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Several studies have identified the main barriers and facilitators that breast cancer survivors experience in the return to work (RTW). The authors conducted a qualitative study using focus group discussions with a group of female non-metastatic breast cancer survivors (n = 6), a group of health professionals from different medical specialties (n = 8), and a third group of company managers mainly composed of human resources managers (n = 7). The study was carried out between March and December 2021 in Zaragoza (Spain). Transcripts were analyzed using inductive content analysis to identify work-related barriers and facilitators and coded by the research team. Barriers identified included physical and cognitive symptoms, psychosocial problems, lack of knowledge and coordination (health professional, patients, and managers), legal vacuum, physical change, time constraints, work characteristics (lower skilled jobs), unsupportive supervisors and coworkers, family problems and self-demand. Facilitators included family and work support, physical activity and rehabilitation, personalized attention, interdisciplinary collaboration, legal advice for workers, knowledge about breast cancer in companies, positive aspects of work, elaboration of protocols for RTW in women with breast cancer. RTW in working women with breast cancer requires a personalized and holistic view that includes the perspectives of patients, healthcare professionals and company managers.

BackgroundMSDs are the most prevalent work-related diseases in the European Union (EU). Developmental pathways of these health problems are known to be related to physical and psychosocial working conditionsObjectives and MethodsThis study aimed to describe physical and psychological risk factors involved in the appearance of neck and upper limb MSDs in workers.A survey was conducted in health workers of the La Rioja Regional Department of Health (Spain) (n=3939) using an observational design. Over a 12 month period, all health workers from this Department who used the Occupational Medicine Service for neck and upper limb pain and discomfort were invited to participate. Finally, a total of 707 health workers were recruited for the survey. Information on workplace exposure to physical and psychological risks was collected using three different tools: the Standardised Nordic Musculoskeletal questionnaire, the Siegrist’s and a self-reporting questionnaire (drafted ad hoc and validated prior to administration ) to gather socio-demographic and occupational variables.Results and conclusionsA high prevalence of neck and upper extremity symptoms has been found among our sample (73.55%). The most common location was neck (65.77%). Being a female worker with high physical workload, low career progress and over-involvement at work was configured as a risk profile. The studied symptoms were highly predicted by the existence of work stress and effort-reward imbalance. Therefore, medical doctors should be aware of what may be behind of these complaints, as they could be a warning of underlying mental strain and potential exposure to psychosocial risks.

Fuel oil-derived volatile organic compounds (VOCs) inhalation is associated with accidental marine spills. After the petroleum tanker sank off northern Spain in 2002 and the oil rig catastrophe in 2009, subjects involved in environmental decontamination showed signs of ongoing or residual lung disease up to 5 y after the exposure. We aimed at investigating mechanisms driving persistent respiratory disease by developing an animal model of inhalational exposure to fuel oil-derived VOCs. Female Wistar and Brown Norway (BN) rats and C57BL mice were exposed to VOCs produced from fuel oil mimicking the spill. Exposed animals inhaled the VOCs 2 h daily, 5 d per week, for 3 wk. Airway responsiveness to methacholine (MCh) was assessed, and bronchoalveolar lavage (BAL) and lung tissues were analyzed after the exposure and following a 2-wk washout. Consistent with data from human studies, both strains of rats that inhaled fuel oil-derived VOCs developed airway hyperresponsiveness that persisted after the washout period, in the absence of detectable inflammation in any lung compartment. Histopathology and quantitative morphology revealed the development of peripherally distributed pulmonary emphysema, which persisted after the washout period, associated with increased alveolar septal cell apoptosis, microvascular endothelial damage of the lung parenchyma, and inhibited expression of vascular endothelial growth factor (VEGF). In this rat model, fuel oil VOCs inhalation elicited alveolar septal cell apoptosis, likely due to DNA damage. In turn, the development of a peculiar pulmonary emphysema pattern altered lung mechanics and caused persistent noninflammatory airway hyperresponsiveness. Such findings suggest to us that humans might also respond to VOCs through physiopathological pathways different from those chiefly involved in typical cigarette smoke-driven emphysema in chronic obstructive pulmonary disease (COPD). If so, this study could form the basis for a novel disease mechanism for lasting respiratory disease following inhalational exposure to catastrophic fuel oil spills. https://doi.org/10.1289/EHP4178.