The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic and human data suggests that occupational exposure to noise may cause cardiovascular disease. In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to noise for estimating (if feasible) the number of deaths and disability-adjusted life years from cardiovascular disease that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to noise. We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines, and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. We included working-age (≥15 years) workers in the formal and informal economies in any WHO Member and/or ILO member State, but excluded children (<15 years) and unpaid domestic workers. We included all study types with an estimate of the prevalence of occupational exposure to noise, categorized into two levels: no (low) occupational exposure to noise (<85dBA) and any (high) occupational exposure to noise (≥85dBA). At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the RoB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. Sixty-five studies (56 cross-sectional studies and nine cohort studies) met the inclusion criteria, comprising 157,370 participants (15,369 females) across 28 countries and all six WHO regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). For the main analyses, we prioritized the four included studies that surveyed national probability samples of general populations of workers over the 58 studies of workers in industrial sectors and/or occupations with relatively high occupational exposure to noise. The exposure was generally assessed with dosimetry, sound level meter, or official or company records; in the population-based studies, it was assessed with validated questions. Estimates of the prevalence of occupational exposure to noise are presented for all 65 included studies, by country, sex, 5-year age group, industrial sector, and occupation where feasible. The pooled prevalence of any (high) occupational exposure to noise (≥85dBA) among the general population of workers was 0.17 (95% confidence interval 0.16 to 0.19, 4 studies, 108,256 participants, 38 countries, two WHO regions, I² 98%, low quality of evidence). Subgroup analyses showed that pooled prevalence differed substantially by WHO region, sex, industrial sector, and occupation. Our systematic review and meta-analysis found that occupational exposure to noise is prevalent among general populations of workers. The current body of evidence is, however, of low quality, due to serious concerns for risk of bias and indirectness. Producing estimates of occupational exposure to noise nevertheless appears evidence-based, and the pooled effect estimates presented in this systematic review are suitable as input data for the WHO/ILO Joint Estimates (if feasible). Protocol identifier: 10.1016/j.envint.2018.09.040 PROSPERO registration number: CRD42018092272.

Background: With the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP.Methods: We adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors.Results: LBP annual incidence among workers in China’s key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors.Conclusion: LBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers’ health.

Objectives: Studies have shown that in addition to energy, kurtosis plays an important role in the assessment of hearing loss caused by complex noise. The objective of this study was to investigate how to use noise recordings and audiometry collected from workers in industrial environments to find an optimal kurtosis-adjusted algorithm to better evaluate hearing loss caused by both continuous noise and complex noise. Design: In this study, the combined effects of energy and kurtosis on noise-induced hearing loss (NIHL) were investigated using data collected from 2601 Chinese workers exposed to various industrial noises. The cohort was divided into three subgroups based on three kurtosis (β) levels (K₁: 3 ≤ β ≤ 10, K₂: 10 <β ≤ 50, and K₃: β > 50). Noise-induced permanent threshold shift at test frequencies 3, 4, and 6 kHz (NIPTS₃₄₆) was used as the indicator of NIHL. Predicted NIPTS₃₄₆ was calculated using the ISO 1999 model for each participant, and the actual NIPTS was obtained by correcting for age and sex using non-noise-exposed Chinese workers (n = 1297). A kurtosis-adjusted A-weighted sound pressure level normalized to a nominal 8-hour working day (L_Aeq,8h) was developed based on the kurtosis categorized group data sets using multiple linear regression. Using the NIPTS₃₄₆ and the L_Aeq.8h metric, a dose-response relationship for three kurtosis groups was constructed, and the combined effect of noise level and kurtosis on NIHL was investigated. Results: An optimal kurtosis-adjusted L_Aeq,8h formula with a kurtosis adjustment coefficient of 6.5 was established by using the worker data. The kurtosis-adjusted L_Aeq,8h better estimated hearing loss caused by various complex noises. The analysis of the dose-response relationships among the three kurtosis groups showed that the NIPTS of K₂ and K₃ groups was significantly higher than that of K₁ group in the range of 70 dBA ≤ L_Aeq,8h < 85 dBA. For 85 dBA ≤ L_Aeq,8h ≤ 95 dBA, the NIPTS₃₄₆ of the three groups showed an obvious K₃ > K₂ > K₁. For L_Aeq,8h >95 dBA, the NIPTS₃₄₆ of the K₂ group tended to be consistent with that of the K₁ group, while the NIPTS₃₄₆ of the K₃ group was significantly larger than that of the K₁ and K₂ groups. When L_Aeq,8h is below 70 dBA, neither continuous noise nor complex noise produced significant NIPTS₃₄₆. Conclusions: Because non-Gaussian complex noise is ubiquitous in many industries, the temporal characteristics of noise (i.e., kurtosis) must be taken into account in evaluating occupational NIHL. A kurtosis-adjusted L_Aeq,8h with an adjustment coefficient of 6.5 allows a more accurate prediction of high-frequency NIHL. Relying on a single value (i.e., 85 dBA) as a recommended exposure limit does not appear to be sufficient to protect the hearing of workers exposed to complex noise.

Benzo [a]pyrene (BaP) is a model compound for the study of polycyclic aromatic hydrocarbon (PAH) carcinogenesis. Upon metabolism, BaP is metabolized to the ultimate metabolite, BaP trans-7,8-diol-anti-9,10-epoxide (BPDE), that reacts with cellular DNA to form BPDE-dG adducts responsible for BaP-induced mutagenicity, carcinogenicity, and teratogenicity. In this study, we employed our developed LC-MS/MS method to detect and quantity BPDE-dG adducts present in 42 normal human umbilical cord blood samples and 42 birth defect cases. We determined that there is no significant difference in the level of BPDE-dG formation between the normal and birth defect groups. This represents the first time to use an LC-MS/MS method to quantify BPDE-dG in human umbilical blood samples. The results indicated that under experimental conditions, BPDE-dG adducts were detected in all the human umbilical cord blood samples from the normal and birth defect groups.

What is already known about this topic? Work-related musculoskeletal disorders (WMSDs) have a high prevalence and seriously harmful, which has attracted extensive attention in various countries in the world. Currently, the occurrence and rules of WMSDs in key industries are not known in China. What is added by this report? The prevalence of WMSDs is relatively high among professional populations in key industries in China, with the most commonly affected body parts concentrated in neck, shoulders, and low back and increasing with age and working years. What are the implications for public health practice? This study determined the prevalence and distribution characteristics of WMSDs in key industries in China and provided scientific evidence to recommend for inclusion of WMSDs in the new revision of the list of occupational diseases in China.