Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review

Michael A. Fox et al

Keywords: Cumulative Risk Assessment, Combined Exposure, Health Determinants, Occupational Health, Workplace

The Study: This scoping review investigated how multiple occupational stressors (chemical, physical, and psychosocial) combined with personal risk factors (e.g., age, sex, smoking, obesity) influence worker health. From 2,299 articles screened, 32 were included based on strict criteria focusing on combined exposure and clinical health outcomes in occupational settings.

Main Findings: The included studies revealed that combined exposures and personal risk factors are linked to adverse health outcomes such as cancers (lung, liver, bladder, prostate), hearing loss, cardiovascular disease, metabolic and reproductive disorders, and musculoskeletal impairments. The highest risks were found when personal risks like smoking or hepatitis B infection coincided with chemical exposures. Notably, co-exposure to solvents and noise significantly increased the risk of hearing loss. While some interactions exceeded additivity, most current assessments assume additive effects, potentially underestimating real risks.

Practical Implications: Incorporating multiple stressors and personal characteristics into risk assessments enhances worker health protection. Exposure limits and control strategies should reflect both modifiable and non-modifiable traits. Tailored management approaches might include enhanced engineering controls, smoking cessation programs, and identification of vulnerable groups. The study supports integrated frameworks like Total Worker Health® and highlights research gaps in cumulative risk assessment methods.

Reference: Fox, M.A., Niemeier, R.T., Hudson, N., Siegel, M.R., & Dotson, G.S. (2021). Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review. International Journal of Environmental Research and Public Health, 18(11), 5850. https://doi.org/10.3390/ijerph18115850

Fox et al., 2021.pdf

Download PDF • 508KB