Danish Ramazzini Center

Respiratory complaints during indoor training among elite professional soldiers. During a four-hour period (3*15 min) eighteen male healthy non-smoking Caucasians practiced enemy neutralization and building security. At each session 65-246 blanks and dummy hand grenades were used and no respiratory protection. Each soldier underwent blood sampling and spirometry testing before and after the training session and monitored own exposure. The mean (range) exposure of total dust was 18.1 (6.0-25.5) mg/m 3 , Cu 17.4 (9.4-28.4) ug/m 3 and Zn 165.1 (63.4-328.7) ug/m 3 . Mean (95% CI) post-values for Forced Expiratory Volume after 1 second and Forced Vital Capacity were -130 mL (-180; -80) and -120 mL (-170; -70) lower than corresponding pre-values. Blood concentration of neutrophils increased from 48% to 57%. Respiratory protection equipment is recommended in future indoor training sessions.

Sleep disorders such as obstructive sleep apnea (OSA) may be influenced by environmental exposures, yet the contribution of indoor microbial communities is not well understood. In this study, we examined whether the composition and load of airborne bacteria in bedrooms were associated with the Multivariable Apnea Prediction (MAP) index, a validated indicator of OSA risk. Bedroom air was sampled using electrostatic dust fall collectors in five Nordic centres participating in ECRHS III. Dust was analysed for bacterial load, endotoxin levels, and microbial composition using qPCR, LAL assay, and 16S rRNA sequencing. Associations between microbial exposures and MAP index were assessed using linear regression and categorical MAP cutoffs (≥ 0.5 and ≥ 0.7) adjusting for environmental factors. Bacterial community composition differed significantly between MAP groups, and participants with MAP ≥ 0.7 showed higher bacterial loads. However, alpha diversity and endotoxin levels did not vary by MAP category. A total of 35 bacterial genera were associated with MAP scores; taxa enriched in individuals with higher MAP values were primarily anaerobic and human-associated, whereas negatively associated genera were mostly aerobic and environmental. These findings suggest that the bedroom microbiome may carry a distinct microbial signature related to elevated OSA risk, potentially reflecting or contributing to sleep-disordered breathing.

Stress is associated with negative health outcomes, with increasing levels observed in adolescents, particularly among females. Despite the known association between low social status and stress, longitudinal studies on stress trajectories and the impact of social status in adolescence remain limited. This study describes mean levels of perceived stress by sex and social status over time, and models group-based trajectories of stress levels and examines the associations between social status at age 15 and these trajectories. Data were drawn from a longitudinal Danish study following participants from adolescence to early adulthood (ages 15–32), supplemented with register data. Stress levels were measured at five time points and analysed by sex across social status groups using various measures of social status. Group-based trajectory modelling was used to identify patterns over time. Sex differences in stress levels were observed at ages 15, 18, and 21 but diminished by age 32, as stress levels decreased among females. Low social status at age 15, across all social status measures, was associated with higher stress levels over time. Optimal models identified three trajectories among males (low-stable, mid-stable, and increasing) and four among females (low-stable, mid-stable, increasing, and high mid-peak). Low social status was associated with higher odds of being in all other trajectories than the low-stable trajectory, for both sexes, regardless of the social status measure. Preventive interventions should focus on individuals with low social status to reduce high-stress trajectories.

<h3>Objective</h3> To examine the exposure-response relations between cumulative evening and night shifts and incident myocardial infarction among hospital employed health care workers, including nurses, physicians, and others. <h3>Material and Methods</h3> This national register-based cohort study includes all newly hired health care workers ever working evening or night shifts with day by day payroll information on evening and night shifts, from 2008/2009 to 2020. In total, we included 137 184 health care workers (mean age 33.3 years at inclusion, 77% women) who were followed from first registered evening or night shift for an average of 6.4 years. First time hospital contacts for myocardial infarction were identified in national health registers. Incidence rates of myocardial infarction by cumulative evening and night shifts were estimated by Poisson regression adjusted for sex, age, calendar year, diabetes, obesity, hypertension, hypercholesterolemia, education, and family history of cardiovascular disease; and for a subset of 13 080 workers, additionally adjusted for self-reported smoking, body mass index, and alcohol consumption. <h3>Results</h3> During follow-up, 477 workers (49% women) were diagnosed with myocardial infarction. Men and women showed overall incidence rates of 12.5 and 3.4 per 10 000 person years. No increasing incidence rates of myocardial infarction with cumulative number of evening or night shifts were observed. <h3>Conclusions</h3> This study of health care workers found no exposure-response relation between cumulative evening or night shifts and incident myocardial infarction during up to 13 years after the first recorded evening or night shift.

<h3>Objective</h3> This study aims to examine the link between psychosocial working conditions (PWC) at labour market entry and subsequent labour market participation (LMP) over a five-year follow-up period. The guiding research question is whether jobs with poor PWC serve as steppingstones to better jobs and employment stability or if these jobs constrain individuals in dead-end jobs and employment instability. <h3>Material and Methods</h3> The study population consists of all Danish citizens who have completed their education by age 28 and were born between 1978 and 1995. Psychosocial working conditions are measured using Job Exposure Matrices at labour market entry after graduation and constitute the primary exposure. Information on LMP and receipt of public subsidies measured monthly obtained from the Danish Register for Evaluation of Marginalization constitute the foundation for the outcome. Data are based on administrative registers from Statistics Denmark. Sequence and cluster analyses will classify different LMP trajectories. Descriptive measures from the sequence analysis literature will be used to characterise the different types of LMP trajectories. Multinomial logistic regression will determine if different levels of PWC at entry predict different LMP trajectories. Control variables include education level, gender, ethnicity, family socioeconomic status, age at labour market entry, and year of entry. <h3>Results/conclusion</h3> Sequence analysis is introduced as a methodological addition to studying the long-term consequences of employment in entry jobs with poor or satisfactory PWC. The longitudinal design uses comprehensive data (60 monthly LMP records per person) rather than single time points post-exposure, which is a common approach. No results have been produced at this preliminary stage of the study but will be provided at the conference.

The aim of this systematic review was to identify, evaluate, and synthesize the relation between ten potential occupational sensitizing exposure groups and asthma. A systematic literature search was conducted in three databases for peer-reviewed articles published between July 2011 and March 2023. Exposures included ten potential occupational sensitizing exposure groups (amines, anhydrides, biocides [eg, pesticides], crustaceans, enzymes, mammals, metals, "mold, fungi and yeast", molluscs, and other chemicals [eg, cleaning agents]) classified as having no or limited evidence of a causal relation with asthma in our previous overview of systematic reviews. We included observational and case studies. Study selection, data extraction, risk of bias assessment, and evidence level evaluation were conducted independently by two reviewers, who also upgraded or downgraded the level of evidence found in our overview. This review included 55 articles. The overall confidence in study results was rated high in 8, moderate in 18, and low in 29 studies. No new studies were found for molluscs. For the remaining exposures, we upgraded main groups of crustaceans and enzymes to moderate evidence, mammals and metals to limited/contradictory, and amines and biocides to very limited/contradictory. For subgroups/specific exposures, pesticides, cleaning agents - such as chloramine and disinfection products - and an unspecified group of other chemicals, specifically acrylates and epoxy, were upgraded to moderate. New occupational sensitizing exposures with moderate evidence include crustaceans, enzymes, pesticides, cleaning agents such as chloramine and disinfection products, and chemicals such as acrylates and epoxy.

Outdoor workers are exposed to high levels of solar ultraviolet radiation (UVR). UVR causes skin cancer and is a risk factor for cataract and other short- and long-term health effects, but there are significant knowledge gaps regarding the exposure-response relations based on quantitative measures of UVR exposure. We developed a quantitative UVR job-exposure matrix (JEM) for the general working population of Europe. Three experts from each of Northern, Central, and Southern Europe rated duration of outdoor work for all 372 occupations defined by the International Standard Classification of Occupations from 1988 (ISCO-88(COM)). A systematic literature search identified 12 studies providing 223 sets of summary workday UVR exposure for 49 ISCO-88(COM) occupations based on 75,711 personal workday measurements obtained from 2,645 participants and reported as arithmetic mean standard erythemal dose (SED). We combined the expert ratings with the measured occupational UVR exposure data and estimated harmonized workday UVR exposures for all 372 occupations in a linear mixed effects model. Monotonically increasing workday UVR exposure of 0.68, 1.57, 1.80, and 2.49 SED were seen by increasing expert ratings of 0, 1 to 2, 3 to 4, and ≥5 h of daily outdoor work. The UVR exposure showed a 6-fold increase from lowest to highest exposed occupation. Farm hands, roofers, concrete placers, and other occupations within craft and related trades were among the highest exposed, while bartenders, wood-processing-plant operators, and several white-collar occupations who typically work indoor were among the lowest exposed. This quantitative JEM for solar UVR exposure proves able to provide substantial discrimination between occupations, shows good agreement with expert assessments, and may facilitate epidemiological studies characterizing the exposure-response relation between occupational solar UVR exposure and different health effects.

We aimed to 1) identify distinct segments within the general population characterized by various combinations of stressors (stressor profiles) and to 2) examine the socio-demographic composition of these segments and their associations with perceived stress levels. Segmentation was carried out by latent class analysis of nine self-reported stressors in a representative sample of Danish adults (N = 32,417) aged 16+ years. Perceived stress level was measured by the Perceived Stress Scale (PSS). Seven classes were identified: Class 1 was labeled Low Stressor Burden (64% of the population) and the remaining six classes, which had different stressor combinations, were labeled: 2) Burdened by Financial, Work, and Housing Stressors (10%); 3) Burdened by Disease and Death among Close Relatives (9%); 4) Burdened by Poor Social Support and Strained Relationships (8%); 5) Burdened by Own Disease (6%); 6) Complex Stressor Burden Involving Financial, Work, and Housing Stressors (2%); and 7) Complex Stressor Burden Involving Own Disease and Disease and Death among Close Relatives (2%). Being female notably increased the likelihood of belonging to Classes 2, 3, 5, and 7. Higher age increased the likelihood of belonging to Class 3. Low educational attainment increased the likelihood of belonging to Classes 5 and 6. A significant difference was observed in perceived stress levels between the seven latent classes. Average PSS varied from 9.0 in Class 1 to 24.2 in Class 7 and 25.0 in Class 6. Latent class analysis allowed us to identify seven population segments with various stressor combinations. Six of the segments had elevated perceived stress levels but differed in terms of socioeconomic composition and stressor combinations. These insights may inform a strategy aimed at improving mental health in the general population by targeting efforts to particular population segments, notably segments experiencing challenging life situations.