title: Non-communicable disease risk factor patterns among mining industry workers in Papua, Indonesia: longitudinal findings from the Cardiovascular Outcomes in a Papuan Population and Estimation of Risk (COPPER) Study.
abstract: OBJECTIVE
  Non-communicable diseases (NCDs) constitute an increasing slice of the global burden of disease, with the South-East Asia region projected to see the highest increase in NCD-related deaths over the next decade. Mining industry employees may be exposed to various factors potentially elevating their NCD risk. This study aimed to assess the distribution and 5-year longitudinal trends of key metabolic NCD risk factors in a cohort of copper-gold mining company workers in Papua, Indonesia.
  
  
  METHODS
  Metabolic indicators of NCD risk were assessed among employees (15 580 at baseline, 6496 prospectively) of a large copper-gold mining operation in Papua, Indonesia, using routinely collected 5-year medical surveillance data. The study cohort comprised individuals aged 18-68 years employed for ≥1 year during 2008-2013. Assessed risk factors were based on repeat measures of cholesterol, blood glucose, blood pressure and body weight, using WHO criteria.
  
  
  RESULTS
  Metabolic risk indicator rates were markedly high and increased significantly from baseline through 5-year follow-up (p<0.001). Adjusting for gender and age, longer duration of employment (≥10 years) predicted raised cholesterol (adjusted OR (AOR)=1.13, p=0.003), raised blood pressure (AOR=1.16, p=0.009) and overweight/obesity (AOR=1.14, p=0.001) at baseline; and persistent raised cholesterol (AOR=1.26, p=0.003), and both incident (AOR=1.33, p=0.014) and persistent raised blood glucose (AOR=1.62, p=0.044) at 3-year follow-up.
  
  
  CONCLUSIONS
  Individuals employed for longer periods in a mining operations setting in Papua, Indonesia, may face elevated NCD risk through various routes. Workplace health promotion interventions and policies targeting modifiable lifestyle patterns and environmental exposures present an important opportunity to reduce such susceptibilities and mitigate associated health risks.
authors.affiliation: Public Health and Malaria Control, International SOS, Kuala Kencana, Papua, Indonesia NCD Asia Pacific Alliance, Tokyo, Japan.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Rodriguez-Fernandez
authors.affiliation: Non-Communicable Disease Control, Ministry of Health, Jakarta, Indonesia.
authors.forename: Ekowati
authors.initials: E
authors.lastname: Rahajeng
authors.affiliation: Public Health Consulting Services and Community Health, International SOS, Copenhagen, Denmark.
authors.forename: Francesca
authors.initials: F
authors.lastname: Viliani
authors.affiliation: Public Health and Malaria Control, International SOS, Kuala Kencana, Papua, Indonesia Faculty of Medicine, Department of Public Health, Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: Haripurnomo
authors.initials: H
authors.lastname: Kushadiwijaya
authors.affiliation: NCD Asia Pacific Alliance, Tokyo, Japan Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Amiya
authors.affiliation: Public Health and Malaria Control, International SOS, Kuala Kencana, Papua, Indonesia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bangs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000453:epidemiology; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008906:Mining / Q000706:statistics & numerical data*; D009765:Obesity / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D018570:Risk Assessment; D016019:Survival Analysis; D055815:Young Adult