Karl-Christian Karlsen Nordby

• Turner, Michelle C; Pronk, Anjoeka; Bouziri, Hanifa; Bültmann, Ute; Falkstedt, Daniel & Garde, Anne Helene [Show all 26 contributors for this article] (2026). Cohort Profile: The European Occupational Exposome Mega Cohort Consortium (OMega-X). International Journal of Epidemiology. ISSN 0300-5771. 55(5). doi: 10.1093/ije/dyag151. Full text in Research Archive Show summary

  The European Occupational Exposome Mega Cohort Consortium (OMega-X) was established as a long-term resource to support large-scale coordinated cohort analysis to advance knowledge regarding the health impacts of complex working-life exposures. Twenty-four cohorts based in eight European countries, as well as multi-country studies, containing >20 million participants, currently form the Consortium. · Industrial/occupational and population-based cohorts range in size from a few hundred to thousands of workers; large-scale register-based general-population cohorts comprise millions of workers. Most cohorts were established and followed participants since the year 2000; some follow workers from the 1950s to the 1990s. Job-history data primarily capture the working lifetime or follow-up period. The Consortium is supported by online inventories and tools. The European job-exposure matrix (EuroJEM) provides harmonized exposure assessment information by job code for airborne infectious agents, chemical and particle exposures, heat stress, noise, physical workload, precarious employment, psychosocial exposures, and solar ultraviolet radiation. Analyses have to date examined a broad range of occupational exposures in relation to cancer; cardiometabolic, musculoskeletal, neurodegenerative, and respiratory diseases; mental disorders; and work-participation outcomes. · Application procedures for researchers to propose a new analysis or for new cohorts to join the Consortium are available.

• Leite, Mimmi; Larsson, Per; Kokelj, Spela; Nordby, Karl-Christian; Alfonso, Jose Hernan & Koca, Hatice [Show all 9 contributors for this article] (2025). Phospholipid composition in small airway lining fluid among tunnel construction workers exposed to respirable crystalline silica. Lipids in Health and Disease. 24(1). doi: 10.1186/s12944-025-02790-5. Full text in Research Archive Show summary

  Objective: To explore if the phospholipid composition in the small airway lining fluid differed between a group of tunnel construction workers exposed to respirable crystalline silica (RCS) and a reference group. Methods: In total, 19 healthy, non-smoking workers under exposure to RCS and 21 unexposed referents from the same construction site were included. The participants underwent a health examination including lung function measurements and collection of exhaled particles (PEx) using the Particles in exhaled air (PExA) method. Analysis of PEx included determination of lipids. In total, 95 lipid species, primarily phospholipids, were determined. Non-parametric analyses (Wilcoxon rank-sum test and quantile regression), principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were used for data analysis. Results: A difference in mol% of phospholipids between the RCS exposed tunnel construction workers and unexposed referents was observed. On lipid class level there was a higher mol% of sphingomyelin (SM) species among exposed workers compared to referents. Regarding single phospholipid species, higher mol % of phosphatidylcholine (PC) and phosphatidylglycerol (PG) species containing diacyl chains with 18:2 (linoleic acid) and 20:4 (arachidonic acid) fatty acid components were observed in the exposed group. Additionally, lower mol% of saturated PC species were observed among the exposed. Conclusions: Differences in phospholipid composition in the small airway lining fluid between workers exposed to RCS and a reference group were observed. This indicates a possible impact of RCS exposure on phospholipids in the small airways. However, whether these are linked to health effects is currently not known.

• Moen, Line Victoria; Lie, Jenny-Anne Sigstad; Sterud, Tom; Christensen, Jan Olav; Haugen, Fred & Skogstad, Marit [Show all 8 contributors for this article] (2025). Association of non-standard working time arrangements with safety incidents: a systematic review. BMJ Open. 15(9). doi: 10.1136/bmjopen-2025-100931. Full text in Research Archive Show summary

  Objective: To systematically review the evidence on the association between non-standard working time arrangements (such as night work or shift work) and the occurrence of safety incidents. Design: Systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using a structured narrative approach and the Synthesis Without Meta-analysis framework to evaluate and summarise findings. Data sources: MEDLINE, Embase, PsycINFO, Web of Science and ProQuest Health and Safety Science Abstracts were searched through February 2024. Eligibility criteria for selecting studies We included peer-reviewed English-language studies of paid workers (18–70 years) that examined the association between non-standard working time arrangements and safety incidents (accidents, near-accidents, safety incidents or injuries), excluding cross-sectional designs and studies on unpaid workers, athletes or military personnel. Data extraction and synthesis: Two reviewers independently extracted data and assessed risk of bias using standardised forms, extracting study characteristics (author, year, country, sector and population), working time arrangements and exposure assessment, outcomes and their assessment, and reported risk estimates. We conducted a narrative synthesis, classifying studies into three exposure contrasts (shift worker versus non-shift worker, time-of-day and shift intensity), and summarised risk estimates using forest plots without calculating pooled effects. Results: A total of 13 569 records were screened, and 24 studies met the inclusion criteria. The results indicated that shift workers generally had an elevated safety incident risk compared with non-shift workers (risk estimates ranged from 1.11 to 5.33). Most of the included studies found an increased risk of safety incidents during or after night shifts. Accumulated exposure to evening or night shifts increased the risk of safety incidents during the following 7 days. However, bias and heterogeneity across studies in design, populations and outcome measures resulted in an overall low to very low certainty of the evidence. Conclusions: Non-standard working time arrangements, including night and evening shifts, appear to increase the risk of occupational safety incidents. Despite the low certainty of evidence, the findings highlight a potential area for preventive measures in work scheduling. Future longitudinal studies using individual data on daily working hours are needed.

• Straumfors, Anne; Haugen, Fred; Skare, Øivind; Wijnand, Eduard; Henneberger, Paul K & Douwes, Jeroen [Show all 8 contributors for this article] (2025). Immune modulating effects of continuous bioaerosol and terpene exposure over three years among sawmill workers in Norway. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 51(5), p. 433–443. doi: 10.5271/sjweh.4240. Full text in Research Archive Show summary

  OBJECTIVES: Exposure to wood dust, resin acids, microbial and volatile components among sawmill workers may impair respiratory health, with inflammation indicated as a key mechanism. Previous, mostly cross-sectional studies have shown mixed results, and a conclusive association between wood dust exposure and chronic respiratory inflammation has therefore not yet been established. This study assessed associations between exposure to bioaerosols and volatile terpenes and serum inflammatory marker levels over three years. METHODS: Serum biomarkers and blood cell counts were analyzed based on 702 observations from 450 exposed sawmill workers and 102 observations from 65 unexposed sawmill workers in Norway at baseline and after three years. Job-exposure-matrices, based on measurements among the same cohort, were used to assess exposures for wood dust, endotoxins, resin acid, monoterpenes, fungal spores, and fungal fragments. Changes in exposures, biomarkers and cell counts over the study period, as well as group differences and potential cause-and-effect associations were assessed using linear mixed regression. RESULTS: Exposures were relatively low and below occupational limits, although variances were relatively high (GSD tot 2.1–8.3), largely driven by differences between workers (GSD bw 1.9–7.8). Serum CC-16 and mCRP were slightly higher after three years, whereas IL-1β, TNF-α and IL-10 levels were significantly lower among exposed compared with unexposed workers. Exposures positively associated with increases in biomarker levels included endotoxin with mCRP, monoterpenes with IL-10, and fungal spores with TNF-α and IL-8. Exposed workers had higher counts of total leucocytes, neutrophils, lymphocytes and basophils after three years. Several of the increased leucocyte counts were associated with concurrent increase in mCRP and IL-6 concentrations, predominantly in the exposed group. Conversely, increased CC-16 levels were associated with lower leucocyte and neutrophil counts, mainly in the unexposed group. CONCLUSION: Continuous exposure to wood dust and related components for three years appears to induce a chronic low-grade inflammatory response among sawmill workers with a shift in cytokine profiles towards a less regulated, potentially more muted immune state.

• Pedersen, Martine; Bast-Pettersen, Rita; Matre, Dagfinn; Skare, Øivind; Nordby, Karl-Christian & Lie, Jenny-Anne Sigstad (2025). Alertness after night shifts among workers in the aluminium industry. Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 67(8), p. 568–575. doi: 10.1097/JOM.0000000000003412. Full text in Research Archive Show summary

  Objective: This case-crossover study aimed to evaluate changes in alertness following night shifts among workers in the aluminium industry, and the potential impact of the number of consecutive night shifts and shift length. Methods: We estimated alertness on 87 aluminium workers by a 3-minute version of the Psychomotor Vigilance Test (PVT) after both day- and night shifts. Linear mixed models were used for statistical analysis. Results: The level of alertness was significantly lower after three and four consecutive night shifts, compared to after a day shift. No significant differences in alertness were observed between three and four consecutive night shifts, nor between periods of three consecutive 8 + 8 + 8-hour versus 8 + 12 + 12-hour night shifts. Conclusions: Our findings indicate reduced alertness after three and four consecutive night shifts, compared to after day work. No significant dose-response effect was observed.

• Aarhus, Lisa; Skare, Øivind; Nordby, Karl-Christian; Gulsvik, Anne Kristine; Vikjord, Sigrid Anna Aalberg & Hedman, L. [Show all 7 contributors for this article] (2025). Occupation and 11-year lung function decline in the HUNT Study. Occupational Medicine. ISSN 0962-7480. 74(9), p. 676–683. doi: 10.1093/occmed/kqae115. Full text in Research Archive Show summary

  Background: The association between occupational titles and lung function has mostly been examined through cross-sectional studies. Preventive measures are expected to mitigate adverse effects; hence, updated estimates are necessary. Aims: To study change in lung function measured by spirometry across occupations. Methods: This population-based prospective cohort study comprised 5618 working adult participants of the Trøndelag Health Study (HUNT3, 2005–07), Norway. Among these, 3800 individuals (43% men, mean age 42 years, range 20–55) also attended HUNT4 (2017–19). We analysed longitudinal decline in forced expiratory volume in 1 second (FEV1 ) z-score during the 11-year follow-up by occupation (white-collar workers as reference category), in mixed models, adjusting for age, sex and smoking. We assessed the prevalence of self-reported respiratory symptoms and disease in the working population in HUNT4 (n = 32 124) and HUNT3 (n = 32 070). Results: Compared with white-collar workers, agricultural workers and ‘drivers and mobile plant operators’, had larger declines in FEV1 z-score during follow-up. In sex-stratified analyses, men defined as agricultural workers and ‘drivers and mobile plant operators’ had larger declines than white-collar workers. Among women, who were underrepresented in many blue-collar jobs, workers classified as ‘machine operators and assemblers’ experienced greater declines. In the working population in HUNT4, the prevalence of respiratory symptoms in connection with work was 8%, and lower among white-collar workers (6%) than blue-collar workers (14%). Conclusions: Although certain workers in Norway remain at risk for occupational lung function decline, there were modest differences between occupations. The findings encourage continuous efforts to implement preventive measures in high-risk jobs.

• Babigumira, Ronnie; Veierød, Marit Bragelien; Larsen, Inger Kristin; Berge, Leon Alexander Mclaren; Shala, Nita Kaupang & Marjerrison, Niki [Show all 22 contributors for this article] (2025). Benzene exposure and risk of colorectal cancer by anatomical subsite in the Norwegian offshore petroleum workers cohort. Environmental Research. ISSN 0013-9351. 276, p. 1–9. doi: 10.1016/j.envres.2025.121407. Full text in Research Archive Show summary

  Objective: To investigate the association between low levels of benzene exposure (≤0.879 parts per million [ppm]-years) and risk of colorectal cancer (CRC) including its anatomical subsites. Methods: Among 25,347 male workers in the Norwegian Offshore Petroleum Workers (NOPW) cohort with offshore work history (1965–1998), 455 CRC cases were diagnosed 1999–2021. We compared these with a subcohort (n = 2031) drawn from the full cohort. Work histories were linked to a previously developed industry-specific benzene job-exposure matrix (JEM). Cox regression for case-cohort analyses was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC, adjusted for age, body mass index, smoking, alcohol intake, red/processed meat intake, and physical activity. Results: Risks of CRC increased with increasing benzene exposure. For all CRC, the HRs (95% CI) for the most exposed [quartile 4] vs. the unexposed were 1.32 (0.96 to 1.81, [0.177–0.879 ppm-years]; p-trend = 0.085) for cumulative, 1.52 (1.11 to 2.07, [17–34 years]; p-trend = 0.032) for duration, and 1.56 (1.15 to 2.12, [0.015–0.046 ppm]; p-trend = 0.005) for average intensity of benzene exposure. For right-sided colon cancer, the association was most evident for exposure duration (HR = 2.25 (1.33 to 3.80), quartile 4 [17–34 years] vs. unexposed; p-trend = 0.007). Sensitivity analyses showed consistent associations. Conclusion: This study found positive exposure-response associations between low-level benzene exposure and CRC risk in offshore petroleum workers. These findings add to emerging evidence that benzene can be associated with solid tumours including lung and bladder, which potentially has important occupational and public health implications.

• Samulin-Erdem, Johanna Maria; Das, Mrinal Kumar; Ryck, Evi De; Skare, Øivind; Lie, Jenny-Anne Sigstad & Bugge, Merete Drevvatne [Show all 12 contributors for this article] (2025). Night shift work and indicators of cardiovascular risk: A systematic review and meta-analysis. Environmental Research. ISSN 0013-9351. 276. doi: 10.1016/j.envres.2025.121503. Full text in Research Archive Show summary

  Cardiovascular disease (CVD) is a leading cause of death worldwide, and shift workers have an increased risk of CVD. This comprehensive systematic review and meta-analysis aimed to assess the association between night shift work and cardiovascular risk indicators. A systematic literature search was performed according to the PRISMA 2020 guidelines using Medline, Embase, and Web of Science databases from inception through May 2024. Original manuscripts reporting relevant cardiovascular risk indicators and biomarkers in night shift workers were included. Risk of bias was assessed using the JBI's critical appraisal tools. When applicable, random-effect meta-analyses were performed. If suitable data were not available, a narrative synthesis was performed by combining p-values or vote-counting. Meta-regression analyses were performed to assess the contribution of sex, body mass index, and age as possible modifiers of effect. Evidence was weighed using an adapted GRADE. This study is registered in PROSPERO (CRD42022337285). Of the 8,387 studies identified, 81 were included in the synthesis, comprising 14 cohort and 67 cross-sectional studies. Moderate-confidence evidence was presented demonstrating increased inflammation, dyslipidaemia and impaired cardiac excitability among night shift workers. Dose-dependent effects were reported for these cardiovascular risk indicators, suggesting that the intensity and duration of night shift work contribute to risk of CVD. Furthermore, no association between night shift work and indicators of vascular dysfunction, deregulation of the autonomic nervous system, or altered homeostasis was observed. Considering this, regulatory and preventative initiatives are essential to reduce the cardiovascular risk among night shift workers.

• Zegeye, Fikirte Debebe; Graff, Pål; Grgic, Miriam; Mollerup, Steen Kristen; Afanou, Komlavi Anani & Bang, Berit [Show all 9 contributors for this article] (2025). Respiratory symptoms, sensitisation and occupational exposure in the shrimp processing industry. Frontiers in Allergy. 6. doi: 10.3389/falgy.2025.1520576. Full text in Research Archive Show summary

  Introduction: Shellfish processing workers are highly susceptible to respiratory illnesses such as allergies and asthma. This study examined respiratory symptoms and biomarkers of allergy and asthma in Norwegian shrimp processing plant workers and evaluated allergenic and irritant protein exposures in the workplace. Material and methods: The study included 35 shrimp processing workers and 21 controls. Respiratory symptoms were assessed via questionnaire; blood samples were analysed for allergy and asthma biomarkers and specific IgE levels. Air samples were analysed for protein levels and composition. Results: Shrimp processing workers had four to five times higher odds of reporting acute upper and chronic lower respiratory symptoms than the controls. They also had significantly higher plasma levels of IL4, CCL20, CSF2 and MMP12, with 11% of the exposed workers showing elevated levels of shrimp and crab specific IgE. Furthermore, exposed workers showed increased plasma levels of SFTPD and CHI3L1 post-shift. The median total protein exposure was 6 µg/m3, with peaks up to 66 µg/m3 in the cooking and peeling department. Total protein levels were correlated with CCL20, IL13, and basophil counts. Ninety-five shrimp proteins were identified, including seven known and eight potential allergens. Tropomyosin levels were generally high, particularly in the cooking and peeling department. Conclusion: Shrimp workers had a higher prevalence of respiratory symptoms and biomarkers of allergy and asthma. The work environment contained tropomyosin and other allergenic proteins as well as irritants, highlighting the need for protective measures, especially in the cooking and peeling departments.

• Weinbruch, Stephan; Scerri, Mark; Eduard, Wijnand; Thomassen, Yngvar; Nordby, Karl-Christian & Notø, Hilde Pettersen (2024). Job function as determinant of clinker exposure at workplaces during cement production. Annals of Work Exposures and Health. ISSN 2398-7308. 68(5), p. 510–521. doi: 10.1093/annweh/wxae022. Full text in Research Archive Show summary

  Objectives In the cement production industry, exposure to airborne particulate matter is associated with a decline in lung function and increased airway symptoms. Exposure to clinker—the major constituent of cement and supposedly the cause of the observed adverse health effects—was determined recently in 15 cement production plants located in 8 different countries (Estonia, Greece, Italy, Norway, Sweden, Switzerland, Spain, Turkey). It was shown that the median clinker abundance in the thoracic fraction varied between approximately 20% and 70% for individual plants. The present study complements the previous work by investigating the significance of job function as a determinant of clinker exposure. Methods The elemental composition (water and acid-soluble fractions separately) of 1,227 personal thoracic workplace samples was analyzed by positive matrix factorization (PMF) to determine the contribution of different sources to the composition of airborne particulate matter and to quantify the clinker content. Results Median thoracic mass air concentrations varied for individual job functions between 0.094 and 12 mg/m3 (estimated separately for different plants). The PMF 5-factor solution yielded median relative clinker abundances in the personal thoracic samples between 7.6% and 81% for individual job functions. Thoracic clinker air concentrations are highest for cleaning, production, and maintenance work, and lowest for administration and other work. Foremen and laboratory personnel show intermediate exposure levels. The plant was found to have a much higher contribution to the total variance of the thoracic clinker air concentrations than the job function. Thoracic clinker air concentrations (medians between 0.01 and 5.5 mg/m3) are strongly correlated with the thoracic mass air concentrations and to a lesser extent with the relative clinker abundance in an aerosol sample. Conclusions Job function is an important predictor of exposure to clinker in the cement production industry. As clinker is suspected to be the causal agent for the observed adverse health effects among cement production workers, the clinker air concentration may be a better exposure metric than thoracic air mass concentration despite the strong correlation between the two. Reduction strategies should focus on the most exposed job categories cleaning, production, and maintenance work.

• Schenk, Linda; Ho, Meng-Rung; Taxell, Piia; Huuskonen, Pasi; Leite, Mimmi & Martinsone, Inese [Show all 9 contributors for this article] (2024). Occupational exposure limits for reproductive toxicants. A comparative analysis. Reproductive Toxicology. ISSN 0890-6238. 128. doi: 10.1016/j.reprotox.2024.108649. Full text in Research Archive Show summary

  We investigated the level of protection of reproductive and developmental toxicity offered through occupational exposure limits (OELs) and Derived No-Effect Levels for workers’ inhalation exposure (wDNELs). We compared coverage of substances that have a harmonised classification as reproductive toxicant 1 A or 1B (Repr.1 A/B), numerical values and scientific basis of 12 lists of OELs and wDNELs from REACH Registrants’ and the Committee for Risk Assessment. Across the 14 sources of OELs and wDNELs, 53 % of the Repr1A/B-substances had at least one exposure limit (counting groups of metals as one entry). Registrants’ wDNELs covered the largest share, 40 %. The numerical values could be highly variable for the same substance across the lists. How often reproductive toxicity is identified as the critical effect varies between the examined lists, both due to different assessments of the same substance and different substance coverage. Reviewing the margin of safety to reproductive toxicity cited in the documents, we found that 15 % of safety margins were lower to reproductive toxicity than the critical effect. To conclude, neither the REACH nor work environment legislation supply wDNELs or OELs for a substantial share of known reproductive toxicants. EU OELs cover among the fewest substances in the range, and in many cases national OELs or wDNELs are set at more conservative levels.

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 9 contributors for this article] (2024). Occupational exposures of firefighting and prostate cancer risk in the Norwegian Fire Departments Cohort. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 51(2), p. 100–110. doi: 10.5271/sjweh.4202. Full text in Research Archive Show summary

  Objectives Excess incidence of prostate cancer (PC) is frequently observed among firefighters; however, the association with specific occupational exposures of firefighting, as well as the influence of a medical surveillance bias, remains unclear. Our aim was to study PC risk within a firefighter cohort, applying indicators of exposures. Methods We used indicators of various firefighting exposures to examine PC risk among men in the Norwegian Fire Departments Cohort (N=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960–2021). Cox regression was used to estimate hazard ratios (HR) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PC, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined. Results No clear associations emerged for any of the exposure indicators, although we observed an HR of 1.31 [95% confidence interval (CI) 0.63–2.72] for aggressive PC in the highest tertile of fire exposure score and 1.31 (95% CI 0.60–2.89) for indolent PC in the highest tertile of inhalation score. Assessment of cumulative incidence demonstrated a greater number of diagnoses at younger ages after 1990, particularly for indolent and unclassifiable PC. Conclusions We found little support for an association between firefighting exposures and PC risk. However, our study had few cases in analyses by clinical stage. Challenges in studies of firefighters’ PC risk remain, including difficulties in exposure characterization and the unclear magnitude of a medical surveillance bias.

• Ervik, Torunn Kringlen; Leite, Mimmi; Weinbruch, Stephan; Nordby, Karl-Christian; Ellingsen, Dag & Ulvestad, Bente [Show all 9 contributors for this article] (2024). Characterization of particle exposure during tunnel excavation by tunnel boring machines. Annals of Work Exposures and Health. ISSN 2398-7308. 68(7), p. 713–724. doi: 10.1093/annweh/wxae041. Full text in Research Archive Show summary

  Tunnel boring machines (TBMs) are used to excavate tunnels in a manner where the rock is constantly penetrated with rotating cutter heads. Fine particles of the rock minerals are thereby generated. Workers on and in the vicinity of the TBM are exposed to particulate matter (PM) consisting of bedrock minerals including α-quartz. Exposure to respirable α-quartz remains a concern because of the respiratory diseases associated with this exposure. The particle size distribution of PM and α-quartz is of special importance because of its influence on adverse health effects, monitoring and control strategies as well as accurate quantification of α-quartz concentrations. The major aim of our study was therefore to investigate the particle size distribution of airborne PM and α-quartz generated during tunnel excavation using TBMs in an area dominated by gneiss, a metamorphic type of rock. Sioutas cascade impactors were used to collect personal samples on 3 separate days. The impactor fractionates the dust in 5 size fractions, from 10 µm down to below 0.25 µm. The filters were weighted, and the α-quartz concentrations were quantified using X-ray diffraction (XRD) analysis and the NIOSH 7500 method on the 5 size fractions. Other minerals were determined using Rietveld refinement XRD analysis. The size and elemental composition of individual particles were investigated by scanning electron microscopy. The majority of PM mass was collected on the first 3 stages (aerodynamic diameter = 10 to 0.5 µm) of the Sioutas cascade impactor. No observable differences were found for the size distribution of the collected PM and α-quartz for the 3 sampling days nor the various work tasks. However, the α-quartz proportion varied for the 3 sampling days demonstrating a dependence on geology. The collected α-quartz consisted of more particles with sizes below 1 µm than the calibration material, which most likely affected the accuracy of the measured respirable α-quartz concentrations. This potential systematic error is important to keep in mind when analyzing α-quartz from occupational samples. Knowledge of the particle size distribution is also important for control measures, which should target particle sizes that efficiently capture the respirable α-quartz concentration.

• Peters, Susan; Undem, Karina; Solovieva, Svetlana E.; Selander, Jenny; Schlünssen, Vivi & Hengel, Karen M. Oude [Show all 43 contributors for this article] (2024). Narrative review of occupational exposures and noncommunicable diseases. Annals of Work Exposures and Health. ISSN 2398-7308. 68(6), p. 562–580. doi: 10.1093/annweh/wxae045. Full text in Research Archive Show summary

  Objective Within the scope of the Exposome Project for Health and Occupational Research on applying the exposome concept to working life health, we aimed to provide a broad overview of the status of knowledge on occupational exposures and associated health effects across multiple noncommunicable diseases (NCDs) to help inform research priorities. Methods We conducted a narrative review of occupational risk factors that can be considered to have “consistent evidence for an association,” or where there is “limited/inadequate evidence for an association” for 6 NCD groups: nonmalignant respiratory diseases; neurodegenerative diseases; cardiovascular/metabolic diseases; mental disorders; musculoskeletal diseases; and cancer. The assessment was done in expert sessions, primarily based on systematic reviews, supplemented with narrative reviews, reports, and original studies. Subsequently, knowledge gaps were identified, e.g. based on missing information on exposure–response relationships, gender differences, critical time-windows, interactions, and inadequate study quality. Results We identified over 200 occupational exposures with consistent or limited/inadequate evidence for associations with one or more of 60+ NCDs. Various exposures were identified as possible risk factors for multiple outcomes. Examples are diesel engine exhaust and cadmium, with consistent evidence for lung cancer, but limited/inadequate evidence for other cancer sites, respiratory, neurodegenerative, and cardiovascular diseases. Other examples are physically heavy work, shift work, and decision latitude/job control. For associations with limited/inadequate evidence, new studies are needed to confirm the association. For risk factors with consistent evidence, improvements in study design, exposure assessment, and case definition could lead to a better understanding of the association and help inform health-based threshold levels. Conclusions By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review will help setting priorities in occupational health research. Future epidemiological studies should prioritize to include large sample sizes, assess exposures prior to disease onset, and quantify exposures. Potential sources of biases and confounding need to be identified and accounted for in both original studies and systematic reviews.

• Eduard, Wijnand; Weinbruch, Stephan; Skogstad, Asbjørn; Skare, Øivind; Nordby, Karl-Christian & Notø, Hilde Pettersen (2023). Content of clinker and other materials in personal thoracic aerosol samples from cement plants estimated by scanning electron microscopy and energy-dispersive X-ray microanalysis. Annals of Work Exposures and Health. ISSN 2398-7308. 67(8), p. 990–1003. doi: 10.1093/annweh/wxad047. Full text in Research Archive Show summary

  Objectives To estimate the composition and exposure to clinker and other specific components in personal thoracic dust samples of cement production workers. Methods A procedure for the classification of airborne particles in cement production plants was developed based on classification trees. For this purpose, the chemical compositions of 27,217 particles in 29 material samples (clinker, limestone, gypsum, clay, quartz, bauxite, iron source, coal fly ash, and coal) were determined automatically by scanning electron microscopy (SEM) and energy-dispersive X-ray microanalysis (EDX). The concentrations of the major elements in cement (calcium, aluminium, silicon, iron, and sulphur) were used for the classifications. The split criteria of the classification trees obtained in the material samples were used to classify 44,176 particles in 34 personal thoracic aerosol samples. The contents of clinker and other materials were estimated, and the clinker contents were analysed statistically for differences between job types and job tasks. Results Between 64% and 88% of the particles from material samples were classified as actual materials. The material types with variable composition (clay, coal fly ash, and coal) were classified with the lowest consistency (64% to 67%), while materials with a more limited compositional variation (clinker, gypsum, and quartz) were classified more consistently (76% to 85%). The arithmetic mean (AM) of the clinker content in personal samples was 62.1%, the median was 55.3%, and 95% confidence interval (CI) was 42.6% to 68.1%. No significant differences were observed between job types. However, the clinker content in samples when workers handled materials with high clinker content was significantly higher than when materials with lower clinker content were handled, 85% versus 65% (P = 0.02). The limestone content was AM 14.8%, median 13.2% (95% CI 5.5 to 20.9), whereas the other materials were present with relative abundances of median ≤ 6.4%. Discussion Automated particle analysis by SEM-EDX followed by classification tree analysis quantified clinker with fairly high consistency when evaluated together with raw materials that are expected to be airborne in cement production plants. The clinker proportions for job types were similar. Tasks a priori ranked by assumed clinker content were significantly different and according to expectations, which supports the validity of the chosen methodology. Conclusions The composition of personal samples of mineral aerosols in the cement production industry could be estimated by automated single particle analysis with SEM-EDX and classification by a classification tree procedure. Clinker was the major component in the thoracic aerosol that cement production workers were exposed to. Differences between job types were relatively small and not significant. The clinker content from tasks was in agreement with assumptions.

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 8 contributors for this article] (2023). Occupational exposures of firefighting and urinary tract cancer risk among men in the Norwegian Fire Departments Cohort. Occupational and Environmental Medicine. ISSN 1351-0711. 80(12). doi: 10.1136/oemed-2023-109003. Full text in Research Archive Show summary

  Objectives: Increased risks of bladder cancer and mesothelioma were the strongest evidence for the recent reclassification of firefighting as carcinogenic (Group 1) by the International Agency for Research on Cancer. Our study aim was to develop indicators for specific firefighting exposures and examine associations with urinary tract cancer (UTC), including bladder cancer. Methods: We developed indicators for exposure from employment at a fire department or in firefighting jobs, to fire and smoke, and to diesel exhaust for men in the Norwegian Fire Departments Cohort (n=4250). Incident UTC cases were obtained from the Cancer Registry of Norway (1960–2021). Poisson regression was used to estimate incidence rate ratios (IRR) with cumulative exposures grouped into tertiles (reference: lowest exposed tertile) with 0-year, 10-year and 15-year lagging of exposures. Results: During 125 090 person-years of follow-up, there were 76 cases of UTC. IRRs were mostly non-significantly increased in the middle tertile and at or below 1 in the highest tertile for total duration of employment, number of fires attended and fire exposure score with and without lags. In the middle tertile for diesel exhaust exposure, UTC risk was elevated over twofold with 10-year (IRR 2.27, 95% CI 1.22 to 4.20) and 15- year (2.21, 1.18 to 4.16) lags, and near 1 in the highest tertile. Findings for bladder cancer were similar to those for UTC. Conclusions: Dose-response associations between the exposure indicators and UTC were not observed. Future studies using the indicators with more cases are needed.

• Weinbruch, Stephan; Scerri, Mark; Wijnand, Eduard; Thomassen, Yngvar; Nordby, Karl-Christian & Berlinger, Balazs [Show all 10 contributors for this article] (2023). Chemical Composition of Thoracic Dust at Workplaces During Cement Production. Annals of Work Exposures and Health. ISSN 2398-7308. 67(5), p. 609–621. doi: 10.1093/annweh/wxad011. Full text in Research Archive Show summary

  Objectives Cement belongs to the most used building materials. Clinker is the major constituent of cement, and it is believed that the strong increase of pH after hydration of clinker minerals is responsible for the observed decline in lung function of cement production workers. Information on clinker exposure at workplaces in the cement production industry is scarse. The aims of this study are to determine the chemical composition of thoracic dust and to quantify workplace exposure to clinker in cement production. Methods The elemental composition of 1250 personal thoracic samples collected at workplaces in 15 plants located in 8 different countries (Estonia, Greece, Italy, Norway, Sweden, Switzerland, Spain, Turkey) was determined by inductively coupled plasma optical emission spectrometry (ICP-OES), separately for water- and acid-soluble fraction. Positive matrix factorization (PMF) was used to determine the contribution of different sources to the dust composition and to quantify the clinker content in 1227 of the thoracic samples. In addition, 107 material samples were analysed to facilitate interpretation of the factors obtained by PMF. Results The median thoracic mass concentrations varied for individual plants between 0.28 and 3.5 mg/m3. PMF with 8 water-soluble and 10 insoluble (i.e., acid-soluble) element concentrations yielded a five-factor solution: Ca, K, Na sulfates; silicates; insoluble clinker; soluble clinker-rich; and soluble Ca-rich. The clinker content of the samples was calculated as sum of the insoluble clinker and soluble clinker-rich factors. The median clinker fraction of all samples was 45% (range 0–95%), and varied between 20% and 70% for individual plants. Discussion The 5-factor solution of PMF was selected on the basis of several mathematical parameters recommended in the literature as well as the mineralogical interpretability of the factors. In addition, interpretation of the factors was supported by the measured apparent solubility of Al, K, Si, Fe, and to a lesser extent Ca in material samples. The total clinker content obtained in the present study is considerably lower than estimates based on the Ca concentrations in a sample, and somewhat lower than estimates based on Si concentrations after selective leaching with a methanol/maleic acid mixture. The clinker abundance in workplace dust of one plant investigated in the present contribution was also estimated in a recent study by electron microscopy, and the good agreement between both studies gives confidence in the results of PMF. Conclusions The clinker fraction in personal thoracic samples could be quantified from the chemical composition by positive matrix factorization. Our results allow for further epidemiological analyses of health effects in the cement production industry. As these estimates are more accurate for clinker exposure than aerosol mass, stronger associations with respiratory effects are expected if clinker is the main cause of these effects.

• Afanou, Komlavi Anani; Mundra, Sunil; Estensmo, Eva Lena Fjeld; Pedersen, Ine; Liland, Rasmus & Eriksen, Elke [Show all 10 contributors for this article] (2023). Divergent TLR2 and TLR4 Activation by Fungal Spores and Species Diversity in Dust from Waste Sorting Plants. Applied and Environmental Microbiology. ISSN 0099-2240. 89(3). doi: 10.1128/aem.01734-22. Full text in Research Archive Show summary

  This manuscript presents the results of an exploratory study on the relationships between NF-κB response through Toll-like receptor (TLR) activation by dust characterized by fungal spore concentrations and species diversity. Personal total dust samples were collected from Norwegian waste sorting plants and then characterized for fungal spores and fungal species diversity, as well as for other bioaerosol components, including endotoxins and actinobacteria. The ability of the dust to induce an NF-κB response by activating TLR2 and TLR4 in vitro was evaluated, as well as the relationship between such responses and quantifiable bioaerosol components. The average concentrations of bioaerosols were 7.23 mg total dust m−3, 4.49 × 105 fungal spores m−3, 814 endotoxin units m−3, and 0.6 × 105 actinobacteria m−3. The mean diversity measurements were 326, 0.59, and 3.39 for fungal richness, evenness, and Shannon index, respectively. Overall, fungal operational taxonomic units (OTUs) belonging to the Ascomycota phylum were most abundant (55%), followed by Basidiomycota (33%) and Mucoromycota (3%). All samples induced significant NF-κB responses through TLR2 and TLR4 activation. While fungal spore levels were positively associated with TLR2 and TLR4 activation, there was a trend that fungal species richness was negatively associated with the activation of these receptors. This observation supports the existence of divergent immunological response relationships between TLR activation and fungal spore levels on one hand and between TLR activation and fungal species diversity on the other. Such relationships seem to be described for the first time for dust from waste facilities.

• Leite, Mimmi; Nordby, Karl-Christian; Skare, Øivind; Ulvestad, Bente; Ellingsen, Dag & Dahl, Kari [Show all 8 contributors for this article] (2023). Exposure to Particulate Matter and Respirable Crystalline Silica in Tunnel Construction Workers Using Tunnel Boring Machines. Annals of Work Exposures and Health. ISSN 2398-7308. 67(5), p. 584–595. doi: 10.1093/annweh/wxad004. Full text in Research Archive Show summary

  Objectives This study aimed to assess the exposure to a selection of aerosols and gases in the work environment for workers performing tunnel construction using tunnel boring machines (TBMs), to identify determinants of exposure based on the information available and to calculate robust estimates of exposure using a statistical model. The focus was particulate matter (PM) and respirable crystalline silica (RCS). In addition, concentrations of nitrogen dioxide (NO2), elemental carbon (EC), and oil mist were assessed. Methods Personal sampling was conducted from February 2017 to February 2019. PM in the thoracic and the respirable aerosol fractions was collected, and RCS was determined in the respirable aerosol fraction. Context information was collected on questionnaires. Because the workers could participate in the sampling more than once and multiple measurements were performed on the same date a mixed model was used in the analysis. Concentrations of PM and RCS are presented as estimated and measured geometric means (GMest and GMmea) and estimated arithmetic mean (AMest) in addition to the median. Measured concentrations of NO2, EC, and oil mist are presented as geometric means. Results A total of 290 and 289 personal samples of PM in the thoracic and respirable aerosol fractions were available for analysis, respectively. Work title/work location, type of work (production, maintenance, or a combination of the two), and date of sampling were identified as determinants of exposure. Workers in the front of the TBMs had the highest exposure to PM and RCS. The GMest of RCS exposure varied from 35 to 413 μg m–3 depending on the work title. The geometric standard deviations for measured RCS concentrations by work title ranged from 1.6 to 3.5. A total of 16 samples of NO2 and EC and 12 samples of oil mist were collected. Maximum values of NO2 and EC were 54 µg m–3 and 23 µg m–3, respectively. The maximum measured value of oil mist was 0.08 mg m–3. Conclusions All TBM workers were exposed to PM and RCS. Exposure to RCS may be substantial, and workers in front of the TBM were exposed to the highest concentrations of both PM and RCS. A day-to-day variation was found, probably caused by differences in drilling activities. Preventive measures are warranted to keep the exposure to PM and consequently the exposure to RCS as low as possible to protect the health of workers in tunnel construction.

• Kim, Joanne; Leon, Maria E.; Schinasi, Leah H.; Baldi, Isabelle; Lebailly, Pierre & Freeman, Laura E Beane [Show all 16 contributors for this article] (2023). Exposure to pesticides and risk of Hodgkin lymphoma in an international consortium of agricultural cohorts (AGRICOH). Cancer Causes and Control. ISSN 0957-5243. 34, p. 995–1003. doi: 10.1007/s10552-023-01748-1. Full text in Research Archive Show summary

  Purpose: Some pesticides may increase the risk of certain lymphoid malignancies, but few studies have examined Hodgkin lymphoma (HL). In this exploratory study, we examined associations between agricultural use of 22 individual active ingredients and 13 chemical groups and HL incidence. Methods: We used data from three agricultural cohorts participating in the AGRICOH consortium: the French Agriculture and Cancer Cohort (2005-2009), Cancer in the Norwegian Agricultural Population (1993-2011), and the US Agricultural Health Study (1993-2011). Lifetime pesticide use was estimated from crop-exposure matrices or self-report. Cohort-specific covariate-adjusted overall and age-specific (< 40 or ≥ 40 years) hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression and combined using random effects meta-analysis. Results: Among 316 270 farmers (75% male) accumulating 3 574 815 person-years at risk, 91 incident cases of HL occurred. We did not observe statistically significant associations for any of the active ingredients or chemical groups studied. The highest risks of HL overall were observed for the pyrethroids deltamethrin (meta-HR = 1.86, 95% CI 0.76-4.52) and esfenvalerate (1.86, 0.78-4.43), and inverse associations of similar magnitude were observed for parathion and glyphosate. Risk of HL at ≥ 40 years of age was highest for ever-use of dicamba (2.04, 0.93-4.50) and lowest for glyphosate (0.46, 0.20-1.07). Conclusion: We report the largest prospective investigation of these associations. Nonetheless, low statistical power, a mixture of histological subtypes and a lack of information on tumour EBV status complicate the interpretability of the results. Most HL cases occurred at older ages, thus we could not explore associations with adolescent or young adult HL. Furthermore, estimates may be attenuated due to non-differential exposure misclassification. Future work should aim to extend follow-up and refine both exposure and outcome classification.

• Matre, Dagfinn; Goffeng, Elisabeth Martinsen; Nordby, Karl-Christian & Lie, Jenny-Anne Sigstad (2022). Extended Work Shifts Increase Subjective Pain Complaints Among Cabin Crewmembers, but Not Among Airline Pilots or Healthcare Workers: A Repeated-Measures Study. Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 64(6), p. 381–386. doi: 10.1097/JOM.0000000000002543. Full text in Research Archive Show summary

  Objective To determine whether four consecutive extended work shifts are associated with an increased risk of subjective pain complaints, sleep duration, and sleep disturbances. Methods Forty-three healthcare workers, 41 cabin crewmembers, and 18 airline pilots working 4 consecutive extended workdays reported subjective pain complaints and sleep after the 1st and 4th workday. Results The risk of headache (odds ratio [OR] 21.4, 95% confidence interval [CI] 1.85 to 246.5) and pain in the hands, arms, or wrists (OR 3.78, 95% CI 1.84 to 7.76) increased after workday 4 versus workday 1 in cabin crewmembers. Sleep duration was longer (0.6 to 1.1 hours), and sleep disturbances fewer, the night before the fourth extended workday, compared with before the first workday, in all occupations. Conclusions We found no general support for an association between extended work shifts and subjective pain, whereas sleep duration was improved, and sleep disturbances reduced after 4 consecutive extended workdays.

• Schulze, Daniel Gregor; Nilsen, Kristian Bernhard; Clemm, Thomas; Grotle, Margreth; Zwart, John Anker Henrik & Ulvestad, Bente [Show all 7 contributors for this article] (2022). Influence of ergonomic factors on peripheral neuropathy under HAV exposure. Occupational Medicine. ISSN 0962-7480. 73(1), p. 13–18. doi: 10.1093/occmed/kqac118. Full text in Research Archive Show summary

  Background: Hand-arm vibration (HAV) is a risk factor for carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE). It is unclear how ergonomic factors influence the relationship between HAV exposure and CTS and UNE. Aims: We aimed to assess the relationship between cumulative HAV exposure and CTS and UNE in workers exposed to HAV from two tools with different ergonomic profiles. Methods: We performed nerve conduction studies (NCSs) of the sensory and motor median and ulnar nerves and recorded symptoms indicating CTS and UNE in workers exposed to HAV from impact wrenches or from rock drills. Exposure was measured as cumulative lifetime exposure. We used linear regression adjusted for age and body mass index to assess linear relationships. Results: Sixty-five workers participated (33 rock drill and 32 impact wrench operators). We found inverse linear associations between cumulative HAV exposure and median nerve sensory conduction velocity in impact wrench operators and ulnar nerve motor conduction velocity in rock drill operators (beta of 0.63 and 0.75). Based on NCS findings and symptoms, seven impact wrench operators had CTS and one UNE, and four rock drill operators had CTS and six UNE. Conclusions: Our findings indicate that ergonomic factors influence the development of CTS and UNE under HAV exposure. The ergonomic profile seems to influence which type of neuropathy workers exposed to HAV will develop. Design of occupational exposure guidelines and future studies should be based on ergonomic profile and exposure characteristics for different tools and not merely HAV.

• Clemm, Thomas; Lunde, Lars-Kristian; Ulvestad, Bente; Færden, Karl & Nordby, Karl-Christian (2022). Exposure-response relationship between hand-Arm vibration exposure and vibrotactile thresholds among rock drill operators: A 4-year cohort study. Occupational and Environmental Medicine. ISSN 1351-0711. 79(11), p. 775–781. doi: 10.1136/oemed-2022-108293. Full text in Research Archive Show summary

  Objectives The risk of developing hand-arm vibration syndrome (HAVS) from occupational hand-arm vibration (HAV) exposure is traditionally determined by the onset of vascular symptoms (white fingers). However, changes in tactile sensibility at the fingertips is a clinical sign of HAVS which in most cases precedes vascular signs. We aimed to assess relationships between occupational HAV exposure and HAVS-related signs including vibration perception thresholds (VPT) and pegboard score on an individual level, using a longitudinal study design with follow-up tests. Methods We followed-up 148 workers exposed to different HAV levels for 4 years, with health examinations including VPT tests and pegboard tests carried out at baseline, 2 years and 4 years. VPT testing included seven frequencies, from 8 to 500 Hz. Second and fifth finger on both hands were tested, thus a total of 28 tests on each subject. We investigated associations using linear mixed models and significance level at p≤0.05. Results There was a significant exposure-response relationship on an individual level between HAV exposure from rock drills and VPT for 16 of 28 test frequencies. The highest rise (worsening) in VPT was found at the 500 Hz test frequency with 1.54 dB increased VPT per 10-fold increase in cumulative exposure. We found no deterioration in pegboard performance associated with HAV exposure among the participants. Conclusions Risk predictions of HAVS may be based on exposure-response relationships between HAV exposure and VPT. The 500 Hz test frequency should be included in the VPT test protocols for early detection of signs related to reduced tactile sensibility.

• Marjerrison, Niki; Jakobsen, Jarle; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar & Nordby, Karl-Christian [Show all 8 contributors for this article] (2022). Cancer incidence in sites potentially related to occupational exposures: 58 years of follow-up of firefighters in the Norwegian Fire Departments Cohort. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 48(3), p. 210–219. doi: 10.5271/sjweh.4009. Full text in Research Archive Show summary

  Objectives Firefighters are exposed to a variety of known and suspected carcinogens through their work. However, the association with cancer risk has limited evidence. We examined cancer incidence among firefighters in the newly established Norwegian Fire Departments Cohort restricted to sites with established associations with carcinogens encountered during firefighting. This included sites within the respiratory, urinary, and lympho-hematopoietic systems, and the skin and all sites combined. Methods Male firefighters (N=3881) in the cohort were linked to the Cancer Registry of Norway for incident cancer cases occurring during the period 1960–2018. We calculated standardized incidence ratios (SIR) with rates for the national male population as reference, and stratified SIR analyses by period of first employment, duration of employment, and time since first employment. Results Elevated risk was seen for all sites combined (SIR 1.15, 95% confidence interval 1.07–1.23). Elevated risk of urinary tract cancer was observed among firefighters who began working before 1950, and with observation ≥40 years since first employment. Risk of mesothelioma and laryngeal cancer were elevated with ≥40 years since first employment and with ≥30 years employment duration. Conclusions The observed associations between firefighting and urinary tract cancer, laryngeal cancer, and mesothelioma have been observed in some studies previously, and our results suggest the observed elevated risks are related to carcinogenic occupational exposures. Differences in risk by period of employment potentially reflect changes in exposures from improved quality and use of personal protective equipment.

• Marjerrison, Niki; Jacobsen, Jarle; Demers, Paul A.; Grimsrud, Tom Kristian; Hansen, Johnni & Martinsen, Jan Ivar [Show all 9 contributors for this article] (2022). Comparison of cancer incidence and mortality in the Norwegian Fire Departments Cohort, 1960-2018. Occupational and Environmental Medicine. ISSN 1351-0711. 79, p. 736–743. doi: 10.1136/oemed-2022-108331. Full text in Research Archive Show summary

  Objectives Elevated risk of cancer at several sites has been reported among firefighters, although with mixed findings. The purpose of this study was to calculate standardised incidence ratios (SIRs) and standardised mortality ratios (SMRs) for cancer and compare them to assess whether use of the different measures could be a source of inconsistencies in findings. Methods The Norwegian Fire Departments Cohort, comprising 4295 male employees who worked at 15 fire departments across Norway, was linked to health outcome registries for the period 1960–2018. SIRs and SMRs were derived using national reference rates. Results Overall, we observed elevated incidence of colon cancer (SIR, 95% CI 1.27, 1.01 to 1.58), mesothelioma (2.59, 1.12 to 5.11), prostate cancer (1.18, 1.03 to 1.34) and all sites combined (1.15, 1.08 to 1.23). Smaller, non-significant elevations were found for mortality of colon cancer (SMR, 95% CI 1.20, 0.84 to 1.67) and mesothelioma (1.66, 0.34 to 4.86), while SMR for prostate cancer was at unity. Potential errors were observed in some of the mortality data, notably for mesothelioma cases. Among those who died of cancer, 3.7% (n=14) did not have a prior diagnosis of malignancy at the same site group. Conclusions Assessment of incidence or mortality did not greatly influence the interpretation of results. The most prominent differences in SIR and SMR appeared to be due to inconsistencies between sites of cancer diagnosis and cause of death. The difference in SIR and SMR for prostate cancer suggested a detection bias from differential screening practices.

• Ramsperger, Anja F.R.M.; Bergamaschi, Enrico; Panizzolo, Marco; Fenoglio, Ivana; Barbero, Francesco & Peters, Ruud [Show all 31 contributors for this article] (2022). Nano- and microplastics: a comprehensive review on their exposure routes, translocation, and fate in humans. NanoImpact. ISSN 2452-0748. doi: 10.1016/j.impact.2022.100441. Full text in Research Archive Show summary

  Contamination of the environment with nano-and microplastic particles (NMPs) and its putative adverse effects on organisms, ecosystems, and human health is gaining increasing scientific and public attention. Various studies show that NMPs occur abundantly within the environment, leading to a high likelihood of human exposure to NMPs. Here, different exposure scenarios can occur. The most notable exposure routes of NMPs into the human body are via the airways and gastrointestinal tract (GIT) through inhalation or ingestion, but also via the skin due to the use of personal care products (PCPs) containing NMPs. Once NMPs have entered the human body, it is possible that they are translocated from the exposed organ to other body compartments. In our review article, we combine the current knowledge on the (1) exposure routes of NMPs to humans with the basic understanding of the potential (2) translocation mechanisms into human tissues and, consequently, their (3) fate within the human body. Regarding the (1) exposure routes, we reviewed the current knowledge on the occurrence of NMPs in food, beverages, personal care products and the air (focusing on indoors and workplaces) and found that the studies suggest an abundant presence of MPs within the exposure scenarios. The overall abundance of MPs in exposure matrices relevant to humans highlights the importance of understanding whether NMPs have the potential for tissue translocation. Therefore, we describe the current knowledge on the potential (2) translocation pathways of NMPs from the skin, GIT and respiratory systems to other body compartments. Here, particular attention was paid to how likely NMPs can translocate from the primary exposed organs to secondary organs due to naturally occurring defence mechanisms against tissue translocation. Based on the current understanding, we conclude that a dermal translocation of NMPs is rather unlikely. In contrast, small MPs and NPs can generally translocate from the GIT and respiratory system to other tissues. Thus, we reviewed the existing literature on the (3) fate of NMPs within the human body. Based on the current knowledge of the contamination of human exposure routes and the potential translocation mechanisms, we critically discuss the size of the detected particles reported in the fate studies. In some cases, the particles detected in human tissue samples exceed the size of a particle to overcome biological barriers allowing particle translocation into tissues. Therefore, we emphasize the importance of critically reading and discussing the presented results of NMP in human tissue samples.

• Clemm, Thomas; Nordby, Karl-Christian; Lunde, Lars-Kristian; Ulvestad, Bente & Bråtveit, Magne (2021). Hand-arm vibration exposure in rock drill workers. A comparison between measurements with hand-attached and tool-attached accelerometers. Annals of Work Exposures and Health. ISSN 2398-7308. 65(9), p. 1123–1132. doi: 10.1093/annweh/wxab051. Full text in Research Archive Show summary

  Objectives To assess the hazard of tool vibrations, we need valid exposure measurements. The use of hand-attached accelerometers (vibration sensors) to measure hand-arm vibrations (HAVs) has become a popular approach. However, according to International Standard ISO 5349-2, the preferred attachment of accelerometers is at the tool handle. We compared measures of HAV between hand- and tool-attached accelerometers in rock drilling. Methods We measured HAV in five rock drillers using jackleg drills in normal working operations with simultaneous measures of both hand-attached and tool-attached accelerometers. Five to seven measurement cycles of 15 s were executed on each worker, resulting in a total of 29 measurement cycles. To identify possible differences in working technique, we recorded videos of tool handle handgrips during drilling. Results There was a significant difference (9.5 m s−2; P ≤ 0.05) in vibration magnitudes measured by the tool-attached accelerometers compared with the hand-attached accelerometers. The hand-attached accelerometer showed a lower vibration magnitude for all workers (range of difference: 2.3–14.6). The variation between the two accelerometer attachments was larger between workers than within workers (ICC = 0.68). Conclusions For measurements of HAV from jackleg drills, the use of hand-attached accelerometers may cause a lower recorded vibration level compared with tool-attached accelerometers. This difference is likely to vary depending on how workers grip the tool handle, and a misclassification of exposure will occur if workers grip the tool handle in a way that makes the accelerometer lose contact with the vibrating surface. Individual differences in how workers grip the tool handles should be considered when assessing HAV.

• Togawa, Kayo; Leon, Maria E.; Lebailly, Pierre; Freeman, Laura E. Beane; Nordby, Karl-Christian & Baldi, Isabelle [Show all 20 contributors for this article] (2021). Cancer incidence in agricultural workers. Findings from an international consortium of agricultural cohort studies (AGRICOH). Environment International. ISSN 0160-4120. 157. doi: 10.1016/j.envint.2021.106825. Full text in Research Archive Show summary

  Background Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations. Methods The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis. Results During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01–1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04–1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01–1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77–0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men. Conclusion The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.

• Corbin, Sara; Togawa, Kayo; Schüz, Joachim; Cornet, Charlotte Le; Fervers, Beatrice & Feychting, Maria [Show all 16 contributors for this article] (2021). Parental occupational exposures in wood‑related jobs and risk of testicular germ cell tumours in offspring in NORD‑TEST a registry‑based case–control study in Finland, Norway, and Sweden. International Archives of Occupational and Environmental Health. ISSN 0340-0131. doi: 10.1007/s00420-021-01818-4. Full text in Research Archive Show summary

  Objective We assessed the association between parental prenatal exposures in wood-related jobs and risk of testicular germ cell tumours (TGCT) in offspring. Methods NORD-TEST, a registry-based case–control study in Sweden, Finland and Norway, included 8112 TGCT cases diagnosed at ages 14–49 years between 1978 and 2012 with no history of prior cancer, and up to four controls matched to each case on year and country of birth. Parents of cases and controls were identified via linkages with the population registries and their occupational information was retrieved from censuses. The Nordic Occupational Cancer Study Job-Exposure Matrix was used to assign occupational exposures to each parent. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results Maternal wood-related job was not associated with the risk of TGCT in offspring (OR 1.08, CI 0.55–2.14), while paternal wood-related job was associated with a decreased risk of TGCT in offspring (OR 0.85, CI 0.75–0.96). None of the specific wood-related jobs, such as upholsterers, sawyers, or construction carpenters, were significantly associated with a risk of TGCT. Only exception was observed in a sensitivity analysis which showed an increased risk in the small group of sons of fathers working as ‘cabinetmakers and joiners’ the year before conception (OR of 2.06, CI 1.00–4.25). Conclusion This large-scale NORD-TEST analysis provided no evidence of an association between parental prenatal exposures in wood-related jobs and TGCT in sons.

• Bast-Pettersen, Rita; Nordby, Karl-Christian; Wastensson, Gunilla & Aarhus, Lisa (2021). Tremor measurements in a 22-year cohort study of workers exposed to hand-held vibrating tools. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 94, p. 1049–1059. doi: 10.1007/s00420-020-01612-8. Full text in Research Archive Show summary

  Objectives The objectives of this cohort study were to evaluate possible long-term effects of occupational exposure to hand-arm vibration (HAV) in terms of increased tremor. The aims were to evaluate whether exposure during follow-up, baseline hand-arm vibration syndrome (HAVS), baseline manual dexterity or current medical conditions or life-style habits might be associated with increased tremor. A further aim was to compare two different activation conditions: postural vs rest tremor. Methods Forty men (current age: 60.4 years) who had previously worked as manual workers in a specialized engineering and construction company enrolled in the study. Their hand functions had been examined in 1994. At the baseline examination, 27 had been diagnosed with HAVS, while 13 were not exposed. The follow-up examination in 2016–2017 comprised the CATSYS Tremor Pen® for measuring postural and rest tremor and the Grooved Pegboard Test for assessing manual dexterity. Blood samples were taken for assessing biomarkers that might have impact on tremor. Results Neither cumulative exposure to HAV during follow-up nor HAVS at baseline were associated with increased tremor. A test for manual dexterity at baseline was significantly associated with increased tremor (Tremor Intensity) at follow-up. Blood markers of current medical conditions and tobacco consumption were associated with increased tremor. Rest tremor frequency was higher than postural tremor frequency (p < 0.001). Conclusions The main findings of this 22-year cohort study were no indications of long-term effects on tremor related to HAV exposure and previous HAVS status. However, baseline manual dexterity was significantly associated with increased tremor at follow-up. Activation conditions (e.g., hand position) are important when testing tremor.

• Matre, Dagfinn; Skogstad, Marit; Sterud, Tom; Nordby, Karl-Christian; Knardahl, Stein & Christensen, Jan Olav [Show all 7 contributors for this article] (2021). Safety incidents associated with extended working hours. A systematic review and meta-analysis. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 47(6), p. 415–424. doi: 10.5271/sjweh.3958. Full text in Research Archive Show summary

  Objective: We performed a systematic review to assess potential consequences of extended working hours on accidents, near-accidents, safety incidents and injuries (incidents) by considering the overall certainty of evidence. Methods: We searched five databases systematically (Medline, Embase, PsycINFO, Web of Science, and Proquest Health and safety Science Abstract) and identified 10072 studies published until December 2020. Twenty-two studies met the inclusion criteria. We followed a systematic approach to evaluate risk of bias and synthesize results in a meta-analysis. The certainty of evidence was determined by a modified version of The Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Our analyses indicated an association between working >12 hours/day (RR: 1.24, 95%CI: 1.11, 1.40), or working >55 hours/week (RR: 1.24, 95%CI: 0.98, 1.57), and elevated risk of incidents. The certainty of evidence evaluated as low. Weak or no associations were observed for other exposure contrasts: working >8 hours/day (RR: 0.93, 95%CI: 0.72, 1.19), or working overtime (RR: 1.08, 95%CI: 0.75, 1.55), working 41-48 hours/week (RR: 1.02, 95%CI: 0.92, 1.13) or 49-54 hours/week (RR: 1.02, 95%CI: 0.97, 1.07). The certainty of evidence was evaluated as low (very low for 41-48 hours/week). Conclusions: Daily working hours >12 hours and weekly working hours exceeding 55 hours was associated and increased risk of incidents. The level of evidence was low. Hence, further high-quality research is warranted to elucidate these associations.

• Clemm, Thomas; Færden, Karl; Ulvestad, Bente; Lunde, Lars-Kristian & Nordby, Karl-Christian (2020). Dose-response relationship between hand-arm vibration exposure and vibrotactile thresholds among roadworkers. Occupational and Environmental Medicine. ISSN 1351-0711. 77, p. 188–193. doi: 10.1136/oemed-2019-105926. Full text in Research Archive Show summary

  Background Testing of vibration perception threshold (VPT) at the fingertips as a quantitative measure of tactile sensitivity is a commonly used tool in diagnosing hand–arm vibration syndrome. There is limited research on dose–response relationships between hand–arm vibration (HAV) exposure and VPT on an individual level. Aims Assess possible dose–response relationships on an individual level between HAV exposure and VPT at the fingertips. Methods We assessed average daily vibration exposure (m/s2A8) and cumulative lifetime HAV exposure for 104 participants from different departments in a road maintenance company based on vibration measurements and questionnaires. VPT was measured based on the technical method described in ISO 13091-1:2005 using octave frequencies 8–500 Hz. We investigated associations using linear regression models with significance level p≤0.05. Results The participants were either exposed to rock drills (n=33), impact wrenches (n=52) or none of these tools (n=19). Exposure to rock drills and impact wrenches was associated with elevated VPT for all seven test frequencies in the second and fifth fingers of both hands. A dose–response with the daily exposure measure m/s2(A8) was found based on 1.2 m/s2(A8) for impact wrenches, and 5.4 m/s2(A8) for rock drills. A stronger association was found with the cumulative exposure for rock drills compared with impact wrenches, and for the second finger compared with the fifth finger. Conclusions HAV exposure was associated with elevated VPT, also at exposure levels below the common exposure action value of 2.5 m/s2(A8). Lowering the HAV exposure can contribute to prevent increasing VPTs in these workers.

• Fix, Jonathan; Annesi-Maesano, Isabella; Baldi, Isabelle; Boulanger, Mathilde; Cheng, Soo & Cortes, Sandra [Show all 34 contributors for this article] (2020). Gender differences in respiratory health outcomes among farming cohorts around the globe. Findings from the AGRICOH consortium. Journal of Agromedicine. ISSN 1059-924X. 26(2), p. 97–108. doi: 10.1080/1059924X.2020.1713274. Full text in Research Archive Show summary

  Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents.Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD).Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma.Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.

• Goffeng, Elisabeth Martinsen; Nordby, Karl-Christian; Tarvainen, Mika P.; Järvelin-Pasanen, Susanna; Wagstaff, Anthony & Skare, Øivind [Show all 7 contributors for this article] (2019). Cardiac Autonomic Activity in Commercial Aircrew During an Actual Flight Duty Period. Aerospace Medicine and Human Performance. ISSN 2375-6314. 90(11), p. 945–952. doi: 10.3357/AMHP.5389.2019. Full text in Research Archive Show summary

  BACKGROUND: The work schedules of airline crewmembers include extended workdays, compressed work periods, and limited time for recovery, which may lead to cardiovascular strain and fatigue. The aim of this study was to evaluate changes in heart rate variability (HRV) during work and sleep, and with respect to work characteristics and breaks. METHODS: We followed 49 airline crewmembers during four consecutive workdays of ≥39 h. Data included HRV measurements, a questionnaire, and sleep/work diaries. HRV parameters include root mean square of successive differences (RMSSD), standard deviation of the normal beat-to-beat differences (SDNN), and the low and high frequency ratio (LF/HF). RESULTS: The results indicate higher levels of cardiovascular strain on the 4th compared to the 1st workday, most prominent among cabin crewmembers. In this group, we observed indications of decreased cardiovascular strain by increasing duration of sleep, demonstrated by increased RMSSD (B = 2.7, 95% CI 1.6, 3.8) and SDNN (B = 4.4, 95% CI 3.0, 5.7), and decreased LF/HF (B = −0.2, 95% CI, −0.4,−0.01). Similarly, longer duration of breaks was associated with lower cardiovascular strain, indicated by increased RMSSD (B = 0.1, 95% CI 0.03, 0.1) and SDNN (B = 0.1, 95% CI 0.1, 0.1). Among pilots, increased LF/HF indicated higher cardiovascular strain in those who often or always reported of high workload (B = 4.3, 95% CI 2.3, 6.3; and B = 7.3, 95% CI 3.2, 11.4, respectively). DISCUSSION: The results support the contention that the studied work period increases cardiac strain among airline crew. Work characteristics, breaks, and sleep are associated with changes in HRV.

• Goffeng, Elisabeth Martinsen; Wagstaff, Anthony; Nordby, Karl-Christian; Meland, Anders; Goffeng, Lars Ole & Skare, Øivind [Show all 8 contributors for this article] (2019). Risk of fatigue among airline crew during 4 consecutive days of flight duty. Aerospace Medicine and Human Performance. ISSN 2375-6314. 90(5), p. 466–474. doi: 10.3357/AMHP.5236.2019. Full text in Research Archive Show summary

  BACKGROUND: Airline crew are being exposed to extended workdays and compressed work periods, with quick returns between duties, implying a heightened physiological and psychological strain that may lead to sleep deprivation and fatigue. The aim of the study was assessment of the effect of an extended day of flight duty and a compressed work week with regard to recovery, cumulative fatigue, and neurobehavioral performance. METHODS: We followed 18 pilots and 41 cabin crewmembers during four consecutive days of flight duty, comprising a total of ≥ 39 h, where the first day was ≥ 10 h. Information on demographics, work characteristics, health status, and physical activity was collected at baseline. Subjects completed logs for the first and fourth workday, including the Samn-Perelli Fatigue Checklist at three time points during these workdays. Two computer-based neurobehavioral tests were completed the evening prior to the first shift, and after the first and the fourth day of the work period. RESULTS: Number of flight sectors during the work period was 10–20. Self-reported fatigue levels increased during the workdays. Neurobehavioral test-scores did not deteriorate. The effects of each additional flight sector during the work period was elevated reaction times (RT) both among cabin crewmembers (B = 5.05 ms, 95% CI 0.6, 9.5) and pilots (B = 4.95 ms, 95% CI 0.4, 9.5). Precision was unaffected. DISCUSSION: Airline pilots and cabin crewmembers seem to obtain satisfactory sleep before and during the period of 4 consecutive days. The association between multiple flight sectors and increased fatigue supports previous findings.

• Schulze, Daniel Gregor; Nordby, Karl-Christian; Småstuen, Milada Cvancarova; Clemm, Thomas; Grotle, Margreth & Zwart, John-Anker [Show all 7 contributors for this article] (2019). Impact of technical variations on the ring-finger test for carpal tunnelsyndrome. Clinical Neurophysiology Practice (CNP). 5, p. 23–29. doi: 10.1016/j.cnp.2019.11.005. Full text in Research Archive Show summary

  Objective To assess if recording the sensory latencies of the median and ulnar nerves one-by-one (consecutive) or at the same time (simultaneous) in the ring-finger test for carpal tunnel syndrome (CTS) will show equivalent results or if it will lead to a different clinical classification of patients. Methods We assessed the limits of agreement between the simultaneous and the consecutive method based on the median- ulnar sensory latency difference derived by both methods in 80 subjects and compared the number of minimal CTS cases identified by the two methods. Results Limits of agreement ranged from −0.23 to 0.29 ms. A significantly higher proportion of subjects with minimal CTS (only detectable by using the comparison test) was found using the simultaneous method (n = 8 and 2, respectively; p = 0.03). Conclusion The two methods have a poor to moderate agreement as indicated by the range of the limits of agreement (0.5 ms).

• Heldal, Kari Emilie; Austigard, Åse Dalseth; Svendsen, Kristin V Hirsch; Thornér, Elin Einarsdóttir; Goffeng, Lars Ole & Sikkeland, Liv Ingunn Bjoner [Show all 7 contributors for this article] (2019). Endotoxin and Hydrogen Sulphide Exposure and Effects on the Airways Among Waste Water Workers in Sewage Treatment Plants and Sewer Net System. Annals of Work Exposures and Health. ISSN 2398-7308. 63(4), p. 437–447. doi: 10.1093/annweh/wxz020. Full text in Research Archive Show summary

  Background: The purpose of this study is to investigate whether airborne exposure to endotoxins, hydrogen sulphide (H2S), and inhalable particles negatively impacts the respiratory system and inflammatory blood proteins in sewage plant and sewer net system workers and, further, to determine dose-response associations between exposure and health outcomes. Methods: In total, 148 waste water workers (WWWs) from urban and rural sewage plants and the sewer net system participated. One hundred and twenty-one workers were exposed to sewage, 46 from sewage plants and 75 from the sewer net system. Twenty-seven workers were characterized as little or not exposed and served as an internal reference group. Personal inhalable samples were analysed for endotoxins (Limulus assay), particle dust (gravimetrically) and Salmonella and Yersinia spp. (polymerase chain reaction method, PCR). Levels of H2S were measured using personal electro chemical sensors. Intercellular adhesion molecule 1 (ICAM-1), interleukin 8 (IL-8), surfactant protein D (SP-D), club cell protein 16 (CC16), and macrophage inflammatory protein (MIP) were determined by enzyme-linked immunosorbent assay and C-reactive protein (CRP) by an HS-MicroCRP assay in blood samples. Results: Workers in sewage plants were exposed to significantly higher levels of endotoxins compared to workers in the sewer net system [median 55 EU m−3 (4–262 EU m−3) and median 27 EU m−3 (1–304 EU m−3), respectively]. The estimated H2S index showed higher values when working in the sewer net system [median 3.1 (0.5–78.1)] compared to workers at the sewage plants [median 1.3 (0.5–9.3)], and the most excessive exposure was collecting sewage from cesspools (273 p.p.m.). No viable airborne Salmonella and Yersinia spp. were detected. The exposed workers had significantly higher CRP compared to the referents [1.2 µg ml−1 (0.1–19.0 µg ml−1) and 0.8 µg ml−1 (0.1–5.0 µg ml−1), respectively] and lower forced expiratory volume in 1 s (FEV1)% [92.6%, standard deviation (SD) 14.6 and 102.0%, SD 10.1, respectively], with numbers given as mean and SD. The serum concentration of CRP was significantly and negatively associated with FEV1% (β = −7.7, R2 = 0.05) and forced vital capacity % (β = −8.5, R2 = 0.08), and the serum concentration of ICAM-1 with the estimated exposure to H2S (β = −19.9, R2 = 0.07). Conclusion: Despite moderate levels of endotoxin and H2S exposure, the results indicate an impact of these agents on lung function and the adhesion molecule ICAM-1, and a low-grade systemic inflammation was indicated in increased levels of CRP.

• El-Zaemey, Sonia; Schinasi, Leah; Ferro, Gilles; Tual, Séverine; Lebailly, Pierre & Baldi, Isabelle [Show all 17 contributors for this article] (2019). Animal farming and the risk of lymphohaematopoietic cancers. A meta-analysis of three cohort studies within the AGRICOH consortium. Occupational and Environmental Medicine. ISSN 1351-0711. 76(11), p. 827–837. doi: 10.1136/oemed-2018-105655. Full text in Research Archive Show summary

  Animal farming entails a variety of potential exposures, including infectious agents, endotoxins and pesticides, which may play a role in the aetiology of lymphohaematopoietic cancers (LHCs). The aim of this study was to assess whether farming specific animal species is associated with the risk of overall LHC or its subtypes. Data from three prospective cohort studies in the USA, France and Norway which are part of the Agricultural Cohort consortium and which collected information about animal farming and cancer were used. Analyses included 316 270 farmers and farm workers. Adjusted Cox models were used to investigate the associations of 13 histological subtypes of LHC (n=3282) with self-reported livestock (cattle, pigs and sheep/goats) and poultry (ever/never and numbers raised) farming. Cohort-specific HRs were combined using random-effects meta-analysis. Ever animal farming in general or farming specific animal species was not meta-associated with overall LHC. The risk of myeloid malignancies decreased with increasing number of livestock (p trend=0.01). Increased risk of myeloproliferative neoplasms was seen with increasing number of sheep/goats (p trend <0.01), while a decreased risk was seen with increasing number of livestock (p trend=0.02). Between cohorts, we observed heterogeneity in the association of type of animal farmed and various LHC subtypes. This large-scale study of three prospective agricultural cohorts showed no association between animal farming and LHC risk, but few associations between specific animal species and LHC subtypes were observed. The observed differences in associations by countries warrant further investigations.

• Leon, Maria E.; Schinasi, Leah H.; Lebailly, Pierre; Freeman, Laura E. Beane; Nordby, Karl-Christian & Ferro, Gilles [Show all 17 contributors for this article] (2019). Pesticide use and risk of non-Hodgkin lymphoid malignancies in agricultural cohorts from France, Norway and the USA: A pooled analysis from the AGRICOH consortium. International Journal of Epidemiology. ISSN 0300-5771. 48(5), p. 1519–1535. doi: 10.1093/ije/dyz017. Full text in Research Archive Show summary

  Background: Pesticides are commonly used in agriculture, and previous studies endorsed the need to further investigate the possible association between their use and risk of lymphoid malignancies in agricultural workers. Methods: We investigated the relationship of ever use of 14 selected pesticide chemical groups and 33 individual active chemical ingredients with non-Hodgkin lymphoid malignancies (NHL) overall or major subtypes, in a pooled analysis of three large agricultural worker cohorts. Pesticide use was derived from self-reported history of crops cultivated combined with crop-exposure matrices (France and Norway) or self-reported lifetime use of active ingredients (USA). Cox regression models were used to estimate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs), which were combined using random effects meta-analysis to calculate meta-HRs. Results: During follow-up, 2430 NHL cases were diagnosed in 316 270 farmers accruing 3 574 815 person-years under risk. Most meta-HRs suggested no association. Moderately elevated meta-HRs were seen for: NHL and ever use of terbufos (meta-HR = 1.18, 95% CI: 1.00–1.39); chronic lymphocytic leukaemia/small lymphocytic lymphoma and deltamethrin (1.48, 1.06–2.07); and diffuse large B-cell lymphoma and glyphosate (1.36, 1.00–1.85); as well as inverse associations of NHL with the broader groups of organochlorine insecticides (0.86, 0.74–0.99) and phenoxy herbicides (0.81, 0.67–0.98), but not with active ingredients within these groups, after adjusting for exposure to other pesticides. Conclusions: Associations of pesticides with NHL appear to be subtype- and chemical-specific. Non-differential exposure misclassification was an important limitation, showing the need for refinement of exposure estimates and exposure–response analyses.

• Aarhus, Lisa; Veiersted, Kaj Bo; Nordby, Karl-Christian & Bast-Pettersen, Rita (2019). Neurosensory component of hand-arm vibration syndrome: a 22-year follow-up study. Occupational Medicine. ISSN 0962-7480. 69(3), p. 215–218. doi: 10.1093/occmed/kqz029. Full text in Research Archive Show summary

  Knowledge about the long-term course of the neurologic component of hand–arm vibration syndrome (HAVS) is scarce. To study the course and prognostic factors of the neurosensory component of HAVS over a period of 22 years. Forty male sheet metal workers, with a mean age of 60 (range 45–78) years at follow-up, were examined with a test battery in 1994 and 2017. At baseline, the sample comprised 27 workers with HAVS symptoms and 13 workers without HAVS symptoms. Among the 27 workers, 25 workers reported work-related hand–arm vibration during follow-up (mean 3639 h). In 2017, the mean time since vibration stopped was 8.4 years. Among the 27 workers with HAVS in 1994, no overall statistically significant change was observed in hand numbness (Stockholm Workshop Scale), shoulder/arm pain (pain scale) or finger pain from 1994 to 2017. However, vibration exposure during follow-up was associated with increased finger pain. Cotinine, carbohydrate-deficient transferrin, glycosylated haemoglobin and folate were not associated with changes in neurosensory symptoms or manual dexterity (Grooved Pegboard) from 1994 to 2017. A diagnosis of HAVS in 1994 did not predict poor hand strength 22 years later. Isolated hand numbness (without white finger attacks) was more common at baseline than at follow-up. This 22-year follow-up study indicates a tendency towards irreversibility of hand numbness and finger pain in workers with HAVS. Continued vibration exposure seems to predict increased finger pain. Our findings highlight the importance of HAVS prevention.

• Notø, Hilde Pettersen; Nordby, Karl-Christian; Skare, Øivind & Wijnand, Eduard (2018). Job tasks as determinants of thoracic aerosol exposure in the cement production industry. Annals of Work Exposures and Health. ISSN 2398-7308. 62(1), p. 88–100. doi: 10.1093/annweh/wxx085. Full text in Research Archive Show summary

  Background: The aims of this study were to identify important determinants and investigate the variance components of thoracic aerosol exposure for the workers in the production departments of European cement plants. Methods: Personal thoracic aerosol measurements and questionnaire information (Notø et al., 2015) were the basis for this study. Determinants categorized in three levels were selected to describe the exposure relationships separately for the job types production, cleaning, maintenance, foreman, administration, laboratory, and other jobs by linear mixed models. The influence of plant and job determinants on variance components were explored separately and also combined in full models (plant&job) against models with no determinants (null). The best mixed models (best) describing the exposure for each job type were selected by the lowest Akaike information criterion (AIC; Akaike, 1974) after running all possible combination of the determinants. Results: Tasks that significantly increased the thoracic aerosol exposure above the mean level for production workers were: packing and shipping, raw meal, cement and filter cleaning, and de-clogging of the cyclones. For maintenance workers, time spent with welding and dismantling before repair work increased the exposure while time with electrical maintenance and oiling decreased the exposure. Administration work decreased the exposure among foremen. A subjective tidiness factor scored by the research team explained up to a 3-fold (cleaners) variation in thoracic aerosol levels. Within-worker (WW) variance contained a major part of the total variance (35–58%) for all job types. Job determinants had little influence on the WW variance (0–4% reduction), some influence on the between-plant (BP) variance (from 5% to 39% reduction for production, maintenance, and other jobs respectively but an 79% increase for foremen) and a substantial influence on the between-worker within-plant variance (30–96% for production, foremen, and other workers). Plant determinants had little influence on the WW variance (0–2% reduction), some influence on the between-worker variance (0–1% reduction and 8% increase), and considerable influence on the BP variance (36–58% reduction) compared to the null models. Conclusion: Some job tasks contribute to low levels of thoracic aerosol exposure and others to higher exposure among cement plant workers. Thus, job task may predict exposure in this industry. Dust control measures in the packing and shipping departments and in the areas of raw meal and cement handling could contribute substantially to reduce the exposure levels. Rotation between low and higher exposed tasks may contribute to equalize the exposure levels between high and low exposed workers as a temporary solution before more permanent dust reduction measures is implemented. A tidy plant may reduce the overall exposure for almost all workers no matter of job type.

• Aarhus, Lisa; Stranden, Einar; Nordby, Karl-Christian; Thornér, Elin Einarsdóttir; Olsen, Raymond & Ruud, Bjørn [Show all 7 contributors for this article] (2018). Vascular component of hand-arm vibration syndrome: A 22-year follow-up study. Occupational Medicine. ISSN 0962-7480. 68(6), p. 384–390. doi: 10.1093/OCCMED/KQY085. Full text in Research Archive Show summary

  Background Vibration-induced white finger (VWF) is often assessed using the Stockholm Workshop Scale (SWS) and cold challenge plethysmography. However, long-term longitudinal studies using both methods are scarce. Aims To study the long-term course and prognostic factors of VWF assessed with the SWS and photoplethysmography (PPG), and to examine the effects of lifestyle on PPG score, regardless of VWF status. Methods Forty male construction workers were examined with a test battery and clinical examination in 1994 and 2016/17. Results At baseline, the sample comprised 27 workers with, and 13 without, symptoms of hand-arm vibration syndrome (HAVS). Thirty-five workers reported vibration exposure during follow-up. The mean age of the workers was 60 years (45–78) at follow-up. The paired t-test showed that PPG scores deteriorated from 1994 to 2017 in the 27 workers with HAVS in 1994 (mean difference 2.7 min, 95% confidence interval (CI) 0.2–5.2). However, there was no statistically significant change in SWS scores in these workers over time. Smoking and age were associated with PPG score deterioration. Vibration exposure during follow-up predicted SWS score deterioration: 1000 h of exposure predicted a deterioration stage of 0.09 (95% CI 0.03–0.16). Analysis of all 40 workers showed that 2017 PPG scores were associated with positive serum cotinine and self-reported smoking during follow-up. Conclusions Whereas age and smoking predicted a PPG deterioration, continued vibration exposure predicted worsening of white finger symptoms. The association of PPG score and smoking should be considered in diagnostic and prognostic factor evaluations.

• Goffeng, Elisabeth Martinsen; Nordby, Karl-Christian; Tarvainen, Mika P.; Järvelin-Pasanen, Susanna; Wagstaff, Anthony & Goffeng, Lars Ole [Show all 9 contributors for this article] (2018). Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep. Industrial Health. ISSN 0019-8366. 56(2), p. 122–131. doi: 10.2486/indhealth.2017-0100. Full text in Research Archive Show summary

  The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

• Cornet, Charlotte Le; Fervers, Béatrice; Pukkala, Eero; Tynes, Tore; Feychting, Maria & Hansen, Johnni [Show all 15 contributors for this article] (2017). Parental occupational exposure to organic solvents and testicular germ cell tumors in their offspring. NORD-TEST Study. Environmental Health Perspectives. ISSN 0091-6765. 125(6). doi: 10.1289/EHP864. Full text in Research Archive Show summary

  Background: Testicular germ cell tumors (TGCT) were suggested to have a prenatal environmentally related origin. The potential endocrine disrupting properties of certain solvents may interfere with the male genital development in utero. Objectives: We aimed to assess the association between maternal and paternal occupational exposures to organic solvents during the prenatal period and TGCT risk in their offspring. Methods: This registry-based case control study included TGCT cases aged 14–49 y (n=8,112) diagnosed from 1978 to 2012 in Finland, Norway, and Sweden. Controls (n=26,264) were randomly selected from the central population registries and were individually matched to cases on year and country of birth. Occupational histories of parents prior to the child’s birth were extracted from the national censuses. Job codes were converted into solvent exposure using the Nordic job-Nordic Occupational Cancer Study Job-Exposure Matrix. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: Overall, no association was found between prenatal maternal exposure to solvents and TGCT risk. In subset analyses using only mothers for whom occupational information was available in the year of or in the year prior to the child’s birth, there was an association with maternal exposure to aromatic hydrocarbon solvents (ARHC) (OR=1.53; CI: 1.08, 2.17), driven by exposure to toluene (OR=1.67; CI: 1.02, 2.73). No association was seen for any paternal occupational exposure to solvents with the exception of exposure to perchloroethylene in Finland (OR=2.42; CI: 1.32, 4.41). Conclusions: This study suggests a modest increase in TGCT risk associated with maternal prenatal exposure to ARHC.

• Fell, Anne Kristin Møller & Nordby, Karl-Christian (2017). Association between exposure in the cement production industry and non-malignant respiratory effects: A systematic review. BMJ Open. 7(4). doi: 10.1136/bmjopen-2016-012381. Full text in Research Archive Show summary

  Objectives: Based on findings from a systematic literature search, we present and discuss the evidence for an association between exposure to cement dust and non-malignant respiratory effects in cement production workers. Design and setting: Systematic literature searches (MEDLINE and Embase) were performed. Outcomes were restricted to respiratory symptoms, lung function indices, asthma, chronic bronchitis, chronic obstructive pulmonary disease, pneumoconiosis, induced sputum or fraction of exhaled nitric oxide (FeNO) measurements. Participants: The studies included exposed cement production workers and non-exposed or low-exposed referents. Primary and secondary outcomes: The searches yielded 594 references, and 26 articles were included. Cross-sectional studies show reduced lung function levels at or above 4.5 mg/m3 of total dust and 2.2 mg/m3 of respiratory dust. ORs for symptoms ranged from 1.2 to 4.8, while FEV1/FVC was 1–6% lower in exposed than in controls. Cohort studies reported a high yearly decline in FEV1/FVC ranging from 0.8% to 1.7% for exposed workers. 1 longitudinal study reported airflow limitation at levels of exposure comparable to ∼1 mg/m3 respirable and 3.7–5.4 mg/m3 total dust. A dose–response relationship between exposure and decline in lung function has only been shown in 1 cohort. 2 studies have detected small increases in FeNO levels during a work shift; 1 study reported signs of airway inflammation in induced sputum, whereas another did not detect an increase in hospitalisation rates. Conclusions: Lack of power, adjustment for possible confounders and other methodological issues are limitations of many of the included studies. Hence, no firm conclusions can be drawn. There are few longitudinal data, but recent studies report a dose–response relationship between cement production dust exposure and declining lung function indicating a causal relationship, and underlining the need to reduce exposure among workers in this industry.

• Brouwer, Maartje; Schinasi, Leah; Freeman, Laura E. Beane; Baldi, Isabelle; Lebailly, Pierre & Ferro, Gilles [Show all 10 contributors for this article] (2016). Assessment of occupational exposure to pesticides in a pooled analysis of agricultural cohorts within the AGRICOH consortium. Occupational and Environmental Medicine. ISSN 1351-0711. 73(6), p. 359–367. doi: 10.1136/oemed-2015-103319. Full text in Research Archive Show summary

  Background This paper describes methods developed to assess occupational exposure to pesticide active ingredients and chemical groups, harmonised across cohort studies included in the first AGRICOH pooling project, focused on the risk of lymph-haematological malignancies. Methods Three prospective agricultural cohort studies were included: US Agricultural Health Study (AHS), French Agriculture and Cancer Study (AGRICAN) and Cancer in the Norwegian Agricultural Population (CNAP). Self-reported pesticide use was collected in AHS. Crop-exposure matrices (CEMs) were developed for AGRICAN and CNAP. We explored the potential impact of these differences in exposure assessment by comparing a CEM approach estimating exposure in AHS with self-reported pesticide use. Results In AHS, 99% of participants were considered exposed to pesticides, 68% in AGRICAN and 63% in CNAP. For all cohorts combined (n=316 270), prevalence of exposure ranged from 19% to 59% for 14 chemical groups examined, and from 13% to 46% for 33 active ingredients. Exposures were highly correlated within AGRICAN and CNAP where CEMs were applied; they were less correlated in AHS. Poor agreement was found between self-reported pesticide use and assigned exposure in AHS using a CEM approach resembling the assessment for AGRICAN (κ −0.00 to 0.33) and CNAP (κ −0.01 to 0.14). Conclusions We developed country-specific CEMs to assign occupational exposure to pesticides in cohorts lacking self-reported data on the use of specific pesticides. The different exposure assessment methods applied may overestimate or underestimate actual exposure prevalence, and additional work is needed to better estimate how far the exposure estimates deviate from reality.

• Nordby, Karl-Christian; Notø, Hilde Pettersen; Wijnand, Eduard; Skogstad, Marit; Fell, Anne Kristin Møller & Thomassen, Yngvar [Show all 12 contributors for this article] (2016). Thoracic dust exposure is associated with lung function decline in cement production workers. European Respiratory Journal. ISSN 0903-1936. 48(2), p. 331–339. doi: 10.1183/13993003.02061-2015. Full text in Research Archive Show summary

  We hypothesised that exposure to workplace aerosols may lead to lung function impairment among cement production workers. Our study included 4966 workers in 24 cement production plants. Based on 6111 thoracic aerosol samples and information from questionnaires we estimated arithmetic mean exposure levels by plant and job type. Dynamic lung volumes were assessed by repeated spirometry testing during a mean follow-up time of 3.5 years (range 0.7–4.6 years). The outcomes considered were yearly change of dynamic lung volumes divided by the standing height squared or percentage of predicted values. Statistical modelling was performed using mixed model regression. Individual exposure was classified into quintile levels limited at 0.09, 0.89, 1.56, 2.25, 3.36, and 14.6 mg·m−3, using the lowest quintile as the reference. Employees that worked in administration were included as a second comparison group. Exposure was associated with a reduction in forced expiratory volume in 1 s (FEV1), forced expiratory volume in 6 s and forced vital capacity. For FEV1 % predicted a yearly excess decline of 0.84 percentage points was found in the highest exposure quintile compared with the lowest. Exposure at the higher levels found in this study may lead to a decline in dynamic lung volumes. Exposure reduction is therefore warranted.

• Knardahl, Stein; Sterud, Tom; Nielsen, Morten Birkeland & Nordby, Karl-Christian (2016). Arbeidsplassen og sykefravær : arbeidsforhold av betydning for sykefravær. Tidsskrift for velferdsforskning. ISSN 0809-2052. 14(2), p. 179–199. doi: 10.18261/issn.2464-3076-2016-02-05. Full text in Research Archive Show summary

  Det var sterkeste evidens som er mulig ved observasjonsstudier, for at mekanisk eksponering generelt, repetitive bevegelser, bøying av nakke/rygg, kombinasjonen høye krav og lav kontroll, og trakassering/mobbing øker risiko for sykefravær. Det var sterkeste mulige evidens ved observasjonsstudier for at kontroll, kontroll over arbeidstid og positivt sosialt klima reduserer risikoen. Det var evidens for manglende sammenheng mellom krav og sykefravær.

• Alfonso, Jose Hernan; Martinsen, Jan Ivar; Pukkala, Eero; Weiderpass, Elisabete; Tryggvadottir, Laufey & Nordby, Karl-Christian [Show all 7 contributors for this article] (2016). Occupation and relative risk of cutaneous squamous cell carcinoma (cSCC). A 45-year follow-up study in 4 Nordic countries. Journal of American Academy of Dermatology. ISSN 0190-9622. 75(3), p. 548–555. doi: 10.1016/j.jaad.2016.03.033. Full text in Research Archive Show summary

  Background: The age-adjusted incidence of cutaneous squamous cell carcinoma (cSCC) in the Nordic countries has increased during the last 60 years, and the identification of occupational variation in the relative risk of cSCC may have preventive implications. Objective: We sought to describe variation in the relative risk of cSCC between occupational categories in Finland, Iceland, Norway, and Sweden. Methods: This is a historical prospective cohort study based on record linkages between census data for 12.9 million people and cancer registry data from 1961 to 2005. Standardized incidence ratios for cSCC were estimated for 53 occupational categories with the cSCC incidence rates for the national population of each country used as reference. Results: During follow-up, 87,619 incident cases of cSCC were reported to the national cancer registries. In all countries combined, significant increased standardized incidence ratios were observed among seamen, military personnel, public safety workers, technical workers, teachers, transport workers, physicians, dentists, nurses, other health workers, religious workers, clerical workers, administrators, and sale agents (standardized incidence ratios between 1.08 and 1.77).

• Notø, Hilde Pettersen; Nordby, Karl-Christian & Wijnand, Eduard (2016). Relationships between Personal Measurements of 'Total' Dust, Respirable, Thoracic, and Inhalable Aerosol Fractions in the Cement Production Industry. Annals of Occupational Hygiene. ISSN 0003-4878. 60(4), p. 453–466. doi: 10.1093/annhyg/mev093. Full text in Research Archive Show summary

  Aims: The aims of this study were to examine the relationships and establish conversion factors between ‘total’ dust, respirable, thoracic, and inhalable aerosol fractions measured by parallel personal sampling on workers from the production departments of cement plants. ‘Total’ dust in this study refers to aerosol sampled by the closed face 37-mm Millipore filter cassette. Methods: Side-by-side personal measurements of ‘total’ dust and respirable, thoracic, and inhalable aerosol fractions were performed on workers in 17 European and Turkish cement plants. Simple linear and mixed model regressions were used to model the associations between the samplers. Results: The total number of personal samples collected on 141 workers was 512. Of these 8.4% were excluded leaving 469 for statistical analysis. The different aerosol fractions contained from 90 to 130 measurements and-side-by side measurements of all four aerosol fractions were collected on 72 workers. The median ratios between observed results of the respirable, ‘total’ dust, and inhalable fractions relative to the thoracic aerosol fractions were 0.51, 2.4, and 5.9 respectively. The ratios between the samplers were not constant over the measured concentration range and were best described by regression models. Job type, position of samplers on left or right shoulder and plant had no substantial effect on the ratios. Conclusions: The ratios between aerosol fractions changed with different air concentrations. Conversion models for estimation of the fractions were established. These models explained a high proportion of the variance (74–91%) indicating that they are useful for the estimation of concentrations based on measurements of a different aerosol fraction. The calculated uncertainties at most observed concentrations were below 30% which is acceptable for comparison with limit values (EN 482, 2012). The cement industry will therefore be able to predict the health related aerosol fractions from their former or future measurements of one of the fractions.

• Lie, Arve; Skogstad, Marit; Johannessen, Håkon Andre; Tynes, Tore; Mehlum, Ingrid Sivesind & Nordby, Karl-Christian [Show all 8 contributors for this article] (2016). Occupational noise exposure and hearing: a systematic review. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 89(3), p. 351–372. doi: 10.1007/s00420-015-1083-5. Full text in Research Archive Show summary

  Purpose: To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. Methods: A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Results: Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. Conclusion: The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age.

• Skogstad, Marit; Johannessen, Håkon Andre; Tynes, Tore; Mehlum, Ingrid Sivesind; Nordby, Karl-Christian & Lie, Arve (2016). Systematic review of the cardiovascular effects of occupational noise. Occupational Medicine. ISSN 0962-7480. 66(1), p. 10–16. doi: 10.1093/occmed/kqv148. Full text in Research Archive Show summary

  Abstract: Background Cross-sectional studies of occupational noise and cardiovascular effects show an association between noise and hypertension but for coronary heart disease or other cardiovascular diseases (CVDs) the evidence is not convincing. Aims: To assess possible associations between occupational noise exposure and the risk for cardiovascular effects in follow-up studies published after 1999. Methods: We performed a systematic critical literature review of original articles from key literature databases of associations between workplace noise and health. The studies were identified by search in Ovid Medline, Ovid Embase, Web of Science, Scopus and ProQuest Health and Safety Sciences Abstracts. We selected prospective studies of adequate quality with a measure of association between occupational noise exposure and cardiovascular health for the meta-analysis. Results: Twelve papers, all prospective and mostly with high quality but with methodological shortcomings in exposure assessment, were included in the review and meta-analysis. Exposure to noise at work was consistently positively associated with hypertension [Hazard ratio (HR) = 1.68; 95% confidence interval (CI) 1.10–2.57] and CVD [relative risk (RR) = 1.34; 95% CI 1.15–1.56]. In addition, we found a trivial effect of noise exposure on CVD mortality (HR = 1.12; 95% CI 1.02–1.24). Conclusions: Occupational noise exposure is strongly associated with hypertension. For other cardiovascular effects, this meta-analysis suggests a weak association, but the evidence is limited. More longitudinal studies on the effects of occupational noise on the cardiovascular system are warranted.

• Togawa, Kayo; Cornet, Charlotte Le; Feychting, Maria; Tynes, Tore; Pukkala, Eero & Hansen, Johnni [Show all 15 contributors for this article] (2016). Parental occupational exposure to heavy metals and welding fumes and risk of testicular germ cell tumors in offspring: A registry-based case-control study. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 25(10), p. 1426–1434. doi: 10.1158/1055-9965.EPI-16-0328. Full text in Research Archive Show summary

  Background: Data are scarce on the association between prenatal/preconception environmental exposure and testicular germ cell tumor (TGCT) in offspring. We examined parental occupational exposures to heavy metals and welding fumes in relation to TGCT in offspring in a registry-based case–control study (NORD-TEST Study). Methods: We identified TGCT cases diagnosed at ages 14–49 years in Finland (1988–2012), Norway (1978–2010), and Sweden (1979–2011) through nationwide cancer registries. These cases were individually matched by country and year of birth to controls selected from population registries. Information on parental occupations was retrieved from censuses. From this, we estimated prenatal/preconception exposures of chromium, iron, nickel, lead, and welding fumes (all three countries), and cadmium (Finland only) for each parent using job-exposure matrices specifying prevalence (P) and mean exposure level (L). Exposure indices were calculated as a product of P and L (P × L), and exposure categories were based on P × L or different combinations of P and L. Results: The study comprised 8,112 cases and 26,264 controls. We observed no statistically significant TGCT risk associated with presence of heavy metals/welding fumes (P × L > 0) and no dose-response relationship (Ptrend ≥ 0.32). A statistically significant elevated TGCT risk was found in paternal exposure category where both P and L of chromium were high (vs. no chromium; OR = 1.37, 95% confidence interval; 1.05–1.79). Conclusions: Our study provides little evidence of associations between parental exposures to heavy metals/welding fumes and TGCT in offspring with the potential exception of high paternal chromium exposure.

• Bast-Pettersen, Rita; Ulvestad, Bente; Færden, Karl; Clemm, Thomas Aleksander C.; Olsen, Raymond & Ellingsen, Dag [Show all 7 contributors for this article] (2016). Tremor and hand-arm vibration syndrome (HAVS) in road maintenance workers. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 90(1), p. 93–106. doi: 10.1007/s00420-016-1175-x. Full text in Research Archive Show summary

  Objectives: The aim of this study was to evaluate postural and rest tremor among workers using vibrating hand tools, taking into account the possible effects of toxicants such as alcohol and tobacco. A further aim was to study workers diagnosed with hand-arm vibration syndrome (HAVS) at the time of examination. Methods: This study comprises 103 road maintenance workers, 55 exposed to vibrating hand tools (age 41.0 years; range 21–62) and 48 referents (age 38.5 years; range 19–64). They were examined with the CATSYS Tremor Pen®. Exposure to vibrating tools and serum biomarkers of alcohol and tobacco consumption were measured. Results: Cumulative exposure to vibrating tools was associated with increased postural (p < 0.01) and rest tremor (p < 0.05) and with a higher Center Frequency of postural tremor (p < 0.01) among smokers and users of smokeless tobacco. Rest tremor Center Frequency was higher than postural tremor frequency (p < 0.001). Conclusions: The main findings indicate an association between cumulative exposure to hand-held vibrating tools, tremor parameters and consumption of tobacco products. The hand position is important when testing for tremor. Rest tremor had a higher Center Frequency. Postural tremor was more strongly associated with exposure than rest tremor. The finding of increased tremor among the HAVS subjects indicated that tremor might be a part of the clinical picture of a HAVS diagnosis. As with all cross-sectional studies, inferences should be made with caution when drawing conclusions about associations between exposure and possible effects. Future research using longitudinal design is required to validate the findings of the present study.

• Cornet, Charlotte Le; Fervers, Beatrice; Dalton, Susanne Oksbjerg; Feychting, Maria; Pukkala, Eero & Tynes, Tore [Show all 16 contributors for this article] (2015). Testicular germ cell tumours and parental occupational exposure to pesticides: A register-based case-control study in the nordic countries (NORD-TEST study). Occupational and Environmental Medicine. ISSN 1351-0711. 72(11), p. 805–811. doi: 10.1136/oemed-2015-102860. Full text in Research Archive Show summary

  Abstract: Objectives A potential impact of exposure to endocrine disruptors, including pesticides, during intrauterine life, has been hypothesised in testicular germ cell tumour (TGCT) aetiology, but exposure assessment is challenging. This large-scale registry-based case–control study aimed to investigate the association between parental occupational exposure to pesticides and TGCT risk in their sons. Methods: Cases born in 1960 or onwards, aged between 14 and 49 years, and diagnosed between 1978 and 2013 in Denmark, Finland, Norway or Sweden, were identified from the respective nationwide cancer registries. Four controls per case were randomly selected from the general national populations, matched on year of birth. Information on parental occupation was collected through censuses or Pension Fund information and converted into a pesticide exposure index based on the Finnish National Job-Exposure Matrix. Results: A total of 9569 cases and 32 028 controls were included. No overall associations were found for either maternal or paternal exposures and TGCT risk in their sons, with ORs of 0.83 (95% CI 0.56 to 1.23) and of 1.03 (0.92 to 1.14), respectively. Country-specific estimates and stratification by birth cohorts revealed some heterogeneity. Cryptorchidism, hypospadias and family history of testicular cancer were risk factors but adjustment did not change the main results. Conclusions: This is the largest study on prenatal exposure to pesticides and TGCT risk, overall providing no evidence of an association. Limitations to assess individual exposure in registry-based studies might have contributed to the null result.

• Pearce, Neil; Blair, Aaron; Vineis, Paolo; Ahrens, Wolfgang; Andersen, Aage & Anto, Josep M. [Show all 124 contributors for this article] (2015). IARC monographs: 40 years of evaluating carcinogenic hazards to humans. Environmental Health Perspectives. ISSN 0091-6765. 123(6), p. 507–514. doi: 10.1289/ehp.1409149. Full text in Research Archive Show summary

  Background: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. Objectives: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed. Discussion: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. Conclusions: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public’s health.

• Casas, Maribel; Cordier, Sylvaine; Martinez, David; Barros, Henrique; Bonde, Jens Peter & Burdorf, Alex [Show all 34 contributors for this article] (2015). Maternal occupation during pregnancy, birth weight, and length of gestation: Combined analysis of 13 European birth cohorts. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 41(4), p. 384–396. doi: 10.5271/sjweh.3500. Full text in Research Archive Show summary

  Objectives We assessed whether maternal employment during pregnancy – overall and in selected occupational sectors – is associated with birth weight, small for gestational age (SGA), term low birth weight (LBW), length of gestation, and preterm delivery in a population-based birth cohort design. Methods We used data from >200 000 mother-child pairs enrolled in 13 European birth cohorts and compared employed versus non-employed women. Among employees, we defined groups of occupations representing the main sectors of employment for women where potential reproductive hazards are considered to be present. The comparison group comprised all other employed women not included in the occupational sector being assessed. We performed meta-analyses of cohort-specific estimates and explored heterogeneity. Results Employees had a lower risk of preterm delivery than non-employees [adjusted odds ratio (ORadj) 0.86, 95% confidence interval (95% CI) 0.81–0.91]. Working in most of the occupational sectors studied was not associated with adverse birth outcomes. Being employed as a nurse was associated with lower risk SGA infants (ORadj 0.91, 95% CI 0.84–0.99) whereas food industry workers had an increased risk of preterm delivery (ORadj 1.50, 95% CI 1.12–2.02). There was little evidence for heterogeneity between cohorts. Conclusions This study suggests that, overall, employment during pregnancy is associated with a reduction in the risk of preterm birth and that work in certain occupations may affect pregnancy outcomes. This exploratory study provides an important platform on which to base further prospective studies focused on the potential consequences of maternal occupational exposures during pregnancy on child development.

• Notø, Hilde Pettersen; Nordby, Karl-Christian; Kjuus, Helge; Skare, Øivind; Thomassen, Yngvar & Wijnand, Eduard (2014). Exposure to thoracic aerosol in a prospective lung function study of cement production workers. Annals of Occupational Hygiene. ISSN 0003-4878. 59(1), p. 4–24. doi: 10.1093/annhyg/meu080. Full text in Research Archive Show summary

  Introduction: An exposure study was conducted as part of a multi-national longitudinal study of lung function in cement production workers. Aim: To examine exposure to thoracic aerosol among cement production workers during a 4-year follow-up period. Methods: Personal shift measurements of thoracic aerosol were conducted among the cement production workers within seven job types, 22 plants, and eight European countries (including Turkey) in 2007, 2009, and 2011. The thoracic sub-fraction was chosen as the most relevant aerosol fraction related to obstructive dynamic lung function changes. Production factors, job type, and respirator use were recorded by questionnaire. The exposure data were log-transformed before mixed models analysis and results were presented by geometric mean (GM adj ) exposure levels adjusted for plant or job type, worker, and season as random effects. Results: A total of 6111 thoracic aerosol samples were collected from 2534 workers. Repeated measurements were obtained from 1690 of these workers. The GM adj thoracic aerosol levels varied between job types from 0.20 to 1.2mg m −3 . The highest exposure levels were observed for production, cleaning, and maintenance workers (0.79–1.2mg m −3 ) and could reach levels where the risk of lung function loss may be increased. The lowest levels were found for administrative personnel (0.20mg m −3 ) serving tasks in the production areas. Office work was not monitored. GM adj exposure levels between plants ranged from 0.19 to 2.0mg m −3 . The time of year/season contributed significantly to the total variance, but not year of sampling. Production characteristics explained 63% of the variance explained by plant. Workers in plants with the highest number of employees (212–483 per plant) were exposed at a level more than twice as high as those in plants with fewer employees. Other production factors such as cement production, bag filling, and tidiness were significant, but explained less of the exposure variability. These determinants factors can be useful in qualitative exposure assessment and exposure prevention in the cement production industry. Respirator use was minor at exposure levels <0.5mg m −3 but more common at higher levels. Conclusion: Production, cleaning, and maintenance work were the job types with highest exposure to thoracic aerosol in cement production plants. However, plant had an even larger effect on exposure levels than job type. The number of employees was the most important factor explaining differences between plants. Exposure reached levels where the risk of lung function loss may be increased. No significant differences in exposure between sampling campaigns were observed during the 4-year study period.

• Bast-Pettersen, Rita; Skare, Øivind; Nordby, Karl-Christian & Skogstad, Marit (2014). A twelve-year longitudinal study of neuropsychological function in non-saturation professional divers. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 88, p. 669–682. doi: 10.1007/s00420-014-0991-0. Full text in Research Archive Show summary

  Objectives: Our main aim was to study the long-term neuropsychological effects of non-saturation diving. Further, we aimed to investigate whether neuropsychological performance was predictive of subsequent diving accidents and diving status. Methods: In this prospective longitudinal study, we enrolled 50 male diving students (mean age 25.3 years) at a diving school and followed them up six and 12 years later (43 and 37 divers, respectively). At each wave of the study, divers completed a comprehensive neuropsychological test battery and answered questionnaires on cumulative number of dives, incidents of decompression illness (DCI) and professional diver status. Results: At the 12-year follow-up, the divers reported a median number of 455 (range 40–5,604) cumulative dives. Cumulative number of dives was not associated with any adverse neuropsychological effects. However, divers with an incident of DCI performed worse in a memory test (Benton Visual Retention Test) and reported slightly more neuropsychiatric symptoms (Q 16). Diver students who performed well on a blindfolded memory test (tactual performance test) had an increased likelihood of becoming a professional diver 12 years later. Conclusions: The main findings in the present study support the view that asymptomatic non-saturation divers who have dived under controlled conditions do not have an increased risk of impaired nervous system function, at least not to an extent that can be detected with neuropsychological tests while they still are relatively young. The observed associations between a history of DCI and impaired results in a memory test and reporting of neuropsychiatric symptoms may be due to a nervous system effect caused by DCI. The diver students’ ability of problem-solving while they were blindfolded was predictive of their likelihood of becoming a professional diver 12 years later.

• Weinbruch, Stephan & Nordby, Karl-Christian (2013). Fatalities in High Altitude Mountaineering: A Review of Quantitative Risk Estimates. High Altitude Medicine & Biology. ISSN 1527-0297. 14(4), p. 346–359. doi: 10.1089/ham.2013.1046. Full text in Research Archive Show summary

  Fatalities in high altitude mountaineering: A review of quantitative risk estimates. High Alt Med Biol 14:346–359, 2013.—Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59–0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.

View all works in NVA

• Hasting, Rachel Louise; Kirkeleit, Jorunn; Hoff, Rune; Skaugset, Nils Petter; Straumfors, Anne & Nordby, Karl-Christian Karlsen (2025). 8292123 Cumulative occupational exposure to wood dust and interstitial lung disease: a Norwegian cohort study. Occupational and Environmental Medicine. ISSN 1351-0711. 82(Suppl 2), p. A99–A99. doi: 10.1136/oemed-2025-epicohabstracts.241. Full text in Research Archive
• Pedersen, Martine & Nordby, Karl-Christian (2025). Arbeidsmiljøeksponeringer i petroleumsindustrien og helseeffekter. Full text in Research Archive
• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnni; Martinsen, Jan Ivar; Nordby, Karl-Christian & Olsen, Raymond [Show all 9 contributors for this article] (2025). Occupational exposures of firefighting and prostate cancer risk in the Norwegian fire departments cohort. Occupational and Environmental Medicine. ISSN 1351-0711. 82(Suppl. 1). doi: 10.1136/oemed-2024-epicohabstracts.3. Full text in Research Archive Show summary

  Objectives: In their 2022 classification of firefighting as carcinogenic, the International Agency for Research on Cancer deemed the evidence of the association with prostate cancer (PC) ‘limited’, citing an inability to rule out that a medical surveillance bias fully explained firefighters’ excess PC incidence compared to the general population. Our aim was to compare PC risk within a firefighter cohort, applying indicators of exposures. Methods: We used employment duration and the indicators fire exposure score, inhalation score and diesel exhaust exposure score to examine PC risk among men in the Norwegian Fire Departments Cohort (n=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960–2021). Cox regression was used to estimate hazard ratios (HRs) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PCs, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined. Results: During 123,835 person-years of follow-up, there were 268 PC cases (61 aggressive, 69 indolent, 138 unclassifiable). No clear associations emerged for any of the exposure indicators, although elevated HRs were observed for aggressive PCs in the highest tertile of fire exposure score compared to the lowest (1.51, 95% CI 0.63–2.72), and for indolent PCs in the highest tertile of inhalation score compared to the lowest (1.31, 95% CI 0.60–2.89). Assessment of cumulative incidence by stage demonstrated a greater number of diagnoses of indolent and unclassifiable PC at younger ages from 1990. Conclusions: We did not observe clear associations between our exposure indicators and PC risk. However, our study had few cases in analyses by clinical stage. Studies of PC risk among firefighters remain challenged by difficulties in exposure characterization and a limited understanding of PC etiology, as well as the unclear magnitude of a medical surveillance bias. Funding: This work was funded by the Foundation Dam (grant no: 2019/FO247424), Cancer Society of Norway, Norwegian Firefighters Fight Cancer, Norwegian Union of Municipal and General Employees, Norwegian Union of Marine Engineers, and the Fire Union in Delta. Acknowledgements: We wish to thank Jarle Jakobsen (Nordland Hospital, Bodø, Norway) for his work in the early stages of this study. We also wish to thank the fire departments that collected and shared their data that constitutes the Norwegian Fire Departments Cohort, as well as our project reference group (comprising representatives from firefighters’ unions, employers’ organisations, the volunteer organisation ‘Norwegian Firefighters Fighting Cancer’, the Norwegian Directorate for Civil Protection, the Norwegian Labour Inspection Authority, and the Norwegian Cancer Society) for their contributions to the project.

• Håland, Alexander; Nordby, Karl-Christian; Olsen, Raymond & Alfonzo, Sabrina (2025). Duftlys sammenlignes med gasskomfyrer: – Kan bli farlig. [Internet]. www.tv2.no. Full text in Research Archive
• Hasting, Rachel Louise; Merkus, Suzanne; Undem, Karina; Kirkeleit, Jorunn; Hoff, Rune & Gran, Jon Michael [Show all 8 contributors for this article] (2025). Cohort Profile: The Nor-Work Cohort. International Journal of Epidemiology. ISSN 0300-5771. 54(2). doi: 10.1093/ije/dyaf019. Full text in Research Archive Show summary

  The Nor-Work cohort was established in 2018 to identify differences in health, labour force participation, and related outcomes, and to study how these outcomes are associated with other factors, including occupation and occupational exposures. The dynamic cohort consists of individuals born between 1930 and 1992 who have ever lived and/or worked in Norway and who have a Norwegian personal identification number (N = 5 799 138). Data are available from 1960 to 2022, though exact time periods vary between data sources. Nor-Work contains data from several national administrative registers, which allows for prospective follow-up. The register-based nature means individuals cannot opt out, and thus there is no attrition. The cohort is mainly intended for occupational epidemiological research, and contains information on employment, occupation and industry, diagnoses from specialist healthcare and health registries, health-related benefits and their diagnoses (sickness absence, disability benefits), as well as demographic and socioeconomic factors. Occupation is registered from 2003; prior to this, self-reported occupation is available from the censuses in 1960, 1970, and 1980, and for a subset of the population in 1990. For the years in which occupational data are missing, imputed occupation is available.

• Ervik, Torunn Kringlen; Leite, Mimmi; Weinbruch, Stephan; Nordby, Karl-Christian; Ellingsen, Dag & Ulvestad, Bente [Show all 9 contributors for this article] (2024). Size distribution and characterization of particles generated during tunnel boring machine excavation. Full text in Research Archive
• Graff, Pål; Grgic, Miriam; Mollerup, Steen Kristen; Afanou, Komlavi Anani; Bang, Berit Elisabeth & Nordby, Karl-Christian [Show all 8 contributors for this article] (2024). Respiratory symptoms and exposure to allergenic proteins in shrimp processing plants. Full text in Research Archive
• Haugen, Øyvind Pernell; Sagen, Andreas Solberg; Ervik, Torunn Kringlen; Graff, Pål; Brinchmann, Bendik Christian & Alcolea-Rodriguez, Victor [Show all 11 contributors for this article] (2024). Immune Effects of Pristine and Microbially Contaminated PET Nanoplastics. Full text in Research Archive
• Pedersen, Martine; Leite, Mimmi & Nordby, Karl-Christian (2023). BHTs kjerneoppgaver. Full text in Research Archive
• Nordby, Karl-Christian (2023). Health effects bioaerosol exposure. Full text in Research Archive
• Nordby, Karl-Christian (2023). Health effects of hand-arm vibration exposure. Full text in Research Archive
• Nordby, Karl-Christian (2023). Reprotoksikologi. Full text in Research Archive
• Nordby, Karl-Christian (2023). Risikovurdering i arbeidsmedisinen. Full text in Research Archive
• Nordby, Karl-Christian (2023). Reprotoxicology mechanisms. Full text in Research Archive
• Nordby, Karl-Christian (2023). Introduksjon epidemiologi, kausalitet i epidemiologi. Full text in Research Archive
• Nordby, Karl-Christian (2023). Epidemiology. Full text in Research Archive
• Nordby, Karl-Christian (2023). Risikovurdering, Full text in Research Archive
• Nordby, Karl-Christian (2023). Helseundersøkelser ved toksikologiske eksponeringer. Full text in Research Archive
• Schulze, Daniel Gregor; Nilsen, Kristian Bernhard; Clemm, Thomas; Grotle, Margreth; Ulvestad, Bente & Nordby, Karl-Christian (2023). Peripheral neuropathy among workers with Hand-arm vibration exposure. Clinical Neurophysiology. ISSN 1388-2457. 150. doi: 10.1016/j.clinph.2023.03.028. Full text in Research Archive Show summary

  Objectives Identify associations between peripheral neuropathy and Hand-arm vibration exposure. Content Background: Carpal tunnel syndrome (CTS) and ulnar neuropathy (UNE) are common among workers exposed to hand-arm vibration (HAV). The role of ergonomic factors is unclear. We aimed to investigate the relationship between CTS and UNE and HAV-exposure in workers using vibrating tools with different ergonomic profile. Methods: We tested two groups of workers with exposure to hand-arm vibration from different tools. All workers were tested with nerve conduction studies (NCS) of sensory and motor

• Marjerrison, Niki; Grimsrud, Tom Kristian; Hansen, Johnnie; Martinsen, Jan Ivar; Nordby, Karl-Christian & Veierød, Marit Bragelien [Show all 7 contributors for this article] (2022). Cancer incidence and mortality in the Norwegian Fire Departments cohort: Are incidence versus mortality outcome measures contributing to variability in risk estimates? Full text in Research Archive
• Marjerrison, Niki; Jakobsen, Jarle; Grimsrud, Tom Kristian; Hansen, Johnnie; Martinsen, Jan Ivar & Nordby, Karl-Christian [Show all 8 contributors for this article] (2022). Cancer incidence and mortality in the Norwegian Fire Departments Cohort, 1960-2018. Full text in Research Archive
• Brinchmann, Bendik Christian; Bugge, Merete Drevvatne; Nordby, Karl-Christian & Alfonso, Jose Hernan (2022). Firefighting and melanoma, epidemiological and toxicological associations: a case report. Occupational Medicine. ISSN 0962-7480. 72(2), p. 142–144. doi: 10.1093/occmed/kqab183. Full text in Research Archive Show summary

  The International Agency for Research on Cancer (IARC) classifies firefighting as possibly carcinogenic to humans, and polychlorinated biphenyls (PCBs) as carcinogens with sufficient evidence for development of melanoma in humans. We present a case report of a firefighter with melanoma and history of 33 years of occupational exposure. Based on the available epidemiological and toxicological evidence of association between being a firefighter and developing melanoma, melanoma was recognized by the Norwegian Labour and Welfare Service as an occupational disease in our patient. In 2017, melanoma was acknowledged as an occupational disease in only 8 out of 28 surveyed European countries. Melanoma should be considered as a possible occupational disease among firefighters with a history of relevant exposure. Further recognition of the occupational exposures leading to increased risk of melanoma is still needed for preventive purposes.

• Brouwer, Maartje; Schinasi, Leah; Freeman, Laura E. Beane; Baldi, Isabelle; Lebailly, Pierre & Ferro, Gilles [Show all 10 contributors for this article] (2017). Assessment of occupational exposure to pesticides in a pooled analysis of agricultural cohorts within the AGRICOH consortium: Authors' response. Occupational and Environmental Medicine. ISSN 1351-0711. 74(1), p. 82–82. doi: 10.1136/oemed-2016-104110. Full text in Research Archive
• Bast-Pettersen, Rita; Ulvestad, Bente; Færden, Karl; Clemm, Thomas Aleksander C; Olsen, Raymond & Ellingsen, Dag [Show all 7 contributors for this article] (2016). Erratum to: Tremor and hand-arm vibration syndrome (HAVS) in road maintenance workers (Int Arch Occup Environ Health, 10.1007/s00420-016-1175-x). International Archives of Occupational and Environmental Health. ISSN 0340-0131. 90(1), p. 107–107. doi: 10.1007/s00420-016-1188-5. Full text in Research Archive
• Heldal, Kari K; Svendsen, Kristin V Hirsch; Madsø, Lene; Einarsdottir, Elin; Austigard, Åse Dalseth & Goffeng, Lars Ole [Show all 7 contributors for this article] (2015). lung function and systemic inflammation among waste water workers. Full text in Research Archive
• Goffeng, Lars Ole; Heldal, Kari Emilie; Madsø, Lene; Einarsdottir, Elin; Svendsen, Kristin V Hirsch & Austigard, Åse Dalseth [Show all 7 contributors for this article] (2015). Respiratory and neuropsychological function among waste water workers. Full text in Research Archive
• Kristensen, Petter & Nordby, Karl-Christian (2014). Kan gravide fortsette i jobb? Arbeid og helse. ISSN 0806-3648. p. 14–15. Full text in Research Archive
• Straumfors, Anne; Notø, Hilde Pettersen; Zardin, Erika; Olsen, Raymond; Foss, Oda Astrid Haarr & Afanou, Komlavi Anani [Show all 8 contributors for this article] (2026). Eksponering for kjemiske plantevernmidler og mikrobiologisk mangfold blant veksthusansatte. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Norge har omfattende produksjon av blomster, frukt og grønt, med grønnsaker som største hagebrukssektor. Bruk av plantevernmidler (PVM) varierer fra minimal på urter til svært utbredt på blomstrende planter. På grunn av mulig spredning og helserisiko er PVM et viktig forskningsfelt, men reell human eksponering er lite studert og ikke tidligere målt i Norge. Denne rapporten er den første norske studien som kvantifiserer PVM-eksponering i arbeidsmiljø via luft og hud, og undersøker om funnene gjenspeiles i urin. Den er også først til å vurdere om PVM påvirker mikrobiomet i arbeidsplassluft, på hud og i nesesvelg hos veksthusansatte. Trettifire veksthusansatte fra fem veksthus med blomstrende planter som bruker kjemiske PVM og tre veksthus med tomat, agurk og blomster som ikke bruker kjemiske PVM deltok. I tillegg deltok 30 kontoransatte som en kontrollgruppe som ikke jobber med planter eller kjemiske stoffer. Virkestoffer fra vanlige PVM ble analysert parallelt med mengde og mangfold av bakterier og sopp. Alle virkestoffene ble påvist over deteksjonsgrensen i flere luftprøver fra blomsterveksthus, hovedsakelig på lave nivåer (ng/m³), med høyest konsentrasjoner av daminozid og flonikamid. Hudnivåene økte etter arbeid, særlig for daminozid, med enkelte målinger opp til 100–500 ng/cm². Eksponeringen var høyere i blomsterveksthus enn i grønnsaksveksthus. Lave nivåer av imazalil og fenhexamid i urin hos et mindretall indikerte begrenset systemisk opptak, mens kontoransatte sjelden hadde påvisbare nivåer. Total bakteriekonsentrasjon var lik i veksthus med og uten bruk av kjemiske plantevernmidler, mens soppkonsentrasjonen i inhalerbar aerosol var høyere i veksthus uten slik bruk. Veksthusansatte hadde høyere mikrobiell eksponering på håndledd etter arbeid enn kontoransatte, mens forskjellene på nesevingene var små. Høyest bakteriemengde i nesesvelg ble funnet hos ansatte i blomsterveksthus med plantevernmiddelbruk. Det mikrobielle artsmangfoldet var generelt høyere hos veksthusansatte, særlig i blomsterveksthus, og mikrobiomsammensetningen skilte seg fra kontoransattes, men med delvis overlapp. Det ble ikke funnet noen klar indikasjon på at bruk av PVM reduserte det mikrobielle artsmangfoldet i blomsterveksthus. Av 45 testede antimikrobielle resistens (AMR)-gener ble 20 påvist i inhalerbar aerosol fra veksthusmiljøer. Høyest andel positive prøver ble observert for aph3_2, int1_3, strA_3 og strB_5. Flere β‑laktam‑ og tetrasyklinresistensgener forekom i høyere konsentrasjoner i blomsterveksthus enn i grønnsaksveksthus, med enkelte ekstreme verdier. Normalisert mot bakteriemengde var AMR‑gen-nivåene lave, men med tydelig variasjon mellom bedrifter. Veksthusansatte rapporterte flere plager etter arbeid enn kontoransatte. Luftveis- og øyesymptomer, tørr hud og tretthet forekom blant ansatte i grønnsaksveksthus, trolig relatert til støveksponering. Symptomer som tungpustethet, tetthet i brystet og kvalme/oppkast ble kun rapportert av ansatte i veksthus der PVM ble benyttet. Antall respondenter var imidlertid lavt, og funnene må tolkes med varsomhet. Det anbefales å styrke rutiner for håndtering av kjemiske PVM med hensyn til bruk og vedlikehold av blandings- og påføringsutstyr, korrekt og konsekvent bruk av personlig verneutstyr, overhold av ventetid (re-entry-tid), hyppig skifte/vask av klær og hansker, og hudvask etter arbeid. Det er behov for videre forskning for å kartlegge mikrobiomets artssammensetning og vurdere betydningen forskjellene kan ha for human helse, og for å vurdere om nivåene av AMR-gener utgjør en sprednings- og helserisiko for ansatte.

• Marjerrison, Niki; Kjærheim, Jenny Kristina; Stenehjem, Jo; Grimsrud, Tom Kristian; Veierød, Marit Bragelien & Martinsen, Jan Ivar [Show all 9 contributors for this article] (2025). Kreftrisiko blant brannkonstabler 2015–2024. Folkehelseinstituttet. Full text in Research Archive Show summary

  Rapporten undersøker kreftrisiko blant norske brannkonstabler basert på en stor kohortstudie med nær 4700 ansatte fra 15 brannvesen. Studien viser at brannkonstabler har høyere forekomst av enkelte kreftformer enn den generelle befolkningen, særlig urinveiskreft, mesoteliom (brysthinnekreft), strupekreft, prostatakreft og tarmkreft. Risikoen var størst blant personer med lang ansettelsestid og blant dem som arbeidet i de tidligste periodene. Funnene gir særlig støtte til en sammenheng mellom yrkeseksponering ved brannslokking og risiko for urinveiskreft og mesoteliom. For prostatakreft kan den økte forekomsten delvis forklares av tidligere og hyppigere diagnostisering. Rapporten konkluderer med at resultatene støtter IARCs vurdering av brannyrket som kreftfremkallende, og understreker behovet for fortsatt forebygging og videre forskning på helsekonsekvenser av brannyrket

• Clemm, Thomas; Lindell, Hans & Nordby, Karl-Christian (2025). Minimering av støv og vibrasjoner. Prosjekt i IA-bransjeprogram for Bygg og anlegg: Utvikling og testing av tekniske hjelpemidler som reduserer helseskadelig kvartsstøv og vibrasjoner ved fjellboring. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Prosjektet «Minimering av støv og vibrasjoner» har hatt som mål å utvikle og teste tekniske hjelpemidler for å redusere eksponeringen for kvartsstøv og mekaniske vibrasjoner ved fjellboring. Arbeidet er et samarbeid mellom Statens Arbeidsmiljøinstitutt (STAMI), IA-bransjeprogram for bygg og anlegg, RISE Institute, og flere entreprenører og byggherrer. Gjennom prosjektet ble det utviklet og testet flere prototyper, inkludert vibrasjonsdempende håndtak, fjærdempere, vektlodd med integrert demping og en spesialtilpasset støvsuger for fjellbor. Målinger viste at vibrasjonsnivået ble redusert med 50–80 %, og at støvsugeren effektivt ledet bort steinstøv fra arbeidstakernes pustesone. Dette bidrar til å redusere risikoen for yrkessykdommer som hånd-arm vibrasjonssyndrom (HAVS) og lungesykdommer forårsaket av kvartsstøv. Tilbakemeldinger fra arbeidstakere som testet utstyret var overveiende positive. Samtlige opplevde redusert vibrasjonsnivå, og flertallet rapporterte om mindre støv i pustesonen. Noen opplevde at det krevde tilvenning og justering av arbeidsteknikk, men de fleste ønsket å fortsette å bruke utstyret. Prototypene har allerede blitt kommersialisert gjennom TM Verkstad, og verktøyprodusenter vurderer videreutvikling av teknologien, inkludert implementering av avansert demping i nye borhammerdesign. Prosjektet har også bidratt til økt bevissthet blant byggherrer og entreprenører, og det pågår initiativ for å innlemme krav til støv- og vibrasjonsdemping i anbudsprosesser. På lengre sikt kan tiltakene bidra til redusert sykefravær, færre tilfeller av yrkessykdom, mindre belastningsskader og et tryggere arbeidsmiljø i bygg- og anleggsbransjen.

• Merkus, Suzanne; Christensen, Jan Olav; Hasting, Rachel Louise; Lie, Jenny-Anne Sigstad; Koch, Markus & Nordby, Karl-Christian [Show all 8 contributors for this article] (2025). Arbeidsmiljøets påvirkning på kvinners arbeidshelse og arbeidstilknytning.En kunnskapsoppsummering. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Rapporten gir en oversikt over vitenskapelige artikler publisert siden 2010 om hvordan arbeidsmiljøfaktorer påvirker kvinners arbeidshelse og arbeidstilknytning i en nordisk kontekst. Rapporten begrenser inklusjonskriteriene til fagfellevurderte vitenskapelige artikler med longitudinelle studier fra nordiske land med populasjoner bestående av enten bare kvinner, hovedsakelig kvinner eller ansatte i kvinnedominerte yrker. Funnene må derfor tolkes innenfor disse rammene, og rapporten gir ikke noen uttømmende oversikt over all relevant kunnskap knyttet til kvinners arbeidshelse eller arbeidstilknytning. Totalt ble 327 artikler inkludert. 243 handlet om påvirkning av arbeidsmiljøfaktorer på arbeidshelse og 94 om påvirkning av arbeidsmiljøfaktorer på arbeidstilknytning. Psykososiale arbeidsmiljøfaktorer er studert i flest artikler (148 artikler), etterfulgt av mekaniske/ ergonomiske (96 artikler), organisatoriske (69 artikler) og kjemiske/biologiske (44 artikler). Færrest antall artikler studerte fysiske arbeidsmiljøfaktorer (23 artikler). Sju artikler har sett på flere arbeidsmiljøfaktorer samtidig. Av de inkluderte studiene var 0 fra Island, 41 fra Norge, 58 fra Finland, 92 fra Sverige og 119 fra Danmark, og 17 artikler kombinerte data fra flere land i Norden. Vi vurderte på forhånd følgende helseforhold til å være spesielt relevante for kvinner i arbeid: vanlige psykiske plager, muskel- og skjelettplager, brystkreft, hjerte- og karsykdom, hodepine, utbrenthet og søvn og søvnforstyrrelser. I tillegg kartla vi hvilke arbeidsmiljøfaktorer som påvirker følgende tilstander som kun angår kvinner: graviditet og kvinnelig reproduksjon samt livsfaser med hormonell påvirkning. Vi fant at disse arbeidsmiljøfaktorene var viktige for helseforhold som er spesielt relevante for kvinner: Vanlige psykiske plager: Mobbing, trakassering/vold/trusler, høye jobbkrav, høye krav / lav kontroll, prekære arbeidsforhold (arbeidsbetingelser preget av uforutsigbarhet og dårlige lønns- og kontraktsvilkår) og jobbusikkerhet, arbeidsoppgaver som oppfattes som urimelige eller unødvendige, nattarbeid og tungt fysisk arbeid øker risikoen for vanlige psykiske plager. Muskel- og skjelettplager: Fysisk tungt arbeid, pasientforflytning uten hjelpemidler og ubekvemme arbeidsposisjoner øker risikoen for muskel- og skjelettplager. Brystkreft: Skift- og nattarbeid og løsemiddeleksponering øker risikoen for brystkreft. Hjerte- og karsykdom: Høye jobbkrav og korte arbeidsfrie perioder mellom skift øker risikoen for hjerte- og karsykdom. Hodepine: Det finnes ikke nok forskning til å fastslå hvilke arbeidsmiljøfaktorer som er forbundet med hodepine hos kvinner. Utbrenthet: Høye jobbkrav, trakassering, vold/trusler og lang arbeidstid øker risikoen for utbrenthet. Søvn og søvnforstyrrelser: Mobbing, korte arbeidsfrie perioder mellom skift og skiftarbeid øker risikoen for søvnforstyrrelser.

• Hasting, Rachel Louise; Straumfors, Anne; Skaugset, Nils Petter & Nordby, Karl-Christian (2024). Sykefravær og helseplager i trevareindustrien. En tilleggsstudie til trestøvprosjektet. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Denne registerbaserte studien har undersøkt mulige helseeffekter av å jobbe i trevareindustrien kontra andre næringer, med spesielt fokus på luftveissykdommer som kan skyldes eksponering for trestøv. Data fra flere administrative registre ble koblet sammen for perioden 1983-2021, og vi valgte å se på insidens av sykefravær ≥16 kalenderdager, arbeidsavklaringspenger (AAP), uføretrygd, kontakt med spesialisthelsetjenesten, og kreft blant ansatte i næringer som tilhører trevareindustrien kontra en sammenligningsnæring (oppføring av bygninger) og resten av den generelle yrkesbefolkningen. Vi så også på forskjellige lengder av sykefravær og AAP hver for seg (mindre enn 6 måneder kontra mer enn 6 måneder). Vi fokuserte særlig på luftveisdiagnoser og kreft i nesen og bihulene, svelget og strupehodet, samt lungekreft. Selv om vi ikke hadde eksponeringsnivå koblet til registerdataene tilgjengelig i denne studien, kan disse utfall si noe om plager som oppleves i trevareindustrien kontra andre næringer, og de hyppigst forekommende helseplagene kan gi en indikasjon på om eksponering for trestøv eller andre eksponeringer beskrevet i en tidligere STAMI-rapport (STAMI, 2023) kan spille inn. Resultatene tyder på at trevareindustrien har en noe høyere forekomst av sykefravær generelt, men at forekomsten av luftveisdiagnoser var noe lavere enn i andre næringer. Dette gjaldt særlig for sykefraværsepisoder som varte lenger enn 6 måneder. Det var også flere i trevareindustrien som hadde kontakt med spesialisthelsetjenesten, både generelt og for luftveissykdommer. Av luftveisdiagnosene (rhinitt, kols, bronkitt og astma) som vi så nærmere på, skilte rhinitt og astma seg ut, med høyere forekomst i trevareindustrien sammenliknet med oppføring av bygninger og resten av den generelle yrkesbefolkningen. Kreftinsidens var ikke særlig annerledes blant trevareindustrien og de andre næringene, med unntak av næringen 16.231 (produksjon av monteringsferdige hus) som hadde en noe høyere forekomst av lungekreft, spesielt undergruppen adenokarsinom, sammenlignet med de andre næringene i trevareindustrien og generelt. Tallene er imidlertid deskriptive, og det er ikke mulig å justere for andre faktorer som kan også være årsak til lungekreft, for eksempel røyking. Vi fant ingen tydelige forskjeller mellom trevareindustrien og andre næringer i forhold til AAP og uføretrygd. Vi fant heller ingen klare endringer i helseutfallene ved sammenlikning av utfall som oppstod før og etter 1991 (da grenseverdien for myke treslag ble satt ned fra 5mg/m3 til 2mg/m3), før og etter 2001 (da Avtalen om et mer inkluderende arbeidsliv ble innført), eller før og etter 2020 (da grenseverdien for harde treslag og blandede treslag ble endret til 1mg/m3). Det sistnevnte var dessuten vanskelig å undersøke med vårt datamateriale, da vi hadde data bare frem til 2021. Det ser ut som om eksponeringer i trevareindustrien kan føre til helseplager, og at luftveisplager er såpass plagsomt at mange oppsøker en spesialist. Siden vi manglet data på sykefraværsepisoder som var kortere enn 16 kalenderdager, kan det hende at vi ikke har klart å fange opp forskjeller mellom trevareindustrien og andre næringer i forbindelse med luftveissykdommer som vanligvis ikke vil trenge lengre sykemeldinger. Vi hadde imidlertid ikke informasjon om hvor mye eller hvor ofte arbeidstakerne var eksponert for trestøv, så det er vanskelig å tolke dette som en sikker sammenheng mellom helseplagene og eksponeringer i trevareindustrien. Men variasjonene i helseutfall og den økte forekomsten av sykefravær og kontakt med spesialisthelsetjenester i trevareindustrien, sammenliknet med oppføring av bygninger, som har lignende oppgaver, men sannsynligvis mindre eksponering, tyder på at 4 eksponering kan være en del av forklaringen på de næringsvise forskjellene vi ser i studien. Det er viktig for bedrifter å følge med på symptomer og sykdommer som ikke nødvendigvis viser seg i sykefravær. De bør også fokusere på eksponering og innføring av forebyggende tiltak for arbeidstakere som viser tegn på helseplager som kan være relatert til arbeidet.

• Clemm, Thomas & Nordby, Karl-Christian (2023). Bad vibrations: Exposure-response between rock drilling and vibration sensitivity at the fingertips. Universitetet i Oslo. ISSN 9788234803024. Full text in Research Archive Show summary

  This study, conducted at the National Institute of Occupational Health in Norway, delves into the occupational health risks faced by workers exposed to vibration from handheld power tools. The research, led by Thomas Clemm as part of his PhD work at the University of Oslo addresses the limited understanding of dose-response mechanisms for neurological symptoms. The challenge of biased exposure measurements, especially in hand-guided tools like rock drills, is acknowledged, emphasizing the need for accurate exposure assessment. The research, involving 148 workers in road maintenance, evaluates dose-response relationships between HAV exposure and vibration perception thresholds (VPT) and pegboard scores. Lifetime cumulative exposure and daily vibration exposure were measured, employing health examinations, including VPT and Pegboard tests, at baseline, 2 years, and 4 years. The findings highlight a significant exposure-response relationship between rock drill exposure and VPT, with a stronger correlation using a novel exposure measure. Even workers with relatively low exposure from impact wrenches exhibit increased VPT, challenging the safety limit level. The 500 Hz test frequency emerges as a potential marker for early signs of reduced tactile sensitivity. Simultaneous measurements using tool-attached and hand-attached accelerometers reveal a significant difference, with individual working techniques influencing the variance. This underscores the importance of careful assessment and consideration of accelerometer placement to avoid exposure misclassification. The study concludes that exposure from rock drills correlates with increased VPT, suggesting a basis for risk models of HAVS. It emphasizes the need to reconsider the exposure limit level and explore the 500 Hz frequency as an early marker. The research also cautions against bias introduced by hand-attached accelerometers, underscoring the importance of precise exposure assessments in occupational health studies.

• Clemm, Thomas; Lindell, Hans & Nordby, Karl-Christian (2023). Ingen dårlige vibber, vibrasjonseksponering i bygg- og anleggsbransjen. Utvikling og måling av vibrasjonsreduserende tiltak for arbeidstakere som bruker håndstyrte- og håndholdte vibrerende verktøy. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Arbeidstakere som håndterer vibrerende verktøy med høyt vibrasjonsnivå som overføres til hånd og arm under bruk, har risiko for å utvikle kroniske skader av vibrasjon, blant annet hånd-arm vibrasjonssyndrom (HAVS). Ifølge NOAs Faktabok er anslagsvis 60 000 norske arbeidstakere utsatt for vibrasjoner mot hånd og arm mer enn ¼ av arbeidsdagen. Et samarbeidsprosjekt ble opprettet på initiativ fra IA-programmet – Bygg og Anlegg for å evaluere og gjøre kjent tiltak mot vibrasjonseksponering. Prosjektet identifiserte teknologiske løsninger som kan anvendes for å redusere de håndoverførte vibrasjonene i utvalgte håndholdte og håndstyrte verktøy som brukes i bygg- og anleggsbransjen og som er kjent for å bidra til risiko for vibrasjonsskader. Hovedaktiviteten i prosjektet ble knyttet til ombyggingstiltak på fjellbor som brukes under sikring av fjellskråninger. Utvalgte fjellbor ble modifisert med ny teknologi og et måleprogram for å evaluere effekten av ombyggingene ble gjennomført før og etter modifiseringen. I tillegg ble utvalgte mindre vibrerende verktøy som er i bruk i bransjen systematisk målt for å vurdere de faktiske vibrasjonsnivåene i praktisk bruk, sammenliknet med oppgitt vibrasjonsnivå fra produsent. Endelig ble det også utviklet en ny støvsugerløsning for å begrense støveksponering ved bruk av trykkluftdrevet fjellbor, og effekten ble dokumentert med video. Måling av vibrasjon fra håndstyrte fjellbor og mindre håndholdte verktøy brukt i bygg- og anleggsbransjen viser at de målte vibrasjonsegenskapene til verktøyene til dels kan avvike betydelig fra oppgitte vibrasjonsdata fra produsent. Det kan derfor, ved vibrasjonsnivåer opp mot eller over tiltaksgrensen for eksponering (2,5 m/s2 for en 8-timersdag) være behov for måling av vibrasjon i arbeidsmiljøet som supplement til vurdering av eksponering ut fra en kalkulasjon av eksponeringsnivå. Vanligvis er slik kalkulasjon basert på produsentdata og estimert faktisk brukstid for de ulike håndholdte vibrerende verktøy som arbeidstaker bruker gjennom arbeidsdagen. Resultatene i prosjektet viser at kartlegging av eksponeringsnivåer kun basert på vibrasjonsdata oppgitt fra produsent kan gi et feilaktig eksponeringsbilde og er derfor kun egnet til grovkartlegging av eksponeringen i praktisk bruk av verktøyet. Metoden er imidlertid mindre egnet til detaljert kartlegging og risikovurdering når nivået på vibrasjonen kalkuleres til å ligge nær eller over tiltaksverdien. To typer fjellbor som er i bruk i Mesta AS sin fjellsikringsavdeling ble valgt ut og modifisert gjennom påmontering av ATVA (en mekanisk innretning som bygger på prinsippet om å dempe vibrasjon gjennom å skape motbevegelse med samme frekvens som vibrasjonen som skal dempes). Videre ble håndtakene/ kontaktpunktene som arbeidstaker bruker for å styre retning, stabilitet og press mot stenflaten det bores gjennom modifisert med fjærdempende mekanismer. Endelig ble det også gjort målinger med og uten påmontert lodd på fjellbor som brukes i vertikal boring. De utprøvde modifikasjonene viser at det er mulig å redusere vibrasjonsnivået under bruk av verktøyet med 50-90%. Den praktiske bruken av de ombygde verktøyene ble noe påvirket av mekaniske feil som oppsto etter modifikasjonene, noe som indikerer behov for videre utvikling av innfestingspunktene for dempehåndtak og den mekaniske holdbarheten av utstyret. Videre viser prosjektet at det er mulig å bygge inn ATVAmekanisme under oppbygging av nye fjellbor. Dette vil kreve noe utviklingsarbeid hos produsentene av utstyret, men vil gi betydelig reduksjon i vibrasjonsnivå. Slik reduksjon innebærer redusert helserisiko ved bruk, men gir også økt brukstid for verktøyet før tiltaks- og grenseverdier overskrides og reduserer også behovet for at verktøyene designes med ekstra masse i vibrasjonsdempende øyemed. Tyngden på verktøyet i seg selv er vibrasjonsdempende, men gir også økt belastning for arbeidstakeren i form av tung håndtering – ofte under krevende topografiske forhold. Slik sett er lette verktøy med lavere vibrasjonsnivå fordelaktig i en bredere ergonomisk sammenheng. Prosjektgruppen håper at rapporten vil bidra til etterspørsel av utstyr med gunstigere vibrasjonsegenskaper fra byggherrer og entreprenører ut fra disse betraktningene, og at dette vil føre til at produsentene videreutvikler aktuelle utstyr og bygger inn tilgjengelige vibrasjonsdempende løsninger i utstyret. Vi ønsker at de dokumenterte erfaringene fra de prototypene som samarbeidsprosjektet under IAprogrammet Bygg og Anlegg har utviklet kan bidra til denne utviklingen.

• Nordby, Karl-Christian; Pedersen, Ine; Hovik, Jon; Afanou, Komlavi Anani; Trulssen, Tonje Hildre & Heldal, Kari Emilie (2018). Utførelse av arbeid – oversikt over arbeidsmiljøforhold. Kjemiske og biologiske arbeidseksponeringer i gjenvinningsindustrien. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Dette prosjektet er et bidragsprosjekt der STAMI, med økonomisk støtte fra Norsk Industri og med praktisk tilrettelegging fra 3 av medlemsbedriftene i Norsk Industri, har foretatt en kartlegging av eksponering for biologiske arbeidsmiljøfaktorer i gjenvinningsindustrien. Det ble bestemt i samråd med referansegruppen at fokus skulle være på prøvetaking i representative anlegg for prosessering av innsamlet avfall og at analysene skulle konsentreres omkring faktorer av betydning for mulig biologisk helsefare ved eksponering for bioaerosoler. Det ble også besluttet å gå gjennom og beskrive hovedtrekk fra aktuell dokumentasjon fra de deltakende bedriftene, mottatt direkte fra disse og ekstrahert fra EXPO-databasen ved STAMI. Fire anlegg i de tre deltakende bedriftene ble valgt ut i samråd med bedriftene. Helskifts personlig prøvetaking (5-7 timers innsamlingstid) av luft fra pustesonen for analyse av biologiske faktorer ble foretatt med i alt 18 parallelle prøvesett (personer). Prøvetakingen ble gjennomført over 6 dager på de 4 anleggene. Personene ble valgt ut fra deres planlagte arbeid den aktuelle dagen, og vi valgte personer som skulle utføre sine normale arbeidsoppgaver i det vesentlige utenfor maskiner med lukket kabin. Prøvematerialet er analysert og resultatet presentert som gjennomsnittlig luftkonsentrasjon av totalstøv, endotoksin, soppsporer og aktinobakteriesporer, alle pr. kubikkmeter innsamlet luft. Resultatene viste som ventet en meget stor variasjon av måleverdiene. Av de målte verdiene for endotoksineksponering og soppsporeeksponering lå henholdsvis 76 prosent og 83 prosent over de anbefalte grenseverdiene, noe som innebærer risiko for at betennelsessystemene i kroppen blir aktivisert. Selv om en høy andel av de som er eksponert på dette nivået oppgir å bruke åndedrettsvern, bør det gjøres en oppdatering av risikovurderingene knyttet til arbeidsoperasjonene som er inkludert i den foreliggende undersøkelsen, og av disse bør tiltak for eksponeringsreduksjon følge. De målte nivåene for eksponering i de kartlagte situasjonene tilsier videre at flere av arbeidsoppgavene på anleggene bør kartlegges enn det som ble gjort i denne studien. Resultatene i denne 2 rapporten vil være egnet som bakgrunnsmateriale ved utarbeidelse og revisjon av informasjonsdatablader. Det vil bli levert en tilleggsrapport om analyser av sopp- og bakterie-DNA fra prøvetakere som er blitt eksponert som tilleggsaktivitet integrert med prøvetakingen i det foreliggende prosjektet. Disse resultatene er forventet tilgjengelig i løpet av 2018

• Olsen, Raymond; Pedersen, Ine; Berlinger, Balazs; Nordby, Karl-Christian; Daae, Hanne Line & Johansen, Thea Haugsten [Show all 9 contributors for this article] (2017). Rengjøringsmidler i sprayform. Frigir de helsefarlige stoffer til arbeidsatmosfæren som kan inhaleres til lungene? STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Statens arbeidsmiljøinstitutt (STAMI) sin faktabok om arbeidsmiljø og helse 2015 viser at renholdere er yrkesgruppen som oppgir høyest forekomst av luftveisplager i form av tetthet og piping i brystet. I vitenskapelig litteratur for øvrig, konkluderer to populasjonsbaserte studier og en systematisk oversiktsartikkel med at renholdere har økt risiko for utvikling av astma, både blant profesjonelle renholdere og andre yrkesgrupper som er involvert i renholdsarbeid. Bruk av rengjøringsmidler i sprayform er en eksponering som peker seg ut, men det er en mangel på studier som har karakteriserert denne eksponeringen. Ut i fra et forebyggende perspektiv er det nødvendig å studere hvorvidt rengjøringsmidler i sprayform frigir helseskadelige stoffer som kan inhaleres til lungene. Det er derfor gjennomført en undersøkelse av det kjemiske arbeidsmiljøet til renholdere ved rom- og sanitærrengjøring. Hensikten med studien var å etablere en universell prøvetakings- og analysemetode som kan benyttes på alle rengjøringsmidler i sprayform, undersøke sprayflasker og rengjøringsmidler som benyttes til rom- og sanitærrengjøring med hensyn på generering av de helserelaterte aerosolfraksjonene; inhalerbar, torakal og respirabel aerosolfraksjon og flyktige organiske forbindelser (VOC), samt utføre personbårne eksponeringsmålinger på renholdere ved relevante arbeidsoperasjoner. Undersøkelsen av sprayflasker og rengjøringsmidler i laboratorieforsøk omfattet 17 produkter og 7 sprayflasker fra de to største levererandørene av rengjøringsmidler i Norge. Resultatene viser at det er vesentlige forskjeller mellom sprayflasker som benyttes til rom- og sanitærrengjøring i Norge både når det gjelder andel luftbåren massefraksjon ved spraying og generering av de helserelaterte aerosolfraksjonene; inhalerbar, torakal og respirabel aerosolfraksjon. Canyon sprayflasken med regulerbar dyse, som er en av de mest benyttede sprayflaskene i Norge blant profesjonelle renholdere, var den sprayflasken som genererte mest inhalerbar og torakal aerosol i et standardisert laboratorieforsøk. Laboratorieforsøkene viste at mengden inhalerbar og torakal aerosol kan reduseres med mer enn 92 % ved å bruke en lavtrykksprøyte med regulerbar dyse i stedet for en Canyon sprayflaske med regulerbar dyse. Laboratorieforsøkene viste også at mengden inhalerbar og torakal aerosol vil bli ytterligere redusert ved bruk av sprayflasker med skumdyse. De personbårne eksponeringsmålingene av torakal aerosolfraksjon i forbindelse med rom- og sanitærrengjøring viste seg å være relativt lave sammenlignet med eksponeringer en vanligvis finner i norsk arbeidsliv, men det er vanskelig å gjøre vurderingen, da det ikke finnes grenseverdier for flesteparten av kjemikaliene som finnes i rengjøringsmidler. De personbårne målingene viste videre at eksponeringen for flyktige organiske forbindelser fra parfymer var lav sammenlignet med gjeldende grenseverdier, men at eksponeringen for 2-propanol potensielt kan overskride gjeldende grenseverdi ved bruk av «klar-til-bruk» glass- og overflaterengjøringsprodukter som inneholder 2propanol. Eksponering til de øvre og dypere luftveier er en forutsetning for at eksponeringen skal kunne gi helseskadelige effekter på luftveiene. I et forebyggende øyemed bør derfor eksponeringen for inhalerbar og torakal aerosolfraksjon ved bruk av rengjøringsmidler i sprayform være så lav som mulig. En reduksjon av eksponeringen er i så måte å forbinde med god forebygging.

• Heldal, Kari Emilie; Madsø, Lene; Thornér, Elin Einarsdóttir; Goffeng, Lars Ole; Nordby, Karl-Christian & Austigard, Åse Dalseth [Show all 7 contributors for this article] (2016). Eksponering og helse-effekter på luftveiene og sentralnervesystemet ved håndtering av avløpsvann. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Tidligere studier fra Stami har vist at arbeidere på renseanlegg har en risiko for å bli eksponert for biologiske faktorer og da spesielt endotoksin og bakterier som kan forårsake irritasjoner og betennelsesreaksjoner i luftveiene. Det ble registrert en reduksjon i lungefunksjonen og endringer i inflammatoriske biomarkører fra lungene, noe som ble tolket som tidlige tegn på betennelsesreaksjoner grunnet eksponering under arbeid. En lavgradig systemisk betennelsesreaksjon viste også en sammenheng med en redusert lungefunksjon. Mange rapporterte også plager fra sentralnervesystemet, noe som kan relateres til eksponering for den giftige gassen hydrogensulfid (H2S). I en ny oppfølgingsstudie finansiert av Norsk Vann, Fagforbundet, Arbeidstilsynet og LO ønsket vi derfor å sette fokus på eksponering for hydrogensulfid i tillegg til endotoksin. Andre arbeidsgrupper som eksponeres for avløpsvann, nemlig arbeidere i avløpsnettet er lite studert og ble inkludert i undersøkelsesgruppen. En oppfølging av lungefunksjonen for å studere mer kronisk utvikling av tetthet i luftveiene ble også inkludert. 149 arbeidere fra renseanlegg og avløpsnett i Oslo og Trondheim med kommuner i omegn deltok i helseundersøkelsen. Helseundersøkelsen besto av lungefunksjonsmåling, nevropsykologiske undersøkelser og en blodprøve for å studere inflammatoriske markører. 27 av arbeiderne ble karakterisert som lavt eller ikke eksponert i løpet av arbeidsdagen og benyttet som en intern referansegruppe. Til sammen 160 personlige målinger av eksponering under håndtering av avløpsvann ble tatt fra de samme stedene, inkludert er personlige prøver fra et tidligere eksponeringsprosjekt i Trondheim kommune. Prøvene ble analysert for endotoksin, støvpartikler og patogene bakterier (Salmonella sp., Yersinia sp.). Samtidig målte vi personbåren eksponering for H2S. Eksponering for endotoksin ved arbeid med avløpsvann ble målt i moderate konsentrasjoner (1-350 EU/m3), men høye topper over nivåer som kan gi effekter på luftveiene forekommer. Eksponering for H2S ble påvist i uakseptable konsentrasjoner ved arbeid med septik (30-40 ppm) og transport av slam (270 ppm). Opp mot halvparten (47-61 %) av alle arbeiderne svarte at de var plaget av luftveisirritasjoner, trøtthet og hodepine i forbindelse med arbeidet, og luftveisplager 8 ble rapportert oftere enn referentene. Det ble registrert redusert lungefunksjon (FEV1, FVC) blant eksponerte arbeidere i forhold til referentene, og det var ingen forskjell i lungefunksjon blant arbeidere på renseanlegg i forhold til arbeidere i avløpsnettet. I en tidligere studie av avløpsarbeidere på renseanlegg så vi en sammenheng mellom en forhøyet lavgradig betennelsesreaksjon i kroppen (CRP) og en redusert lungefunksjon. Dette ble videre bekreftet også i denne studien. I serum ble det målt noe forhøyet CRP blant arbeidere i forhold til referenter (2,6 og 1,4 µg/ml) og spesielt blant i arbeidere i avløpsnettet (3,0 µg/ml). Den forhøyede reaksjonen viste en sammenheng med den reduserte lungefunksjonen også i denne studien. Det var ingen signifikante sammenhenger mellom opplevde plager og eksponering på arbeidsplassen. Vi så imidlertid en sammenheng mellom en lavere lungefunksjon og de som var høyere eksponert for endotoksin (β = - 0,21, R2=0,18, p<0,05). Selv om vi ikke kunne registrere noen signifikante endringer i noen av biomarkørene fra lungene blant arbeidere i forhold til referenter, så vi en sammenheng mellom beregnet H2S eksponering og lunge biomarkørene ICAM-1 og CC16. Disse resultatene bekrefter funn fra tidligere studier fra arbeid på renseanlegg og kan videre tolkes som at arbeidere som håndterer avløpsvann kan være mer sårbare for inflammasjonsreaksjoner fra lungene og i kroppen forårsaket av eksponeringen de daglig utsettes for, også i avløpsnettet. Resultatene kan være til hjelp for å vurdere i hvilken grad arbeiderne bør følges opp i bedriftshelsetjenestene med hensyn på symptomer og lungefunksjon. Det var imidlertid kun en tendens til at ekspsonering for H2S og endotoksin kunne forsterke hverandre i effektene på lungefunksjonen. Det var heller ingen tydelige forskjeller mellom arbeidere og referenter fra de nevropsykologiske testene som registrerte tremor, skjelving osv. Det må bemerkes at plager som undersøkes ved testene er diffuse og det er begrenset standardisert referanse-materiale å kunne vurdere plagene opp mot. I en oppfølging av lungefunksjonen etter tre år, så vi ingen større fall i lungefunksjonen enn det som er normalt. Selv om tre år kan være noe kort tid og undersøkelsesgruppen er liten, betyr dette at det ikke er tegn til kronisk obstruktive effekter på lungene blant arbeiderne.

• Nordby, Karl-Christian; Kristensen, Petter; Grimsrud, Tom Kristian; Ulvestad, Bente & Kjærheim, Kristina (2015). Forekomst av lymfohematologisk kreft hos ansatte og studenter ved Rosenborglaboratoriene, NTNU. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Denne rapporten omhandler forekomst av LH-kreft blant studenter og ansatte ved Rosenborglaboratoriene i perioden 1960-2004. LH-kreft er forkortelse for lymfohematologisk kreft – kreftsykdommer i blod- og lymfedannende organer. Undersøkelsesgruppen omfatter alle ansatte, stipendiater og studenter med tilknytning til Rosenborglaboratoriene ved NTNU i perioden fra 1960 til 2004 (kalt Rosenborgkohorten). Utredningen bygger på tidligere utredninger i denne saken, og i sin natur kan slike utredninger som dette aldri sikkert bekrefte eller avkrefte årsakssammenhenger knyttet til de studerte utfallene, slik tilfellet er for alle studier som tar utgangspunkt i en allerede observert overhyppighet av sykdom i en gruppe (cluster). Bakgrunnen for den foreliggende undersøkelsen er at det midt på 1990-tallet ble observert en opphoping (engelsk: cluster) av LH-kreft blant individer som arbeidet eller studerte ved Rosenborglaboratoriene. Det er kjent at kreftfremkallende stoffer (agens) har vært i bruk ved laboratoriene, og det ble tidlig reist mistanke om at det kunne være en sammenheng mellom opphopingen av kreft og eksponering for slike agens. Hensikten med denne undersøkelsen er å beskrive forekomsten av LH-kreft i Rosenborgkohorten i lys av individuell tilknytning til laboratorier og kurs der kreftfremkallende agens har vært i bruk, med en lengre observasjonstid enn det man har hatt tidligere. Rapporten omfatter 8552 personer som har studert eller arbeidet ved NTNU sine biologiske og kjemiske laboratorier på Rosenborg i en periode fra 1960-tallet, inkludert alle som var ansatt før 1960 og som ikke hadde sluttet før dette året. Kreftdiagnoser stilt i tiden mellom startåret for den enkelte på Rosenborg og utgangen av 2012 er tatt med, men ikke diagnoser stilt før 1953 som er det første året for Kreftregisterets virksomhet. Totalt 47 tilfeller av LH-kreft er meldt til Kreftregisteret i kohorten i løpet av oppfølgingstiden. I rapporten er kreft diagnostisert før 1.1.2006 og kreft diagnostisert i perioden 1.1.2006-31.12.2012 behandlet separat, slik at en kan sammenlikne den foreliggende rapporten med tidligere rapportering av kreft i den samme kohorten (Kristensen m.fl. 2007a, 2007b). Det er ikke funnet overhyppighet av LH-kreft i den totale undersøkelsesgruppen i oppfølgingsperioden 1953-2012. I enkelte undergrupper var det derimot en overhyppighet av LH-kreft fram til utgangen av 2005. I første rekke var den økte forekomsten knyttet til virksomhet av ansatte og studenter ved laboratorier hvor det har vært bruk av kreftfremkallende agens som benzen og formaldehyd, slik det har vært påvist i de tidligere rapportene av kreftforekomst i kohorten. Gjennom de siste årene av oppfølgingstiden i denne rapporten (2006-2012), er det ikke lenger påvist en overhyppighet i de tidligere eksponerte gruppene. Dagens kunnskap tyder på at risikoen for benzenutløst leukemi avtar etter opphør av eksponeringen, og at den blir nærmest normal etter 15 år, men for non-Hodgkin-lymfom (NHL) antas at en eventuell risiko knyttet til benzen vil holde seg forhøyet i lengre tid. Når benzeneksponering knyttet til arbeid/studier opphører, vil en derfor forvente at risikoen for LH-kreft knyttet til slik eksponering etter som tiden går vil komme ned på samme nivå som i befolkningen forøvrig. Siden forrige undersøkelse er det også kommet nye vitenskapelige holdepunkter for at kjemisk utløst LH-kreft kan oppstå ved lavere eksponeringsnivåer enn tidligere antatt. Det er også kommet til kunnskap som underbygger mistanken om at flere typer LH-kreft innenfor non-Hodgkin-lymfomgruppen kan være benzen-relaterte. Således er analysene av clusteret, sammenholdt med den nye kunnskapen om kjemisk indusert LHkreft, forenlig med en opphoping av tilfeller grunnet arbeidsmiljøeksponering. Like fullt kan funnene fortsatt også være forenlig med en tilfeldig opphoping av tilfeller. Selv om det ikke er mulig å konkludere om årsaker med vitenskapelig sikkerhet i denne typen studier, er en forklaringsmodell knyttet til eksponering for benzen og formaldehyd noe tydeligere sannsynliggjort som forklaring på LH-kreft i Rosenborgkohorten enn tidligere.

• Sterud, Tom; Christensen, Jan Olav; Johannessen, Håkon Andre & Nordby, Karl-Christian (2014). Midlertidig ansettelsesformer og helse – en kunnskapsoversikt. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Bakgrunn: Utbredelsen av midlertidige ansettelsesordninger har økt de siste tiårene i mange Europeisk land. Fra slutten av 1990 tallet og utover på 2000-tallet er det blitt publisert flere studier som har undersøkt sammenheng mellom midlertidige ansettelsesformer og dårligere helse, sykefravær og ulykker. Forskningslitteraturen fram til 2003 ble oppsummert i en systematisk litteraturgjennomgang publisert av Virtanen og medarbeidere i 2005 (1). En oppdatering av denne litteraturgjennomgangen ble publisert av Ferrie og medarbeider i 2008 (2). For å etterprøve konklusjonene fra foreliggende litteraturgjennomganger gjennomførte vi et oppdatert litteratursøk for perioden 2003 til desember 2013. Søkestrategien er basert på søketermene som ble rapportert i den systematiske litteraturgjennomgang til Virtanen m.fl. Vårt formål med denne kunnskapsoversikten er å gjengi hovedresultatene fra de to forliggende litteraturgjennomgangene og vurdere hvorvidt det har kommet fram nye studier som svekker eller styrker tilliten til gjeldende konklusjoner. Resultater: Basert på vår litteratursøk for perioden 2003 til desember 2013 identifiserte vi ytterligere 68 studier (i tillegg til de 27 studiene publisert fram til 2003). Helseutfallene som ble hyppigst rapportert var ulykker (n = 19), psykiske helseplager (n =28 ), somatiske plager (n =17) og sykefravær (n =4). En overvekt av nyere studier underbygger konklusjonen fra den forrige litteraturgjennomgangen. Midlertidig ansatte ser ut til å ha høyere forekomst av psykiske plager på tvers av studier fra ulike land, men nasjonale forskjeller ser ut til å ha betydning. Studier fra henholdsvis Sverige og Finland har funnet henholdsvis en vesentlig økt risiko for selvrapporterte psykiske plager og en økt risiko for bruk av reseptbelagt medisin mot depresjon. Det er indikasjoner på at sammenhengen mellom midlertidig ansettelser og psykisk helse er knyttet til graden av stabilitet og forutsigbarhet i ansettelsesforholdet og dermed vil kunne påvirkes av lovverk og regulering i ulike land og også mellom ulike sektorer. Forskning på sammenhengen mellom midlertidig arbeid og selvrapportert generell fysisk helse og muskelskjelettplager gir ikke entydige svar. Nyere studier fra Finland har dokumenter økt dødelighet blant de som var mest misfornøyd med å være midlertidig ansatte og blant ufrivillig midlertidig ansatte, men det er vanskelig å si noe sikkert om årsaken til dette. En klar overvekt av studier finner en forhøyet risiko for arbeidsskader blant midlertidig ansatte. Resultatene ser ut til å være rimelig konsistente på tvers av ulike nasjonal kontekster, men påvirkes av hvilke populasjoner man har studert. I en studie fra Finland ble den observerte økende skadetrenden blant midlertidig ansatte i Finland i perioden 1998-2007 tilskrevet en samtidig økt utbredelse av midlertidig ansettelser i skaderisikoutsatt industri i privat sektor. Midlertidig ansatte ser ikke ut til å ha høyere sykefravær enn fast ansatte. Konklusjoner: Resultatene fra gjennomgangen av litteratur publisert etter 2003 utført for denne kunnskapsoppsummeringen underbygger i all hovedsak konklusjonene fra litteraturgjennomgangen til Virtanen og medarbeidere (2003). De gjennomførte en systematisk gjennomgang av litteraturen fram til 2003 og et hovedfunn var gjennomgående høyere forekomst av psykiske plager blant midlertidig ansatte sammenlignet med fast ansatte. En overvekt av studier viste også at midlertidig ansatte hadde en høyere risiko for yrkesskader, men at sykefraværet var lavere. Helserisikoen kan være høyere i midlertidige jobber med høy grad av usikkerhet og ustabilitet. Helserisikoen kan også være høyere blant midlertidige ansatte i land med lavt antall midlertidig ansatte og lav arbeidsledighet. Studier fra ulike land og kulturer er ikke nødvendigvis sammenliknbare, da de ulike landene har varierende rammebetingelser som det midlertidige arbeidet må tolkes i lys av. Slike rammebetingelser er landets nivå på arbeidsledighet, i hvilke typer yrker ansettelse i midlertidig stilling forekommer hyppig og i hvilken grad kategoriseringen av midlertidig ansatte er sammenliknbare. Samtidig er det også slik at lovregulering knyttet til midlertidige stillinger varierer mellom land, slik at eksponering for faktorer av betydning for helserisiko kan variere selv innenfor en bestemt gruppe av midlertidig ansatte (f.eks vikarer) på tvers av land. Varierende definisjoner av midlertidig arbeid på tvers av studier fra ulike land begrenser også muligheten til å generalisere kunnskap om helseeffekter av midlertidige ansettelser fra et land til et annet. Det er således vanskelig å studere effekten av midlertidig ansettelser isolert fra andre aspekter av arbeidslivet, og dermed vanskelig å uttale seg generelt om effekten av midlertidig ansettelser på helse. Selv om det foreligger enkelte studier fra nordiske og europeiske land, har vi ikke funnet studier fra norsk arbeidsliv.

• Lie, Arve; Skogstad, Marit; Tynes, Tore; Johannessen, Håkon Andre; Nordby, Karl-Christian & Mehlum, Ingrid Alethe Sivesind [Show all 9 contributors for this article] (2013). Støy i arbeidslivet og helse. STAMI - Statens arbeidsmiljøinstitutt. Full text in Research Archive Show summary

  Arbeidsdepartementet har bedt Statens arbeidsmiljøinstitutt om å lage en kunnskapsstatus om sammenhengen mellom støy og helse. Bakgrunnen er bl.a. at støy anses som et av de største problemene i arbeidslivet. Meldte arbeidsrelaterte støyskader utgjør om lag 60 % av totalt antall meldte arbeidsrelaterte sykdommer og holder seg stabilt trass i forebyggende tiltak. Omfanget av støyskader er også et betydelig problem offshore, og meldte tilfeller av støyskader er økende trass i redusert eksponering. Arbeidet med rapporten er gjennomført som en systematisk gjennomgang av forskningslitteratur på området og er avgrenset til støy og helseeffekter i arbeidslivet. Arbeidet er gjort med bidrag fra Arbeidstilsynet, Petroleumstilsynet og Folkehelseinstituttet. Prosjektet er støttet økonomisk med kr. 450.000 fra Arbeidsdepartementet. Rapporten vil bli fulgt opp med kunnskapsformidling til relevante miljøer, og flere vitenskapelige publikasjoner er under planlegging. Støy er et utbredt arbeidsmiljøproblem både i norsk arbeidsliv og internasjonalt. 250 000 norske yrkesaktive rapporterer at de er utsatt for et høyt støynivå en fjerdedel av arbeidsdagen eller mer og 86 000 rapporterer at de har pådratt seg hørselsskade pga støyeksponering i arbeidet. Nedsatt hørsel er den best dokumenterte helseeffekten av yrkesmessig støyeksponering og skyldes skade på sneglehuset i det indre øret. Mesteparten av skaden kommer i løpet av de første 10-15 årene med støyeksponering. Ved 40 års eksponering på nivå rundt grenseverdien på 85 dB(A) vil hørselstapet på gruppenivå være forholdsvis begrenset, i størrelsesorden 5 dB i det frekvensområdet som er mest utsatt for støy (3-6 kHz). Ved høyere eksponering på nivå 100 dB(A) vil hørselstapet i samme frekvensområde kunne bli betydelig med 30-40 dB på gruppenivå. På individnivå varierer tapene betydelig i forhold til gjennomsnittstap for eksponerte grupper. Befolkningsstudier viser at den viktigste risikofaktor for hørselstap er økende alder. Det aldersbetingede hørselstapet ligger på om lag 30-40 dB i 3-6 kHz-området hos en mannlig og i overkant av 20 dB hos en kvinnelig 60-åring, men varierer sterkt mellom individer. For å sammenlikne resultat av hørselsmåling med normaltap for alder finnes både internasjonale og norske normalverdier for hørselstap hos ikke støyeksponerte (ISO 1999, HUNT). Dette gjør det mulig å beregne hvor mye av hørselstapet som skyldes støy og eventuelt andre hørselsskadelig eksponeringer. På individnivå er det ikke mulig sikkert å skille mellom aldersbetinget og støybetinget hørselstap. Impulsstøy er trolig mer hørselsskadelig enn kontinuerlig støy og kan, hvis eksponeringen er stor nok, føre til akutt skade på hørselen. Andre faktorer kan også påvirke hørselen. Populasjonsundersøkelser viser at menn taper mer hørsel enn kvinner, og arv spiller også en stor rolle. Dessuten ser det ut til at lav sosioøkonomisk posisjon og etnisitet spiller inn (personer med afroamerikansk bakgrunn taper mindre hørsel enn hvite). Røyking, hjerte- og karsykdom, diabetes, høyt blodtrykk og andre risikofaktorer for hjerte- og karsykdom som forhøyet kolesterol, ser også ut til kunne skade hørselen, men her er forskningsresultatene mer usikre. Eksponering for kjemikalier (løsemidler, bly mv.) og visse medikamenter kan gi nedsatt hørsel, og det ser også ut til at samtidig vibrasjon kan forsterke den hørselsskadelige effekten av støy. Fritidsstøy, spesielt bruk av skytevåpen, kan også gi hørselsskade. Annen fritidsstøy (musikkspiller, konsertbesøk, hobbyverktøy etc.) ser imidlertid ut til å ha liten effekt på hørselen i populasjonsstudier, men kan gi skade på individnivå hvis eksponeringen er tilstrekkelig høy. Undersøkelser av ulike yrkesgrupper tyder på at hørselstapet som følge av støy har vært betydelig på 1960 og 70-tallet i industrialiserte land, men at hørselstapet er blitt mindre blant den yngre delen av befolkningen. Bedringen skyldes trolig redusert eksponering, bedre regelverk og mer bruk av verneutstyr. Dette gjelder ikke utviklingsland, hvor hørselstapet pga arbeidsrelatert støy fortsatt er betydelig. Vi har imidlertid fortsatt utsatte bransjer også i Norge som Forsvaret, offshore, verkstedindustri, bygg- og anlegg, landbruk og tungindustri. Bransjer som ser ut til å være mindre utsatt er skole, barnehager, transportbransjen og blant musikere, politi og brannfolk. Omfanget av yrkesbetinget hørselsskade som meldes til Arbeidstilsynet ligger stabilt på 1500 - 2000 tilfeller i året. Offshore har tallet økt fra 200 i 2005 til om lag 600 i 2010. I forhold til antallet ansatte er dette 25 ganger flere enn fastlands-Norge og 450 ganger mer enn det som meldes i EU. Dette er forhold som må analyseres nærmere, for eksempel ved at man sammenligner hørselstapet offshore med normalverdier fra ISO eller HUNT. Rapporten gir anvisning på hvordan dette kan gjøres. Det finnes flere helseeffekter enn nedsatt hørsel som kan skyldes støy. Tinnitus (”øresus”) rammer om lag 10 % av befolkningen og kan hos noen være invalidiserende. Tinnitus er forbundet med nedsatt hørsel, støypåvirkning, tretthet, stress og ulike helseplager og øker med alderen. Feilfunksjon ved komplekse mekanismer i sentralnervesystemet og det indre øret er trolig årsaken. En annen tilstand som kan opptre etter støyeksponering er overømfintlighet for støy (hyperakusis), som i særlig grad er omtalt hos musikere. Tilstanden kan være svært plagsom og til dels invalidiserende hos enkelte. Personer med posttraumatisk stressyndrom kan ha overømfintlighet for støy og tinnitus som ledsagesymptomer. Emosjonelt stress kan også utløse overømfintlighet for støy. Støy kan også føre til både fysiologiske og psykologiske stressreaksjoner med midlertidig nedsatt kognitiv yteevne som resultat. Varig økning i blodtrykket settes i sammenheng med støyeksponering og kan være et resultat av støy som en stressor. Hjerte- og karsykdom har også i enkelte studier vært funnet relatert til støyeksponering. Flertallet av gode studier konkluderer med at støy kan påvirke blodtrykket, mens det er mer usikkert for iskemisk hjertesykdom. Det finnes også gode holdepunkter for at støy kan føre til ulykker gjennom at varsler eller faresignaler ikke oppfattes når støyen maskerer signalet eller på grunn av distraksjon, nedsatt hørsel eller via arbeidsrelatert stress. Ved eksponering > 90dB(A) er det estimert at en av 10 arbeidsulykker kan tilskrives støyeksponering. Økt forekomst av godartede svulster på hørselsnerven, Schwannom, hos støyutsatte er påvist i flere undersøkelser. Om disse skyldes støy eller at tilstanden blir oppdaget pga mer omfattende hørselstesting, er usikkert. Spørsmålet om støyeksponering av gravide kan føre til skade på hørselen til det kommende barnet har vært reist. Vi har imidlertid ikke funnet sikre holdepunkter for dette, men forskningen på området er ikke omfattende. Til slutt har vi sett på effekter av lavfrekvent støy på helse. Litteraturen på området er for begrenset til at vi kan trekke konklusjoner om slike sammenhenger.

View all works in NVA