% CI 1.01 to 1.24; HR_mb=1.19, 95% CI 1.09 to 1.31); machining (HR_p=1.13, 95% CI 1.04 to 1.21; HR_mb=1.17, 95% CI 1.09 to 1.25); construction trades (HR_p=1.57, 95% CI 1.48 to 1.67; HR_mb=1.59, 95% CI 1.51 to 1.68); materials handling (HR_p=1.32, 95% CI 1.22 to 1.43; HR_mb=1.22, 95% CI 1.13 to 1.31); mining and quarrying (HR_mb=1.68, 95% CI 1.34 to 2.11); and transport equipment operating occupations (HR_p=1.18, 95% CI 1.09 to 1.27). Elevated risks were observed among select workers in service, sales, clerical and health. Findings by industry were similar.</p><p><strong>Conclusions: </strong>Results provide additional evidence that opioid-related harms cluster among certain occupational groups. Findings can be used to strategically target prevention and harm reduction activities in the workplace.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"507-514"},"PeriodicalIF":3.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471225","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":"Excess potential years of working life lost in six countries from Latin America and Europe in 2020 and 2021.","authors":"Michael Silva-Peñaherrera, Fernando G Benavides","doi":"10.1136/oemed-2023-109406","DOIUrl":"10.1136/oemed-2023-109406","url":null,"abstract":"<p><strong>Objective: </strong>This descriptive study aimed to measure the excess all-cause mortality potential years of working life lost (PYWLL) in the working-age population of six Ibero-American countries in 2020 and 2021.</p><p><strong>Methods: </strong>This study was based on all-cause deaths for the age group 15-69 years for men and women in six countries: Colombia, Costa Rica, México, Peru, Portugal and Spain. The expected PYWLL was the average value determined from the previous 5 years (2015-2019). To estimate the excess of PYWLL, the expected PYWLL was subtracted from the observed PYWLL values for 2020 and 2021, separately.</p><p><strong>Results: </strong>In the four Latin American countries, the excess PYWLL per death was approximately double (between 12 and 16 years) that of the two European countries (between 3 and 9 years).</p><p><strong>Conclusions: </strong>The loss of working-age individuals will probably have a profound social and economic recovery impact, affecting families and communities. The informal employment and labour market structures may be contributing to the adverse effects of the pandemic in the region. Investing in universal, comprehensive and sustainable health and social protection systems in the Latin American countries is crucial to build resilience against current and future crises.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"532-534"},"PeriodicalIF":3.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392203","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":"Impact of work pace on cardiorespiratory outcomes, perceived effort and carried load in industrial workers: a randomised cross-over trial.","authors":"Sasha Javanmardi, Ludwig Rappelt, Lars Heinke, Daniel Niederer, Janis Alexander Zemke, Jürgen Freiwald, Christian Baumgart","doi":"10.1136/oemed-2024-109563","DOIUrl":"10.1136/oemed-2024-109563","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the impact of different work paces on cardiorespiratory outcomes, perceived effort and carried load (CL) in industrial workers.</p><p><strong>Methods: </strong>A randomised cross-over trial was conducted at a mid-sized steel company. We included 12 healthy industrial workers (8 females, age: mean 44±SD 9 years, height: 1.70±0.08 m, body mass: 79.5±13.4 kg) with at least 6 months of working experience. All participants performed 5 min of piece work at 100% (P100), 115% (P115) and 130% (P130) of the company's internal target yielded in a randomised order, separated by 5 min familiarisation breaks. The primary outcome was energy expenditure (EE), calculated from a respiratory gas exchange using a metabolic analyser. Secondary outcomes were total ventilation, oxygen uptake, carbon dioxide release, respiratory exchange ratio, heart rate and rating of perceived effort (0-10). Furthermore, the metabolic equivalent and the CL were calculated. Data were analysed with repeated measure analyses of variance.</p><p><strong>Results: </strong>For EE, a large 'pace' effect with a small difference between P100 and P130 (165.9±33.4 vs 178.8±40.1 kcal/hour^-1, p=0.008, standard mean difference, SMD=0.35) was revealed. Additionally, a large difference in CL between all paces (p<0.001, SMD≥1.10) was revealed. No adverse events occurred.</p><p><strong>Conclusions: </strong>Cardiorespiratory outcomes rise with increased work pace, but the practical relevance of these differences still needs to be specified. However, the CL will add up over time and may impact musculoskeletal health in the long term.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"456-461"},"PeriodicalIF":3.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292386","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":"Mortality follow-up of Fernald Feed Materials Production Center workers exposed to uranium from 1951 to 1985.","authors":"Cato M Milder, Michael B Bellamy, Sara C Howard, Elizabeth D Ellis, Ashley P Golden, Sarah S Cohen, Michael T Mumma, Benjamin French, Lydia B Zablotska, John D Boice","doi":"10.1136/oemed-2023-109192","DOIUrl":"10.1136/oemed-2023-109192","url":null,"abstract":"<p><strong>Objective: </strong>This follow-up study of uranium processing workers at the Fernald Feed Materials Production Center examines the relationship between radiation exposure and cancer and non-cancer mortality among 6403 workers employed for at least 30 days between 1951 and 1985.</p><p><strong>Methods: </strong>We estimated cumulative, individual, annualised doses to 15 organs/tissues from external, internal and radon exposures. Vital status and cause of death were ascertained in 2017. The analysis employed standardised mortality ratios, Cox proportional hazards and Poisson regression models. Competing risk analysis was conducted for cardiovascular disease (CVD) mortality risk given several assumptions about risk independent of competing outcomes. Emphysema was examined to assess the potential for confounding by smoking.</p><p><strong>Results: </strong>Vital status was confirmed for 98.1% of workers, with 65.1% deceased. All-cause mortality was less than expected in salaried but not hourly workers when compared with the US population. A statistically significant dose response was observed between external (but not total or internal) lung dose and lung cancer mortality (HR at 100 mGy adjusted for internal dose=1.45; 95% CI=1.05 to 2.01). Significantly increased HRs at 100 mGy dose to heart were observed for CVD (1.27; 95% CI=1.07 to 1.50) and ischaemic heart disease (1.30; 95% CI=1.07 to 1.58). CVD risk remained elevated regardless of competing risk assumptions. Both external and internal radiation were associated with emphysema.</p><p><strong>Conclusions: </strong>Lung cancer was associated with external dose, though positive dose responses for emphysema imply residual confounding by smoking. Novel use of competing risk analysis for CVD demonstrates leveraging retrospective data for future risk prediction.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"439-447"},"PeriodicalIF":3.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988481","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":"Maryland opioid overdose deaths from 2018 to 2022: occupational patterns and their sociodemographic variations.","authors":"Masoumeh Amin-Esmaeili, Ryoko Susukida, Himani Byregowda, Zhiqing E Zhou, Clifford S Mitchell, Renee M Johnson","doi":"10.1136/oemed-2024-109536","DOIUrl":"10.1136/oemed-2024-109536","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to describe the occupational pattern of opioid overdose deaths in Maryland between 2018 and 2022 and determine the occupations at higher risk of opioid overdose death.</p><p><strong>Methods: </strong>The sample included undetermined or unintentional opioid overdose deaths among those aged 16 years or older in Maryland, drawn from the State Unintentional Drug Overdose Reporting System. We calculated population-based incidence overdose rates by occupation, stratified by sex and race. We further calculated the incidence rate ratios (IRRs) comparing each occupation with all other groups combined and estimated the IRRs among males versus females and non-Hispanic whites versus other racial/ethnic groups.</p><p><strong>Results: </strong>The pooled sample included 11 455 opioid overdose decedents (72% male and 55% non-Hispanic whites) of whom 80% were employed. The three occupation groups with the highest incidence rates were 'construction and extraction', 'transportation and material moving' and 'installation/maintenance and repair' with 291, 137 and 133 deaths per 100 000 workers in these respective occupational groups. Incidence rates were significantly higher in males than females in all categories except those 'Not in Labour Force' (IRR=0.51, p<0.001). Non-Hispanic whites relative to other racial/ethnic groups had a lower incidence of opioid overdose death in 'Military-Specific' occupations (IRR=0.53, p=0.031).</p><p><strong>Conclusion: </strong>Opioid overdose deaths vary by type of occupation and certain occupations are at higher risk of overdose death. The findings highlight the need for priority setting in the implementation and expansion of existing strategies to target the workers most impacted by opioid overdose.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"462-470"},"PeriodicalIF":3.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351082","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":"Sarin exposure, mortality and cancer incidence in UK military veterans involved in human experiments at Porton Down: 52-year follow-up.","authors":"Gemma Archer, Thomas Keegan, Simon Wessely, Katherine M Venables, Nicola T Fear","doi":"10.1136/oemed-2024-109525","DOIUrl":"10.1136/oemed-2024-109525","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated whether UK military personnel exposed to sarin during the 'Service Volunteer Programme' at Porton Down had increased rates of mortality or cancer incidence over a 52-year follow-up.</p><p><strong>Methods: </strong>A historical cohort study assembled from UK military records, comprising male veterans exposed to sarin during the 'Service Volunteer Programme' at Porton Down, UK (n=2975) and a comparison group of similar veterans who did not attend (n=2919). Mortality and cancer incidence data were obtained from national registries up to December 2019. Analysis was conducted using Cox regression adjusted for age, year of birth and service characteristics.</p><p><strong>Results: </strong>Over a median follow-up of 52.2 years (range 2 days to 74.6 years), 1598 (53.7%) sarin-exposed veterans and 1583 (54.3%) non-exposed veterans died. Adjusted HRs for all-cause mortality were raised for any sarin exposure (HR=1.08, 95% CI 1.01 to 1.16), two or more exposures (HR=1.25, 95% CI 1.04 to 1.49) and higher doses (air >15 mg.min/m³) (HR=1.15, 95% CI 1.02 to 1.30). For cause-specific mortality, sarin exposure was associated with deaths from 'other' circulatory diseases (excludes ischaemic and cerebrovascular diseases) (HR=1.41, 95% CI 1.06 to 1.87) and alcohol-attributable deaths (HR=2.66, 95% CI 1.40 to 5.07). There was no association between sarin exposure and overall cancer incidence (HR=1.01, 95% CI 0.93 to 1.10), but cancer incidence was higher for alcohol-related neoplasms (HR=1.24, 95% CI 1.01 to 1.51).</p><p><strong>Conclusions: </strong>Sarin exposure was associated with increased rates of mortality over a 50-year follow-up. The strongest associations were observed for deaths attributable to alcohol and 'other' circulatory diseases.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"480-488"},"PeriodicalIF":3.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351085","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}