Gemma Castano-Vinyals, Karin Broberg, Maria Albin, Jelle Vlaanderen, Anne Helene Garde, Kirsten Nabe-Nielsen, Anjoeka Pronk, Manolis Kogevinas

Abstract

Objective: The EPHOR night shift study (EPHOR-NIGHT) provides population-based mechanistic evidence that will help prevent negative health effects of night shift work. The study was initiated to examine how the working-life exposome among night shift workers affects key body functions and biological pathways, and examine these mechanisms in relation to the development of cardiometabolic, mental health, and cognitive outcomes.

Material and Methods: Day and night shift workers from the transportation and health sector were sampled from four countries (Denmark, Spain, Sweden, The Netherlands). We employed a baseline questionnaire, repeated app-based daily questionnaires, exposure sensors, and biological samples to measure exposures and outcomes among participants. For mental health, we used the validated 9-item Patient Health Questionnaire (depression) and the validated 10- item Perceived Stress Scale (perceived stress). For immune marker levels, we measured several cytokines, chemokines and growth factors in plasma samples using the Luminex Cytokine Human Magnetic 30-Plex Panel. For the gut microbiome, stool samples were collected for 16S rRNA sequencing.

Results: The study includes 966 participants (850 women, 116 men) mostly in the health sector (96%). This presentation will summarize the design, sample characteristics and data types that have been collected in EPHOR-NIGHT. We will present a summary of findings on outcomes including mental health (higher levels of depression and anxiety among night shift workers compared to day shift workers), immune marker levels (lower levels of several immune markers among night shift workers) and gut microbiome findings (less diversity among night shift workers).

Conclusions: The baseline data collection and laboratory analyses are complete and the cohort is currently undergoing the first 2-year follow-up, developing translational activities and outreach to study participants. Findings from EPHOR-NIGHT will provide much needed additional mechanistic evidence linking night shift work to adverse health outcomes.

Anette Linnersjö, Ioannis Basinas, Theo Bodin, Hanifa Bouziri, Alexis Descatha , Daniel Falkstedt , Anne Helene Garde, Calvin Ge, Marcel Goldberg, Julio Hernando, Katarina Kjellberg , Henrik Kolstad, Ingrid Sivesind Mehlum , Karen Oude Hengel, Susan Peters, Vivi Schlünssen, Svetlana Solovieva, Zara Ann Stokholm, Mattias Sjöström , Håkan Tinnerberg, Else Toft Würtz, Martie Van Tongeren, Michelle Turner, Sanni Uuksulainen, Pernilla Wiebert, Anjoeka Pronk, Maria Albin

Abstract

Objective EuroJEM aims to provide comprehensive, state-of-the-art occupational exposure assessment data to support population-based studies across Europe.

Materials and Methods A systematic search was conducted to identify national Job-Exposure Matrices (JEMs) and relevant source data suitable for developing a unified European exposure framework. Three expert panels were established to lead harmonization efforts in chemical and particulate exposures, physical exposures, and psychosocial and ergonomic conditions. Where national JEMs were limited or absent, new matrices were developed. All partners contributed to aligning exposure assignments and occupational coding systems. EuroJEM 1.0 is coded using the European version of the International Standard Classification of Occupations, 1988 edition (ISCO-88(COM)) to ensure compatibility with cohort data.

Results The result is a multidimensional JEM covering a broad range of occupational exposures, including: Chemicals and particles Heat stress Noise Physical workload Precarious employment Psychosocial working conditions Solar UV radiation Airborne infectious agents A dedicated website (http://ki.se/en/imm/eurojem) provides access to EuroJEM’s content, usage guidelines, and tools for researchers and policymakers. The infrastructure is designed to evolve, with ongoing updates and new matrices added as new data and exposure risks emerge.

Conclusion EuroJEM 1.0 represents a major step forward in harmonizing occupational exposure data across Europe. Its integration of multiple exposure domains and use of standardized coding systems offers a valuable resource for occupational health research and policy. However, as current data are largely derived from Nordic and Western European sources, caution is advised when applying the matrix to Eastern European contexts. Continued development will enhance EuroJEM’s scope, ensuring its relevance and reliability across the continent.

Miranda Loh, IOM, United Kingdom; Maria Albin, Karolinska, Sweden; Jenny Selander, Karolinska, Sweden; Lode Godderis, KU Leuven, Belgium; Manosij Gosh, KU Leuven, Belgium; Roel Vermeulen, Utrecht University, Netherlands; Susan Peters, Utrecht University, Netherlands; Ingrid S Mehlum, STAMI, Norway; Michelle C Turner, ISGlobal, Spain; Vivi Schlünssen, Aarhus University, Denmark; Barbara Harding, ISGlobal, Spain; Svetlana Solovieva, FIOH, Finland; Tina Garani-Papadatos , PDA, Greece; Martie Van Tongeren, Manchester University, United Kingdom; Eelco Kuijpers, TNO, Netherlands; Jorunn Kirkeleit, STAMI, Norway; Wenxin Wan, UU, The Netherlands, Anne Mette Lund Würtz, Aarhus University, Aarhus, Denmark; Manolis Kogevinas, ISGlobal

Abstract

Objective The EPHOR project (2020–2025) aims to move beyond the conventional “one exposure – one outcome” paradigm by investigating complex working-life exposures in relation to a wide range of non-communicable diseases (NCDs). The goal is to lay the groundwork for cost-effective evidence-based prevention by generating: (i) Improved knowledge on how multiple exposures in the working-life exposome relate to NCDs, and; (ii) Innovative methods for collecting, storing, and interpreting exposome data in occupational settings.

Material and methods The project combines in-depth exposome investigations in two case studies: night shift work and respiratory disease with large-scale analyses of existing cohorts. New methods were developed to assess both external (e.g. sensor-based) and internal (e.g. noninvasive biological sampling) exposures. For cohort-based analyses, efforts included a comprehensive inventory of European cohorts, development of a harmonized job exposure matrix (EuroJEM), and methods for handling multiple exposures.

Results This presentation concludes the symposium by summarizing key lessons learned and outlining future prospects. A major achievement was demonstrating the feasibility—but also the complexity—of combined analyses across multiple existing cohorts as well as of using intensive measurement approaches to collect new exposome data. With respect to using existing cohorts, harmonization of methods and data is essential for producing meaningful results. These efforts can be complemented by smaller, targeted exposome studies that use intensive but feasible measurement approaches to test findings from cohorts and generate new hypotheses to be evaluated in larger datasets. This bidirectional strategy is a key recommendation. The EPHOR We-Expose Toolbox—developed for researchers, policymakers, and occupational health practitioners—as a resource for applying exposome approaches in occupational Health, will also be introduced.

Conclusion The EPHOR project highlights that while exposome research in occupational settings is complex, it can be feasible and informative. The tools and lessons from this project offer valuable guidance for shaping future occupational health research and policy.