Intervention 1
Wednesday 8 October 2025, 11.00 – 12.30 Fluor
Chairs: Amanda Eng, Alex Burdorf
EPHOR: Forecasting health intervention effects under increasingly complex working life exposome scenarios
Matthew Gittins (presenter)
Roberto Carrasco, Luke Munford, Ioannis Basinas, Calvin Ge, Svetlana Solovieva, Anjoeka Pronk, Miranda Loh, Martie van Tongeren
Abstract
Abstract Background/Objectives Given workplace exposures contribute to many non-communicable diseases (NCDs), ensuring a healthy work environment is a strategic goal for policy makers and employers. Understanding the heath impact of workplace exposure interventions, whilst under complex working life exposome, is important. Through simulations, we forecast the performance of exposure interventions whilst varying the exposome characteristics. Methods A dynamic longitudinal population cohort representing real-world Lung Cancer (LC) risk in construction workers was simulated. Life-time employee exposure profiles were generated for exposures Silica, Diesel Fumes, and Smoking understood to be associated with LC. The exposome characteristics were manipulated, modifying correlation structures, decaying risk, latency, and dose-response risk definitions. We applied intervention effects to working exposures such that 1. average exposure reduced 30% 2. max exposure limited to 75%. Annual population level LC incidence rates were forecasted and compared before and after interventions were applied. Results Five million construction workers were simulated to enter the workforce at a uniform rate between the 1970 and 2070. Annual incidence rates (prior to the addition of exposures) initially matched current general population incidence rates (i.e. 7% lifetime risk, 180 new cases per 100,000 person years in 2010s). By 2060, annual incidence rates decrease by ~20% and ~22% for 30% average reduction in Silica only, and Silica & Diesel, respectively. Whereas for 75% max exposure limit it was ~35%, and ~38%. Conclusion Intervention effects from single exposure outcome models are likely limited when determining the true effect of a health intervention effect dependent on the combination of exposome characteristics.
Insights from 10 years of research on the effectiveness of occupational health and safety management system programs: an updated analysis of the Certificate of Recognition program in British Columbia, Canada
Robert Macpherson (presenter)
Laksika Banu Sivaraj; Lillian Tamburic; Christopher McLeod
Abstract
Objective Building on a decade of research on the effectiveness of occupational health and safety management system certification programs across Canada, the objective of this study was to conduct an updated evaluation of the Certificate of Recognition (COR) program on firm work injury rates in British Columbia (BC), Canada, and determine if COR firms are associated with greater injury rate reductions compared to similar non-COR firms, and whether the findings differ between internally and externally audited firms. Material and Method Using COR registration, firm-, and claim-level data from the workers’ compensation board of BC (WorkSafeBC), the effect of becoming newly COR-certified on firm injury rates was assessed using a matched difference-in-differences study design with population-averaged negative binomial regression models, overall, by audit type (internal vs. external), and sector. Results A total of 3,100 certified firms were matched with 2,964 non-certified firms during the years 2010 to 2021. Firms that became certified experienced a greater reduction in their lost-time injury rate during the years after their first certification year (RR: 0.91; 95 CI: 0.85-0.98). Stratified analysis showed that the overall effectiveness was being primarily driven by large, externally audited, firms in the manufacturing sector (RR: 0.76, 95% CI: 0.64-0.89). Imprecisely estimated reductions were observed for small, internally audited firms in transportation (RR: 0.82; 95% CI: 0.57-1.18), and primary resources sectors (RR: 0.85; 95% CI: 0.62-1.16). Conclusion While the COR program is still effective in reducing firm injury rates, its effectiveness has diminished over time and is not equal across all sectors and sizes of firm. Continual assessment and improvement of the program is important to ensure ongoing impact. Furthermore, through using more rigorous cohort restrictions and matching strategies, the findings suggest that effectiveness observed in previous evaluations may have been driven by the selection process of firms into the COR program.
Real-time impact of surgical vacuum use on air particulate matter during electrocautery procedures
Ping Shih (presenter)
Hung-Hsuan Yen
Abstract
Objective: Surgical smoke generated during electrocautery procedures contains hazardous particulate matter (PM) such as PM₂.₅ and PM₁₀, which may compromise the respiratory health of operating room personnel. Although vacuum (Vac) systems are commonly used to reduce such exposure, their time-resolved effectiveness across surgical phases remains understudied. This study aims to fill that gap by applying time-normalized analyses to evaluate whether Vac use consistently reduces airborne particulate concentrations during surgery. Material and Methods: This study analyzed real-time air quality data by DustTrak™ DRX Aerosol Monitor 8533 from 46 laparoscopic cholecystectomy (LC) surgeries conducted in the same operating room. Cases were randomly categorized into full-time Vac use (n=21) and no Vac use (n=15). Concentrations of PM₂.₅, PM₁₀, and total PM were continuously recorded. Surgical time was normalized and divided into 100 equal time bins. Mean pollutant levels across these bins were compared between Vac and non-Vac groups, stratified further by surgical complexity (LC: simple vs. complex). Results: Vac-use surgeries consistently demonstrated lower PM₂.₅ and PM₁₀ levels across most of the procedure timeline, with statistically significant differences in high-concentration phases (p < 0.01). Total PM also trended lower with Vac use. Subgroup analysis by surgical complexity revealed that complex procedures (n=17) were associated with higher pollutant exposure overall than simple LC (n=29), but Vac implementation helped reduce extreme spikes and smoothed fluctuations. Conclusion: Full-time use of Vac systems significantly reduces airborne PM exposure, particularly during complex procedures. Ongoing analyses with a larger sample size are underway to further substantiate the evidence supporting Vac implementation as a routine safety standard in electrosurgical protocols.
Strategies for diseases surveillance based on workers‘ exposure in a blueberry farming company in Peru
Norvil Antonio Mera Chu (presenter)
Abstract
Objective: The purpose of the study was to describe strategies for diseases surveillance based on workers ‘exposure in a blueberry farming company in Perú and its impact on workers’ health.
Material and Methods: This research was a case report study in a Blueberry farming company which had 355 workers. The unit of analysis included the indicators of characteristics of participants (demographic, level of education, gender, job position, etc.), risk assessment (qualitative and quantitative), labor inspections, interviews in focus groups, questionnaires solved, education methods used, previous investigations of workplace accidents, use of personal protection equipment (PEE), medical history of workers, internal audits, among others. It also analyzed the impact of the OHS on the frequency of accidents and illnesses in workers and on absenteeism for 4 years. The instruments used were Data collection sheet and Occupational health and safety (OHS) records.
Results: 355 workers participated, of which 58% were between the age of 30 and 50 years old and 38% were younger than 30. 62% lived in a rural area with low income. 31% finished a professional career, 22% finished a short-technical program and 40% had only finished high school. Each year, the OHS programs were adapted based on the updated risk exposure assessment. The most common causes of job injuries were accidents related to chemical and mechanical risk factors. The most common types of diseases were Infectious, dermatologic and Cardiovascular. By the end of the fourth year, the frequency of accidents was reduced by 25%, the frequency of diseases and comorbidities was reduced by 36% and absenteeism was reduced by 22%.
Conclusion: Strategies for diseases surveillance based on workers ‘exposure for 4 years, had good results in decreasing diseases and job injuries in workers in a blueberry farming company in Piura.
The Safe Home Care Intervention Study: coaching clients to protect their aides’ safety
Margaret Quinn (presenter)
Susan Sama, Pia Markkanen, Rebecca Gore, John Lindberg, David Kriebel, Catherine Galligan
Abstract
Objective: Home care (HC) aides experience numerous safety hazards while delivering health and personal care services in clients’ homes; many hazards also put clients at risk. We hypothesized that clients would improve safety conditions in their homes when coached by a nurse who conducts a HC needs assessment before aides are assigned to begin the care services. Material and Methods: In partnership with HC employers, elder services agencies, a labor union, and aides, we developed home safety coaching methods and materials for nurses to use when they first assess clients for HC services. We evaluated the coaching intervention using a proof-of-concept, 2-arm intervention study design. During their patient intake assessment, nurses participating in the intervention arm used motivational interviewing, facilitated by a safety handbook and video, to coach clients on home safety improvements. Control arm nurses performed client intake assessments with no changes to usual practices. Intervention effectiveness was assessed by the nurses and independently by aides who began visiting clients’ homes after the intervention implementation; aides were not aware of the intervention status of their clients. Following the study, we conducted 6 interview sessions including 11 nurses to evaluate their experiences while applying the intervention materials. Results: Three HC agencies and two elder services contributed 35 intervention and 23 control homes. Nurses coached 97% of the clients and reported that 94% were engaged; 63% of clients implemented improvements. Nurses’ and aides’ assessments were correlated; homes with clients reported by nurses as resistant to safety changes had higher aides’ hazard scores. Interviews results indicated that the coaching provided a useful, structured approach for nurses to introduce safety principles, including how clients can establish positive working relationships with aides. Conclusion: This proof-of-concept intervention was effective, inexpensive and can be scaled up to evaluate in a larger population. This study was funded by the U.S. National Institute for Occupational Safety and Health (NIOSH) I am submitting for an ORAL PRESENTATION
How incidental exposure to ethylene oxide resulted in air measurements, biomonitoring and strong collaboration between occupational hygienist and occupational physician
Erik van Deurssen (presenter)
Arné Oerlemans
Abstract
Accidentally, a warehouse company was alerted to the potential exposure to ethylene oxide. In response, the company took immediate action in accordance with the measures outlined in the occupational hygiene strategy. However, to what extent has this been an issue in the past? By conducting air measurements and taking blood samples, the company aims to find answers to alleviate concerns among employees. In total, over 55 personal and stationary air samples were conducted. Blood samples were taken both before and after control measures from nearly all employees to determine the adduct N-(2-hydroxyethyl)valine (HEV) as a measure of historical exposure. Additionally, a occupational physician was involved in the process to conduct health assessments. The results of the air measurements indicate that the exposure for warehouse employees can be considered controlled according to the criteria from NEN-EN 689 (UTL95,70 of 37.3 μg/m3). However, the results of the blood samples regarding historical exposure show that 75% of the samples contained a concentration approximately equal to the limit value for EtO in air. For 95% of the most highly exposed employees, there is an additional risk of developing cancer. In two employees from this group, a concentration above the prohibition level was found. The results of the blood samples taken after 4 months show a significant decrease (>60%) in the concentration of HEV. An overview of the diagnosed health complaints will be presented during the presentation. Currently, there is no longer a health risk for warehouse employees. However, employees were exposed to health-damaging concentrations of EtO in the past. The question remains how it is possible that the company was unaware of potential exposure. We will elaborate on which lessons can be learned for other companies in this sector and highlight the importance of the intensive collaboration between the hygienist and physician.