Andreas Seidler

Publications (27)56.22 Total impact

• Article: Cancer incidence among workers occupationally exposed to dinitrotoluene in the copper mining industry.

  Andreas Seidler, Thomas Brüning, Dirk Taeger, Matthias Möhner, Katarzyna Gawrych, Annekatrin Bergmann, Johannes Haerting, Hermann Maximilian Bolt, Kurt Straif, Volker Harth
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  ABSTRACT: PURPOSE: Epidemiological and toxicological studies point to a potential carcinogenic effect of dinitrotoluene (DNT), particularly with respect to renal and urothelial cancer. METHODS: The cohort comprised all men born between 1920 and 1974 (n = 16,441) who were gainfully employed between 1953 and 1990 in one of two underground copper mines in Mansfeld, Saxony-Anhalt, former German Democratic Republic, and who were followed up for cancer incidence, 1961-2005. Incident cancer cases were identified by record linkage with the Common Cancer Registry of the New Laender. Standardized incidence ratios (SIR) were calculated with the general population of Saxony-Anhalt as the reference. RESULTS: Standardized incidence ratios for all cancers were not significantly elevated in the cohort (SIR = 1.04; 95 % confidence intervals (CI) 0.96-1.14). We found an increase in lung cancer (SIR = 1.29; 1.13-1.46), but not in kidney cancer (SIR = 1.01; 95 % CI 0.79-1.27) or bladder cancer (SIR = 1.04; 95 % CI 0.82-1.30). Standardized incidence ratios stratified by duration of employment with DNT exposure indicated moderately increased risks for kidney and bladder cancer in cohort members with longer exposure. CONCLUSIONS: The SIR analysis of workers in the copper mining industry in comparison with the general population of Saxony-Anhalt overall did not indicate increased risks for renal or bladder cancer. However, results by years of exposure to DNT suggested weakly increased risks for outcomes of a priori interest, bladder and kidney cancer. A subsequent case-cohort analysis including expert assessment of DNT exposure and identification of additional cancer cases from a network of pathology institutes will provide further insight into a potential etiologic role of DNT in renal and urothelial cancer.
  Archiv für Gewerbepathologie und Gewerbehygiene 12/2012; · 1.89 Impact Factor
• Article: Systematic review and quantification of respiratory cancer risk for occupational exposure to hexavalent chromium.

  Andreas Seidler, Sabine Jähnichen, Janice Hegewald, Alba Fishta, Olga Krug, Luisa Rüter, Claudia Strik, Ernst Hallier, Sebastian Straube
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  ABSTRACT: AIM: To investigate the exposure-risk relationship for occupational chromium (VI) exposure and lung cancer in order to establish exposure limits. METHODS: We systematically searched for studies reporting on occupational Cr(VI) exposure and cancers of the respiratory tract. To be included, studies needed to provide data for more than one level of occupational Cr(VI) exposure, adequately consider the confounder smoking and be of adequate methodological quality. Because direct genotoxicity was considered the predominant mechanism of carcinogenesis of Cr(VI), linear models were applied in order to fit risk data. Relative risks were calculated based on these linear regression models and then used to estimate excess absolute risks. RESULTS: Five studies of two cohorts of chromium production workers in Baltimore, Maryland, and Painesville, Ohio, were included. Based on different estimates for the exposure effect, the absolute excess risk was found to be "acceptable" (less than 4 per 10,000 according to the German Committee on Hazardous Substances, "AGS") at a Cr(VI) concentration of 0.1 μg/m(3), and became "intolerable" (more than 4 per 1,000) beyond a Cr(VI) concentration of 1 μg/m(3). CONCLUSION: Occupational exposure limits for Cr(VI) based on excess absolute risks can be derived from published data identified by a systematic literature review.
  Archiv für Gewerbepathologie und Gewerbehygiene 10/2012; · 1.89 Impact Factor
• Article: Correction: The role of cumulative physical work load in symptomatic knee osteoarthritis -- a case--control study in Germany (Seidler et al. 2008).

  Andreas Seidler, Ulrich Bolm-Audorff, Nasreddin Abolmaali, Gine Elsner
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  ABSTRACT: In the original paper (Seidler et al. 2008), there is a mistake in the results of the occupational group analysis. This mistake occurred when the core data set was merged with the occupational group data. According to the modified occupational group analysis (see modified Table 1), OR for chemical processers and manufacturers of plastics products are no longer significantly elevated. Having worked more than 10 years as metal worker is associated with knee osteoarthritis (OR=2.2; 95% CI 1.1-4.4). The knee osteoarthritis risk of plasterers, insulators, glaziers, terrazzo workers, construction carpenters, roofers, and upholsters approaches statistical significance in the long-duration category (OR=3.7; 95% CI 0.9-15.2). For woodworkers, the knee osteoarthritis risk is no longer significantly elevated. Having worked more than 10 years as painter or varnisher is associated with knee osteoarthritis (OR=9.6; 95% CI 1.2-77.9). Finally, we find a significantly elevated OR of 3.2 (95% CI 1.1-9.1) among subjects having worked as physically exposed service workers (storemen, nurses, refuse collectors) for more than 10 years. When subjects with non-service work as main occupation ("blue-collar workers") are compared with "white-collar workers", the odds ratio for knee osteoarthritis is still significantly elevated (OR=2.0; 95% CI 1.3-2.9).
  Journal of Occupational Medicine and Toxicology 10/2012; 7(1):21.
• Article: Impact of employment status and work-related factors on risk of completed suicide. A case-control psychological autopsy study.

  Barbara Schneider, Kristin Grebner, Axel Schnabel, Harald Hampel, Klaus Georgi, Andreas Seidler
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  ABSTRACT: The objective of this study was to determine the impact of work-related factors on risk for completed suicide. Psychiatric disorders and socio-demographic factors including work-related factors were assessed by a semi-structured interview using the psychological autopsy method in 163 completed suicide cases and by personal interview in 396 living population-based control persons. Unemployment (in particular, for more than six months), (early) retirement, or homemaker status were associated with highly significantly increased suicide risk, independently of categorized psychiatric diagnosis. In addition, adverse psychosocial working conditions, such as monotonous work, increased responsibility and pronounced mental strain due to contact with work clients, significantly increased suicide risk as well, again independently of categorized psychiatric diagnosis. These findings demonstrate that negative consequences of unemployment, homemaker status with no outside occupation, or (early) retirement, as well as adverse psychosocial working conditions, present relevant risk factors contributing to suicidal behavior, independently of diagnosed psychiatric disorders. Employment and a positive modification of working conditions, may possibly be preventive to important adverse mental health outcomes, including suicidality.
  Psychiatry Research 09/2011; 190(2-3):265-70. · 2.52 Impact Factor
• Article: Can the relationship between shoulder tendon lesions and lifting or carrying be explained by pushing or pulling?

  Andreas Seidler, Ulrich Bolm-Audorff, Gabriela Petereit-Haack, Elke Ball, Gine Elsner
  Archiv für Gewerbepathologie und Gewerbehygiene 06/2011; · 1.89 Impact Factor
• Source

  Available from: PubMed Central

  Article: The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review.

  Eva-Maria Backé, Andreas Seidler, Ute Latza, Karin Rossnagel, Barbara Schumann
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  ABSTRACT: A systematic review was carried out to assess evidence for the association between different models of stress at work, and cardiovascular morbidity and mortality. A literature search was conducted using five databases (MEDLINE, Cochrane Library, EMBASE, PSYNDEX and PsycINFO). Inclusion criteria for studies were the following: self-reported stress for individual workplaces, prospective study design and incident disease (myocardial infarction, stroke, angina pectoris, high blood pressure). Evaluation, according to the criteria of the Scottish Intercollegiate Guidelines Network, was done by two readers. In case of disagreement, a third reader was involved. Twenty-six publications were included, describing 40 analyses out of 20 cohorts. The risk estimates for work stress were associated with a statistically significant increased risk of cardiovascular disease in 13 out of the 20 cohorts. Associations were significant for 7 out of 13 cohorts applying the demand-control model, all three cohorts using the effort-reward model and 3 out of 6 cohorts investigating other models. Most significant results came from analyses considering only men. Results for the association between job stress and cardiovascular diseases in women were not clear. Associations were weaker in participants above the age of 55. In accordance with other systematic reviews, this review stresses the importance of psychosocial factors at work in the aetiology of cardiovascular diseases. Besides individual measures to manage stress and to cope with demanding work situations, organisational changes at the workplace need to be considered to find options to reduce occupational risk factors for cardiovascular diseases.
  Archiv für Gewerbepathologie und Gewerbehygiene 05/2011; 85(1):67-79. · 1.89 Impact Factor
• Article: Work-related lesions of the supraspinatus tendon: a case-control study.

  Andreas Seidler, Ulrich Bolm-Audorff, Gabriela Petereit-Haack, Elke Ball, Magdalena Klupp, Noëlle Krauss, Gine Elsner
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  ABSTRACT: To examine the dose-response relationship between cumulative duration of work with highly elevated arms (work above shoulder level) as well as of manual material handling and ruptures of the supraspinatus tendon in a population-based case-control study. In 14 radiologic practices, we recruited 483 male patients aged 25-65 with radiographically confirmed partial (n = 385) or total (n = 98) supraspinatus tears associated with shoulder pain. A total of 300 male control subjects were recruited. Data were gathered in a structured personal interview. To calculate cumulative exposure, the self-reported duration of lifting/carrying of heavy loads (>20 kg) as well as the duration of work with highly elevated arms was added up over the entire working life. The results of our study support a dose-response relationship between cumulative duration of work with highly elevated arms and symptomatic supraspinatus tendon tears. For a cumulative duration of >3,195 h work above shoulder level, the risk of a supraspinatus tendon rupture is elevated to 2.0 (95% CI 1.1-3.5), adjusted for age, region, lifting/carrying of heavy loads, handheld vibration, apparatus gymnastics/shot put/javelin/hammer throwing/wrestling, and tennis. The cumulative duration of carrying/lifting of heavy loads also yields a positive dose-response relation with disease (independent from work above shoulder level and from handheld vibration), with an adjusted odds ratio of 1.8 (95% CI 1.0-3.2) in the highest exposure category (>77 h). We find an increased risk for subjects exposed to handheld vibration with an adjusted OR of 3.2 (95% CI 1.7-5.9) in the highest exposure category (16 years or more in the job with exposure), but a clear dose-response relationship is lacking. This study points to a potential etiologic role of long-term cumulative effects of work with highly elevated arms and heavy lifting/carrying on shoulder tendon disorders.
  Archiv für Gewerbepathologie und Gewerbehygiene 04/2011; 84(4):425-33. · 1.89 Impact Factor
• Source

  Available from: Martina Michaelis

  Article: Physical workload and accelerated occurrence of lumbar spine diseases: risk and rate advancement periods in a German multicenter case-control study.

  Andreas Seidler, Ulrike Euler, Ulrich Bolm-Audorff, Rolf Ellegast, Joachim Grifka, Johannes Haerting, Matthias Jäger, Martina Michaelis, Oliver Kuss
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  ABSTRACT: In a German multicenter case-control study of lumbar disc diseases, we calculated risk and rate advancement periods (RAP) for physical workload. Patients aged 25-70 years with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were compared with population control subjects (453 males and 448 females). For this analysis, all manual handling of objects of about ≥5 kg and postures with trunk inclination of ≥20 °, as assessed by technical experts, were included in the calculation of cumulative lumbar load, determined by biomechanical model calculations. Logistic regression analysis was applied to calculate RAP, adjusted for region. We found a steep positive dose-response relationship between age and lumbar disc narrowing among men as well as women; however, we did not find a monotonic increase in lumbar disc herniation risk with age. As a monotonic increase in disease risk with age constitutes a fundamental assumption underlying the RAP concept, we restricted our RAP analysis to cases with symptomatic lumbar disc narrowing. Among men, there was a positive dose-response relationship between the cumulative lumbar load and the acceleration of lumbar disc narrowing. In the highest exposure category, a RAP of 28.0 years [95% confidence interval (95% CI) 9.7-46.3 years] was found. Among women, the RAP was 8.8 years (95% CI 2.4-15.2 years) in the highest exposure category. This study emphasizes the conceptual importance of risk acceleration - causation not only comprises the occurrence of a disease (that without a specific exposure would not have occurred at all) but also the accelerated occurrence of a disease (that without exposure would have occurred later in life).
  Scandinavian journal of work, environment & health 01/2011; 37(1):30-6. · 3.12 Impact Factor
• Source

  Available from: PubMed Central

  Article: Lifestyle factors and lumbar disc disease: results of a German multi-center case-control study (EPILIFT).

  Barbara Schumann, Ulrich Bolm-Audorff, Annekatrin Bergmann, Rolf Ellegast, Gine Elsner, Joachim Grifka, Johannes Haerting, Matthias Jäger, Martina Michaelis, Andreas Seidler
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  ABSTRACT: In the large-scale case-control study EPILIFT, we investigated the dose-response relationship between lifestyle factors (weight, smoking amount, cumulative duration of different sports activities) and lumbar disc disease. In four German study regions (Frankfurt am Main, Freiburg, Halle/Saale, Regensburg), 564 male and female patients with lumbar disc herniation and 351 patients with lumbar disc narrowing (chondrosis) aged 25 to 70 years were prospectively recruited. From the regional population registers, 901 population control subjects were randomly selected. In a structured personal interview, we enquired as to body weight at different ages, body height, cumulative smoking amount and cumulative duration of different sports activities. Confounders were selected according to biological plausibility and to the change-in-estimate criterion. Adjusted, gender-stratified odds ratios with 95% confidence intervals were calculated using unconditional logistic regression analysis. The results of this case-control study reveal a positive association between weight and lumbar disc herniation as well as lumbar disc narrowing among men and women. A medium amount of pack-years was associated with lumbar disc herniation and narrowing in men and women. A non-significantly lowered risk of lumbar disc disease was found in men with high levels of cumulative body building and strength training. According to our multi-center case-control study, body weight might be related to lumbar disc herniation as well as to lumbar disc narrowing. Further research should clarify the potential protective role of body building or strength training on lumbar disc disease.
  Arthritis research & therapy 10/2010; 12(5):R193. · 4.27 Impact Factor
• Article: Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis.

  Barbara Schumann, Andreas Seidler, Alexander Kluttig, Karl Werdan, Johannes Haerting, Karin Halina Greiser
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  ABSTRACT: Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension. Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45-83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups. Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04-1.65), 1.28 (CI 1.00-1.64), and 1.21 (0.95-1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09-1.49), 1.23 (0.99-1.51), and 1.22 (1.01-1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women. Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.
  Archiv für Gewerbepathologie und Gewerbehygiene 10/2010; 84(4):361-9. · 1.89 Impact Factor
• Article: Asbestos exposure and malignant lymphoma: a multicenter case-control study in Germany and Italy.

  Andreas Seidler, Nikolaus Becker, Alexandra Nieters, Rolf Arhelger, Birte Mester, Karin Rossnagel, Evelin Deeg, Gine Elsner, Massimo Melis, Simonetta Sesler, Giuseppe Avataneo, Michele Meloni, Pierluigi Cocco
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  ABSTRACT: To analyze the relationship between asbestos exposure and malignant lymphoma in a multicenter case-control study conducted in Germany and Italy according to a common core protocol. Male and female patients with malignant lymphoma (n = 1,034) between 18 and 80 years of age were prospectively recruited in six study areas in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/East Westphalia, and Munich) and in two study areas in Sardinia, Italy (Cagliari and Nuoro provinces). A total of 1,173 population control subjects were drawn from population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least 1 year. On the basis of job task-specific supplementary questionnaires, trained experts assessed the exposure to asbestos. As a measure of cumulative asbestos exposure on a time by intensity scale, fiber-years were calculated. 12 cases (1.2%) and 12 control subjects (1.0%) had a cumulative asbestos exposure of more than 2.6 fiber-years (highest exposure category according to the 90th percentile of exposed control subjects). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis adjusted for age, sex and study region. Patients with specific lymphoma sub-entities were additionally compared with the entire control group. We observed no statistically significant association between cumulative asbestos exposure and the risk of any lymphoma subtype. An elevated risk was found for the association between exposure to more than 2.6 fiber-years and multiple myeloma (OR = 6.0; 95% CI 1.4-25.1); however, numbers were small (n = 3 cases, all of them from Italy; n = 12 control subjects). Our study does not support an association between asbestos exposure and risk of malignant lymphoma.
  Archiv für Gewerbepathologie und Gewerbehygiene 06/2010; 83(5):563-70. · 1.89 Impact Factor
• Article: Erratum to: Case-control study of knee osteoarthritis and lifestyle factors considering their interaction with physical workload.

  Ilias Vrezas, Gine Elsner, Ulrich Bolm-Audorff, Nasreddin Abolmaali, Andreas Seidler
  Archiv für Gewerbepathologie und Gewerbehygiene 05/2010; · 1.89 Impact Factor
• Source

  Available from: Nasreddin Abolmaali

  Article: Case-control study of knee osteoarthritis and lifestyle factors considering their interaction with physical workload.

  Ilias Vrezas, Gine Elsner, Ulrich Bolm-Audorff, Nasreddin Abolmaali, Andreas Seidler
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  ABSTRACT: The aim of this study is to examine the dose-response relationships between age, "lifestyle factors" (body mass index, tobacco smoking, sports), and symptomatic knee osteoarthritis in a population-based case-control study. Additionally, the study aims to investigate the mode of interaction between body mass index (BMI) and physical workload (occupational kneeling/squatting and lifting/carrying of loads) with respect to the risk of symptomatic knee osteoarthritis. In five orthopedic clinics and five practices, 295 male patients aged 25-70 with radiographically confirmed knee osteoarthritis associated with chronic complaints were recruited. The control group comprised 327 male control subjects. In a structured personal interview, body weight at different ages, body height, cumulative amount of smoking, and cumulative duration of different sports activities until the date of first diagnosis of knee osteoarthritis were elicited. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis. An interaction analysis for the parameters BMI and kneeling/squatting respective lifting/carrying of loads was performed. Population attributable risks (PAR) for knee osteoarthritis were determined for BMI solely and for the combination of BMI with occupational kneeling/squatting and lifting/carrying of loads, respectively. Age and overweight were strongly associated with the diagnosis of knee osteoarthritis. Compared with persons less than 35 years old, persons who were at least 65 years old had an odds ratio (OR) of 19.0 (95% CI 6.1-58.7) for knee osteoarthritis. Persons with a BMI > or = 28.41 kg/m2 had a strongly elevated risk of knee osteoarthritis (OR 10.8; 95% CI 4.8-24.3) compared to persons with a BMI < 22.86 kg/m2. Heavy tobacco smoking (> or = 55.5 pack years) was associated with a decreased knee osteoarthritis risk in comparison with never-smoking (OR 0.2; 95% CI 0.1-0.5). Ball games (handball, volleyball, basketball) and cycling were associated with symptomatic knee osteoarthritis (OR 4.0; 95% CI 1.8-8.9 and OR 3.7; 95% CI 1.7-7.8 in the highest category of cumulative duration, respectively); to a weaker degree jogging, swimming, and soccer also were positively related to symptomatic knee osteoarthritis. Combining the two parameters, BMI and kneeling/squatting into one variable led to a multiplicative interaction mode for symptomatic knee osteoarthritis. For persons with elevated BMI in combination with moderate to high exposure to occupational kneeling/squatting, the population attributable risk (PAR) was 4%. The PAR for elevated BMI in combination with moderate to high exposure to occupational lifting/carrying of loads was 7%. In accordance with the literature, we find a strong association between BMI and knee osteoarthritis risk. Considering the relatively high prevalence of occupational manual materials handling, prevention of knee osteoarthritis should not only focus on body weight reduction, but should also take into account work organizational measures particularly aiming to reduce occupational lifting and carrying of loads.
  Archiv für Gewerbepathologie und Gewerbehygiene 11/2009; 83(3):291-300. · 1.89 Impact Factor
• Source

  Available from: PubMed Central

  Article: Cumulative occupational lumbar load and lumbar disc disease--results of a German multi-center case-control study (EPILIFT).

  Andreas Seidler, Annekatrin Bergmann, Matthias Jäger, Rolf Ellegast, Dirk Ditchen, Gine Elsner, Joachim Grifka, Johannes Haerting, Friedrich Hofmann, Oliver Linhardt, Alwin Luttmann, Martina Michaelis, Gabriela Petereit-Haack, Barbara Schumann, Ulrich Bolm-Audorff
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  ABSTRACT: The to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study. In four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg), patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were prospectively recruited. Population control subjects (453 males and 448 females) were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR) and 95% confidence intervals (CI) were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males) or psychosocial strain at work (in females), respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag-time analyses. We found a positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women. Even past lumbar load seems to contribute to the risk of lumbar disc disease. According to our study, cumulative physical workload is related to lumbar disc diseases among men and women.
  BMC Musculoskeletal Disorders 06/2009; 10:48. · 1.58 Impact Factor
• Source

  Available from: Torsten T. Bauer

  Article: Development and evaluation of a computer-based medical work assessment programme.

  Stefanie Mache, Cristian Scutaru, Karin Vitzthum, Alexander Gerber, David Quarcoo, Tobias Welte, Torsten T Bauer, Michael Spallek, Andreas Seidler, Albert Nienhaus, Burghard F Klapp, David A Groneberg
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  ABSTRACT: There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified.
  Journal of Occupational Medicine and Toxicology 01/2009; 3:35.
• Source

  Available from: Nasreddin Abolmaali

  Article: The role of cumulative physical work load in symptomatic knee osteoarthritis - a case-control study in Germany.

  Andreas Seidler, Ulrich Bolm-Audorff, Nasreddin Abolmaali, Gine Elsner
  [show abstract] [hide abstract]
  ABSTRACT: To examine the dose-response relationship between cumulative exposure to kneeling and squatting as well as to lifting and carrying of loads and symptomatic knee osteoarthritis (OA) in a population-based case-control study. In five orthopedic clinics and five practices we recruited 295 male patients aged 25 to 70 with radiographically confirmed knee osteoarthritis associated with chronic complaints. A total of 327 male control subjects were recruited. Data were gathered in a structured personal interview. To calculate cumulative exposure, the self-reported duration of kneeling and squatting as well as the duration of lifting and carrying of loads were summed up over the entire working life. The results of our study support a dose-response relationship between kneeling/squatting and symptomatic knee osteoarthritis. For a cumulative exposure to kneeling and squatting > 10.800 hours, the risk of having radiographically confirmed knee osteoarthritis as measured by the odds ratio (adjusted for age, region, weight, jogging/athletics, and lifting or carrying of loads) is 2.4 (95% CI 1.1-5.0) compared to unexposed subjects. Lifting and carrying of loads is significantly associated with knee osteoarthritis independent of kneeling or similar activities. As the knee osteoarthritis risk is strongly elevated in occupations that involve both kneeling/squatting and heavy lifting/carrying, preventive efforts should particularly focus on these "high-risk occupations".
  Journal of Occupational Medicine and Toxicology 07/2008; 3:14.
• Source

  Available from: Jochem König

  Article: Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study.

  Andreas Seidler, Gaël Paul Hammer, Gabriele Husmann, Jochem König, Anne Krtschil, Irene Schmidtmann, Maria Blettner
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  ABSTRACT: To investigate the cancer risk among residents of Rhineland-Palatinate winegrowing communities in an ecological study. On the basis of the Rhineland-Palatinate cancer-registry, we calculated age-adjusted incidence rate ratios for communities with a medium area under wine cultivation (>5 to 20 percent) and a large area under wine cultivation (>20 percent) in comparison with communities with a small area under wine cultivation (>0 to 5 percent). In a side analysis, standardized cancer incidence ratios (SIR) were computed separately for winegrowing communities with small, medium and large area under wine cultivation using estimated German incidence rates as reference. A statistically significant positive association with the extent of viniculture can be observed for non-melanoma skin cancer in both males and females, and additionally for prostate cancer, bladder cancer, and non-Hodgkin lymphoma in males, but not in females. Lung cancer risk is significantly reduced in communities with a large area under cultivation. In the side-analysis, elevated SIR for endocrine-related tumors of the breast, testis, prostate, and endometrium were observed. This study points to a potentially increased risk of skin cancer, bladder cancer, and endocrine-mediated tumors in Rhineland-Palatinate winegrowing communities. However, due to the explorative ecologic study design and the problem of multiple testing, these findings are not conclusve for a causal relationship.
  Journal of Occupational Medicine and Toxicology 02/2008; 3:12.
• Article: Sun exposure and malignant lymphoma: a population-based case-control study in Germany.

  Thomas Weihkopf, Nikolaus Becker, Alexandra Nieters, Birte Mester, Evelin Deeg, Gine Elsner, Maria Blettner, Andreas Seidler
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  ABSTRACT: Although some causes for malignant lymphoma are known their etiology is not well understood so far. We analyze the relationship between sun exposure and malignant lymphoma in a multicenter, population-based case-control study. Patients with malignant lymphoma (n = 710, 18-80 years) were prospectively recruited in 6 study regions in Germany. For each case, a gender, region and age-matched control was drawn from population-registers. In personal interviews, lifetime holidays spent in sunny climate, outdoor leisure activities and sunbed or sunlamp use were recorded. On basis of job task-specific supplementary questionnaires, an occupational physician assessed the cumulative working time outside. Odds ratios (OR) and 95%-confidence-intervals (CI) were calculated using conditional logistic regression analysis, adjusted for smoking and alcohol consumption. To increase statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression. We observed a reduced overall lymphoma risk among subjects having spent vacations at sunny climates or frequently used sunbeds or sunlamps. The analysis of lymphoma subentities revealed similar results with the exception of T-NHL and follicular lymphoma which were positively associated with outdoor leisure activities. While cumulative working time outside appeared unrelated to NHL overall and most subentities, it was negatively associated with follicular lymphoma and weakly positively to HL. This data suggest that exposure to natural and artificial ultraviolet radiation may reduce the OR for lymphoma in this study population.
  International Journal of Cancer 07/2007; 120(11):2445-51. · 5.44 Impact Factor
• Article: Occupational exposure to low frequency magnetic fields and dementia: a case-control study.

  Andreas Seidler, Petra Geller, Albert Nienhaus, Tanja Bernhardt, Ingeburg Ruppe, Siegfried Eggert, Maila Hietanen, Timo Kauppinen, Lutz Frölich
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  ABSTRACT: Several studies point to a potential aetiological relevance to dementia of exposure to low-frequency magnetic fields, but the evidence is inconclusive. To further examine the relationship between low frequency magnetic fields and dementia. From 23 general practices, 195 patients with dementia were recruited. Of these, 108 had possible Alzheimer's disease, 59 had possible vascular dementia and 28 had secondary or unclassified dementia. A total of 229 controls were recruited: 122 population controls and 107 ambulatory patients free from dementia. Data were gathered in a structured personal interview; in cases, the interview was administered to the next of kin. Exposure to low-frequency electromagnetic fields was assessed by expert rating. To identify occupations suspected to be associated with dementia, major occupations were a priori formed. Odds ratios were calculated using logistic regression, to control for age, region, sex, dementia in parents and smoking. Exposure to magnetic fields was not significantly associated with dementia; restriction of the analysis to cases with possible Alzheimer's disease or possible vascular dementia did not lead to statistically significant results. We found an increased risk of dementia in blue-collar occupations (electrical and electronics workers, metal workers, construction workers, food and beverage processors and labourers). Our study does not support a strong association between occupational exposure to low-frequency magnetic fields and dementia. Further studies should consider the relationship between blue-collar work and the late development of dementia.
  Occupational and environmental medicine 03/2007; 64(2):108-14. · 3.64 Impact Factor
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  Available from: PubMed Central

  Article: Solvent exposure and malignant lymphoma: a population-based case-control study in Germany.

  Andreas Seidler, Matthias Möhner, Jürgen Berger, Birte Mester, Evelin Deeg, Gine Elsner, Alexandra Nieters, Nikolaus Becker
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  ABSTRACT: To analyze the relationship between exposure to chlorinated and aromatic organic solvents and malignant lymphoma in a multi-centre, population-based case-control study. Male and female patients with malignant lymphoma (n = 710) between 18 and 80 years of age were prospectively recruited in six study regions in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/Gütersloh, and Munich). For each newly recruited lymphoma case, a gender, region and age-matched (+/- 1 year of birth) population control was drawn from the population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least one year. On the basis of job task-specific supplementary questionnaires, a trained occupational physician assessed the exposure to chlorinated hydrocarbons (trichloroethylene, tetrachloroethylene, dichloromethane, carbon tetrachloride) and aromatic hydrocarbons (benzene, toluene, xylene, styrene). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression analysis, adjusted for smoking (in pack years) and alcohol consumption. To increase the statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. We observed a statistically significant association between high exposure to chlorinated hydrocarbons and malignant lymphoma (Odds ratio = 2.1; 95% confidence interval 1.1-4.3). In the analysis of lymphoma subentities, a pronounced risk elevation was found for follicular lymphoma and marginal zone lymphoma. When specific substances were considered, the association between trichloroethylene and malignant lymphoma was of borderline statistical significance. Aromatic hydrocarbons were not significantly associated with the lymphoma diagnosis. In accordance with the literature, this data point to a potential etiologic role of chlorinated hydrocarbons (particularly trichloroethylene) and malignant lymphoma. Chlorinated hydrocarbons might affect specific lymphoma subentities differentially. Our study does not support a strong association between aromatic hydrocarbons (benzene, toluene, xylene, or styrene) and the diagnosis of a malignant lymphoma.
  Journal of Occupational Medicine and Toxicology 02/2007; 2:2.