Hospitalization in Winnipeg, Canada due to occupational disease: a pilot study

Our plain-English summary of Hospitalization in Winnipeg, Canada due to occupational disease: a pilot study, by A.G. Kraut (American Journal of Industrial Medicine, 2009).

The study

• Author: A.G. Kraut
• Journal: American Journal of Industrial Medicine
• Published: 2009;52(5):372-9
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The objectives of this study were to identify the extent of occupational exposures to hazardous substances amongst male medical inpatients and to determine the extent to which these exposures may have contributed to the development of medical conditions.

Methods: A random sample of 297 male who were admitted from outside the hospital to the medical wards to a large tertiary care hospital, were between age 18-75 and could communicate in English completed an occupational history questionnaire. This information was merged with an inpatient database which contained patient demographics, admission diagnoses, and co-morbidity data. A specialist in occupational medicine and internal medicine determined whether the medical conditions the participants had were related to their exposures.

Results: One individual had a condition causing admission that was related to his work and 12 others (4%) had a condition that was possibly related to their work which had caused symptoms. One additional individual was found to have asymptomatic asbestos related pleural fibrosis. Fourteen of 37 possible harmful occupational exposures were reported by more than 10% of the study participants. On average each participant reported 5.5 exposures.

Conclusions: Occupational exposures to male medical inpatients are common. For 4.4% (13/297) of male admissions to the general medical wards from the emergency room occupational factors may have played a role in the development of medical conditions which led to admission or to major co-morbidities. Detailed occupational histories will likely lead to more suspected cases of work related medical admissions.

Copyright 2009 Wiley-Liss, Inc.

In plain English

This pilot study at the largest hospital in Manitoba, Canada, located in Winnipeg, questioned 297 men aged 18 to 75 admitted from outside the hospital to the general medical wards between July 2006 and November 2007. Each man reported his jobs and whether he had been exposed to 37 possible workplace hazards. A specialist in occupational and internal medicine (the author) judged whether each man's conditions were work-related. The men reported 5.5 exposures on average, and 84 (28.3%) reported asbestos. One admission, sepsis following paraplegia from a construction accident, was judged definitely work-related. In 12 other men (4.0%), work was judged a possible cause of a condition. These included a former railway brakeman, a 60 pack-year smoker with potential asbestos exposure, whose lung cancer was judged possibly caused by asbestos and/or polycyclic aromatic hydrocarbons. A miner had asbestos-related pleural fibrosis that caused no symptoms and played no role in his admission. The author concluded that workplace exposures are common among male medical inpatients and that 4.4% of admissions were either related to work or involved a major co-morbidity that may have been due to occupational factors. Stated limitations included self-reported exposures, exclusion of the sickest patients, and a single assessor.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Pilot study: survey of hospital inpatients using an occupational history questionnaire, merged with an inpatient database, with work-relatedness judged by one specialist
• Who was studied: 297 men aged 18 to 75 who could communicate in English, admitted from outside the hospital to the general medical wards of the largest hospital in Manitoba (Winnipeg, Canada), recruited July 23, 2006 to November 14, 2007
• Exposure: Self-reported occupational exposure to 37 potential hazards (including asbestos), plus job titles for up to the last three jobs
• Main results:
  • Asbestos exposure was reported by 84 of the 297 participants (28.3%)
  • Participants reported on average 5.5 potentially harmful exposures, ranging from 0 to 19
  • One admission was judged definitely work-related: sepsis as a long-term complication of occupational traumatic paraplegia
  • In 12 additional men (4.0%), work was thought to be a possible cause of one of their medical conditions
  • A 73-year-old railway worker with a history of lung cancer, who had smoked 60 pack years and had potential asbestos exposure as a brakeman, was judged a possible case of asbestos and/or PAH (polycyclic aromatic hydrocarbon) induced lung cancer
  • All lung cancer and COPD cases judged possibly work-related had significant personal smoking histories
  • One man, a miner, had asbestos-related pleural fibrosis that did not play a role in his admission
  • Of the 15 lung cancer cases in the study, four (26.7%) had a possible occupational contribution
• The authors' conclusion: The author concluded that occupational exposures are common among male medical inpatients, and that 4.4% of admissions to the medical wards from outside the hospital were either related to work or had a major co-morbidity that may have been due to occupational factors
• Limitations the authors state:
  • Exposure data were self-reported and may be under- or over-reported
  • Sicker patients who could not complete the questionnaire were excluded; participants were less likely to die or be transferred to the ICU than eligible non-participants
  • Patients admitted directly to the hospital's small respiratory unit were not included, a possible source of under-diagnosis of occupational disease
  • Work-relatedness was assessed by only one individual
  • Results can only be generalized to hospitals admitting similar patient populations

Topics

Medical terms in this study, explained in our Lexicon: Occupational Disease, Occupational Exposure, Occupational History, Fibrosis.

Related studies

• Canada, chrysotile, and the search for truth — T. Ogden (2008)
• Health advocates assail Canada's asbestos stance — R. Collier (2008)
• Occurrence, behaviour, and human exposure pathways and health risks of toxic geogenic contaminants in serpentinitic ultramafic geological environments (SUGEs): A medical geology perspective — W. Gwenzi (2020)
• Development of an automated asbestos counting software based on fluorescence microscopy — M. Alexandrov, E. Ichida, et al. (2015)
• Asbestos Consumption in Mongolia: 1996-2014 — N. Damiran, A. Frank (2018)
• The potential impact of epidemiology on the prevention of occupational disease — D.H. Wegman (1992)

Browse more research in American Journal of Industrial Medicine, or return to medical research.