Pyrometallurgical nickel production exposes workers to a wide range of occupational risk factors, including nickel aerosol, occupational noise and heat, but occupational (compensation) claims do not get enough attention in the literature. We, therefore, aimed to identify and analyze new occupational disease predictors in order to tailor prevention measures in the nickel pyrometallurgical production workers. In a prospective observational study, a cohort of workers grouped in 16 occupations (N = 1424, 88% males, median age 39 (interquartile range (IQR) 31–47 years)), was fixed in 2007 at a large nickel production plant in the Russian High North. We then followed the cohort until 2021 and analyzed the association of selected predictors, including exposure to nickel and occupational group, with the risk of an occupational (compensation) claim in a Cox regression analysis. With 18,843 person-years of observation, occupational disease claims were confirmed in 129 workers (9% of the initial cohort, N = 108 men (84%)). Top three diagnoses were chronic bronchitis (3.81 cases/1000 workers/year), sensorineural deafness (2.36 cases/1000 workers /year) and musculoskeletal disorders (1.90 cases/1000 workers/year). Smoking was significantly associated with each diagnosis (adjusted hazard ratio (HR) ranged from 2.56 (95% confidence interval (CI) 1.17–5.57) for bronchitis to 6.69 (95% CI 1.46–30.64) for chronic obstructive pulmonary disease (COPD)). High nickel exposure was associated with occupational bronchitis and occupational asthma, whereas associations of occupational groups were also identified for COPD, asthma and musculoskeletal disorders. Smoking, high exposure to nickel and specific exposure in the occupational groups increase the risk of occupational disease claims and should be prioritized directions for targeted intervention.

中文翻译：

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镍火法冶金生产中的职业病预测因素：前瞻性队列观察

火法镍生产使工人暴露在广泛的职业风险因素中，包括镍气溶胶、职业噪音和高温，但职业（补偿）索赔在文献中没有得到足够的关注。因此，我们旨在识别和分析新的职业病预测因子，以便为镍火法冶金生产工人制定预防措施。在一项前瞻性观察研究中，2007 年在 2007 年的一家大型镍生产厂固定了一组 16 个职业的工人（N = 1424，88% 男性，中位年龄 39 岁（四分位距 (IQR) 31-47 岁））俄罗斯高北地区。然后，我们跟踪该队列直到 2021 年，并分析了选定预测因子的关联，包括接触镍和职业群体，在 Cox 回归分析中存在职业（补偿）索赔的风险。通过 18,843 人年的观察，129 名工人（初始队列的 9%，N = 108 名男性（84%））确认了职业病索赔。前三位诊断为慢性支气管炎（3.81例/千人/年）、感音神经性耳聋（2.36例/千人/年）和肌肉骨骼疾病（1.90例/千人/年）。吸烟与每种诊断显着相关（调整后的风险比（HR）范围从支气管炎的 2.56（95% 置信区间（CI）1.17-5.57）到慢性阻塞性肺病（COPD）的 6.69（95% CI 1.46-30.64）） . 高镍暴露与职业性支气管炎和职业性哮喘相关，而 COPD 也与职业群体相关，哮喘和肌肉骨骼疾病。吸烟、高镍接触和职业群体中的特定接触会增加职业病索赔的风险，应作为针对性干预的优先方向。