Burden of Disease 1
Tuesday 7 October 2025, 11.00 – 12.30 Neon
Chairs: Margaret Quinn, Karina Undem
Chronic kidney disease and occupational risk factors in agricultural workers from the Maule cohort
Sandra Cortes (presenter)
Sandra Córtes, Jenny Ruedlinger, María José Ojeda, Cinthya Leiva, Margarita Valenzuela, Camilo Sotomayor, Roberto Jalil and Claudia Foerster
Abstract
Objective: To estimate the prevalence of chronic kidney disease (CKD) and to explore associations with occupational exposures among workers in an agricultural area of Chile.
Material and Methods: A cross-sectional study was conducted within the MAUCO cohort in Molina, including 1,006 participants aged 41–81 years (566 women [56.3%], 440 men [43.7%]). Occupational factors included current employment, agricultural work and pesticide exposure. Data were collected using the DEGREE protocol. Risk factors for CKD were characterized, and biological samples were collected. Estimated glomerular filtration rate (eGFR, in mL/min/1.7m2) was calculated using the CKD-EPI 2021 equation and categorized according to KDIGO guidelines: 90 (normal). Adjusted logistic regression models examined factors associated with eGFR <90.
Results: Mean age was 55.1 ± 7.5 years; 35.6% had 90 in 56.6%, 60–90 in 50.9%, and <60 in 2.6% (CKD), with no differences by sex. Lower eGFR was significantly associated with older age, hypertension, higher creatinine, uric acid, BUN, and unemployment (p<0.05). Agricultural and pesticide exposures were more frequent in the CKD group. In regression analysis, hypertension and diuretic use were associated with eGFR <90, while female sex and being employed were associated with lower odds.
Conclusion: This is the first study in Chile to investigate traditional and non-traditional risk factors associated with CKD. In this sample of workers, CKD prevalence was lower than the one reported for Chilean adult population in the last national survey (2.6% vs 3.2%). Impaired kidney function was linked to known risk factors and social vulnerability. Although not significant, the trend with agricultural exposure warrants further investigation into occupational risks in rural populations.
Health status and occupational risks in platform-based food delivery workers in France: a participatory study
Marwân-al-Qays Bousmah (presenter)
Marwân-al-Qays Bousmah, Kevin Poperl , Anne Gosselin , Solène Delorme , Circé Lienart , Annabel Desgrées du Loû , Flore Gubert
Abstract
Objective: In high-income countries, platform-based delivery workers, among whom immigrants are over-represented, are particularly exposed to occupational risks. Although this exposure seems to be even higher among undocumented immigrant workers, there is little data to document this social and public health issue.
Methods: The SANTE-COURSE participatory research project, conducted with community-based organizations (Maison des Coursiers, Maison des Livreurs, Médecins du Monde), aims to assess the exposure to occupational risks among gig delivery workers in Paris and Bordeaux, France. These risks include work-related accidents, psychosocial risks, musculoskeletal disorders, urogenital problems, as well as exposure to discrimination and violence. Data are collected through face-to-face questionnaires between January and May 2025, via an outreach approach. We further investigate the determinants of occupational risk using multivariate regressions.
Results: Preliminary results on a sub-sample of 729 individuals show that this population is overexposed to occupational hazards. As an example, 55.4% of delivery riders had a work accident, and 41.5% have symptoms of moderate to severe depression. In the meantime, they suffer from a great lack of access to social protection, especially health coverage: 30.8% lack health insurance coverage, and an overwhelming majority of 95.8% reported that they are not protected by insurance provided by the platform in the event of an on-the-job accident.
Conclusions: Our findings will help construct an intervention to prevent occupational risks among gig delivery workers and moderate their financial impacts by improving access to health coverage. This contribution will also provide a better understanding of the construction of social inequalities in health in the context of worsening working conditions and the rise of the platform economy, with the emerging social category of “uberized” workers.
Malignant mesothelioma in Australia – information from the Australian Mesothelioma Registry
Tim Driscoll (presenter)
Tim Driscoll, Fraser Brims, Sue Barker, Geza Benke, Meredith Bryant, Elizabeth Chalker, Claire Cooke-Yarborough, Jodie Deakes, Justin Harvey, Susie Harden, Sonja Klebe, Ewan MacFarlane, Kathleen Mahorney, Sarita Prabhakaran, Tom Watson, Phillip Wise, Sue Young, Karen Walker-Bone
Abstract
Objectives The Australian Mesothelioma Registry (AMR) was established in 2011. It collects information on all new cases of mesothelioma diagnosed in Australia from 1 July 2010. This presentation summarises information received by the AMR to May 2024, focussing on 2023. Exposure to asbestos in Australia significantly diminished from the mid to late 1980s and although asbestos importation and use has been banned since 2003, some exposure still occurs.
Methods Most notifications to the AMR come directly from State and Territory cancer registries (new diagnoses of cancer are legally required to be reported to these registries). All notified persons are invited to participate in the AMR’s exposure assessment activity, providing information by questionnaire followed by a structured telephone interview using a computer-based exposure assessment system (OccIDEAS).
Results In 2023, 617 people (76% male; median age 77 years) were diagnosed with mesothelioma (with more cases likely to be reported due to a lag in reporting – 775 people were diagnosed in 2022). The overall rate per 100,000 was 2.3, with rates rising to a peak (21.2) in those 85 years and over. The (age-standardised) rate in males (2.9) was much higher than in females (0.8). 1,305 persons diagnosed with mesothelioma from July 2010 to May 2024 provided detailed asbestos exposure information. About 94% of these people were considered to have had possible or probable asbestos exposure above background levels – 11% occupational only; 36% non-occupational only; 53% both. Of these, most men (78%) had occupational exposure; most women (93%) did not. The most common non-occupational exposure was from home renovation.
Conclusion The high per capita use of asbestos in Australia has left an unfortunate legacy of continuing high rates of mesothelioma in Australia. Nearly all affected persons appear to have had asbestos exposure.
Occupational burden of disease and mortality in the Netherlands
Petra Eysink (presenter)
Maaike van der Noordt, Gulliver de Boer
Abstract
Background: A large proportion of the working population is at risk of illnesses, accidents and mortality caused by exposure to unfavourable working conditions, such as chemicals, physical strain, noise and stress. To assess the health impact of occupational exposures in the population, we estimated Population Attributable Fractions (PAFs). PAF is defined as the fraction of all cases of a particular disease in a population that is attributable to a specific exposure. The PAF provides insight in the estimated fraction of all workers that would not have occurred if there had been no exposure.
Methods: In the context of the Public Health Foresight Study 2024, we estimated the attributable mortality, years of life lost, years of life lived with disability and disability-adjusted life years (DALYs) for a selection of occupational risk-outcome pairs. PAFs were calculated using relative risks (RRs) of a given outcome and the proportion of workers exposed to the working conditions. RRs were derived from the literature, data on occupational exposure from Dutch studies. If these were not available, PAFs from the literature were used. The estimated PAFs were combined with the disease-specific burden and mortality results and summed.
Results: In 2022, unfavourable working conditions caused 4.1% of the total disease burden and 2.4% of the total mortality in the Netherlands. Exposure to substances leads to the highest occupational burden, followed by psychosocial stressors. The highest occupational burden is due mental disorders, followed by respiratory diseases, cancer and musculoskeletal disorders. Whereas most work-related deaths are caused by cancer, followed by heart diseases and respiratory diseases.
Discussion: Attributable burden of disease assessments provide comprehensive, comparable estimates of health impacts and their associated occupational risks. These estimates give policy makers insight in the influence of occupational risks on the health of employees.
Silica dust exposure pattern, job categorization and severity of silicosis and silico-tuberculosis amongst selected population in Birbhum district, West Bengal, India
Priyanka Roy (presenter)
Arthur P Frank
Abstract
Objective: This study aimed to assess and compare occupational health vulnerability among two distinct groups of workers exposed to silica dust in Birbhum district, West Bengal. It evaluated key domains—hazard exposure, risk perception, coping capacity, adaptive capacity, and overall vulnerability—to identify gaps in occupational health and guide targeted interventions. Notably, this is the first documented silicosis vulnerability assessment in this region.
Materials and Methods: A cross-sectional design was adopted using a structured vulnerability assessment tool. Field data were collected via household surveys, focus group discussions, and key informant interviews across two health districts—Suri and Rampurhat. Each vulnerability domain was quantified and visualized using radar charts to reveal risk disparities. Workers were classified based on job roles, including stone crushers, drivers, residents near crusher zones, and others.
Results: Screening across six blocks revealed a total of 3,315 individuals screened at the community level, with 941 referred to final diagnostic camps. Among them, 185 cases were confirmed with silicosis by the State Diagnosis Board. Md. Bazar in Suri district and Rampurhat I in Rampurhat district accounted for the highest burden. Alarmingly, 86% of confirmed cases were stone crusher workers, 63% had a history of active or past tuberculosis, and none received any personal protective equipment such as face masks. Silico-tuberculosis patients showed higher mortality. The vulnerability radar charts highlighted that Group A workers (active in crusher units) had significantly higher hazard exposure and lower coping capacity than Group B (residents).
Conclusion: This study reveals a high burden of silicosis and silico-tuberculosis among informal sector workers in Birbhum, driven by poor occupational safeguards and inadequate risk awareness. Urgent multi-sectoral interventions are needed, including protective regulations, health surveillance, and community-based capacity building, to mitigate long-term health impacts.
Too hot, too cold, too dangerous: How extreme temperatures affect firefighter slips, falls, and overexertion
Marie-Claire Meadows (presenter)
Bridget A. Bender, Bruce H. Alexander, Jesse D. Berman
Abstract
Firefighters are required to perform strenuous physical tasks in situations that are both hazardous and stressful. This, combined with extreme outdoor temperatures, can lead to injuries that impede their work and can have long-term effects. We study the effects of extreme heat and cold on overexertion and slips and falls in firefighters across Minnesota. Using the National Fire Incident Reporting System (NFIRS) data, we compiled data on firefighter injuries in Minnesota from 2017-2023. Following geocoding fire department addresses, we linked our injury data with daily maximum temperature at the census tract level. We calculated incidence rates per 10,000 person years for each outcome at different temperature intervals and by season. Slips and falls were more likely to be seen in winter (IR: 1.73 per 10,000 per/yrs) and were the most likely between -20 and -10℉ (IR: 6.41 per 10,000 per/yrs) compared to the next highest incidence rate at -10 to 0℉ (IR: 2.32 per 10,000 per/yrs). Overexertion injuries were highest during spring and summer (IR: 2.65 and 2.57 per 10,000 per/yrs) and were most likely at temperatures between 80 and 90℉ (IR: 3.23 per 10,000 per/yrs followed closely by 90 to 100℉ (IR: 2.87 per 10,000 per/yrs). These findings suggest that slips and falls are occurring at lower temperatures, indicating that these injuries may be caused by ice. Overexertion injuries are normally happening at hotter temperatures, indicating a potential for a more severe outcome, such as heat stroke or stress.