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Wei-Shan Chin

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Papers by Wei-Shan Chin

0099 Psychological work environment and suicidal ideation among nurses in taiwan

Poster Presentation, 2017

The aim of this study was to evaluate relationships between job physical demands and risk of low-... more The aim of this study was to evaluate relationships between job physical demands and risk of low-back pain (LBP), using medication to treat LBP (M-LBP) and seeking care for LBP (SC-LBP). Methods Worker demographics, LBP history, psychosocial factors, hobbies, job physical demands (using the Revised NIOSH Lifting Equation) were assessed at the time of enrollment (551 workers). There were 258 incident-eligible workers (a continuous pain-free period of at least 90 days at the time of enrollment) and were followed monthly for up to 4.5 years to determine new LBP, M-LBP, and SC-LBP cases. Changes in job physical demands were measured. Associations between risk factors and LBP outcomes were modelled using proportional hazards regression with time varying covariates. Results LBP and M-LBP were fairly common affecting 47.7% and 37% workers, respectively. SC-LBP much less common affecting 1 in 11 workers. Peak Lifting Index (PLI) and Peak Composite Lifting Index (PCLI) were associated with all three outcomes of LBP (p<0.05). PLI and PCLI had peak Hazard Ratios of 4.3 and 4.2 for LBP, 3.8 and 4.3 for M-LBP, and 23.0 and 21.9 for SC-LBP, respectively. LBP history was associated with all three outcomes of LBP. Age, gender, BMI, hobbies, and psychosocial factors showed inconsistent relationships with the three outcomes of LBP. Conclusion Job physical demands are associated with increased risk of LBP, M-LBP and SC-LBP. The PLI and PCLI are useful metrics for estimating job physical demands.

Proximity to petrochemical industrial parks and risk of chronic glomerulonephritis

Environmental Research, 2022

This study determined whether individuals residing near petrochemical industrial parks (PIPs) hav... more This study determined whether individuals residing near petrochemical industrial parks (PIPs) have a higher risk of chronic glomerulonephritis (CGN). We performed population-based 1:4 case-control study by using Taiwan's National Health Insurance Research Database from 2000 to 2016. The subjects were aged 20-65 years, residing in western Taiwan, and did not have a history of any renal or urinary system disease in 2000. The case cohort included those who had at least three outpatient visits or one hospitalization between 2001 and 2016 with codes for CGN as per International Classification of Diseases (ICD)-Ninth and Tenth Revisions. Controls were randomly sampled age-, sex-, and urbanization-matched individuals without renal and urinary system diseases. Petrochemical exposure was evaluated by the distance to the nearest PIP of the residential township, and petrochemical exposure probability was examined considering the monthly prevailing wind direction. Conditional logistic regression was used to determine the association between petrochemical exposure and CGN risk. A total of 320,935 subjects were included in the final analysis (64,187 cases and 256,748 controls). After adjustment for potential confounders, living in townships within a 3-km radius of PIPs was associated with a higher risk of CGN (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.28-1.37). Compared with townships more than 20 km away from PIPs, those within 10 km of PIPs were associated with significantly increased risks of CGN in a dose-dependent manner. When prevailing wind was considered, townships with high exposure probability were associated with a significantly increased risk of CGN. We found that those residing near PIPs or with high petrochemical exposure probability had a higher risk of CGN. These findings highlight the need for monitoring environmental nephrotoxic substances and the renal health of residents living near PIPs.

Short sleep and chronic neck and shoulder discomfort in nurses

Journal of Occupational Health, 2021

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more

Maternal proximity to petrochemical industrial parks and risk of premature rupture of membranes

ISEE Conference Abstracts, 2020

Background Living near petrochemical industries has been reported to increase the risks of advers... more Background Living near petrochemical industries has been reported to increase the risks of adverse birth outcomes, such as low birth weight and preterm delivery. However, evidence regarding the role of petrochemical exposure in pregnancy complications remains limited. This study evaluated the association between maternal proximity to petrochemical industrial parks (PIPs) during pregnancy and the occurrence of premature rupture of membranes (PROM).Methods We performed a population-based 1:3 case-control study by using the 2004-2014 Taiwanese Birth Certificate Database. Birth records reported as stillbirth or bearing congenital anomalies were excluded. Cases were newborns reported to have PROM, whereas controls were randomly sampled from those without any pregnancy complications by matching birth year and urbanization index of the residential township. The proximity to PIPs was evaluated by calculating the distance to the nearest PIP of the maternal residential township during pregnancy. Furthermore, petrochemical exposure opportunity, accounting for monthly prevailing wind direction, was quantified during the entire gestational period. We applied conditional logistic regression models to evaluate the associations.Results In total, 29371 PROM cases were reported during the study period, with a corresponding 88113 healthy controls sampled. The results revealed that living within a 3-km radius of PIPs during pregnancy would increase the risk of PROM (odds ratio [OR] = 1.76, 95% CI: 1.66-1.87). Furthermore, compared with the lowest exposed group, those with high petrochemical exposure opportunity had a significantly increased risk of PROM occurrence (OR = 1.69-1.75). The adverse effects remained robust in the subgroup analysis for both term- and preterm-PROM.Conclusions The results of the present work provide evidence that living near PIPs during pregnancy would increase the risk of PROM, and additional studies are warranted to confirm our findings.

0108 Shift work and sleep-related problems: a nationwide survey in taiwan

Oral Presentation, 2017

legislation, all employers have to perform a risk assessment to identify workers exposed to HBV a... more legislation, all employers have to perform a risk assessment to identify workers exposed to HBV and offer them vaccination. Immunisation should be done as early as possible after the start of their career to avoid HBV infection and the development of a carrier status. Methods We performed a cross-sectional survey of representatives from the Occupational Medicine section of the European Union of Medical Specialists (UEMS), to find out how policies have been put into practice in the European countries. Results Answers were received from 21 countries, representing 78% of the population in the EU-28. HBV vaccination was mandatory for medical and nursing staff in 10 countries, mandatory for other paramedical staff, medical and nursing students in nine countries, for paramedical students in eight countries. It was recommended in all other participating countries. Serotesting before vaccination was done in eight countries. The vaccination schedule most often used was 0, 1, 6 months (18 countries). Serotesting after vaccination was done in 18 countries, boosters were recommended in 14 countries. A non-responder policy, including testing for carrier state, was present in 18 countries. Discussion More consultation between key actors from MS at EU level could help to optimise the way this matter is dealt with in different MS in order to contribute to further reducing HBV transmission to HCWs

Effect of Needlestick Injury, Blood & Body Fluid Exposure Surveillance System

0169 The effect of psychological symptom within 1 year after occupational injury on long-term self-perceived health status

Poster Presentation, 2017

2 to 1.2×10 5 cells/m 3. S. aureus were detected in 42.3% of samples for which cell levels varied... more 2 to 1.2×10 5 cells/m 3. S. aureus were detected in 42.3% of samples for which cell levels varied between 4.2×10 1 and 2.8×10 4 cells/m 3. Concentrations of S. aureus and viable bacteria were positively correlated (r=0.61, p<0.005) and the percentages of S. aureus among viable bacteria averaged 22.7% with 11.6%-43.6% in various locations. With the PMA-qPCR technique, this study demonstrates that the abundance of viable S. aureus and total viable bacterial aerosols in various types of occupational fields can be simultaneously quantified. This molecular assay should be taken into account as it will assist occupational hygienists and epidemiologists obtain reliable exposure data in assessing exposure and health risk, managing occupational health and protecting people from biohazards.

0167 Association between ambient temperature and occupational injury

Poster Presentation, 2017

between each exposure method (individual, full JEM and asymptomatic JEM) and hand pain (Prevalenc... more between each exposure method (individual, full JEM and asymptomatic JEM) and hand pain (Prevalence ratios with asymptomatic JEM=1.15-1.34; all p<0.05). Conclusions A JEM using responses only from asymptomatic workers created more homogenous exposure groups, but initial analyses showed no other significant evidence of biassed exposure estimates due to symptoms. JEMs are a useful method of exposure assignment for some epidemiological studies of musculoskeletal disorders.

Occupational and non-occupational injuries can result in prolonged augmentation of psychiatric disorders

Journal of Epidemiology, 2020

This article has been accepted for publication and undergone full peer review but has not been th... more

Ambient air pollution and asthma onset in Taiwanese adults

Respiratory Medicine, 2020

BACKGROUND Ambient nitrogen dioxide is associated with asthma occurrence in adults in Western cou... more BACKGROUND Ambient nitrogen dioxide is associated with asthma occurrence in adults in Western countries. However, two recent large-scale studies have provided inconclusive results regarding this association. Moreover, the association remains unknown in an Asian population. OBJECTIVE We aimed to investigate the association between ambient air pollution exposure and incident adult asthma. METHODS From 2016 to 2017, we conducted a cross-sectional self-administered questionnaire survey with retrospective follow-up of incident asthma cases among schoolchildren's parents from 41 schools within 1 km of air monitoring stations distributed throughout the main island of Taiwan. To estimate participants' exposure, air pollution data of air monitoring stations within 1 km of schools from where participants were sampled were inputted into the proximity model. We used mixed logistic regression models to determine the association between air pollution exposure and asthma onset within five years prior to the survey. RESULTS The questionnaire was completed for a total of 11 585 participants out of 13 424 candidates (response rate, 86.3%). Among 9131 participants aged from 26 to 50 years, 101 were diagnosed with asthma within the five years prior to the survey. The prevalence of incident asthma cases was 2.2 per 1000 person-years. Those exposed to higher ambient nitrogen dioxide (odds ratio = 1.20 per interquartile [5.7 ppb] of nitrogen dioxide, 95% CI = 1.02-1.42) were more likely to develop adult-onset asthma. CONCLUSION In an Asian population, exposure to higher ambient nitrogen dioxide is associated with increased prevalence of incident asthma cases among adults aged 26-50 years.

Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

International Journal of Environmental Research and Public Health, 2019

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the pat... more In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-ti...

Effects of PM2.5 on Skeletal Muscle Mass and Body Fat Mass of the Elderly in Taipei, Taiwan

Scientific Reports, 2019

Loss of skeletal muscle mass is common with aging and can cause morbidity and mortality in the el... more Loss of skeletal muscle mass is common with aging and can cause morbidity and mortality in the elderly. The effects of particulate air pollution on skeletal muscle mass is not known. The study aims to assess the chronic effects of ambient fine particulates (PM 2.5) on the body composition of the elderly. From October 2015 to November 2016, a cross-sectional survey on 530 elderly (age > = 65 years) was conducted in the Taipei Basin, Taiwan. The body composition was measured by bioelectrical impedance analysis (InBody 120). One year exposure to air pollution was estimated using the Kriging method at the participant's residence. Multiple linear regression analysis, after adjustments for demographics and copollutants, was used to examine the effects of PM 2.5 on body composition indices and force of handgrip. Changes in body composition for an interquartile (1.4 μm/m 3) increase in PM 2.5 concentration included a 0.4 kg (95% confidence interval (CI): −0.31, −0.58; p < 0.0001) decrease in skeletal muscle mass (2.0%) and a 0.7 kg (95% CI: 0.47, 0.91; p < 0.0001) increase in body fat mass (3.6%). While PM 2.5 reduced fat free mass in the upper extremities and trunk, but not in the lower extremities, it increased body fat mass in the three parts. There was no significant effect of PM 2.5 on handgrip force. Higher physical activity (versus lower than median) was associated with less detrimental effect of PM 2.5 on skeletal muscle mass and body fat mass (p values for interaction term: 0.009 and 0.013, respectively). Longterm PM 2.5 exposure is associated with decreased skeletal muscle mass and increased body fat mass in the elderly, which can be ameliorated by physical activity. Loss of muscle mass is associated with aging, at a decreasing rate of approximately 6% per decade after mid-life 1. Aging is associated with decreased production of several anabolic hormones like growth hormone, insulin-like growth hormone, testosterone, and estrogen, all of which play important roles in maintaining muscle mass and strength 2. Secondary causes of muscle loss include inadequate nutrition, physical inactivity, and chronic diseases such as malignancy, organ dysfunction, and neurodegenerative or endocrine diseases 3. Extremely low muscle mass with inadequate muscle function in the elderly is referred to as sarcopenia, which is linked to mortality risk 4,5. When sarcopenia is accompanied by increased body fat mass, also known as sarcopenic obesity, mortality risk becomes higher comparing to each condition separately 6-8. Identifying and managing the risk factors for sarcopenia and sarcopenic obesity may help promote healthy aging. Although the precise cause of sarcopenia and sarcopenic obesity is not known, there are several patho-physiologic mechanisms that affect muscle loss and visceral fat gain. Insulin resistance, a common phenomenon of central obesity,

Effects of long-term exposure to CO and PM2.5 on microalbuminuria in type 2 diabetes

International Journal of Hygiene and Environmental Health, 2018

No study has examined the effects of air pollutants on albuminuria in type 2 diabetes. Therefore,... more No study has examined the effects of air pollutants on albuminuria in type 2 diabetes. Therefore, the present study investigated this association. Methods: This follow-up study enrolled 812 patients with type 2 diabetes between 2003 and 2012. The urinary albumin-to-creatinine ratio (ACR) was recorded annually. Exposure to the air pollutants CO, NO 2 , O 3 , SO 2 , and PM 2.5 was interpolated from 72 air-quality monitoring stations to residences by using the kriging method. The association between air pollutants and ACR increase was assessed using mixed-effect model with random intercepts for 36 clinics. Results: The study objects (mean age: 55.4 years) were followed for 3 or more years (average period: 5.4 years). ACR increase was found to be positively associated with the male sex, baseline hemoglobin A1c, and exposure to CO and PM 2.5 , and negatively associated with waist circumference through multiple linear regression. Annually urine albumin/creatinine ratio increase was estimated by the final model, Patients exposed to higher levels of CO (e.g., third quartile, 1025 ppb) and lower levels of CO (e.g., first quartile, 850 ppb) had an annual ACR increase of 3.73 and 3.54 mg/g, respectively. Patients exposed to higher levels of PM 2.5 (e.g., third quartile, 38.8 μg/M3) and lower levels of PM 2.5 (e.g., first quartile, 27.7 μg/M3) had an annual ACR increase of 3.96 and 3.17 mg/g, respectively. Conclusions: Exposure to high CO and PM 2.5 levels increased albuminuria in type 2 diabetes.

Long-Term Effects of Psychological Symptoms after Occupational Injury on Return to Work: A 6-Year Follow-Up

International Journal of Environmental Research and Public Health, 2019

Psychological factors may compromise return to work among workers with occupational injuries, and... more Psychological factors may compromise return to work among workers with occupational injuries, and little is known about the long-term consequences of psychological symptoms relating to return to work. The study examined the impact of psychological symptoms on return to work as well as exploring factors associated with return to work among injured workers. A total of 572 workers who experienced occupational injuries were recruited in this prospective cohort study. Surveys of the psychological symptoms using the 5-item Brief Symptom Rating Scale (BSRS-5) were conducted at 3 and 12 months after the injury. All of the workers were invited to join the study at year 6 after the injury. Sociodemographic factors, psychological symptoms, injury severity, and return-to-work status were collected. Approximately 10% of injured workers could not return to work even 6 years after the injury. Severe psychological symptoms within 1 year after the injury presented a significant risk factor for not r...

Suicidality 6 Years After Occupational Injury

The Journal of clinical psychiatry, Jan 4, 2018

Suicide attempts can result from traumatic events, including those caused by occupational injury.... more Suicide attempts can result from traumatic events, including those caused by occupational injury. However, literature on the long-term prevalence rates of suicidality after occupational injury is relatively lacking. This study investigated the long-term prevalence of suicidality after occupational injury. Between February 1 and August 31, 2009, 4,403 workers in Taiwan sustained occupational injuries and were hospitalized for 3 days or longer. Surveys were conducted at 3 and 12 months after occupational injury, and 2,308 workers responded to either survey. They were invited to join the follow-up at 6 years after occupational injury, using the Brief Symptom Rating Scale (BSRS-5), Posttraumatic Symptom Checklist (PTSC), and 1 question on suicidal ideation. Workers with a high score on the BSRS-5 or PTSC were invited to participate in an in-depth psychiatric evaluation using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI). The estimated MINI-diagnosed sui...

Different seasonal effect on asthma trajectories: A population‐based birth cohort study

Pediatric Allergy and Immunology, 2018

Research has reported heterogeneity in longitudinal wheezing patterns arising in childhood. Data-... more Research has reported heterogeneity in longitudinal wheezing patterns arising in childhood. Data-driven approaches have also identified 4 wheezing trajectory phenotypes in childhood asthma in 2 longitudinal cohorts when the types of transient early and prolonged early wheezing were grouped together. However, a large-scale study following patients from birth to the age of 10 years revealed 3 asthma trajectory phenotypes. This article is protected by copyright. All rights reserved.

Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan

Journal of Nursing Scholarship, 2018

The aim of this study was to evaluate relationships between job physical demands and risk of low-... more The aim of this study was to evaluate relationships between job physical demands and risk of low-back pain (LBP), using medication to treat LBP (M-LBP) and seeking care for LBP (SC-LBP). Methods Worker demographics, LBP history, psychosocial factors, hobbies, job physical demands (using the Revised NIOSH Lifting Equation) were assessed at the time of enrollment (551 workers). There were 258 incident-eligible workers (a continuous pain-free period of at least 90 days at the time of enrollment) and were followed monthly for up to 4.5 years to determine new LBP, M-LBP, and SC-LBP cases. Changes in job physical demands were measured. Associations between risk factors and LBP outcomes were modelled using proportional hazards regression with time varying covariates. Results LBP and M-LBP were fairly common affecting 47.7% and 37% workers, respectively. SC-LBP much less common affecting 1 in 11 workers. Peak Lifting Index (PLI) and Peak Composite Lifting Index (PCLI) were associated with all three outcomes of LBP (p<0.05). PLI and PCLI had peak Hazard Ratios of 4.3 and 4.2 for LBP, 3.8 and 4.3 for M-LBP, and 23.0 and 21.9 for SC-LBP, respectively. LBP history was associated with all three outcomes of LBP. Age, gender, BMI, hobbies, and psychosocial factors showed inconsistent relationships with the three outcomes of LBP. Conclusion Job physical demands are associated with increased risk of LBP, M-LBP and SC-LBP. The PLI and PCLI are useful metrics for estimating job physical demands.

Quality of life at 6 years after occupational injury

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, Mar 29, 2017

Occupational injuries have considerable impact on workers' lives. However, data regarding wor... more Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary...

218 The changing shift pattern and overtime affect nurses’ menstrual characteristics

Occupational and Environmental Medicine, 2013

Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries

European Archives of Psychiatry and Clinical Neuroscience, 2017

both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%... more both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.

0099 Psychological work environment and suicidal ideation among nurses in taiwan

Poster Presentation, 2017

The aim of this study was to evaluate relationships between job physical demands and risk of low-... more The aim of this study was to evaluate relationships between job physical demands and risk of low-back pain (LBP), using medication to treat LBP (M-LBP) and seeking care for LBP (SC-LBP). Methods Worker demographics, LBP history, psychosocial factors, hobbies, job physical demands (using the Revised NIOSH Lifting Equation) were assessed at the time of enrollment (551 workers). There were 258 incident-eligible workers (a continuous pain-free period of at least 90 days at the time of enrollment) and were followed monthly for up to 4.5 years to determine new LBP, M-LBP, and SC-LBP cases. Changes in job physical demands were measured. Associations between risk factors and LBP outcomes were modelled using proportional hazards regression with time varying covariates. Results LBP and M-LBP were fairly common affecting 47.7% and 37% workers, respectively. SC-LBP much less common affecting 1 in 11 workers. Peak Lifting Index (PLI) and Peak Composite Lifting Index (PCLI) were associated with all three outcomes of LBP (p<0.05). PLI and PCLI had peak Hazard Ratios of 4.3 and 4.2 for LBP, 3.8 and 4.3 for M-LBP, and 23.0 and 21.9 for SC-LBP, respectively. LBP history was associated with all three outcomes of LBP. Age, gender, BMI, hobbies, and psychosocial factors showed inconsistent relationships with the three outcomes of LBP. Conclusion Job physical demands are associated with increased risk of LBP, M-LBP and SC-LBP. The PLI and PCLI are useful metrics for estimating job physical demands.

Proximity to petrochemical industrial parks and risk of chronic glomerulonephritis

Environmental Research, 2022

This study determined whether individuals residing near petrochemical industrial parks (PIPs) hav... more This study determined whether individuals residing near petrochemical industrial parks (PIPs) have a higher risk of chronic glomerulonephritis (CGN). We performed population-based 1:4 case-control study by using Taiwan's National Health Insurance Research Database from 2000 to 2016. The subjects were aged 20-65 years, residing in western Taiwan, and did not have a history of any renal or urinary system disease in 2000. The case cohort included those who had at least three outpatient visits or one hospitalization between 2001 and 2016 with codes for CGN as per International Classification of Diseases (ICD)-Ninth and Tenth Revisions. Controls were randomly sampled age-, sex-, and urbanization-matched individuals without renal and urinary system diseases. Petrochemical exposure was evaluated by the distance to the nearest PIP of the residential township, and petrochemical exposure probability was examined considering the monthly prevailing wind direction. Conditional logistic regression was used to determine the association between petrochemical exposure and CGN risk. A total of 320,935 subjects were included in the final analysis (64,187 cases and 256,748 controls). After adjustment for potential confounders, living in townships within a 3-km radius of PIPs was associated with a higher risk of CGN (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.28-1.37). Compared with townships more than 20 km away from PIPs, those within 10 km of PIPs were associated with significantly increased risks of CGN in a dose-dependent manner. When prevailing wind was considered, townships with high exposure probability were associated with a significantly increased risk of CGN. We found that those residing near PIPs or with high petrochemical exposure probability had a higher risk of CGN. These findings highlight the need for monitoring environmental nephrotoxic substances and the renal health of residents living near PIPs.

Short sleep and chronic neck and shoulder discomfort in nurses

Journal of Occupational Health, 2021

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more

Maternal proximity to petrochemical industrial parks and risk of premature rupture of membranes

ISEE Conference Abstracts, 2020

Background Living near petrochemical industries has been reported to increase the risks of advers... more Background Living near petrochemical industries has been reported to increase the risks of adverse birth outcomes, such as low birth weight and preterm delivery. However, evidence regarding the role of petrochemical exposure in pregnancy complications remains limited. This study evaluated the association between maternal proximity to petrochemical industrial parks (PIPs) during pregnancy and the occurrence of premature rupture of membranes (PROM).Methods We performed a population-based 1:3 case-control study by using the 2004-2014 Taiwanese Birth Certificate Database. Birth records reported as stillbirth or bearing congenital anomalies were excluded. Cases were newborns reported to have PROM, whereas controls were randomly sampled from those without any pregnancy complications by matching birth year and urbanization index of the residential township. The proximity to PIPs was evaluated by calculating the distance to the nearest PIP of the maternal residential township during pregnancy. Furthermore, petrochemical exposure opportunity, accounting for monthly prevailing wind direction, was quantified during the entire gestational period. We applied conditional logistic regression models to evaluate the associations.Results In total, 29371 PROM cases were reported during the study period, with a corresponding 88113 healthy controls sampled. The results revealed that living within a 3-km radius of PIPs during pregnancy would increase the risk of PROM (odds ratio [OR] = 1.76, 95% CI: 1.66-1.87). Furthermore, compared with the lowest exposed group, those with high petrochemical exposure opportunity had a significantly increased risk of PROM occurrence (OR = 1.69-1.75). The adverse effects remained robust in the subgroup analysis for both term- and preterm-PROM.Conclusions The results of the present work provide evidence that living near PIPs during pregnancy would increase the risk of PROM, and additional studies are warranted to confirm our findings.

0108 Shift work and sleep-related problems: a nationwide survey in taiwan

Oral Presentation, 2017

legislation, all employers have to perform a risk assessment to identify workers exposed to HBV a... more legislation, all employers have to perform a risk assessment to identify workers exposed to HBV and offer them vaccination. Immunisation should be done as early as possible after the start of their career to avoid HBV infection and the development of a carrier status. Methods We performed a cross-sectional survey of representatives from the Occupational Medicine section of the European Union of Medical Specialists (UEMS), to find out how policies have been put into practice in the European countries. Results Answers were received from 21 countries, representing 78% of the population in the EU-28. HBV vaccination was mandatory for medical and nursing staff in 10 countries, mandatory for other paramedical staff, medical and nursing students in nine countries, for paramedical students in eight countries. It was recommended in all other participating countries. Serotesting before vaccination was done in eight countries. The vaccination schedule most often used was 0, 1, 6 months (18 countries). Serotesting after vaccination was done in 18 countries, boosters were recommended in 14 countries. A non-responder policy, including testing for carrier state, was present in 18 countries. Discussion More consultation between key actors from MS at EU level could help to optimise the way this matter is dealt with in different MS in order to contribute to further reducing HBV transmission to HCWs

Effect of Needlestick Injury, Blood & Body Fluid Exposure Surveillance System

0169 The effect of psychological symptom within 1 year after occupational injury on long-term self-perceived health status

Poster Presentation, 2017

2 to 1.2×10 5 cells/m 3. S. aureus were detected in 42.3% of samples for which cell levels varied... more 2 to 1.2×10 5 cells/m 3. S. aureus were detected in 42.3% of samples for which cell levels varied between 4.2×10 1 and 2.8×10 4 cells/m 3. Concentrations of S. aureus and viable bacteria were positively correlated (r=0.61, p<0.005) and the percentages of S. aureus among viable bacteria averaged 22.7% with 11.6%-43.6% in various locations. With the PMA-qPCR technique, this study demonstrates that the abundance of viable S. aureus and total viable bacterial aerosols in various types of occupational fields can be simultaneously quantified. This molecular assay should be taken into account as it will assist occupational hygienists and epidemiologists obtain reliable exposure data in assessing exposure and health risk, managing occupational health and protecting people from biohazards.

0167 Association between ambient temperature and occupational injury

Poster Presentation, 2017

between each exposure method (individual, full JEM and asymptomatic JEM) and hand pain (Prevalenc... more between each exposure method (individual, full JEM and asymptomatic JEM) and hand pain (Prevalence ratios with asymptomatic JEM=1.15-1.34; all p<0.05). Conclusions A JEM using responses only from asymptomatic workers created more homogenous exposure groups, but initial analyses showed no other significant evidence of biassed exposure estimates due to symptoms. JEMs are a useful method of exposure assignment for some epidemiological studies of musculoskeletal disorders.

Occupational and non-occupational injuries can result in prolonged augmentation of psychiatric disorders

Journal of Epidemiology, 2020

This article has been accepted for publication and undergone full peer review but has not been th... more

Ambient air pollution and asthma onset in Taiwanese adults

Respiratory Medicine, 2020

BACKGROUND Ambient nitrogen dioxide is associated with asthma occurrence in adults in Western cou... more BACKGROUND Ambient nitrogen dioxide is associated with asthma occurrence in adults in Western countries. However, two recent large-scale studies have provided inconclusive results regarding this association. Moreover, the association remains unknown in an Asian population. OBJECTIVE We aimed to investigate the association between ambient air pollution exposure and incident adult asthma. METHODS From 2016 to 2017, we conducted a cross-sectional self-administered questionnaire survey with retrospective follow-up of incident asthma cases among schoolchildren's parents from 41 schools within 1 km of air monitoring stations distributed throughout the main island of Taiwan. To estimate participants' exposure, air pollution data of air monitoring stations within 1 km of schools from where participants were sampled were inputted into the proximity model. We used mixed logistic regression models to determine the association between air pollution exposure and asthma onset within five years prior to the survey. RESULTS The questionnaire was completed for a total of 11 585 participants out of 13 424 candidates (response rate, 86.3%). Among 9131 participants aged from 26 to 50 years, 101 were diagnosed with asthma within the five years prior to the survey. The prevalence of incident asthma cases was 2.2 per 1000 person-years. Those exposed to higher ambient nitrogen dioxide (odds ratio = 1.20 per interquartile [5.7 ppb] of nitrogen dioxide, 95% CI = 1.02-1.42) were more likely to develop adult-onset asthma. CONCLUSION In an Asian population, exposure to higher ambient nitrogen dioxide is associated with increased prevalence of incident asthma cases among adults aged 26-50 years.

Patient–Nurse Ratio is Related to Nurses’ Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction

International Journal of Environmental Research and Public Health, 2019

In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the pat... more In healthcare settings, nurses’ workload, burnout, and job satisfaction are associated to the patient–nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient–nurse ratio on nurses’ intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient–nurse ratio (ADPNR), nurses’ personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-ti...

Effects of PM2.5 on Skeletal Muscle Mass and Body Fat Mass of the Elderly in Taipei, Taiwan

Scientific Reports, 2019

Loss of skeletal muscle mass is common with aging and can cause morbidity and mortality in the el... more Loss of skeletal muscle mass is common with aging and can cause morbidity and mortality in the elderly. The effects of particulate air pollution on skeletal muscle mass is not known. The study aims to assess the chronic effects of ambient fine particulates (PM 2.5) on the body composition of the elderly. From October 2015 to November 2016, a cross-sectional survey on 530 elderly (age > = 65 years) was conducted in the Taipei Basin, Taiwan. The body composition was measured by bioelectrical impedance analysis (InBody 120). One year exposure to air pollution was estimated using the Kriging method at the participant's residence. Multiple linear regression analysis, after adjustments for demographics and copollutants, was used to examine the effects of PM 2.5 on body composition indices and force of handgrip. Changes in body composition for an interquartile (1.4 μm/m 3) increase in PM 2.5 concentration included a 0.4 kg (95% confidence interval (CI): −0.31, −0.58; p < 0.0001) decrease in skeletal muscle mass (2.0%) and a 0.7 kg (95% CI: 0.47, 0.91; p < 0.0001) increase in body fat mass (3.6%). While PM 2.5 reduced fat free mass in the upper extremities and trunk, but not in the lower extremities, it increased body fat mass in the three parts. There was no significant effect of PM 2.5 on handgrip force. Higher physical activity (versus lower than median) was associated with less detrimental effect of PM 2.5 on skeletal muscle mass and body fat mass (p values for interaction term: 0.009 and 0.013, respectively). Longterm PM 2.5 exposure is associated with decreased skeletal muscle mass and increased body fat mass in the elderly, which can be ameliorated by physical activity. Loss of muscle mass is associated with aging, at a decreasing rate of approximately 6% per decade after mid-life 1. Aging is associated with decreased production of several anabolic hormones like growth hormone, insulin-like growth hormone, testosterone, and estrogen, all of which play important roles in maintaining muscle mass and strength 2. Secondary causes of muscle loss include inadequate nutrition, physical inactivity, and chronic diseases such as malignancy, organ dysfunction, and neurodegenerative or endocrine diseases 3. Extremely low muscle mass with inadequate muscle function in the elderly is referred to as sarcopenia, which is linked to mortality risk 4,5. When sarcopenia is accompanied by increased body fat mass, also known as sarcopenic obesity, mortality risk becomes higher comparing to each condition separately 6-8. Identifying and managing the risk factors for sarcopenia and sarcopenic obesity may help promote healthy aging. Although the precise cause of sarcopenia and sarcopenic obesity is not known, there are several patho-physiologic mechanisms that affect muscle loss and visceral fat gain. Insulin resistance, a common phenomenon of central obesity,

Effects of long-term exposure to CO and PM2.5 on microalbuminuria in type 2 diabetes

International Journal of Hygiene and Environmental Health, 2018

No study has examined the effects of air pollutants on albuminuria in type 2 diabetes. Therefore,... more No study has examined the effects of air pollutants on albuminuria in type 2 diabetes. Therefore, the present study investigated this association. Methods: This follow-up study enrolled 812 patients with type 2 diabetes between 2003 and 2012. The urinary albumin-to-creatinine ratio (ACR) was recorded annually. Exposure to the air pollutants CO, NO 2 , O 3 , SO 2 , and PM 2.5 was interpolated from 72 air-quality monitoring stations to residences by using the kriging method. The association between air pollutants and ACR increase was assessed using mixed-effect model with random intercepts for 36 clinics. Results: The study objects (mean age: 55.4 years) were followed for 3 or more years (average period: 5.4 years). ACR increase was found to be positively associated with the male sex, baseline hemoglobin A1c, and exposure to CO and PM 2.5 , and negatively associated with waist circumference through multiple linear regression. Annually urine albumin/creatinine ratio increase was estimated by the final model, Patients exposed to higher levels of CO (e.g., third quartile, 1025 ppb) and lower levels of CO (e.g., first quartile, 850 ppb) had an annual ACR increase of 3.73 and 3.54 mg/g, respectively. Patients exposed to higher levels of PM 2.5 (e.g., third quartile, 38.8 μg/M3) and lower levels of PM 2.5 (e.g., first quartile, 27.7 μg/M3) had an annual ACR increase of 3.96 and 3.17 mg/g, respectively. Conclusions: Exposure to high CO and PM 2.5 levels increased albuminuria in type 2 diabetes.

Long-Term Effects of Psychological Symptoms after Occupational Injury on Return to Work: A 6-Year Follow-Up

International Journal of Environmental Research and Public Health, 2019

Psychological factors may compromise return to work among workers with occupational injuries, and... more Psychological factors may compromise return to work among workers with occupational injuries, and little is known about the long-term consequences of psychological symptoms relating to return to work. The study examined the impact of psychological symptoms on return to work as well as exploring factors associated with return to work among injured workers. A total of 572 workers who experienced occupational injuries were recruited in this prospective cohort study. Surveys of the psychological symptoms using the 5-item Brief Symptom Rating Scale (BSRS-5) were conducted at 3 and 12 months after the injury. All of the workers were invited to join the study at year 6 after the injury. Sociodemographic factors, psychological symptoms, injury severity, and return-to-work status were collected. Approximately 10% of injured workers could not return to work even 6 years after the injury. Severe psychological symptoms within 1 year after the injury presented a significant risk factor for not r...

Suicidality 6 Years After Occupational Injury

The Journal of clinical psychiatry, Jan 4, 2018

Suicide attempts can result from traumatic events, including those caused by occupational injury.... more Suicide attempts can result from traumatic events, including those caused by occupational injury. However, literature on the long-term prevalence rates of suicidality after occupational injury is relatively lacking. This study investigated the long-term prevalence of suicidality after occupational injury. Between February 1 and August 31, 2009, 4,403 workers in Taiwan sustained occupational injuries and were hospitalized for 3 days or longer. Surveys were conducted at 3 and 12 months after occupational injury, and 2,308 workers responded to either survey. They were invited to join the follow-up at 6 years after occupational injury, using the Brief Symptom Rating Scale (BSRS-5), Posttraumatic Symptom Checklist (PTSC), and 1 question on suicidal ideation. Workers with a high score on the BSRS-5 or PTSC were invited to participate in an in-depth psychiatric evaluation using the Chinese version of the Mini-International Neuropsychiatric Interview (MINI). The estimated MINI-diagnosed sui...

Different seasonal effect on asthma trajectories: A population‐based birth cohort study

Pediatric Allergy and Immunology, 2018

Research has reported heterogeneity in longitudinal wheezing patterns arising in childhood. Data-... more Research has reported heterogeneity in longitudinal wheezing patterns arising in childhood. Data-driven approaches have also identified 4 wheezing trajectory phenotypes in childhood asthma in 2 longitudinal cohorts when the types of transient early and prolonged early wheezing were grouped together. However, a large-scale study following patients from birth to the age of 10 years revealed 3 asthma trajectory phenotypes. This article is protected by copyright. All rights reserved.

Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan

Journal of Nursing Scholarship, 2018

The aim of this study was to evaluate relationships between job physical demands and risk of low-... more The aim of this study was to evaluate relationships between job physical demands and risk of low-back pain (LBP), using medication to treat LBP (M-LBP) and seeking care for LBP (SC-LBP). Methods Worker demographics, LBP history, psychosocial factors, hobbies, job physical demands (using the Revised NIOSH Lifting Equation) were assessed at the time of enrollment (551 workers). There were 258 incident-eligible workers (a continuous pain-free period of at least 90 days at the time of enrollment) and were followed monthly for up to 4.5 years to determine new LBP, M-LBP, and SC-LBP cases. Changes in job physical demands were measured. Associations between risk factors and LBP outcomes were modelled using proportional hazards regression with time varying covariates. Results LBP and M-LBP were fairly common affecting 47.7% and 37% workers, respectively. SC-LBP much less common affecting 1 in 11 workers. Peak Lifting Index (PLI) and Peak Composite Lifting Index (PCLI) were associated with all three outcomes of LBP (p<0.05). PLI and PCLI had peak Hazard Ratios of 4.3 and 4.2 for LBP, 3.8 and 4.3 for M-LBP, and 23.0 and 21.9 for SC-LBP, respectively. LBP history was associated with all three outcomes of LBP. Age, gender, BMI, hobbies, and psychosocial factors showed inconsistent relationships with the three outcomes of LBP. Conclusion Job physical demands are associated with increased risk of LBP, M-LBP and SC-LBP. The PLI and PCLI are useful metrics for estimating job physical demands.

Quality of life at 6 years after occupational injury

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, Mar 29, 2017

Occupational injuries have considerable impact on workers' lives. However, data regarding wor... more Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain. Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury. A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary...

218 The changing shift pattern and overtime affect nurses’ menstrual characteristics

Occupational and Environmental Medicine, 2013

Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries

European Archives of Psychiatry and Clinical Neuroscience, 2017

both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%... more both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.