Background: The Ethiopian flower industry is growing fast with successful diversification of export products under greenhouse structures. Higher temperatures in the greenhouses pose a serious threat to the health of w...Background: The Ethiopian flower industry is growing fast with successful diversification of export products under greenhouse structures. Higher temperatures in the greenhouses pose a serious threat to the health of workers and add to the risk of occupational heat stress. Excessive heat in workplace settings also reduces work capacity and labour productivity. This study aims to investigate the level of heat exposure, and workers’ and managers’ perceptions and behavioural responses towards extreme heat exposure in a warming climate. Methods: We used the Wet Bulb Globe Temperature (WBGT) measured in representative greenhouses to capture the heat exposure during hotter and cooler seasons following ISO 7243 (generally risk of heat stress occurs when WBGT exceeds 26°C). A comparative cross-sectional study design with a stratified sampling method was used to assess occupational heat stress and workers’ perceptions of the impact of heat on their health and productivity in six different floriculture greenhouses in Ethiopia representing three different agro-ecologies and products. A questionnaire survey was conducted (30 managers/supervisors and 305 workers;76.1% female) to capture perceptions on heat exposures, symptoms of potential health impacts, productivity losses and coping mechanisms. Results: Heat exposure varied across different agroecologies, product types and greenhouse materials with a median WBGT Index of 25.5°C and a range from 18.1°C to 31.5°C. The impact of heat stress also varied across different employment sectors and geographical regions. Overall, workers in cut-flower greenhouses are exposed to higher than recommended WBGT Index (26°C) for 3 - 6 working hours daily. 65% of the managers reported that heat stress has a significant impact on the workers’ labour productivity, but do not have guidance about working in hot conditions. Workers reported more heat-related health issues and reduced productivity, especially in the mid-altitude greenhouses. About 50% of the workers reported that heat exposure decreased work productivity during hot hours. Sweating, exhaustion, heat-rashes, dehydration, crumps, nausea and headache were self-reported health issues. Labour productivity losses ranged from no loss to 19.5% in the mid- and low-altitudes. Conclusions and Recommendations: Excessive workplace heat in the greenhouses is both an occupational health hazard and detrimental to productivity in the floriculture industry. However, the level of understanding and actions on the ground regarding occupational heat stress are low. The code of conduct in place now does not consider the occupational heat stress issues. Multiple actions (engineering, management, training and policy-related recommendations) have to be implemented by Ethiopian Horticultural Producers and Exporters Association (EHPEA) and farm owners to mitigate heat stress and loss of productivity. Designing and implementing these heat prevention strategies and incorporating them into the code of conduct is in the interests of both employers and employees.展开更多
AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their v...AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers(1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers(2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth loss.CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.展开更多
文摘Background: The Ethiopian flower industry is growing fast with successful diversification of export products under greenhouse structures. Higher temperatures in the greenhouses pose a serious threat to the health of workers and add to the risk of occupational heat stress. Excessive heat in workplace settings also reduces work capacity and labour productivity. This study aims to investigate the level of heat exposure, and workers’ and managers’ perceptions and behavioural responses towards extreme heat exposure in a warming climate. Methods: We used the Wet Bulb Globe Temperature (WBGT) measured in representative greenhouses to capture the heat exposure during hotter and cooler seasons following ISO 7243 (generally risk of heat stress occurs when WBGT exceeds 26°C). A comparative cross-sectional study design with a stratified sampling method was used to assess occupational heat stress and workers’ perceptions of the impact of heat on their health and productivity in six different floriculture greenhouses in Ethiopia representing three different agro-ecologies and products. A questionnaire survey was conducted (30 managers/supervisors and 305 workers;76.1% female) to capture perceptions on heat exposures, symptoms of potential health impacts, productivity losses and coping mechanisms. Results: Heat exposure varied across different agroecologies, product types and greenhouse materials with a median WBGT Index of 25.5°C and a range from 18.1°C to 31.5°C. The impact of heat stress also varied across different employment sectors and geographical regions. Overall, workers in cut-flower greenhouses are exposed to higher than recommended WBGT Index (26°C) for 3 - 6 working hours daily. 65% of the managers reported that heat stress has a significant impact on the workers’ labour productivity, but do not have guidance about working in hot conditions. Workers reported more heat-related health issues and reduced productivity, especially in the mid-altitude greenhouses. About 50% of the workers reported that heat exposure decreased work productivity during hot hours. Sweating, exhaustion, heat-rashes, dehydration, crumps, nausea and headache were self-reported health issues. Labour productivity losses ranged from no loss to 19.5% in the mid- and low-altitudes. Conclusions and Recommendations: Excessive workplace heat in the greenhouses is both an occupational health hazard and detrimental to productivity in the floriculture industry. However, the level of understanding and actions on the ground regarding occupational heat stress are low. The code of conduct in place now does not consider the occupational heat stress issues. Multiple actions (engineering, management, training and policy-related recommendations) have to be implemented by Ethiopian Horticultural Producers and Exporters Association (EHPEA) and farm owners to mitigate heat stress and loss of productivity. Designing and implementing these heat prevention strategies and incorporating them into the code of conduct is in the interests of both employers and employees.
基金Supported by Grant-in-Aid for the Third Term Comprehensive 10-year Strategy for Cancer Control,No.H20-3rd-002Grant-in-Aid for Cancer Research,Grant No.13-21-13-1 from the Japanese Ministry of Health,Labor and Welfare
文摘AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers(1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers(2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth loss.CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.
