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Background: Self-report remains the most practical and cost-effective method for epidemiologic sleep studies involving large population-based samples. Several validated questionnaires have been developed to assess sleep, but these tools are lengthy to administer and may be impractical for epidemiologic studies. We examined whether a 3-item sleep questionnaire, similar to those typically used in epidemiologic studies, closely corresponded with objective measures of sleep as assessed using actigraphy monitoring. Methods: Eligible participants were Western Australian women aged 18 to 80 years. Participants completed a sleep questionnaire, wore a wrist actigraph for 7 nights, and completed a brief daily sleep log. Objective actigraphy measurements for 56 participants were summarized by mean and mode and compared with the subjective reports, using weighted kappa and delta. Results: Data collected from the questionnaire showed poor agreement with objectively measured sleep, with kappas ranging from −0.19 to 0.14. Conclusions: Our results indicate that sleep questions typically used in epidemiologic studies do not closely correspond with objective measures of sleep as assessed using actigraphy. The findings have implications for studies that have used such sleep questions. A means of appropriately measuring sleep as a risk factor in epidemiologic studies remains to be determined. [PUBLICATION ABSTRACT]

Coal mine dust lung disease comprises a group of occupational lung diseases including coal workers pneumoconiosis. In many countries, there is a lack of robust prevalence estimates for these diseases. Our objective was to perform a systematic review and meta-analysis of published contemporary estimates on prevalence, mortality, and survival for coal mine dust lung disease worldwide. Systematic searches of PubMed, EMBASE and Web of Science databases for English language peer-reviewed articles published from 1/1/2000 to 30/03/2021 that presented quantitative estimates of prevalence, mortality, or survival for coal mine dust lung disease. Review was conducted per PRISMA guidelines. Articles were screened independently by two authors. Studies were critically assessed using Joanna Briggs Institute tools. Pooled prevalence estimates were obtained using random effects meta-analysis models. Heterogeneity was measured using the I2 statistics and publication bias using Egger's tests. Overall 40 studies were included, (31 prevalence, 8 mortality, 1 survival). Of the prevalence estimates, fifteen (12 from the United States) were retained for the meta-analysis. The overall pooled prevalence estimate for coal workers pneumoconiosis among underground miners was 3.7% (95% CI 3.0-4.5%) with high heterogeneity between studies. The pooled estimate of coal workers pneumoconiosis prevalence in the United States was higher in the 2000s than in the 1990s, consistent with published reports of increasing prevalence following decades of declining trends. Sub-group analyses also indicated higher prevalence among underground miners, and in Central Appalachia. The mortality studies were suggestive of reduced pneumoconiosis mortality rates over time, relative to the general population. The ongoing prevalence of occupational lung diseases among contemporary coal miners highlights the importance of respiratory surveillance and preventive efforts through effective dust control measures. Limited prevalence studies from countries other than the United States limits our understanding of the current disease burden in other coal-producing countries.

Background Coal mine workers are exposed to many occupational hazards which may affect mortality including respirable coal mine dust, crystalline silica and diesel engine emissions. Several studies have shown decreased overall mortality, but studies did not define the jobs held, did not include women coal mine workers and lacked smoking data. Methods A cohort of coal mine workers, from Queensland, Australia, was linked to the national death registry. Those who had had a health assessment after 1993 were grouped by job title into eight Work Categories. Mortality by Work Categories were compared to the Australian population to produce standardised mortality ratios (SMRs). Relative mortality ratios (RMR) by sex were calculated comparing risks within the cohort, adjusted for age, era (calendar period) and smoking. Results There were 4,555 deaths among 161,534 men and 196 among 23,967 women with job titles. The median age at inception was 33 (men) and 30 (women) years. SMRs were significantly reduced for men and women. However, compared with other men in the cohort, increased mortality was found from digestive diseases (Maintenance workers and Truck Drivers), respiratory diseases (Construction and Labourers) and accidents (Production, Labourers and Truck Drivers). Circulatory disease mortality was increased for male Production workers adjusted RMR (aRMR) 1.22(95%CI 1.06–1.40), Unexposed Non-Office aRMR 1.64(95%CI 1.15–2.35) and Labourers aRMR 1.48 95%CI (1.00-2.17) and Truck Drivers aRMR 1.21(95%CI 0.95–1.54), while accidental deaths were higher in female cleaners aRMR 3.13(95%CI 1.30–7.57). The suicide rate was higher for men and women in Production jobs. Conclusions Although a relatively young cohort, mortality risk varied by type of work. Risk of death from circulatory causes was increased in some workers, even after adjusting for smoking. Suicide rates are higher for men and women doing Production jobs.

Background: Assessment of occupational exposures is an integral component of population-based studies investigating the epidemiology of occupational diseases. However, all the available methods for exposure assessment have been developed, tested and used in high-income countries. Except for a few studies examining pesticide exposures, there is limited research on whether these methods are appropriate for assessing exposure in LMICs. The aim of this study is to compare a task-specific algorithm-based method (OccIDEAS) to a job-specific matrix method (OAsJEM) in the assessment of asthmagen exposures among healthcare workers in a high-income country and a low- and middle- income country (LMIC) to determine an appropriate assessment method for use in LMICs for future research. Methods: Data were obtained from a national cross-sectional survey of occupational asthmagens exposure in Australia and a cross-sectional survey of occupational chemical exposure among Bhutanese healthcare workers. Exposure was assessed using OccIDEAS and the OAsJEM. Prevalence of exposure to asthmagens and inter-rater agreement were calculated. Results: In Australia, the prevalence was higher for a majority of agents when assessed by OccIDEAS than by the OAsJEM (13 versus 3). OccIDEAS identified exposures to a greater number of agents (16 versus 7). The agreement as indicated by κ (Cohen’s Kappa coefficient) for six of the seven agents assessed was poor to fair (0.02 to 0.37). In Bhutan, the prevalence of exposure assessed by OccIDEAS was higher for four of the seven agents and κ was poor for all the four agents assessed (-0.06 to 0.13). The OAsJEM overestimated exposures to high-level disinfectants by assigning exposures to all participants from 10 (Bhutan) and 12 (Australia) ISCO-88 codes; whereas OccIDEAS assigned exposures to varying proportions of participants from these ISCO-codes. Conclusion: There was poor to fair agreement in the assessment of asthmagen exposure in healthcare workers between the two methods. The OAsJEM overestimated the prevalence of certain exposures. As compared to the OAsJEM, OccIDEAS appeared to be more appropriate for evaluating cross-country exposures to asthmagens in healthcare workers due to its inherent quality of assessing task-based determinants and its versatility in being adaptable for use in different countries with different exposure circumstances.

The concept of professional judgement underpins the way in which an occupational hygienist assesses an exposure problem. Despite the importance placed on professional judgement in the discipline, a method of assessment to characterise accuracy has not been available. In this paper, we assess the professional judgement of four occupational hygienists (‘experts’) when completing exposure assessments on a range of airborne contaminants across a number of job roles within a surface mining environment in the Pilbara region of Western Australia. The job roles assessed were project driller, mobile equipment operator, fixed plant maintainer, and drill and blast operator. The contaminants of interest were respirable crystalline silica, respirable dust, and inhalable dust. The novel approach of eliciting exposure estimates focusing on contaminant concentration and attribution of an exposure standard estimate was used. The majority of the elicited values were highly skewed; therefore, a scaled Beta distribution were fitted. These elicited fitted distributions were then compared to measured data distributions, the results of which had been collected as part of an occupational hygiene program assessing full-shift exposures to the same contaminants and job roles assessed by the experts. Our findings suggest that the participating experts within this study tended to overestimate exposures. In addition, the participating experts were more accurate at estimating percentage of an exposure standard than contaminant concentration. We demonstrate that this elicitation approach and the encoding methodology contained within can be applied to assess accuracy of exposure judgements which will impact on worker protection and occupational health outcomes.

Background: This paper reviews international patterns in sinonasal cancer incidence and mortality in light of changes in exposure to known risk factors. Sinonasal tumours are relatively rare, but they have the second highest occupational attributable fraction of all types of cancer, with a well-established link for workers exposed to wood dust. Methods: Data for a variety of countries, mainly in Europe, North America and the Asia-Pacific region, were obtained from publicly accessible sources and supplemented with information requested from selected cancer registries. Rates were directly age-standardised to the World Health Organization Standard Population. Results: The average annual incidence of sinonasal cancer was typically between 5 and 10 per million in males and between 2 and 5 per million in females between 2004 and 2008. Denmark reported the highest rates, with incidence continuing to increase, in contrast to trends in other countries which either remained relatively stable, or were decreasing slightly. There were significant recent decreases in sinonasal cancer mortality rates within two-thirds of the included countries. Conclusions: Our observations are generally consistent with efforts to limit exposure to wood dust and other potentially causal substances in the workplace, as well as a reduction in the prevalence of smoking in many developed countries. Of concern is that occupational and behavioural risks related to sinonasal cancer are likely to increase among people in less developed countries into the future. However the incentive to intervene in these countries is limited by the lack of accurate and reliable cancer data.

Purpose: Gastric colonization with Helicobacter pylori (H. pylori) has been implicated in the pathogenesis of pancreatic cancer, but results of epidemiological studies have been inconclusive. We analyzed data from the Queensland Pancreatic Cancer Study, an Australian population-based case–control study, and incorporated our findings into an updated meta-analysis. Methods: Blood samples were obtained from 580 patients and 626 controls, and enzyme-linked immunosorbent assay kits were used to determine seropositivity to H. pylori and its virulence protein, cytotoxin-associated gene A (CagA). Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using logistic regression. Results were incorporated into a meta-analysis along with results of studies identified through systematic literature review. Adjusted ORs and 95 % CIs were calculated using the DerSimonian and Laird random-effects model. Results: No overall association was observed between H. pylori seropositivity and risk of pancreatic cancer (OR 1.00; 95 % CI 0.74–1.35). Nonsignificantly decreased pancreatic cancer risk was observed with CagA seropositivity (OR 0.74; 95 % CI 0.48–1.15) and increased risk with CagA-negative H. pylori seropositivity (OR 1.23; 95 % CI 0.83–1.82). Ten studies were included in the meta-analysis. There was no significant overall association between H. pylori seropositivity and pancreatic cancer risk (OR 1.13; 95 % CI 0.86–1.50), but evidence of CagA strain-specific associations (OR 0.78; 95 % CI 0.67–0.91 and OR 1.30; 95 % CI 1.02–1.65 for CagA-positive and CagA-negative strains, respectively). Conclusions: Our results provide further evidence for the existence of strain-specific associations between H. pylori and pancreatic cancer.

Background and objectives Although past studies of workplace exposures have contributed greatly to our understanding of carcinogens, significant knowledge gaps still exist with regard to the actual extent of exposure among current workers, with no routinely collected population-based data being available in most countries. This study, the Australian Work Exposures Study (AWES), aimed to investigate the current prevalence of occupational exposure to carcinogens. Methods A random sample of men and women aged between 18 and 65, who were currently in paid employment, were invited to participate in a telephone interview collecting information about their current job and various demographic factors. Interviews were conducted using a web-based application (OccIDEAS). OccIDEAS uses the expert exposure method in which participants are asked about their job tasks and predefined algorithms are used to automatically assign exposures. Responses were obtained from 5023 eligible Australian residents, resulting in an overall response rate of 53%. Results 1879 respondents (37.6%) were assessed as being exposed to at least one occupational carcinogen in their current job. Extrapolation of these figures to the Australian working population suggested 3.6 million (40.3%) current workers could be exposed to carcinogens in their workplace. Exposure prevalence was highest among farmers, drivers, miners and transport workers, as well as men and those residing in regional areas. Conclusions This study demonstrates a practical, web-based approach to collecting population information on occupational exposure to carcinogens and documents the high prevalence of current exposure to occupational carcinogens in the general population.

Background The recurrent threat of zoonotic diseases necessitates integrated, multisectoral strategies, such as the One Health, which recognises the interconnectedness of human, animal and environmental health. Institutionalising such approaches requires comprehensive national policy frameworks that ensure cross-sectoral coordination, sustainable resource allocation, and robust governance mechanisms. Bhutan adopted One Health in 2013, however, its integration into national policies remains unexplored. This study aimed to examine Bhutan’s policy landscape for zoonotic disease prevention and control through a One Health lens. Methods Eleven documents related to zoonotic disease prevention and control in Bhutan, published between 2013 and 2024, were retrieved from official government websites and obtained from relevant authorities. A qualitative document analysis was conducted, guided by the Policy Triangle Framework, which evaluates policy across four dimensions: Actors, Context, Content, and Process. Key One Health components were mapped to each dimension using internationally recognised One Health frameworks to systematically evaluate the extent to which Bhutan’s zoonotic disease policies align with the principles of One Health approach. Results The findings revealed clearly defined roles and responsibilities among key stakeholders, but limited inclusion of the environmental sector. While the policies reflected contextual relevance and alignment to international disease prevention and control frameworks, their integration with holistic One Health strategies remained limited due to persistent sectoral silos. Policy contents revealed a strong commitment to disease prevention and control, but major gaps were identified in financial planning, human resource development, and investment in technical infrastructure. Policy processes were largely undocumented, with weak stakeholder engagement, limited cross-sectoral coordination, and absence of robust monitoring and evaluation mechanisms. Conclusions Strengthening policy design, enhancing governance structures and institutional frameworks are essential to improve intersectoral coordination, resource allocation, and stakeholder engagement for effective operationalisation of zoonotic disease prevention and control within the One Health framework in Bhutan. The insights from this study may offer practical implications for low- and middle-income countries working to embed One Health into national policy. Furthermore, it demonstrates how the Policy Triangle Framework can be adapted to systematically evaluate policy alignment in the context of One Health.