List of Online-first articles on the SJWEH website http://www.sjweh.fi/list_onlinefirst_rss.php en-US SJWEH 1 lodo@ttl.fi (Lisa O\'Donoghue-Lindy) risto@toivonen.biz (Risto Toivonen) http://www.sjweh.fi/show_abstract.php?abstract_id=4315 http://www.sjweh.fi/show_abstract.php?abstract_id=4315 Thu, 18 Jun 2026 12:58:59 +0200 Letter to the Editor References 1. Bonde JP, Skaaby S, Flachs EM, Dollard M, Keyes K, Rosengren A et al. The demands-control-support work stress model and risk of ischemic heart disease: causal inference based on observational epidemiology. Scand J Work Environ Health 2026 Apr. [Epub ahead of print]. https://doi.org/10.5271/sjweh.4299. 2. Xu S, Huang Y, Xiao J, Zhu W, Wang L, Tang H et al. The association between job strain and coronary heart disease: a meta-analysis of prospective cohort studies. Ann Med 2015;47(6):512–8. https://doi.org/10.3109/07853890.2015.1075658. 3. Zahiriharsini A, Gilbert-Ouimet M, Hervieux V, Trudel X, Matteau L, Jalbert L et al. Incorporating sex and gender considerations in research on psychosocial work exposures and cardiovascular diseases: A systematic review of 55 prospective studies. Neurosci Biobehav Rev 2024 Dec;167:105916. https://doi.org/10.1016/j.neubiorev.2024.105916. 4. Schwartz JE, Pieper CF, Karasek RA. A procedure for linking psychosocial job characteristics data to health surveys. Am J Public Health 1988 Aug;78(8):904–9. https://doi.org/10.2105/AJPH.78.8.904. 5. Metcalfe C, Davey Smith G, Macleod J, Heslop P, Hart C. Self-reported stress and subsequent hospital admissions as a result of hypertension, varicose veins and haemorrhoids. J Public Health Med 2003 Mar;25(1):62–8. https://doi.org/10.1093/pubmed/fdg013. 6. Lavigne-Robichaud M, Trudel X, Talbot D, Milot A, Gilbert-Ouimet M, Vézina M et al. Psychosocial stressors at work and coronary heart disease risk in men and women: 18-year prospective cohort study of combined exposures. Circ Cardiovasc Qual Outcomes 2023 Oct;16(10):e009700. https://doi.org/10.1161/CIRCOUTCOMES.122.009700. 7. Tiwa Diffo E, Lavigne-Robichaud M, Milot A, Brisson C, Gilbert-Ouimet M, Vézina M et al. Psychosocial stressors at work and atrial fibrillation incidence: An 18-year prospective study. J Am Heart Assoc 2024 Aug;13(16):e032414. https://doi.org/10.1161/JAHA.123.032414. 8. Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L et al.; IPD-Work Consortium. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet 2012 Oct;380(9852):1491–7. https://doi.org/10.1016/S0140-6736(12)60994-5. 9. Choi BK, Schnall P, Landsbergis P, Dobson M, Ko S, Gómez-Ortiz V et al. Recommendations for individual participant data meta-analyses on work stressors and health outcomes: comments on IPD-Work Consortium papers. Scand J Work Environ Health 2015 May;41(3):299–311. https://doi.org/10.5271/sjweh.3484. 10. Kivimäki M, Singh-Manoux A, Virtanen M, Ferrie JE, Batty GD, Rugulies R; IPD-Work consortium. IPD-Work consortium: pre-defined meta-analyses of individual-participant data strengthen evidence base for a link between psychosocial factors and health. Scand J Work Environ Health 2015 May;41(3):312–21. https://doi.org/10.5271/sjweh.3485. 11. Lavigne-Robichaud M, Trudel X, Talbot D, Milot A, Pena-Gralle AP, Mésidor M et al. Coronary heart disease attributable to psychosocial stressors at work. JACC Adv 2025 Oct;4(10 Pt 2):102160. https://doi.org/10.1016/j.jacadv.2025.102160. by Lavigne-Robichaud M, Landsbergis P, Brisson C, Sembajwe G, Gilbert-Ouimet M, Li J, Milot A, Trudel X. doi:10.5271/sjweh.4308]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4308 http://www.sjweh.fi/show_abstract.php?abstract_id=4308 Thu, 11 Jun 2026 17:20:00 +0200 Review by Magnusson Hanson LL, Madsen IEH, Blomqvist S, Holmgren R, Sørensen K, Rugulies R. doi:10.5271/sjweh.4311]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4311 http://www.sjweh.fi/show_abstract.php?abstract_id=4311 Thu, 11 Jun 2026 00:06:17 +0200 Original article adj) 3.21, 95% CI 1.38–7.48], a positive anti-HCV Ab test (PR_adj 23.52, 95% CI 11.30–48.96), and upward pesticide spraying (PR_adj 3.39, 95% CI 1.52–7.54) as independent risk factors for abnormal liver tests. Conclusions Pesticide use was associated with a higher risk of liver injury, particularly among upward sprayers and those with hepatitis B or C infection. The abnormal liver test cases attributable to upward pesticide spraying in this population might be as large as hepatitis B, supporting the importance of pesticide exposure. by Liu Y-C, Kuo T-C, Guo H-R. doi:10.5271/sjweh.4312]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4312 http://www.sjweh.fi/show_abstract.php?abstract_id=4312 Wed, 03 Jun 2026 20:23:36 +0200 Original article by Jetha A, Liao Q, Smith P, Vu V, Biswas A, Smith B, Vahid Shahidi F. doi:10.5271/sjweh.4313]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4313 http://www.sjweh.fi/show_abstract.php?abstract_id=4313 Wed, 03 Jun 2026 17:34:20 +0200 Letter to the Editor From latent variable models to actionable items It is true that, for decades, influential work-stress theories have relied on latent variable models to operationalize psychological phenomena which, although not directly observable, have repeatedly been linked to employee health outcomes. Methodologically, manifestations of distinct individual aspects of the latent constructs are combined to operationalize the latent variable of interest. It should be noted, however, that eg, the latent variable job demands represents no more an observable hazard than generic categories like dust or metal represent identifiable hazardous substances. Accordingly, while the goal is to optimize job demands or job control, this can only be accomplished by addressing the distinct actionable items that constitute such latent constructs. Guseva Canu and van der Molen themselves use the example of bus drivers for whom efforts had been disentangled into 39 distinct actionable items. As an additional example, the Joint German Occupational Safety and Health Strategy (3) identifies more than 70 actionable items that constitute six latent domains of job stressors (work content, work organization, working time, social relations, work equipment, work environment) each representing a quantifiable presence or absence of hazards. The “fundamental paradigm shift […] toward more specific, measurable, and harmonized approaches”, as advocated by Guseva Canu and van der Molen, is thus already underway. Whether no-observed adverse effect level (NOAEL)/ lowest-observed-adverse effect level (LOAEL) are most usefully defined at the level of individual items, item composites, or aggregated constructs is itself an empirical question that future research should address. Subjective bias and social construction of hazards Guseva Canu and van der Molen argue that assessments of social support, decision authority, or emotional demands are inherently subjective or socially constructed. By referencing cultural norms and economic pressures, they highlight individual processes of perception, implying that actual exposure cannot be accurately quantified in terms of OEL. We believe that these phenomena can still serve as valid and meaningful decision aids for preventive action: Within occupational groups, employees show high within-group agreement in psychosocial risk assessments, and in addition, there is substantial agreement between employee evaluations and those conducted by occupational safety and health (OSH) committees for the same job activities (4). Moreover, methodological advances are improving our understanding of how subjective bias can be minimized. Stress measures frequently confounded exposure with appraisal as items often incorporate evaluations of job characteristics as stressful. To address this, it was recommended to operationalize job stress using condition-related, non-evaluative items (5, 6). Finally, advanced understanding of the psychometrics of psychosocial risk assessment, including activity-based rather than person-based item wordings combined with frequency rather than agreement response options, can further reduce subjective bias via personality traits on assessments (7). These developments demonstrate that, despite inherent subjectivity, psychosocial exposures can be reliably quantified when validated and carefully designed instruments are used. Concluding remarks As with chemical and physical hazards, decisions regarding psychosocial exposures should be guided as objectively as possible by evidence-based criteria, giving both employees and organizations the confidence that preventive measures – or the decision not to implement them – are justified rather than based on subjective judgments. We believe that, despite their construct-dependent ontological nature, OEL for psychosocial hazards can provide substantial support for preventive decision-making. We also share Guseva Canu’s and van der Molen’s emphasis on the political economy of the OEL setting, which our own call for institutionalized discussion forums (Essential 4) explicitly anticipates. With our proposal, we aimed to establish a framework for these decisions based on the current scientific state of the art. While its methodological foundations may not be perfect, we believe it represents a substantial improvement to harmonize research efforts and standardize reporting in a way that encourages researchers to tackle the remaining challenges. In other words, act on OEL where the evidence permits and continue to improve where gaps remain. References 1. Guseva Canu I, van der Molen HF. Occupational exposure limits for psychosocial hazards: A promising concept or a premature leap? Scand J Work Environ Health 2026 Mar. https://doi.org/10.5271/sjweh.4280. 2. Pauli R, Lang J, Müller A, Taibi Y, Kraus T, Metzler Y. Requirements for occupational exposure limits in psychosocial risk assessment: what we know, what we don’t know and what we can learn from other disciplines. Scand J Work Environ Health 2025 Nov;51(6):559–68. https://doi.org/10.5271/sjweh.4247. 3. Gemeinsame Deutsche Arbeitsschutzstrategie: Berücksichtigung psychischer Belastung in der Gefährdungsbeurteilung – Empfehlungen zur Umsetzung in der betrieblichen Praxis [Joint German Occupational Safety and Health Strategy. Consideration of psychological stress in risk assessments: Recommendations for implementation in operational practice] (4th fully revised edition; as of 15 June 2022, updated January 6, 2026). Federal Ministry of Labour and Social Affairs. 4. Schneider I, Mädler M, Lang J. Comparability of self- and observer-ratings in occupational psychosocial risk assessments – Is there agreement? BioMed Res Int 2019 Jun;2019:8382160. https://doi.org/10.1155/2019/8382160. 5. Rau R. Questioning or observation or both together? Which instruments should be used when psychic work load and strain have to be analyzed? Zentralbl Arbeitsmed Arbeitsschutz Ergon 2010;60(9):294–301. https://doi.org/10.1007/BF03344299. 6. Semmer NK, Grebner S, Elfering A. (2004). Beyond self report: Using observational physiological and situation based measures in research on occupational stress. In P. L. Perrewe & D. C. Ganster (Eds.), Research in occupational stress and well being, volume 3. Emotional and physiological processes and positive intervention strategies (1st ed., pp. 205–263). JAI. 7. Pauli R, Lang J. Survey Design Moderates Negativity Bias but not Positivity Bias in Self-Reported Job Stress. Eur J Psychol Assess 2024;41(5):357–66. https://doi.org/10.1027/1015-5759/a000806. by Pauli R, Lang J, Müller A, Taibi Y, Kraus T, Metzler Y. doi:10.5271/sjweh.4296]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4296 http://www.sjweh.fi/show_abstract.php?abstract_id=4296 Mon, 25 May 2026 12:23:42 +0200 Original article adj) 1.25, 95% confidence interval (CI) 1.10–1.41] and developed CKD 2.06 years earlier (95% CI 0.75–3.25). Lifetime night shift exposure showed consistent dose–response relationships, with 16–17% increased risks for either ≥5 cumulative years (HR_adj 1.17, 95% CI1.01–1.36) or ≥3 monthly night shifts (HR_adj 1.16, 95% CI1.01–1.33). Participants with both usual/always night shift exposure and high PRS for cardiometabolic diseases exhibited the greatest CKD risk. Obesity-related parameters (body mass index and waist circumference) mediated 14.7–14.8% of the observed night shift–CKD association. A novel 9-metabolite signature reflective of night shift mediated 5.47% of this association, primarily through disrupted fatty acid metabolism. Conclusions Night shift work exhibits a dose-dependent association with CKD risk, exacerbated by cardiometabolic genetic predisposition and partially mediated through metabolic dysregulation and obesity. These findings underscore the need for workplace interventions targeting shift scheduling and metabolic health among high-risk workers. by Cai X, Zhang Y, Ye Z, Zhang Y, Yang S, Gan X, Xiang H, Huang Y, Wu Y, Chen D, Liang X, Qin X, Zhang Y. doi:10.5271/sjweh.4309]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4309 http://www.sjweh.fi/show_abstract.php?abstract_id=4309 Wed, 20 May 2026 16:55:43 +0200 Original article 3 consecutive night shifts [hazard ratio (HR) 1.64, 95% confidence interval (CI) 1.22–2.21] and evening shifts (HR 1.28, 95% CI 1.03–1.59). Sleep problems and fatigue at work modified the association between night shift work and breast cancer risk, whereas psychological distress and diurnal preference did not. Permanent night shift workers reporting sleep problems (HR 1.76, 95% CI 1.01–3.09) or fatigue at work (HR 1.90, 95% CI 1.08–3.35) had a higher risk compared to day workers with similar symptoms. Conclusions Women aged ≥50 years showed increased breast cancer risk for several shift work characteristics. Permanent night shift work was especially associated with increased risk among those reporting sleep problems or fatigue. These findings may help identify groups needing closer occupational health monitoring, though causal inference is limited by the observational design. Intervention studies are required to determine whether changes in work schedules or management of sleep problems and fatigue could reduce risk. by Shiri R, Vanttola P, Ervasti J, Koskinen A, Hansen J, Härmä M. doi:10.5271/sjweh.4289]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4289 http://www.sjweh.fi/show_abstract.php?abstract_id=4289 Thu, 14 May 2026 21:36:58 +0200 Original article 33 weeks). The outcomes of interest were SGA, BW, and HC. Of 47 factors (17 chemical, 8 physical, 4 biological, 12 biomechanical, 3 organizational and 3 psychosocial) to which mothers were exposed in their occupation assessed by job-exposure matrices in this cohort, we included those for which the epidemiological or experimental literature suggests an association with fetal growth. Logistic and linear regression models that included all preselected exposure variables were performed and adjusted for potential confounders. We conducted additional analysis stratified by trimester of pregnancy. Results The logistic model, which included all preselected variables, reported that – for all women – exposure to ultrafine particles (UFP) increased SGA risk [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.12–1.90] while standing decreased it (OR 0.82, 95% CI 0.67–1.00). Among mothers who stopped working during the first/second trimester of pregnancy, we found the same SGA risk for UFP; exposure to high strain also increased the risk (OR 1.81, 95% CI 1.18–2.83). Among those who stopped working during the third trimester, exposure to oxygenated solvents increased SGA risk (OR 2.24, 95% CI 1.08–4.41). In the linear model, for all women, there was a decrease in BW (β -34 grams, 95% CI -66– -1.1) among those exposed to UFP. For mothers who stopped working during the first/second trimester, exposure to vibration increased BW, while among those who stopped working during the third trimester, exposure to night work increased BW. Exposure to oxygenated solvents decreased HC (β -0.22 cm, 95% CI -0.44–0.00) among all women. Conclusion These findings suggest the possible influence of chemical and strenuous factors at work on fetal growth, particularly depending on the trimester in which pregnant mothers stopped working. While the combined assessment of multiple exposures did not reveal clear associations, further studies are needed to explore potential interactions and underlying biological mechanisms. by Tartaglia M, Jaunas K, Audignon-Durand S, Houot M-T, Turuban M, Roeleveld N, Siemiatycki J, Dufourg MN, Carles C, Pilorget C, Uuksulainen S, Turner MC, Descatha A, Garlantézec R, Delva F. doi:10.5271/sjweh.4306]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4306 http://www.sjweh.fi/show_abstract.php?abstract_id=4306 Wed, 13 May 2026 11:14:17 +0200 Original article by Clevis MGA, van Oostrom SH, Loef B, MenoPause Consortium, van Valkengoed IGM, Nieuwenhuijsen K, Proper KI. doi:10.5271/sjweh.4307]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4307 http://www.sjweh.fi/show_abstract.php?abstract_id=4307 Fri, 08 May 2026 12:22:07 +0200 Original article by Parks J, Zanif U, Bhatti P. doi:10.5271/sjweh.4305]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4305 http://www.sjweh.fi/show_abstract.php?abstract_id=4305 Tue, 05 May 2026 12:36:26 +0200 Original article by Rønnow MM, Vestergaard JM, Rytter D, Fenger-Grøn M, Willert MV, Andersen JH, Kyndi M. doi:10.5271/sjweh.4294]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4294 http://www.sjweh.fi/show_abstract.php?abstract_id=4294 Thu, 30 Apr 2026 01:52:12 +0200 Review 2=43.91%], gastrointestinal temperature (MD -0.26°C; -0.52– -0.001; I²=98.13%), skin temperature (MD -1.14°C; -1.85– -0.42; I²=96.56%), and heart rate (MD -7.69 bpm; -11.22– -4.15; I²=73.19%). Egger’s tests suggested possible small-study effects for skin temperature and heart rate but not for core temperatures. Subgroup analyses indicated more consistent benefits with water/ice and PCM garments. Overall certainty ranged from low to very low due to risk of bias, inconsistency, and imprecision. Conclusions Wearable cooling attenuates physiological heat strain and improves thermal comfort, particularly via water/ice and PCM systems. Given high heterogeneity and low certainty, adequately powered, standardized, head-to-head trials are needed. by Sheth A, Viramgami A, Thakor M, Modi B, Bagepally B, Kar A, Ram E, Dave A, Balachandar R. doi:10.5271/sjweh.4302]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4302 http://www.sjweh.fi/show_abstract.php?abstract_id=4302 Thu, 30 Apr 2026 01:22:23 +0200 Original article X and T_X+1 (concurrent analysis). To clarify temporality, changes in health-related behaviors were further calculated at time T_X+1 to T_X+2 (longitudinal analysis). We applied logistic regression with generalized estimating equations. Subgroup differences by sex were examined. Results Among 125 854 participant-observations across 2–3 study phases of the 78 624 participants, 6–8% experienced onset of workplace bullying and 9–14% reported onset of workplace violence over 1–2 years. The strongest association was observed between onset of violence and becoming obese, with an odds ratio (OR) of 1.13 [95% confidence interval (CI) 1.00–1.27] in the concurrent and 1.31 (95% CI 1.05–1.64) in the longitudinal analysis. In addition, onset of bullying (OR 1.23, 95% CI 1.06–1.44) and violence (OR 1.11, 95% CI 0.99–1.24) were concurrently associated with initiation of excessive alcohol use, with weaker associations in the longitudinal analysis. Exposure–response relationships were observed for all aforementioned associations and findings were consistent across cohorts. Men were more likely to initiate excessive alcohol use than women after experiencing violence (P=0.008). Conclusion Exposure to workplace bullying and violence was associated with adverse changes in health-related behaviors. by Xu T, Nielsen MB, Clark AJ, Rugulies R, Pentti J, Sørensen JK, Nordentoft M, Westerlund H, Stenholm S, Vahtera J, Madsen IEH, Hansen ÅM, Virtanen M, Knardahl S, Oksanen T, Kivimäki M, Magnusson Hanson LL, Rod NH. doi:10.5271/sjweh.4303]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4303 http://www.sjweh.fi/show_abstract.php?abstract_id=4303 Thu, 30 Apr 2026 00:07:54 +0200 Original article by Kashima R, Takada T, Matsuo T, So R. doi:10.5271/sjweh.4297]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4297 http://www.sjweh.fi/show_abstract.php?abstract_id=4297 Mon, 20 Apr 2026 17:46:58 +0200 Original article by Peláez Zuberbuhler J, Strömberg A, Thern E, Landstad BJ, Sjöström M, Brulin E. doi:10.5271/sjweh.4299]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4299 http://www.sjweh.fi/show_abstract.php?abstract_id=4299 Fri, 17 Apr 2026 16:49:24 +0200 Review by Bonde JP, Skaaby S, Flachs EM, Dollard M, Keyes K, Rosengren A, Mehlum IS, Mikkelsen S. doi:10.5271/sjweh.4291]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4291 http://www.sjweh.fi/show_abstract.php?abstract_id=4291 Wed, 15 Apr 2026 15:49:12 +0200 Original article by Nabe-Nielsen K, Aagaard A, Larsen AD, Nielsen HB, Hansen J, Hansen ÅM, Kolstad HA, Vestergaard JM, Garde AH. doi:10.5271/sjweh.4295]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4295 http://www.sjweh.fi/show_abstract.php?abstract_id=4295 Fri, 10 Apr 2026 00:23:00 +0200 Original article by Holme AN, Moen LV, Sallinen M, Nilsen KB, Boccara CN, Phillips AJK, Haugen F, Matre D. doi:10.5271/sjweh.4290]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4290 http://www.sjweh.fi/show_abstract.php?abstract_id=4290 Thu, 09 Apr 2026 23:35:32 +0200 Original article by Shen Q-M, Li Z-Y, Tan Y-T, Gao L-F, Liu D-K, Li H-L, Yang W-S, Xiang Y-B. doi:10.5271/sjweh.4300]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4300 http://www.sjweh.fi/show_abstract.php?abstract_id=4300 Wed, 08 Apr 2026 11:52:17 +0200 Editorial References 1. 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Health effects of informal caregiving across Europe: A longitudinal approach. Soc Sci Med. 2017;173:72-80. https://doi.org/10.1016/j.socscimed.2016.11.036 6. Mikkola TM, Mänty M, Kautiainen H, von Bonsdorff MB, Haanpää M, Koponen H, et al. Work incapacity among family caregivers: a record linkage study. J Epidemiol Community Health. 2022;76(6):580-5. https://doi.org/10.1136/jech-2021-217901 7. Lacey RE, Xue B, Di Gessa G, Lu W, McMunn A. Mental and physical health changes around transitions into unpaid caregiving in the UK: a longitudinal, propensity score analysis. Lancet Pub Health. 2024;9(1):e16-e25. https://doi.org/10.1016/S2468-2667(23)00206-2 8. Lee S, Colditz GA, Berkman LF, Kawachi I. Caregiving and risk of coronary heart disease in U.S. women: a prospective study. Am J Prev Med. 2003;24(2):113-9. https://doi.org/10.1016/S0749-3797(02)00582-2 9. Park SS. Caregivers’ Mental Health and Somatic Symptoms During COVID-19. 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Scand J Work Environ Health. 2017;43(5):426-35. https://doi.org/10.5271/sjweh.3645 by Ervasti J, Mikkola TM. doi:10.5271/sjweh.4292]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4292 http://www.sjweh.fi/show_abstract.php?abstract_id=4292 Mon, 06 Apr 2026 16:25:03 +0200 Original article by Ciliacus R, Porru F, Burdorf A, Schuring M. doi:10.5271/sjweh.4285]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4285 http://www.sjweh.fi/show_abstract.php?abstract_id=4285 Thu, 02 Apr 2026 15:22:20 +0200 Original article by Sivaraj LB, Macpherson RA, McLeod CB. doi:10.5271/sjweh.4282]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4282 http://www.sjweh.fi/show_abstract.php?abstract_id=4282 Thu, 02 Apr 2026 12:27:16 +0200 Review 2=86.0%; 95% PI 10.2–73.4). Prevalence of AOO varied by: (i) data sources (registry/compensation: 50.1% versus clinic: 32.0%; P=0.015); (ii) study size (>80 participants: 43.4% versus ≤80: 27.9%; P=0.033); (iii) baseline forced expiratory volume in 1 second (FEV₁) (≤85% predicted: 38.2% versus >85% predicted: 13.8%; P=0.008); and (iv) exposure duration before symptom onset (>7.1 years: 35.7% versus ≤7.1 years: 15.7%; P=0.015). Heterogeneity across studies was substantial and several subgroups included fewer than five studies. Conclusions More than one-third of workers with OA experience an AOO. The findings highlight the need for harmonized outcome definitions and for interventions integrating early referral, exposure control, and structured return-to-work programs to avoid AOO. by Damerau LS, Helm MW, Pieter J, Velasco Garrido M, Harth V, Hoven H, Preisser AM. doi:10.5271/sjweh.4280]]> http://www.sjweh.fi/show_abstract.php?abstract_id=4280 http://www.sjweh.fi/show_abstract.php?abstract_id=4280 Mon, 02 Mar 2026 13:24:50 +0200 Commentary by Guseva Canu I, van der Molen HF]]>