The occupational exposome: Is it useful?

John Cherrie

PDC Session: The exposome and exposure in the workplace

Summary…

�  What is the “occupational exposome”? �  How can we design this type of study? �  Why would researchers be interested? �  Why would an employer do this? �  A practical strategy to intervene

�  A Total Worker Health programme

Occupation is a common exposure for everyone…

�  Around 78% of all people (16-64 yrs) currently work �  Almost everyone works at some point in their life

�  Jobs are different today from the past

1% of people work in agriculture…

And none of us get our hands dirty…

55%

Future workplace risks… �  increasing use of remote working/virtual teams �  greater demand for highly educated workers �  more part-time/temporary jobs, with organisations

bringing in specialists for short-term projects �  increasing migration for work �  people are working longer as final salary

pensions end and the boundaries between employment and retirement blur

�  continued youth unemployment

www.kingsfund.org.uk/time-to-think-differently/trends/professional-attitudes-and-workforce

We are living longer and working longer…

http://www.ons.gov.uk/ons/dcp171776_237747.pdf

Occupational diseases…

�  Cancer and chronic respiratory disease �  Breast cancer – estimate around 2000 cases in

Britain caused by shift work involving night work �  Neurodegenerative disease

�  Alzheimer’s, Parkinson’s etc. �  Caused by physical inactivity, minor work-related

head trauma? �  Cardiovascular disease

�  Exposure due to exposure to dusts?

Rushton, et al. (2012). Occupational cancer burden in Great Britain. British Journal of Cancer, 107(S1), S3–S7.

What is the occupational exposome…

�  And how could it help with better investigation of occupational disease? �  Prospective collection and storage of

exposure information about workers �  Prospective biobanking of human tissue

samples �  Reconstruction of past exposome

Exposome in birth cohorts

The occupational exposome

Total Worker Health…

�  NIOSH defines TWH as… �  “a strategy integrating occupational safety and

health protection with health promotion to prevent worker injury and illness and to advance health and well-being.”

�  Integrated provision and management �  Needs strong management and worker “buy-

in” �  Needs strong effort to get employee

participation

"Total Worker Health is more than the sum of its parts— protection and promotion— it is a synthesis of all aspects of health that create worker well-being” John Howard, MD, NIOSH Director

What does it involve…

�  Preventing work-related illnesses and injuries �  Supporting healthy behavior, e.g. health

screening, healthy lifestyle choices �  Reducing work-related stress, e.g. fostering

social support among workers �  Expanding work-related resources and

opportunities, e.g. child and elder care services, job training, adequate wages

Summary…

�  Occupational exposome and TWH are two aspects of the same paradigm

�  We need to realise that work and health are closely intertwined for everyone

�  Work can and should have a net positive effect on health