Occupational therapy (OT) is skilled treatment that helps individuals achieve independence in all facets of their lives. OT gives people the "skills for the job of living" necessary for independent and satisfying lives. Services typically include:

• Customized treatment programs to improve one's ability to perform daily activities
• Comprehensive home and job site evaluations with adaptation recommendations
• Performance skills assessments and treatment
• Adaptive equipment recommendations and usage training
• Guidance to family members and caregivers

Information from the American Occupational Therapy Association, Inc. 5/05

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American Journal of Industrial Medicine

Effectiveness of the training program for workers at construction sites of the high-speed railway line between Torino and Novara: Impact on injury rates
A. Bena, P. Berchialla, M.E. Coffano, M.L. Debernardi, L.G. Icardi Wed, 28 Oct 2009 09:46:00 -0000
There are very few published studies evaluating the impact of safety and health training on injury outcomes in the construction industry. The aim of this study was to assess the impact of the training program on injury rates at a major railway construction project.The population consisted of 2,795 workers involved in a safety training program at the construction sites of the high-speed railway line Torino-Novara. Two types of analyses were carried out in order to assess the effectiveness of the training program in reducing the number of injuries: (i) a pre-post analysis, which took into account the fact that workers were enrolled at different times and the training intervention did not occur at the same time for all subjects; (ii) an interrupted time-series model, which corrected for the time trend and considered the autocorrelation between individual observations.Twenty-nine percent of workers who spent at least 1 day at the construction sites attended at least one training module. Pre-post analysis: At the end of the training program, the incidence of occupational injuries had fallen by 16% after the basic training module and by 25% following the specific modules. Time-series model: Training led to a 6% reduction in injury rates, which was not statistically significant.The training program that was implemented had a moderately positive impact on the health of workers. Further studies are being conducted to obtain a more complete assessment of the actual effectiveness of the program in reducing the incidence of injuries. Am. J. Ind. Med. © 2009 Wiley-Liss, Inc.
Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former basotho gold miners
Harriet H. Park, Brendan V. Girdler-Brown, Gavin J. Churchyard, Neil W. White, Rodney I. Ehrlich Wed, 28 Oct 2009 09:46:00 -0000
Pulmonary tuberculosis and HIV incidence, mortality, and the progression of silicosis and lung function impairment are described over a 1-year period in migrant ex-gold miners from Lesotho.Seven hundred seventy-nine Basotho miners were followed for 1 year starting 18 months after lay-off from a South African gold mine in 1998. At baseline and follow-up, they underwent a respiratory symptom interview, physical examination, HIV test, chest radiograph, and spirometry.Five hundred thirteen of 779 (65.9%) participants attended both baseline and follow-up visits. HIV incidence was 5.4/100 person-years (95% CI: 3.4-8.2). Prevalence of silicosis (ILO score [ge]1/1) was 26.6% at baseline and 27.0% at follow-up. Active tuberculosis diagnosed at baseline was a strong predictor of radiological progression of silicosis. Lung function as measured by FEV1 declined an average of 91 ml between visits (95% CI: 67-116 ml). Calculated minimum incidence of tuberculosis was 3,085/100,000/years (95% CI: 1,797-4,940) at follow-up. Of those seen at baseline, 18 died before their scheduled follow-up visit (mean age: 51 years).High rates of mortality and of HIV infection and pulmonary tuberculosis were found in this cohort after leaving the South African goldmines. Continuing lung function loss was also apparent. A partnership between the South African mining industry and governments in labor-sending areas of Southern Africa is needed to provide continuity of care and access to HIV and tuberculosis treatment and prevention services. Active silicosis surveillance and an improved statutory compensation system are also needed. These findings can serve as a baseline against which the impact of such interventions can be assessed. Am. J. Ind. Med. © 2009 Wiley-Liss, Inc.
Effectiveness of an occupational health intervention program to reduce whole body vibration exposure: An evaluation study with a controlled pretest-post-test design
Ivo J.H. Tiemessen, Carel T.J. Hulshof, Monique H.W. Frings-Dresen Wed, 28 Oct 2009 09:46:00 -0000
An effective intervention program aiming to reduce whole body vibration (WBV) exposure at work will reduce the number of low back complaints in the near future.An evaluation study with a controlled pretest-post-test design. Nine companies and 126 drivers were included in the study. Cluster randomization on company level divided the drivers and their employers in an intervention group and a "care-as-usual" group. At baseline (T0) and intervention program was implemented and evaluated after 7 months (T1). The main outcome measure was WBV exposure. Process measures included knowledge, attitude, and (intended) behavior towards reduction of WBV exposure for the drivers and knowledge and WBV policy for the employers.At T1, no significant reduction was found in WBV exposure within both groups compared with T0.Probably due to poor to moderate compliance, the intervention program was not effective in reducing the WBV exposure on group level but small reductions in WBV exposure are possible when intervention compliance is high. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Farmer exposure to organic solvents during the maintenance and repair of farm machinery: A pilot study
Terry L. Bunn, Youcheng Liu, Kiyoung Lee, Medearis Robertson, Lei Yu Wed, 28 Oct 2009 09:47:00 -0000
The maintenance/repair of farm machinery is a common farming activity. Dermal exposure to organic solvents has not been well documented. A pilot study was conducted to characterize exposure to organic solvents.A survey questionnaire was administered to 31 Kentucky farmers in 2008. Dermal exposure assessment was conducted in 10 farmers while farmers performed farm machinery maintenance/repair tasks using a solvent sampling patch. Benzene, toluene, xylene, and n-hexane were analyzed.All four organic solvents were identified from the samples with toluene (<0.5-36,000 µg/patch) and xylene (15-5,700 µg/patch) at significantly higher levels. Twenty-six farmers reported the use of personal protective equipment <50% of their time repairing/maintaining farm machinery on the questionnaire; only two farmers wore gloves during the exposure assessment.Farmers routinely use solvent products for farm machinery maintenance/repair. Dermal exposure to organic solvents is a potential hazard. Further studies to characterize and evaluate exposure in larger samples of farmers are needed. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Work-related carpal tunnel syndrome in Washington State workers' compensation: Utilization of surgery and the duration of lost work
William E. Daniell, Deborah Fulton-Kehoe, Gary M. Franklin Wed, 28 Oct 2009 09:47:00 -0000
Work-related carpal tunnel syndrome (CTS) is a leading cause of lengthy disability.This population-based retrospective cohort study used Washington State workers' compensation claims for CTS to characterize associations between utilization of CTS surgery and duration of lost work. The sample included all claims (n = 8,224) filed during 1990-1994 (followed through 2000) and receiving lost-work compensation.Sixty-four percent of studied workers had CTS surgery. Among workers with >1 month of lost work, the total duration was much shorter when workers had surgery, versus those who did not (median 4.3 and 6.2 months, respectively; P 6 months. When workers had surgery, disability was less likely to end before 6 months if non-CTS conditions were present, surgery occurred >3 months after claim filing, or employment was in an industry with high incidence of CTS; disability was more likely to end if the diagnosing provider and operating surgeon had higher CTS claims volume. Physical and rehabilitation medicine services were associated with lower probability of returning to work, with or without surgery.There is a need to scrutinize the role of surgery and physical-rehabilitation medicine modalities in the management of CTS covered by workers' compensation. The findings suggest disability can be minimized by establishing the CTS diagnosis as early as possible and, if surgery is appropriate, conducting surgery without substantial delay and maximizing post-operative efforts to facilitate return to work. Use of surgery >6 months after filing should be considered with great caution. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Occupational injuries among aides and nurses in acute care
R.L. Rodríguez-Acosta, D.B. Richardson, H.J. Lipscomb, J.C. Chen, J.M. Dement, D.J. Myers, D.P. Loomis Thu, 22 Oct 2009 13:50:00 -0000
Occupational injuries are common among nursing personnel. Most epidemiologic research on nursing aides comes from long-term care settings. Reports from acute care settings often combine data on nurses and aides even though their job requirements and personal characteristics are quite different. Our objective was to assess risk of work-related injuries in an acute care setting while contrasting injuries of aides and nurses.A retrospective cohort of aides (n = 1,689) and nurses (n = 5,082) working in acute care at a large healthcare system between 1997 and 2004 were identified via personnel records. Workers' compensation filings were used to ascertain occupational injuries. Poisson regression was used to estimate rate ratios (RR) and 95% confidence intervals (95% CI).Aides had higher overall injury rates than nurses for no-lost work time (RR = 1.2, 95% CI: 1.1-1.3) and lost work time (RR = 2.8, 95% CI: 2.1-3.8) injuries. The risk of an injury due to lifting was greater among aides compared to nurses for both non-lost work time and lost work time injuries. Injury rates among aides were particularly high in rehabilitation and orthopedics units. Most of the injuries requiring time away from work for both groups were related to the process of delivering direct patient care.Our findings illustrate the importance of evaluating work-related injuries separately for aides and nurses, given differences in injury risk profiles and injury outcomes. It is particularly important that occupational safety needs of aides be addressed as this occupation experiences significant job growth. Am. J. Ind. Med. © 2009 Wiley-Liss, Inc.

International Archives of Occupational and Environmental Health

Karl-Heinz Schaller awarded with Franz Koelsch Medal 2009
Tue, 27 Oct 2009 17:59:33 -0000
Karl-Heinz Schaller awarded with Franz Koelsch Medal 2009 Content Type Journal ArticleCategory AcknowledgementDOI 10.1007/s00420-009-0470-1Authors Hans Drexler, University of Erlangen-Nuremberg Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine Schillerstr. 25 and 29 91054 Erlangen Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Changes in physical performance among construction workers during extended workweeks with 12-hour workdays
Mon, 26 Oct 2009 17:59:38 -0000
Abstract Purpose  To investigate changes of physical performance during long working hours and extended workweeks among construction workers with temporary accommodation in camps. Methods  Nineteen construction workers with 12-h workdays and extended workweeks participated. Physical performance in the morning and evening of the second and eleventh workdays was tested by endurance, ability to react to a sudden load, flexibility of the back, handgrip strength and sub-maximal HR during a bicycle test. HR was registered throughout two separate workdays. Results  HR during each of the two separate workdays corresponded to a relative workload of 25%. Sub-maximal HR was lower, reaction time faster and handgrip strength higher in the end of each test day. In the end of the work period, sub-maximal HR was lower, reaction time faster and sitting balance was better. Conclusion  No trends of decreased physical performance were found after a workday or a work period. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0471-0Authors Anne Faber, National Research Centre for the Working Environment Lersø Park Alle 105 2100 Kbh Ø Copenhagen DenmarkJesper Strøyer, National Research Centre for the Working Environment Lersø Park Alle 105 2100 Kbh Ø Copenhagen DenmarkNis Hjortskov, National Research Centre for the Working Environment Lersø Park Alle 105 2100 Kbh Ø Copenhagen DenmarkBente Schibye, National Research Centre for the Working Environment Lersø Park Alle 105 2100 Kbh Ø Copenhagen Denmark Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Lack of correlation between cadmium level in local brown rice and renal failure mortality among the residents: a nation-wide analysis in Japan
Thu, 15 Oct 2009 17:52:41 -0000
Abstract Objectives  Cadmium is a ubiquitous hazardous element with nephro-toxicity after long-term exposure. The present study was initiated to examine possible effects of dietary cadmium (Cd) intake on health of local residents across Japan. For this purpose, Cd in locally harvested brown rice (Cd-BR) was taken as the parameter of Cd exposure, and two measures of mortality, i.e., standardized mortality ratio (SMR) and age-adjusted renal insufficiency mortality rate (AARIMR) were employed as parameters of over-all health effects including effects on kidney. Methods  Japan consists of 47 prefectures. Data on Cd in 37,250 brown rice samples harvested in 1997–1998 in the 47 prefectures were made available from the Ministry of Agriculture, Forestry and Fisheries, Japan. SMR and AARIMR data (for the year 2000) by two genders in the 47 prefectures were cited from publications of the Ministry of Health, Labour and Welfare, Japan. Possible correlation of Cd in brown rice (Cd-BR) with SMR and AARIMR was examined by Poisson regression analysis. Results  The geometric mean (GM) Cd-BR for Japan as a whole was 0.040 mg/kg with a geometric standard deviation (GSD) of 2.72. Prefectural GM values varied from a low of <0.01 mg/kg to a high of 0.089 mg/kg. Nevertheless, SMR (in a range of 89.9–119.5 for men and 87.1–111.7 for women) did not correlate with Cd-BR significantly. AARIMR (in a range of 5.3–11.9 and 3.2–8.4 for men and women, respectively) tended to decrease as a function of increasing Cd-BR both in men and women, although the correlation was insignificant in both genders. Conclusions  No evidence was obtained in the present analysis to suggest that either mortality as a whole or the mortality due to renal failure is affected by dietary intake of Cd in rice. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0472-zAuthors Naoru Koizumi, Geroge Mason University School of Public Policy Arlington VA 22201 USAFumiko Ohashi, Kyoto Industrial Health Association 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku Kyoto 604-8472 JapanMasayuki Ikeda, Kyoto Industrial Health Association 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku Kyoto 604-8472 Japan Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Information and feedback to improve occupational physicians’ reporting of occupational diseases: a randomised controlled trial
Wed, 14 Oct 2009 17:00:06 -0000
Abstract Purpose  To assess the effectiveness of supplying occupational physicians (OPs) with targeted and stage-matched information or with feedback on reporting occupational diseases to the national registry in the Netherlands. Methods  In a randomized controlled design, 1076 OPs were divided into three groups based on previous reporting behaviour: precontemplators not considering reporting, contemplators considering reporting and actioners reporting occupational diseases. Precontemplators and contemplators were randomly assigned to receive stage-matched, stage-mismatched or general information. Actioners were randomly assigned to receive personalized or standardized feedback upon notification. Outcome measures were the number of OPs reporting and the number of reported occupational diseases in a 180-day period before and after the intervention. Results  Precontemplators were significantly more male and self-employed compared to contemplators and actioners. There was no significant effect of stage-matched information versus stage-mismatched or general information on the percentage of reporting OPs and on the mean number of notifications in each group. Receiving any information affected reporting more in contemplators than in precontemplators. The mean number of notifications in actioners increased more after personalized feedback than after standardized feedback, but the difference was not significant. Conclusions  This study supports the concept that contemplators are more susceptible to receiving information but could not confirm an effect of stage-matching this information on reporting occupational diseases to the national registry. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0468-8Authors Annet F. Lenderink, University of Amsterdam Netherlands Centre for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center (AMC) PO Box 22660 1100 DD Amsterdam The NetherlandsDick Spreeuwers, University of Amsterdam Netherlands Centre for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center (AMC) PO Box 22660 1100 DD Amsterdam The NetherlandsJac J. L. van der Klink, University of Groningen Department of Health Sciences, University Medical Center Groningen Groningen The NetherlandsFrank J. H. van Dijk, University of Amsterdam Netherlands Centre for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center (AMC) PO Box 22660 1100 DD Amsterdam The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Validity of new biomarkers of internal dose for use in the biological monitoring of occupational and environmental exposure to low concentrations of benzene and toluene
Wed, 14 Oct 2009 17:00:06 -0000
Abstract Objectives  This study analyzes the validity of new, more sensitive and specific urinary biomarkers of internal dose, namely, urinary benzene for benzene and urinary toluene and S-benzylmercapturic acid (SBMA) for toluene, to assess their efficacy when compared to traditional biomarkers for biological monitoring of occupational exposure to low concentrations of these two toxic substances. Methods  Assessment was made of 41 workers occupationally exposed to benzene and toluene, 18 fuel tanker drivers and 23 filling-station attendants, as well as 31 subjects with no occupational exposure to these toxic substances (controls). Exposure to airborne benzene and toluene was measured using passive Radiello® personal samplers worn throughout the work shift. In urine samples collected from all subjects at the end of the workday, both the traditional and the new internal dose biomarkers of benzene and toluene were assessed, as well as creatinine so as to apply suitable adjustments. Results  Occupational exposure to benzene and toluene resulted significantly higher in the fuel tanker drivers than the filling-station attendants, and higher in the latter than in controls. Significantly higher concentrations of t,t-muconic acid (t,t-MA), S-phenylmercapturic acid (SPMA), urinary benzene, SBMA and urinary toluene were found in the drivers than the filling-station attendants or the controls. Instead, urinary phenol and hippuric acid were not different in the three groups. In the entire sample, airborne benzene and toluene values were significantly correlated, as were the respective urinary biomarkers, showing coefficients ranging from 0.36 to 0.98. Subdividing the subjects by smoking habit, higher coefficients were evident in non-smokers than in smokers; at multiple regression analysis t,t-MA, SPMA and urinary benzene and toluene were dependent on the number of cigarettes smoked daily and on airborne benzene and toluene, respectively. Instead, SBMA was dependent only on airborne toluene. Conclusions  Our research confirmed the validity of t,t-MA and SPMA for use in the biological monitoring of exposure to low concentrations of benzene. Urinary benzene showed comparable validity to SPMA; both parameters are affected by smoking cigarettes in the hours before urine collection, so it is best to ask subjects to refrain from smoking for 2 h before urine collection. Urinary toluene was found to be a more specific biomarker than SBMA. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0469-7Authors Piero Lovreglio, University of Bari Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro “E.C. Vigliani” Policlinico, Piazza Giulio Cesare, 11 70124 Bari ItalyAnna Barbieri, University of Bologna Dipartimento di Medicina Interna, dell’Invecchiamento e Malattie Nefrologiche, Unità Operativa di Medicina del Lavoro Via Palagi 9 40138 Bologna ItalyMariella Carrieri, University of Padova Dipartimento di Medicina Ambientale e Sanità Pubblica Via Giustiniani 2 35128 Padova ItalyLaura Sabatini, University of Bologna Dipartimento di Medicina Interna, dell’Invecchiamento e Malattie Nefrologiche, Unità Operativa di Medicina del Lavoro Via Palagi 9 40138 Bologna ItalyMaria Enrica Fracasso, University of Verona Dipartimento di Medicina e Salute Pubblica, Sezione di Farmacologia Piazzale L. A. Scuro 10 37134 Verona ItalyDenise Doria, University of Verona Dipartimento di Medicina e Salute Pubblica, Sezione di Farmacologia Piazzale L. A. Scuro 10 37134 Verona ItalyIgnazio Drago, University of Bari Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro “E.C. Vigliani” Policlinico, Piazza Giulio Cesare, 11 70124 Bari ItalyAntonella Basso, University of Bari Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro “E.C. Vigliani” Policlinico, Piazza Giulio Cesare, 11 70124 Bari ItalyMaria Nicolà D’Errico, University of Bari Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro “E.C. Vigliani” Policlinico, Piazza Giulio Cesare, 11 70124 Bari ItalyGiovanni Battista Bartolucci, University of Padova Dipartimento di Medicina Ambientale e Sanità Pubblica Via Giustiniani 2 35128 Padova ItalyFrancesco Saverio Violante, University of Bologna Dipartimento di Medicina Interna, dell’Invecchiamento e Malattie Nefrologiche, Unità Operativa di Medicina del Lavoro Via Palagi 9 40138 Bologna ItalyLeonardo Soleo, University of Bari Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina del Lavoro “E.C. Vigliani” Policlinico, Piazza Giulio Cesare, 11 70124 Bari Italy Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
The relationship between upper extremity musculoskeletal symptoms attributed to work and risk factors in office workers
Tue, 29 Sep 2009 04:05:09 -0000
Abstract Purpose  Office workers are exposed to various individual, work-related and psychosocial factors during work that have been associated with the development of musculoskeletal symptoms. There is an increasing in evidence that suggests that musculoskeletal symptoms in the upper extremity are very common among office workers. The aim of this study was to examine the effects of individual, work-related physical and psychosocial factors on the prevalence of shoulder, elbow and wrist/hand symptoms attributed to work in office workers. Methods  A self-administered questionnaire was delivered to 2,000 office workers in 54 workplaces in Bangkok, registered at the Social Security Office of Thailand. Results  A total of 1,428 subjects (71%) returned the questionnaire, of whom 1,185 were eligible for the study. Alcohol consumption, frequency of working in an uncomfortable posture and relationships with colleagues were each significantly related to the prevalence of experiencing shoulder symptoms. No significant association between the investigated factors and the prevalence of experiencing elbow symptoms was found. Frequency of working in the position that hands were above the shoulder level and self-rated perception of air circulation in the office were significantly associated with the prevalence of experiencing wrist/hand symptoms. Conclusions  Various individual, work-related and psychosocial factors were identified to be associated with high prevalence of musculoskeletal symptoms attributed to work in the shoulder and wrist/hand among office workers. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0466-xAuthors Prawit Janwantanakul, Chulalongkorn University Department of Physical Therapy, Faculty of Allied Health Sciences Bangkok ThailandPraneet Pensri, Chulalongkorn University Department of Physical Therapy, Faculty of Allied Health Sciences Bangkok ThailandWiroj Jiamjarasrangsi, Chulalongkorn University Department of Preventive and Social Medicine, Faculty of Medicine Bangkok ThailandThanes Sinsongsook, Samutprakarn Hospital Department of Occupational Medicine Samutprakarn Province Thailand Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Occupational Therapy International

Post-stroke fatigue: qualitative study of three focus groups
Nancy A. Flinn, Jan E. Stube Mon, 28 Sep 2009 05:18:00 -0000
Fatigue affects many persons after cerebrovascular accident, particularly those with mild stroke. A qualitative methodology using focus groups with 19 community-living post-stroke survivors was utilized to explore the occupational impact of fatigue as communicated by the participants. Although self-report of a small sample of the United States' post-stroke population will have limitations in generalizability, this study identifies specific health-related quality of life issues that can occur with post-stroke fatigue. The participants felt unprepared for the fatigue phenomenon and struggled to adapt, with fatigue having a debilitating influence upon daily occupational performance and roles, including social participation, return to work, driving, reading and sleeping. The participants indicated that exercise (such as walking and water aerobics) and use of assistive technology were helpful strategies in reducing fatigue. The occupational performance and role impact identified by participants in this study can inform the design of effective occupational therapy interventions and further quantitative study of persons with post-stroke fatigue. Copyright © 2009 John Wiley & Sons, Ltd.
Occupational therapy students' attitudes towards inclusion education in Australia, United Kingdom, United States and Taiwan
Keli Mu, Ted Brown, Claudia G. Peyton, Sylvia Rodger, Yan-Hua Huang, Chin-Yu Wu, Callie Watson, Karen Stagnitti, Eve Hutton, Jackie Casey, Chia Swee Hong Fri, 21 Aug 2009 06:45:00 -0000
This international, cross-cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry-level occupational therapy education programmes from Australia, the United Kingdom, the United Sates and Taiwan participated in the study. Among them, 264 were freshmen (first-year students) and 221 were seniors (final-year students). Data collected from a custom-designed questionnaire were analysed both quantitatively and qualitatively.In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities.Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted. Copyright © 2009 John Wiley & Sons, Ltd.
Identifying indicators of well-being for caregivers of children with disabilities
Elizabeth Larson Mon, 17 Aug 2009 08:39:00 -0000
This study identified key indicators of well-being for caregivers of children with disabilities, Thirty-nine caregivers completed life satisfaction and psychological well-being (WB) measures, and qualitative interviews. Data analysis included descriptive statistics of WB measures and categorical analysis of qualitative data. Data triangulation was achieved by importing theoretically derived codes for initial qualitative coding and quantitizing qualitative categories. Core indicators focused on positive family functioning and a reasonable family lifestyle, caregiver's personal growth and capacity to manage life demands, and the importance of daily balance. Study limitations included no standardized assessments of the child with disabilities' functioning, and the inclusion of caregivers with a range of years of experience. Findings suggest therapists need to attend to how interventions foster or impede positive family functioning and assist caregivers in balancing daily occupations to support capacity to caregiving. Future research should examine how well-being varies over time as caregivers adapt from initial and later caregiving. Copyright © 2009 John Wiley & Sons, Ltd.

Occupational Medicine - current issue

OCCUPATIONAL MEDICINE CALENDAR

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In this issue of Occupational Medicine
Williams, N.

pubmed: 0355-3140

The interplay between physical activity at work and during leisure time - risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men.
Holtermann A, Mortensen OS, Burr H, Søgaard K, Gyntelberg F, Suadicani P Related Articles The interplay between physical activity at work and during leisure time - risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men. Scand J Work Environ Health. 2009 Oct 21;:466-474 Authors: Holtermann A, Mortensen OS, Burr H, Søgaard K, Gyntelberg F, Suadicani P OBJECTIVE: Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. METHODS: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasian, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. RESULTS: During the follow-up period, 591 men (11.9%) died from IHD. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high demands had a higher risk of IHD mortality compared to men with low demands [age-adjusted hazard ratio 1.51, 95% confidence interval (95% CI) 1.18-1.94]. In all three groups, men with a low level of physical activity during leisure time had a higher risk of IHD than men with a medium or high level. Overall, the age-adjusted hazard ratio for IHD mortality associated with a high level of leisure time physical activity was 0.49 (95% CI 0.34-0.70). Among workers with high physical work demands, the hazard ratio for IHD mortality (adjusted for confounders) was 0.82 (95% CI 0.42-1.56) for a high level of leisure time physical activity and 0.62 (95% CI 0.40-0.97) for a moderate level. CONCLUSION: We did not find support for the hypothesis that a high level of physical activity during leisure time increases the risk of IHD mortality among men with high physical work demands and with no pre-existing clinical cardiovascular disease. In contrast, moderate and high levels of activity during leisure time seemed to be protective against IHD mortality among people with medium and high physical activity at work. PMID: 19851700 [PubMed - as supplied by publisher]
Fate of abstracts presented at an International Commission on Occupational Health (ICOH) congress - followed by publication in peer-reviewed journals?
Rollin L, Darmoni S, Caillard JF, Gehanno JF Related Articles Fate of abstracts presented at an International Commission on Occupational Health (ICOH) congress - followed by publication in peer-reviewed journals? Scand J Work Environ Health. 2009 Oct 9;:461-465 Authors: Rollin L, Darmoni S, Caillard JF, Gehanno JF OBJECTIVES: Presentations at international meetings offer an excellent way to disseminate current research findings. One measure of the quality of research is its subsequent publication. Our study aimed to determine the publication rate of abstracts presented at a congress of the International Commission of Occupational Health (ICOH), and to identify predictive factors of publication and differences between presented abstracts and -subsequently published papers. METHODS: We identified a random sample of 318 abstracts presented at the 2000 ICOH meeting from the book of abstracts. Using Medline and Embase, we assessed their publication rate in the period ranging from 1998 to 2006 and investigated the factors associated with publication rate. RESULTS: Of 318 abstracts originating from 51 countries, 105 articles [33%, 95% confidence interval (95% CI) 27-38)] were subsequently published in 67 journals indexed in Medline or Embase. Mean time to publication was 17 months (95% CI 13-21). Multivariate analysis revealed that abstracts with quantitative data and written by authors originating from developed countries were significantly more published. From the time of abstract presentation to publication in a peer-reviewed journal, both the study sample size and the first author frequently changed (respectively 25% and 29%), but the overall conclusions remained stable, except in one case. CONCLUSIONS: Most of the abstracts presented at the 2000 ICOH congress were not subsequently published as full research reports. If this is the case for most abstracts submitted to conferences, this may limit the ability of a reader to judge the validity, reliability, and generalizability of the research presented. Caution is advised when referencing or generalizing from abstracts that have not been subsequently published in full. PMID: 19851699 [PubMed - as supplied by publisher]

Annals of Occupational Hygiene - current issue

Data Sharing, Federal Rule of Evidence 702, and the Lions in the Undergrowth
Ogden, T. Many concerns would find it useful to have a publicly available database recording exposures to particular substances, with contextual information. The European Union's Registration, Evaluations, Authorisation, and restriction of Chemicals regulation has increased interest in this. It has been suggested that journals should require detailed publication of exposure data with papers. But there are problems for researchers, for whom the data are a valuable resource which has been obtained with effort and often ingenuity. The publication could also raise problems of confidentiality and liability, and those who have to put the effort in publication are not those who benefit. Also, there are the problems of hostile critics misusing the information—for example, industry reanalysing data to counter any regulatory implications of a study—and this raises serious wider issues of editorial policy. Two books have recently given examples of industry misuse of science, ‘Doubt is their product’ by David Michaels and ‘Defending the indefensible’ by McCullogh and Tweedale. Michaels gives examples of hostile data reanalysis, and among other things, he discusses the impact on journals of US Federal Rule of Evidence 702, which encourages expert witnesses to try to get their testimony material into peer-reviewed journals. This certainly lies behind some submissions to this journal, and Michaels says that it has led to the creation of peer-reviewed journals which have strong industry influence. On the other hand, work funded by industry is not always wrong, papers from other sources are not always free from bias, and the problem for journals is to continue to apply consistent scientific standards in a sea of conflicting interests. It does not seem feasible or desirable for journals to insist on the publication of all the underlying data, although researchers might be encouraged to form consortia to share data.
Trends in Wood Dust Inhalation Exposure in the UK, 1985-2005
Galea, K. S., Van Tongeren, M., Sleeuwenhoek, A. J., While, D., Graham, M., Bolton, A., Kromhout, H., Cherrie, J. W. Objectives: Wood dust data held in the Health and Safety Executive (HSE) National Exposure DataBase (NEDB) were reviewed to investigate the long-term changes in inhalation exposure from 1985 to 2005. In addition, follow-up sampling measurements were obtained from selected companies where exposure measurements had been collected prior to 1994, thereby providing a follow-up period of at least 10 years, to determine whether changes in exposure levels had occurred, with key staff being interviewed to identify factors that might be responsible for any changes observed. Methods: Analysis of the temporal trend in exposure concentrations was performed using Linear Mixed Effect Models on the log-transformed NEDB data set and expressed as the relative annual change in concentration. Results: For the NEDB wood dust data, an annual decline of geometric mean (GM) exposure of 8.1% per year was found based on 1459 exposure measurements collected between 1985 and 2003. This trend was predominantly observed in data from inspection visits (measurements collected on a mandatory basis by a Specialist HSE Inspector) (n = 1009), while data from representative surveys (measurements collected on a voluntary basis to provide information on current practices and exposures) remained relatively stable. Ten follow-up surveys in individual workplaces in 2004–2005 resulted in 70 new measurements and for each of the companies resurveyed, the GM of the wood dust exposure decreased between sampling surveys. Conclusion: Analysis of the temporal trend in UK wood dust exposure concentrations revealed declines of 8% per annum. Interviews with key long-serving employees and management suggest that factors such as technological changes in production processes, response to new legislation, and enforcement agency inspections, together with global economic trends, could be linked to the downward trends observed.
Beryllium Decontamination with Different Solvents on Different Structures
Dufresne, A., Dion, C., Viau, S., Perrault, G. The objective of the present work was to estimate the efficiency of moistened wipes in removing beryllium with different solutions including CitranoxTM, AlconoxTM, NaCl 5%, ResolveTM, and LedizolvTM on various types of surfaces such as unpainted metal, wood frames, painted metal, concrete, painted concrete, and PlexiglasTM from three different occupational settings. Of the three plants that were investigated, only surfaces in the aluminium smelter were decontaminated down to the clearance reference level of 0.2 µg 100 cm–2, with all the solvents used. In the machine tooling and milling department, the clearance level of 0.2 µg 100 cm–2 was reached after the three decontaminations, with all the solvents. In the machine plant for the military, aerospace, and telecommunications industries, the beryllium concentrations on the concrete wall, before decontamination with the high-pressure gun, were usually >3 µg 100 cm–2, and concentrations as high as 31 µg 100 cm–2 were measured. After the high-pressure cleanup, the beryllium concentrations were sometimes reduced by a factor of 10, but never reached the clearance level. Beryllium compounds that had adhered to most types of structures that we attempted to decontaminate were reduced to below the clearance reference value except on concrete floors. There did not seem to be any difference between the decontamination actions for all the solvents used in this study.
Quantification and Statistical Modeling--Part I: Breathing-Zone Concentrations of Monomeric and Polymeric 1,6-Hexamethylene Diisocyanate
Fent, K. W., Gaines, L. G. T., Thomasen, J. M., Flack, S. L., Ding, K., Herring, A. H., Whittaker, S. G., Nylander-French, L. A. We conducted a repeated exposure-assessment survey for task-based breathing-zone concentrations (BZCs) of monomeric and polymeric 1,6-hexamethylene diisocyanate (HDI) during spray painting on 47 automotive spray painters from North Carolina and Washington State. We report here the use of linear mixed modeling to identify the primary determinants of the measured BZCs. Both one-stage (N = 98 paint tasks) and two-stage (N = 198 paint tasks) filter sampling was used to measure concentrations of HDI, uretidone, biuret, and isocyanurate. The geometric mean (GM) level of isocyanurate (1410 µg m–3) was higher than all other analytes (i.e. GM < 7.85 µg m–3). The mixed models were unique to each analyte and included factors such as analyte-specific paint concentration, airflow in the paint booth, and sampler type. The effect of sampler type was corroborated by side-by-side one- and two-stage personal air sampling (N = 16 paint tasks). According to paired t-tests, significantly higher concentrations of HDI (P = 0.0363) and isocyanurate (P = 0.0035) were measured using one-stage samplers. Marginal R2 statistics were calculated for each model; significant fixed effects were able to describe 25, 52, 54, and 20% of the variability in BZCs of HDI, uretidone, biuret, and isocyanurate, respectively. Mixed models developed in this study characterize the processes governing individual polyisocyanate BZCs. In addition, the mixed models identify ways to reduce polyisocyanate BZCs and, hence, protect painters from potential adverse health effects.
Quantification and Statistical Modeling--Part II: Dermal Concentrations of Monomeric and Polymeric 1,6-Hexamethylene Diisocyanate
Fent, K. W., Trelles Gaines, L. G., Thomasen, J. M., Flack, S. L., Ding, K., Herring, A. H., Whittaker, S. G., Nylander-French, L. A. We conducted a quantitative dermal and inhalation exposure assessment of monomeric and polymeric 1,6-hexamethylene diisocyanates (HDI) in 47 automotive spray painters from North Carolina and Washington State. We report here the use of linear mixed modeling (LMM) to identify the primary determinants of dermal exposure. Dermal concentrations of HDI, uretidone, biuret, and isocyanurate were significantly higher in 15 painters who did not wear coveralls or gloves (N = 51 paint tasks) than in 32 painters who did wear coveralls and gloves (N = 192 paint tasks) during spray painting. Regardless of whether protective clothing was worn, isocyanurate was the predominant species measured in the skin [geometric mean (GM) = 33.8 ng mm–3], with a 95% detection rate. Other polyisocyanates (GM ≤ 0.17 ng mm–3) were detected in skin during <23% of the paint tasks. According to marginal R2 statistics, mixed models generated in this study described no <36% of the variability in dermal concentrations of the different polyisocyanates measured in painters who did not wear protective clothing. These models also described 55% of the variability in dermal concentrations of isocyanurate measured in all painters (N = 288 paint tasks). The product of analyte-specific breathing-zone concentration (BZC) and paint time was the most significant variable in all the models. Through LMM, a better understanding of the exposure pathways governing individual polyisocyanate exposures may be achieved. In particular, we were able to establish a link between BZC and dermal concentration, which may be useful for exposure reconstruction and quantitatively characterizing the protective effect of coveralls and gloves. This information can be used to reduce dermal exposures and better protect automotive spray painters from potential adverse health effects.
Guidance Values for Surface Monitoring of Antineoplastic Drugs in German Pharmacies
Schierl, R., Bohlandt, A., Nowak, D. Objectives: Antineoplastic drugs are widely used in anticancer therapy due to their cytotoxic activity but many of them are classified as carcinogenic, mutagenic, or teratogenic to humans. In order to evaluate personal exposure, surface monitoring has been successfully applied for several years. In this study, we present a statistical description of our data set from 102 German pharmacies and propose ‘threshold guidance values (TGVs)’ to facilitate interpretation of monitoring results. Methods: Our database included 1008 results for platinum (PT) and 1237 for 5-fluorouracil (FU) collected in 102 pharmacies in Germany. Wipe sampling on site was performed with one validated procedure. PT concentrations were measured by voltammetry and FU by gas chromatography/mass spectrometry. Data were stratified into 10 locations and statistically evaluated. Results: Contamination was detected on all surfaces in the pharmacies with high levels on storage shelves and floors. The median values for the different locations ranged from 0.20 to 1.70 pg cm–2 (mean: 0.57 pg cm–2) for PT and from 2.50 to 10.00 pg cm–2 (mean: 5.34 pg cm–2) for FU. The mean 75th percentiles were 3.92 pg cm–2 (PT) and 28.90 pg cm–2 (FU). The TGV 1 value was set at the median value and results below demonstrate good working practices. Contaminations above the TGV 2, which was assigned at the 75th percentile, show a clear need for optimizing the handling procedures. Conclusions: The introduction of TGVs helps to reduce occupational exposure and allows pharmacy personnel to benchmark their own contamination levels. This provides a basis for improvement in occupational safety precautions and for regular contamination controls.

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