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Employment also exists in the public, non-profit and household sectors.
In the United States, the "standard" employment contract is considered to be at-will meaning that the employer and employee are both free to terminate the employment at any time and for any cause, or for no cause at all.
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American Journal of Industrial Medicine
Measured occupational solar UVR exposures of lifeguards in pool settings
Peter Gies, Karen Glanz, David O'Riordan, Tom Elliott, Eric Nehl Wed, 01 Jul 2009 14:31:00 -0000
The aim of this study was to measure ultraviolet radiation (UVR) exposures of lifeguards in pool settings and evaluate their personal UVR protective practices.Lifeguards (n = 168) wore UVR sensitive polysulfone (PS) film badges in wrist bracelets on 2 days and completed a survey and diary covering sun protection use. Analyses were used to describe sun exposure and sun protection practices, to compare UVR exposure across locations, and to compare findings with recommended threshold limits for occupational exposure.The measured UVR exposures varied with location, ranging from high median UVR exposures of 6.2 standard erythemal doses (SEDs) to the lowest median of 1.7 SEDs. More than 74% of the lifeguards' PS badges showed UVR above recommended threshold limits for occupational exposure. Thirty-nine percent received more than four times the limit and 65% of cases were sufficient to induce sunburn. The most common protective behaviors were wearing sunglasses and using sunscreen, but sun protection was often inadequate.At-risk individuals were exposed to high levels of UVR in excess of occupational limits and though appropriate types of sun protection were used, it was not used consistently and more than 50% of lifeguards reported being sunburnt at least twice during the previous year. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Declining health insurance access among US hispanic workers: Not all jobs are created equal
Kathryn E. McCollister, Kristopher L. Arheart, David J. Lee, Lora E. Fleming, Evelyn P. Davila, William G. LeBlanc, Sharon L. Christ, Alberto J. Caban-Martinez, Jonathan P. West, John E. Clark III, Michael J. Erard Mon, 29 Jun 2009 11:49:00 -0000
Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages.Health insurance trends were analyzed by race-ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents [ge]18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n = 17,392, representing 123 million US workers on average over this 11 year period).From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%).Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners
David Rees, Jill Murray, Gill Nelson, Pam Sonnenberg Mon, 29 Jun 2009 11:50:00 -0000
Hundreds of thousands of men from rural areas of South Africa and neighboring countries have come to seek work in the gold mines. They are not immigrants in the usual sense as they work for periods in the mines, go home, and then return. This is termed oscillating or circular migration. Today we have serious interrelated epidemics of silicosis, tuberculosis, and HIV infection in the gold mining industry.This article discusses the role of oscillating migration in fuelling these epidemics, by examining the historical, political, social, and economic contexts of these diseases.The impact of silicosis, tuberculosis, and HIV infection extends beyond individual miners to their families and communities.Failure to control dust and tuberculosis has resulted in serious consequences decades later. The economic and political migrant labor system provided the foundations for the epidemics seen in southern Africa today. Am. J. Ind. Med. © 2009 Wiley-Liss, Inc.
Transfer of occupational health problems from a developed to a developing country: Lessons from the Japan-South Korea experience
Jungsun Park, Naomi Hisanaga, Yangho Kim Fri, 26 Jun 2009 10:47:00 -0000
Many corporations move their manufacturing facilities or technologies from developed to developing countries. Stringent regulations have made it costly for industries to operate in developed, industrialized countries. In addition, labor costs are high in these countries, and there is increasing awareness among the general public of the health risks associated with industry. The relocation of hazardous industries to developing countries is driven by economic considerations: high unemployment, a cheaper labor force, lack of regulation, and poor enforcement of any existing regulations make certain countries attractive to business. The transfer of certain industries from Japan to Korea has also brought both documented occupational diseases and a new occupational disease caused by chemicals without established toxicities. Typical examples of documented occupational diseases are carbon disulfide poisoning in the rayon manufacturing industry, bladder cancer in the benzidine industry, and mesothelioma in the asbestos industry. A new occupational disease due to a chemical without established toxicities is 2-bromopropane poisoning. These examples suggest that counter-measures are needed to prevent the transfer of occupational health problems from a developed to a developing country. Corporate social responsibility should be emphasized, close inter-governmental collaboration is necessary and cooperation among non-governmental organizations is helpful. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Mortality among sheet metal workers participating in a medical screening program
John Dement, Laura Welch, Elizabeth Haile, Douglas Myers Fri, 26 Jun 2009 10:47:00 -0000
The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. A study of mortality patterns among screening program participants was undertaken.A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2004. Data from the screening program included chest X-ray results by International Labour Office (ILO) criteria and smoking history. Standardized mortality ratios (SMRs) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate lung cancer risk relative to chest X-ray changes while controlling for smoking.A significantly reduced SMR of 0.83 (95% CI = 0.80-0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. Both lung cancer and COPD SMRs increased consistently and strongly with increasing ILO profusion score. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR = 1.17, 95% CI = 0.89-1.54), with a strong trend for increasing lung cancer risk with increasing ILO profusion score >0/0.Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Mortality patterns among workers exposed to arsenic, cadmium, and other substances in a copper smelter
Gary M. Marsh, Nurtan A. Esmen, Jeanine M. Buchanich, Ada O. Youk Tue, 16 Jun 2009 10:03:00 -0000
To evaluate the long-term mortality experience of workers exposed to arsenic, cadmium, and other substances at a copper mine and smelter in Copperhill, Tennessee studied earlier as part of an industry-wide study.Subjects were 2,422 male workers employed three or more years in the smelter or mill between 1/1/46 until the plant strike and scale-down of operations in April 1996. Vital status was determined through 2000 for 99.4% of subjects and cause of death for 91.3% of 878 deaths. Historical exposures were estimated for lead, SO2, arsenic, cadmium, dust, and cobalt. We computed standardized mortality ratios (SMRs) based on U.S. and local county rates and modeled internal relative risks (RRs).We observed overall deficits in deaths based on national and local county comparisons from all causes, all cancers and most of the cause of death categories examined. We found limited evidence of increasing mortality risks from cerebrovascular disease with increasing duration and cumulative arsenic exposure, but no evidence of an exposure-response relationship for cadmium exposure and bronchitis.Our limited evidence of an association between inhaled arsenic exposure and CVD is an exploratory finding not observed in other epidemiology studies of more highly exposed occupational populations. Possible alternative explanations include chance alone and uncontrolled confounding or effect modification by co-exposures or other factors correlated with arsenic exposure and unique to the Copperhill facility. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
International Archives of Occupational and Environmental Health
Associations between two job stress models and measures of salivary cortisol
Thu, 25 Jun 2009 06:52:59 -0000
Abstract Purpose To investigate the association between two job stress models—the job demand-control model and the effort-reward imbalance model—and repeated measures of salivary cortisol among male and female call-centre operators. Methods Daily cortisol profiles consisting of seven time points were measured across two workdays and one leisure day to determine the cortisol awakening response and the cortisol output in the day in 104 volunteers. The employees completed two self-administered questionnaire—the Karasek’s demand-control questionnaire and the Siegrist’s effort-reward imbalance questionnaire—to assess psychosocial hazards at work. The relations between the perceived workload measures and salivary cortisol levels were analyzed by means of generalized estimating equations method after adjusting for potential confounders (gender, age, educational level, marital status, morning awakening time, sleep duration and quality, weekdays, work schedule, adherence to sampling procedure). Results The total cortisol amount excreted in the awakening period was positively associated with the job strain measures (high strain vs. low strain: 1.4 (2.4–0.3) nmol/l). In contrast, individuals scoring higher in effort-reward imbalance at work had both lower cortisol awakening response (high imbalance vs. low imbalance: −0.7 (−1.3 to −0.2) nmol/l) and lower diurnal secretory activity (−9.2 (−17.7 to −0.7) nmol/l). Gender, weekday and adherence to sampling schedule significantly influenced the cortisol excretion in the morning period. Conclusions Our results indicate that the two work stress models differentially affect salivary cortisol output. This finding suggests that combining the information from two complementary job stress models results in improved knowledge on the psychobiological correlates of the psychosocial work environment. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0439-0Authors Giovanni Maina, Università di Torino Torino ItalyMassimo Bovenzi, Università di Trieste Trieste ItalyAntonio Palmas, Università di Torino Torino ItalyFrancesca Larese Filon, Università di Trieste Trieste Italy Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Letter to the Editor
Wed, 17 Jun 2009 07:05:42 -0000
Letter to the Editor Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00420-009-0435-4Authors Kathleen Kreiss, National Institute for Occupational Safety and Health (NIOSH) Division of Respiratory Disease Studies Mail Stop H2800, 1095 Willowdale Road Morgantown WV 26505 USAAnn Hubbs, National Institute for Occupational Safety and Health (NIOSH) Health Effects Laboratory Division Mail Stop L2015, 1095 Willowdale Road Morgantown WV 26505 USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance
Wed, 17 Jun 2009 07:05:41 -0000
Abstract Purpose The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol. Methods Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands. Results Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand. Conclusion Ambulance service personnel seem to be used to critical situations. There was few awareness of the “physiological” stress response indicating that stress is probably not perceived in work situations characterised by routines. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0428-3Authors Eva M. Backé, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyGerlinde Kaul, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyAndré Klußmann, University of Wuppertal (ASER e.V.) Institute of Occupational Medicine, Safety Engineering and Ergonomics Corneliusstrasse 31 42329 Wuppertal GermanyFalk Liebers, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyCarmen Thim, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyPeter Maßbeck, German Red Cross Secretariat Carstennstrasse 58 12205 Berlin GermanyUlf Steinberg, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Urinary 1-hydroxypyrene levels in offshore workers
Tue, 09 Jun 2009 12:44:17 -0000
Abstract Objectives To compare differences in pre- and post-shift urinary 1-hydroxypyrene (1OHP) levels as a measure of internal dose of polycyclic aromatic hydrocarbons (PAHs) between two groups of oil production workers offshore assumed to be exposed to PAH, and to compare the exposed group to an unexposed control group. Methods Participants’ (n = 42) urine samples, collected over a study period of three consecutive 12-h work days (pre-shift on the first day and post-shift on the third day), were analyzed using high performance liquid chromatography (HPLC) with fluorescence detection. Analysis of covariance was used in the statistical models. Results (1) Post-shift 1OHP levels were significantly higher in the exposed workers compared to the controls. (2) Tank workers and process operators did not show statistically significant different post-shift 1OHP levels. Conclusion Altogether, this study indicates the presence of a low level PAH exposure among offshore oil production workers. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0437-2Authors Nancy Brenna Hopf, University of Cincinnati Cincinnati OH USAJorunn Kirkeleit, University of Bergen Section for Occupational Medicine, Department of Public Health and Primary Health Care Kalfarveien 31 5018 Bergen NorwayStacy L. Kramer, University of Cincinnati Cincinnati OH USABente Moen, University of Bergen Section for Occupational Medicine, Department of Public Health and Primary Health Care Kalfarveien 31 5018 Bergen NorwayPaul Succop, University of Cincinnati Cincinnati OH USAMary Beth Genter, University of Cincinnati Cincinnati OH USATania Carreón, University of Cincinnati Cincinnati OH USAJames Mack, University of Cincinnati Cincinnati OH USAGlenn Talaska, University of Cincinnati Cincinnati OH USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Overweight and obesity among Dutch workers: differences between occupational groups and sectors
Tue, 09 Jun 2009 12:44:17 -0000
Abstract Purpose To describe the prevalence of overweight and obesity among different occupational groups and sectors in a representative sample of the Dutch working population, and to test whether these differences still exist after adjustment for socio-demographic variables. Methods Cross-sectional data among 7,588 working adults were used. Univariate analyses of variance was performed to test differences in body mass index (BMI) values between occupational groups (n = 7) and sectors (n = 28). Adjusted analyses were carried out to examine the role of socio-demographic factors in the differences in overweight and obesity between occupational groups and sectors. Results On average, the mean BMI was 24.3 kg/m2 with 31% being overweight and 6% being obese. Those working in trade, industrial, or transportation occupations as well as the legislators and senior managers had the highest BMI and a relatively high prevalence of overweight (36.7 and 35.5%, respectively) and obesity (6.9 and 7.5%, respectively). In contrast, those working in scientific and artistic professions had the most favorable BMI profile with 25.7% being overweight and 4.2% being obese. After adjusting for sex, age, and education, the proportion of variance changed from about 0.01 to 0.10 with age being the main contributor of the differences in overweight and obesity. Conclusions BMI profile and prevalence of overweight and obesity differs between occupations and sectors. Despite the differences are explained partly by socio-demographic factors, based on a given distribution of age, sex, and education within each occupational group and sector, occupational group- and sector-specific strategies to prevent and reduce overweight are recommended. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0438-1Authors Karin I. Proper, EMGO Institute for Health and Care Research, VU University Medical Center Department of Public and Occupational Health Amsterdam The NetherlandsVincent H. Hildebrandt, TNO Quality of Life Leiden The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Does sickness presenteeism have an impact on future general health?
Sat, 06 Jun 2009 10:02:49 -0000
Abstract Purpose The primary aim of this prospective study was to investigate whether working despite illness, so called “sickness presenteeism”, has an impact on the future general health of two different working populations during a follow-up period of 3 years. Methods The study was based on two bodies of data collected at a number of Swedish workplaces from 1999 to 2003. The first material comprised 6,901 employees from the public sector and the second 2,862 subjects from the private sector. A comprehensive survey was issued three times: at baseline, after 18 months and after 3 years. Apart from the explanatory variable sickness presenteeism, several potential confounders were considered. The outcome variable was good/excellent versus fair/poor self-reported health. Results Sickness presenteeism at baseline was consistently found to heighten the risk of fair/poor health at both the 18-month and 3-year follow ups even after adjusting for the detected confounders. Conclusions To the best of the authors’ knowledge, this study is the first to show that sickness presenteeism appears to be an independent risk factor for future fair/poor general health. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0433-6Authors Gunnar Bergström, Karolinska Institutet Division of Intervention and Implementation Research, Department of Public Health Sciences 171 77 Stockholm SwedenLennart Bodin, Karolinska Institutet Division of Intervention and Implementation Research, Department of Public Health Sciences 171 77 Stockholm SwedenJan Hagberg, Karolinska Institutet Section for Personal Injury Prevention, Department of Clinical Neuroscience Stockholm SwedenTomas Lindh, Stockholm County Council Department of Occupational and Environmental Health, Centre for Public Health Stockholm SwedenGunnar Aronsson, Stockholm University Department of Psychology Stockholm SwedenMalin Josephson, Uppsala University Section of Occupational and Environmental Medicine, Department of Medical Sciences Uppsala Sweden Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Occupational Therapy International
Unilateral and bilateral upper extremity weight-bearing effect on upper extremity impairment and functional performance after brain injury
Timothy Reistetter, Beatriz C. Abreu, Jane Bear-Lehman, Kenneth J. Ottenbacher Tue, 23 Jun 2009 04:04:00 -0000
The purpose of the study was to investigate the effect of upper extremity (UE) weight bearing on UE impairment functional performance of persons with acquired brain injury (BI).A quasi-experimental design was used to examine a convenience sample of 99 persons with acquired BI and 22 without BI (WBI) living in a community re-entry centre. A computerized force-sensing array pressure map system was used to determine the UE pressure during unilateral and bilateral conditions. Differences between groups were examined using t-tests. Correlations were computed between UE weight bearing and hand function, and functional performance as measured by the Fugl-Meyer scale and functional independence measure (FIM) scale.The group of people with BI exerted significantly lower UE weight bearing during unilateral conditions as compared with persons WBI [left: t (119) = 2.34, p = 0.021; right: t (119) = 4.79, p = 0.043). UE weight-bearing measures correlated strongly with FIM motor scores with bilateral UE conditions yielded the highest significant correlation (bilateral left r = 0.487, p < 0.001; bilateral right r = 0.469, p < 0.01).The results indicated that UE weight-bearing pressure differs in unilateral and bilateral conditions, between persons with and WBI and between persons with stroke and traumatic brain injury. These findings may have implications for occupational therapists that use unilateral versus bilateral motor training for rehabilitation.There is a need to replicate the study design with a randomized and stratified sample of persons with BI. Copyright © 2009 John Wiley & Sons, Ltd.
Occupational therapy and neuromotor interventions
Gerry E. Conti Wed, 10 Jun 2009 09:13:00 -0000
No abstract.
A review of bilateral training for upper extremity hemiparesis
Mary Ellen Stoykov, Daniel Corcos Wed, 10 Jun 2009 09:13:00 -0000
Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. Copyright © 2009 John Wiley & Sons, Ltd.
Occupational Medicine - current issue
OCCUPATIONAL MEDICINE CALENDAR
Tue, 26 May 2009 00:00:00 -0000
In this issue of Occupational Medicine
Beach, J. Tue, 26 May 2009 00:00:00 -0000
Consensus on work-related asthma
Tarlo, S. M., Rowe, B., Liss, G. M., Lemiere, C., Beach, J. Tue, 26 May 2009 00:00:00 -0000
pubmed: 0355-3140
Attributable risk of carpal tunnel syndrome in the general population: implications for intervention programs in the workplace.
Roquelaure Y, Ha C, Fouquet N, Descatha A, Leclerc A, Goldberg M, Imbernon E Related Articles Attributable risk of carpal tunnel syndrome in the general population: implications for intervention programs in the workplace. Scand J Work Environ Health. 2009 Jul 2; Authors: Roquelaure Y, Ha C, Fouquet N, Descatha A, Leclerc A, Goldberg M, Imbernon E OBJECTIVE: Carpal tunnel syndrome (CTS) represents one of the most significant and costly health problems occurring in the working population. An estimation of the potential impact of CTS prevention programs in the workplace would be useful for public policy. The aim of this study was to assess the work-related population-attributable fraction (PAF) of CTS in industrial sectors and occupational categories at high risk of CTS in the general population. METHODS: All cases of CTS occurring in patients living in a French region were included prospectively between 2002-2004. Using a mailed questionnaire, we gathered medical and occupational history from 815 women and 320 men. We calculated the age-adjusted relative risks and PAF of CTS in relation to industrial sectors and occupational categories. RESULTS: The PAF for women was higher in lower-grade, white-collar workers (24%, 95% CI 19-29) than blue-collar workers (19%, 95% CI 15-22). The PAF was higher for the service industries sector (16%, 95% CI 8-22) than manufacturing (10%, 95% CI 7-13) or agricultural (5%, 95% CI 3-7) sectors. The PAF was high for men in blue-collar workers (50%, 95% CI 41-57) and in the construction (13%, 95% CI 9-18) and manufacturing industries (17%, 95% CI 10-23). CONCLUSION: The study suggested that 5-50% of CTS cases might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industrial sectors. PMID: 19572088 [PubMed - as supplied by publisher]
Annals of Occupational Hygiene - current issue
How Safe is Control Banding? Integrated Evaluation by Comparing OELs with Measurement Data and Using Monte Carlo Simulation
Tischer, M., Bredendiek-KAmper, S., Poppek, U., Packroff, R. Fri, 03 Jul 2009 00:00:00 -0000
The present study aims to explore the protection level that can be achieved by the German control banding (CB) tool Einfaches Massnahmenkonzept Gefahrstoffe, ‘Easy-to-use workplace control scheme for hazardous substances’. The rationale of our integrated approach is based on the Bewertungsindex (BWI), which is the quotient of the exposure level and the occupational exposure limit (OEL), with BWI <1 indicating compliance. The frequency distributions of the BWI were calculated in order to reflect statistically the variability of workplace conditions. The corresponding statistical values of the frequency distributions (percentiles etc.) are interpreted as an indicator of the level of protection that is achieved. The occupational exposure data sets used in the calculation of the BWI frequency distribution were mainly collected from Bundesanstalt für Arbeitsschutz und Arbeitsmedizin field studies. The data sets taken into account were selected according to the criteria ‘hazard band, exposure potential, control approach’. Such a combination is called the ‘control banding scenario’ (CBS). Measurement data are only available for two CBS: in the case of the CBS ‘hazard band A, EPL3, CS1’ the only data that are available (n = 220) relate to propane-2-ol as used in the area of offset printing. Only 0.4 % of the BWI are above 1, this indicating a high level of compliance. In the case of the CBS ‘Hazard band B, EPL2, CS1’, exposure data are available from screen-printing firms (n = 50), optician workshops (n = 49), and from the area of furniture production (n = 13). The frequency distributions of the BWI reveal almost no instances of values being exceeded in the three branches. In a subsequent step, a Monte Carlo Simulation was employed to explore whether the BWI frequency distributions can be generalized using a probabilistic model. The frequency distributions of the exposure levels and the OELs were used as the input data for the model. The simulation results show that the model distribution, called Modellierter Bewertungsindex distribution, can reproduce the BWI distribution if the data basis is homogeneous (data from one branch) and less correlated. In case of a heterogeneous data set (pooled data from different branches), the simulation results can be interpreted as generic statements about the attainable protection level. It was found that CB does not (at least potentially) guarantee compliance in either case. On the other hand, the generic simulation showed that compliance was high for volatile liquids used in closed systems (CBS: ‘hazard band C, EPL3, CS3’) and for solids in the presence of local exhaust ventilation (CBS: ‘hazard band B, EPS3, CS2’).
Evaluation of COSHH Essentials: Methylene Chloride, Isopropanol, and Acetone Exposures in a Small Printing Plant
Lee, E. G., Harper, M., Bowen, R. B., Slaven, J. Fri, 03 Jul 2009 00:00:00 -0000
The current study evaluated the Control of Substances Hazardous to Health (COSHH) Essentials model for short-term task-based exposures and full-shift exposures using measured concentrations of three volatile organic chemicals at a small printing plant. A total of 188 exposure measurements of isopropanol and 187 measurements of acetone were collected and each measurement took ~60 min. Historically, collected time-weighted average concentrations (seven results) were evaluated for methylene chloride. The COSHH Essentials model recommended general ventilation control for both isopropanol and acetone. There was good agreement between the task-based exposure measurements and the COSHH Essentials predicted exposure range (PER) for cleaning and print preparation with isopropanol and for cleaning with acetone. For the other tasks and for full-shift exposures, agreement between the exposure measurements and the PER was either moderate or poor. However, for both isopropanol and acetone, our findings suggested that the COSHH Essentials model worked reasonably well because the probabilities of short-term exposure measurements exceeding short-term occupational exposure limits (OELs) or full-shift exposures exceeding the corresponding full-shift OELs were <0.05 under the recommended control strategy. For methylene chloride, the COSHH Essentials recommended containment control but a follow-up study was not able to be performed because it had already been replaced with a less hazardous substance (acetone). This was considered a more acceptable alternative to increasing the level of control.
Ultrafine Particle Characteristics in Seven Industrial Plants
Elihn, K., Berg, P. Fri, 03 Jul 2009 00:00:00 -0000
Ultrafine particles are considered as a possible cause of some of the adverse health effects caused by airborne particles. In this study, the particle characteristics were measured in seven Swedish industrial plants, with a special focus on the ultrafine particle fraction. Number concentration, size distribution, surface area concentration, and mass concentration were measured at 10 different job activities, including fettling, laser cutting, welding, smelting, core making, moulding, concreting, grinding, sieving powders, and washing machine goods. A thorough particle characterization is necessary in workplaces since it is not clear yet which choice of ultrafine particle metric is the best to measure in relation to health effects. Job activities were given a different order of rank depending on what particle metric was measured. An especially high number concentration (130 x 103 cm–3) and percentage of ultrafine particles (96%) were found at fettling of aluminium, whereas the highest surface area concentration (up to 3800 µm2 cm–3) as well as high PM10 (up to 1 mg m–3) and PM1 (up to 0.8 mg m–3) were found at welding and laser cutting of steel. The smallest geometric mean diameter (22 nm) was found at core making (geometric standard deviation: 1.9).
Exposure to Hazardous Substances in a Standard Molecular Biology Laboratory Environment: Evaluation of Exposures in IARC Laboratories
Chapot, B., Secretan, B., Robert, A., Hainaut, P. Fri, 03 Jul 2009 00:00:00 -0000
Working in a molecular biology laboratory environment implies regular exposure to a wide range of hazardous substances. Several recent studies have shown that laboratory workers may have an elevated risk of certain cancers. Data on the nature and frequency of exposures in such settings are scanty. The frequency of use of 163 agents by staff working in molecular biology laboratories was evaluated over a period of 4 years by self-administered questionnaire. Of the agents listed, ethanol was used by the largest proportion of staff (70%), followed by ethidium bromide (55%). Individual patterns of use showed three patterns, namely (i) frequent use of a narrow range of products, (ii) occasional use of a wide range of products, and (iii) frequent and occasional use of an intermediate range of products. Among known or suspected carcinogens (International Agency for Research on Cancer Group 1 and 2A, respectively), those most frequently used included formaldehyde (17%), oncogenic viruses (4%), and acrylamide (32%). The type of exposure encountered in research laboratories is extremely diverse. Few carcinogenic agents are used frequently but many laboratory workers may be exposed occasionally to known human carcinogens. In addition, many of the chemicals handled by staff represent a health hazard. The results enabled the staff physician to develop an individual approach to medical surveillance and to draw a personal history of occupational exposures for laboratory staff.
Role of Associated Mineral Fibres in Chrysotile Asbestos Health Effects: The Case of Balangeroite
Turci, F., Tomatis, M., Compagnoni, R., Fubini, B. Fri, 03 Jul 2009 00:00:00 -0000
Objectives: To evaluate the biodurability of balangeroite, present as contaminant of chrysotile asbestos in the Balangero mine, in order to have indication whether it might have been a confounding factor in the association of the mesothelioma cases reported among mine workers and employees. Methods: The modifications taking place following incubation of the fibres in simulated phagolysosomal fluids have been measured on balangeroite, on one pure chrysotile sample (Val Malenco), on one chrysotile from Balangero with some associated balangeroite, and on two tremolite samples. Results: The incubation modifies both chrysotile and balangeroite with substantial release in the medium of the metal ions which occupy the octahedral site in the mineral structure of the fibre while tremolite is virtually unaffected. Conclusions: Considering the profound differences between the structure of balangeroite and amphiboles, previous results and observations on the poor ecopersistence of balangeroite, and the present data, we conclude that balangeroite traces may contribute to the overall toxicity of the airborne fibres in Balangero, but may not be compared to tremolite nor considered the sole responsible for the excess of mesothelioma found in Balangero.
A Survey of Occupational Exposure to 4,4'-methylene-bis (2-chloroaniline) (MbOCA) in the UK
Cocker, J., Cain, J. R., Baldwin, P., McNally, K., Jones, K. Fri, 03 Jul 2009 00:00:00 -0000
Objectives: The main objective of the study was to gather information about the current controls and levels of exposure to 4,4'-methylene-bis (2-chloroaniline) (MbOCA) in a representative cross section of workplaces that use it to manufacture polyurethane elastomers. The study also aimed to investigate whether controls and guidance could be improved and to investigate exposure to isocyanates in these workplaces using biological monitoring. Methods: An occupational hygienist and a field scientist visited the two UK suppliers and 20 out of the 25 workplaces known to be using MbOCA in the UK during 2005 and 2006. They collected air samples, surface wipes, gloves, and urine samples and made observations to assess exposure and the adequacy of controls. All samples were analysed for MbOCA and urine samples were additionally analysed for isocyanate metabolites. A statistical analysis was made of the results. Results: Only 2.5% of the 80 personal inhalation exposures to MbOCA exceeded the workplace exposure limit of 5 µg m–3 8-h time-weighted average and 84% were below the limit of detection (LOD). Surface samples (n = 334) were collected from MbOCA users and suppliers and 60% had detectable levels of MbOCA ranging from 0.019 to 400 µg cm–2. The highest levels were around a hopper, ovens, and the weighing and pouring areas. MbOCA was also detected in 8 of the 75 samples collected from areas not likely to be in contact with MbOCA. At the two suppliers, samples (n = 28) were collected from the outside surfaces of recently imported kegs, pallets, and the floor around kegs. Six samples had detectable levels and four of these (0.2, 0.8, 1, and 6 µg cm–2) were from the floor and pallets in both suppliers. The other two positive results were found on the outside rim (18 µg cm–2) and side (23 µg cm–2) of a keg at one supplier indicating contamination by the manufacturer. Urine samples (n = 79) were collected and 49% were below the LOD for MbOCA and only three samples had levels of MbOCA that exceeded the biological monitoring guidance value (BMGV) of 15 µmol mol–1 creatinine. The highest urinary MbOCA concentrations were in samples from workers casting and moulding. The 90th percentile of the urine MbOCA results was 8.6 µmol MbOCA per mol creatinine. Urine samples were also analysed for the diamine metabolites of toluene diisocyanate and hexamethylene diisocyanate and 33% had detectable levels with 22 and 13% of results, respectively, above the BMGV for isocyanates (1 µmol isocyanate-derived diamine per mol creatinine). The maximum urinary concentration of toluene diamine and hexane diamine were 15.6 and 10.1 µmol mol–1 creatinine, respectively. Conclusions: The survey found that the measures used to control exposure to MbOCA could be improved. Although air levels of MbOCA were generally low, there was evidence of spread of surface contamination and poor maintenance of controls such as local exhaust ventilation. A BMGV based on the 90th percentile of data from workplaces with good control would be less than the 90% value of 8.6 µmol mol–1 creatinine found in this study and suggests that the current BMGV of 15 µmol mol–1 creatinine is no longer acting as a stimulus to reduce exposure. The metabolites of isocyanates found in urine samples in this study could arise from inhalation exposure to isocyanates or from dermal exposure to either isocyanates or their diamine breakdown product and need further investigation.
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Measured occupational solar UVR exposures of lifeguards in pool settings
Peter Gies, Karen Glanz, David O'Riordan, Tom Elliott, Eric Nehl Wed, 01 Jul 2009 14:31:00 -0000
The aim of this study was to measure ultraviolet radiation (UVR) exposures of lifeguards in pool settings and evaluate their personal UVR protective practices.Lifeguards (n = 168) wore UVR sensitive polysulfone (PS) film badges in wrist bracelets on 2 days and completed a survey and diary covering sun protection use. Analyses were used to describe sun exposure and sun protection practices, to compare UVR exposure across locations, and to compare findings with recommended threshold limits for occupational exposure.The measured UVR exposures varied with location, ranging from high median UVR exposures of 6.2 standard erythemal doses (SEDs) to the lowest median of 1.7 SEDs. More than 74% of the lifeguards' PS badges showed UVR above recommended threshold limits for occupational exposure. Thirty-nine percent received more than four times the limit and 65% of cases were sufficient to induce sunburn. The most common protective behaviors were wearing sunglasses and using sunscreen, but sun protection was often inadequate.At-risk individuals were exposed to high levels of UVR in excess of occupational limits and though appropriate types of sun protection were used, it was not used consistently and more than 50% of lifeguards reported being sunburnt at least twice during the previous year. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Declining health insurance access among US hispanic workers: Not all jobs are created equal
Kathryn E. McCollister, Kristopher L. Arheart, David J. Lee, Lora E. Fleming, Evelyn P. Davila, William G. LeBlanc, Sharon L. Christ, Alberto J. Caban-Martinez, Jonathan P. West, John E. Clark III, Michael J. Erard Mon, 29 Jun 2009 11:49:00 -0000
Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages.Health insurance trends were analyzed by race-ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents [ge]18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n = 17,392, representing 123 million US workers on average over this 11 year period).From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%).Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners
David Rees, Jill Murray, Gill Nelson, Pam Sonnenberg Mon, 29 Jun 2009 11:50:00 -0000
Hundreds of thousands of men from rural areas of South Africa and neighboring countries have come to seek work in the gold mines. They are not immigrants in the usual sense as they work for periods in the mines, go home, and then return. This is termed oscillating or circular migration. Today we have serious interrelated epidemics of silicosis, tuberculosis, and HIV infection in the gold mining industry.This article discusses the role of oscillating migration in fuelling these epidemics, by examining the historical, political, social, and economic contexts of these diseases.The impact of silicosis, tuberculosis, and HIV infection extends beyond individual miners to their families and communities.Failure to control dust and tuberculosis has resulted in serious consequences decades later. The economic and political migrant labor system provided the foundations for the epidemics seen in southern Africa today. Am. J. Ind. Med. © 2009 Wiley-Liss, Inc.
Transfer of occupational health problems from a developed to a developing country: Lessons from the Japan-South Korea experience
Jungsun Park, Naomi Hisanaga, Yangho Kim Fri, 26 Jun 2009 10:47:00 -0000
Many corporations move their manufacturing facilities or technologies from developed to developing countries. Stringent regulations have made it costly for industries to operate in developed, industrialized countries. In addition, labor costs are high in these countries, and there is increasing awareness among the general public of the health risks associated with industry. The relocation of hazardous industries to developing countries is driven by economic considerations: high unemployment, a cheaper labor force, lack of regulation, and poor enforcement of any existing regulations make certain countries attractive to business. The transfer of certain industries from Japan to Korea has also brought both documented occupational diseases and a new occupational disease caused by chemicals without established toxicities. Typical examples of documented occupational diseases are carbon disulfide poisoning in the rayon manufacturing industry, bladder cancer in the benzidine industry, and mesothelioma in the asbestos industry. A new occupational disease due to a chemical without established toxicities is 2-bromopropane poisoning. These examples suggest that counter-measures are needed to prevent the transfer of occupational health problems from a developed to a developing country. Corporate social responsibility should be emphasized, close inter-governmental collaboration is necessary and cooperation among non-governmental organizations is helpful. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Mortality among sheet metal workers participating in a medical screening program
John Dement, Laura Welch, Elizabeth Haile, Douglas Myers Fri, 26 Jun 2009 10:47:00 -0000
The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. A study of mortality patterns among screening program participants was undertaken.A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2004. Data from the screening program included chest X-ray results by International Labour Office (ILO) criteria and smoking history. Standardized mortality ratios (SMRs) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate lung cancer risk relative to chest X-ray changes while controlling for smoking.A significantly reduced SMR of 0.83 (95% CI = 0.80-0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. Both lung cancer and COPD SMRs increased consistently and strongly with increasing ILO profusion score. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR = 1.17, 95% CI = 0.89-1.54), with a strong trend for increasing lung cancer risk with increasing ILO profusion score >0/0.Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
Mortality patterns among workers exposed to arsenic, cadmium, and other substances in a copper smelter
Gary M. Marsh, Nurtan A. Esmen, Jeanine M. Buchanich, Ada O. Youk Tue, 16 Jun 2009 10:03:00 -0000
To evaluate the long-term mortality experience of workers exposed to arsenic, cadmium, and other substances at a copper mine and smelter in Copperhill, Tennessee studied earlier as part of an industry-wide study.Subjects were 2,422 male workers employed three or more years in the smelter or mill between 1/1/46 until the plant strike and scale-down of operations in April 1996. Vital status was determined through 2000 for 99.4% of subjects and cause of death for 91.3% of 878 deaths. Historical exposures were estimated for lead, SO2, arsenic, cadmium, dust, and cobalt. We computed standardized mortality ratios (SMRs) based on U.S. and local county rates and modeled internal relative risks (RRs).We observed overall deficits in deaths based on national and local county comparisons from all causes, all cancers and most of the cause of death categories examined. We found limited evidence of increasing mortality risks from cerebrovascular disease with increasing duration and cumulative arsenic exposure, but no evidence of an exposure-response relationship for cadmium exposure and bronchitis.Our limited evidence of an association between inhaled arsenic exposure and CVD is an exploratory finding not observed in other epidemiology studies of more highly exposed occupational populations. Possible alternative explanations include chance alone and uncontrolled confounding or effect modification by co-exposures or other factors correlated with arsenic exposure and unique to the Copperhill facility. Am. J. Ind. Med. 2009 © 2009 Wiley-Liss, Inc.
International Archives of Occupational and Environmental Health
Associations between two job stress models and measures of salivary cortisol
Thu, 25 Jun 2009 06:52:59 -0000
Abstract Purpose To investigate the association between two job stress models—the job demand-control model and the effort-reward imbalance model—and repeated measures of salivary cortisol among male and female call-centre operators. Methods Daily cortisol profiles consisting of seven time points were measured across two workdays and one leisure day to determine the cortisol awakening response and the cortisol output in the day in 104 volunteers. The employees completed two self-administered questionnaire—the Karasek’s demand-control questionnaire and the Siegrist’s effort-reward imbalance questionnaire—to assess psychosocial hazards at work. The relations between the perceived workload measures and salivary cortisol levels were analyzed by means of generalized estimating equations method after adjusting for potential confounders (gender, age, educational level, marital status, morning awakening time, sleep duration and quality, weekdays, work schedule, adherence to sampling procedure). Results The total cortisol amount excreted in the awakening period was positively associated with the job strain measures (high strain vs. low strain: 1.4 (2.4–0.3) nmol/l). In contrast, individuals scoring higher in effort-reward imbalance at work had both lower cortisol awakening response (high imbalance vs. low imbalance: −0.7 (−1.3 to −0.2) nmol/l) and lower diurnal secretory activity (−9.2 (−17.7 to −0.7) nmol/l). Gender, weekday and adherence to sampling schedule significantly influenced the cortisol excretion in the morning period. Conclusions Our results indicate that the two work stress models differentially affect salivary cortisol output. This finding suggests that combining the information from two complementary job stress models results in improved knowledge on the psychobiological correlates of the psychosocial work environment. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0439-0Authors Giovanni Maina, Università di Torino Torino ItalyMassimo Bovenzi, Università di Trieste Trieste ItalyAntonio Palmas, Università di Torino Torino ItalyFrancesca Larese Filon, Università di Trieste Trieste Italy Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Letter to the Editor
Wed, 17 Jun 2009 07:05:42 -0000
Letter to the Editor Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00420-009-0435-4Authors Kathleen Kreiss, National Institute for Occupational Safety and Health (NIOSH) Division of Respiratory Disease Studies Mail Stop H2800, 1095 Willowdale Road Morgantown WV 26505 USAAnn Hubbs, National Institute for Occupational Safety and Health (NIOSH) Health Effects Laboratory Division Mail Stop L2015, 1095 Willowdale Road Morgantown WV 26505 USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance
Wed, 17 Jun 2009 07:05:41 -0000
Abstract Purpose The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol. Methods Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands. Results Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand. Conclusion Ambulance service personnel seem to be used to critical situations. There was few awareness of the “physiological” stress response indicating that stress is probably not perceived in work situations characterised by routines. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0428-3Authors Eva M. Backé, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyGerlinde Kaul, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyAndré Klußmann, University of Wuppertal (ASER e.V.) Institute of Occupational Medicine, Safety Engineering and Ergonomics Corneliusstrasse 31 42329 Wuppertal GermanyFalk Liebers, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyCarmen Thim, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin GermanyPeter Maßbeck, German Red Cross Secretariat Carstennstrasse 58 12205 Berlin GermanyUlf Steinberg, Federal Institute of Occupational Health and Safety (BAuA) Nöldnerstrasse 40-42 10317 Berlin Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Urinary 1-hydroxypyrene levels in offshore workers
Tue, 09 Jun 2009 12:44:17 -0000
Abstract Objectives To compare differences in pre- and post-shift urinary 1-hydroxypyrene (1OHP) levels as a measure of internal dose of polycyclic aromatic hydrocarbons (PAHs) between two groups of oil production workers offshore assumed to be exposed to PAH, and to compare the exposed group to an unexposed control group. Methods Participants’ (n = 42) urine samples, collected over a study period of three consecutive 12-h work days (pre-shift on the first day and post-shift on the third day), were analyzed using high performance liquid chromatography (HPLC) with fluorescence detection. Analysis of covariance was used in the statistical models. Results (1) Post-shift 1OHP levels were significantly higher in the exposed workers compared to the controls. (2) Tank workers and process operators did not show statistically significant different post-shift 1OHP levels. Conclusion Altogether, this study indicates the presence of a low level PAH exposure among offshore oil production workers. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0437-2Authors Nancy Brenna Hopf, University of Cincinnati Cincinnati OH USAJorunn Kirkeleit, University of Bergen Section for Occupational Medicine, Department of Public Health and Primary Health Care Kalfarveien 31 5018 Bergen NorwayStacy L. Kramer, University of Cincinnati Cincinnati OH USABente Moen, University of Bergen Section for Occupational Medicine, Department of Public Health and Primary Health Care Kalfarveien 31 5018 Bergen NorwayPaul Succop, University of Cincinnati Cincinnati OH USAMary Beth Genter, University of Cincinnati Cincinnati OH USATania Carreón, University of Cincinnati Cincinnati OH USAJames Mack, University of Cincinnati Cincinnati OH USAGlenn Talaska, University of Cincinnati Cincinnati OH USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Overweight and obesity among Dutch workers: differences between occupational groups and sectors
Tue, 09 Jun 2009 12:44:17 -0000
Abstract Purpose To describe the prevalence of overweight and obesity among different occupational groups and sectors in a representative sample of the Dutch working population, and to test whether these differences still exist after adjustment for socio-demographic variables. Methods Cross-sectional data among 7,588 working adults were used. Univariate analyses of variance was performed to test differences in body mass index (BMI) values between occupational groups (n = 7) and sectors (n = 28). Adjusted analyses were carried out to examine the role of socio-demographic factors in the differences in overweight and obesity between occupational groups and sectors. Results On average, the mean BMI was 24.3 kg/m2 with 31% being overweight and 6% being obese. Those working in trade, industrial, or transportation occupations as well as the legislators and senior managers had the highest BMI and a relatively high prevalence of overweight (36.7 and 35.5%, respectively) and obesity (6.9 and 7.5%, respectively). In contrast, those working in scientific and artistic professions had the most favorable BMI profile with 25.7% being overweight and 4.2% being obese. After adjusting for sex, age, and education, the proportion of variance changed from about 0.01 to 0.10 with age being the main contributor of the differences in overweight and obesity. Conclusions BMI profile and prevalence of overweight and obesity differs between occupations and sectors. Despite the differences are explained partly by socio-demographic factors, based on a given distribution of age, sex, and education within each occupational group and sector, occupational group- and sector-specific strategies to prevent and reduce overweight are recommended. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0438-1Authors Karin I. Proper, EMGO Institute for Health and Care Research, VU University Medical Center Department of Public and Occupational Health Amsterdam The NetherlandsVincent H. Hildebrandt, TNO Quality of Life Leiden The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Does sickness presenteeism have an impact on future general health?
Sat, 06 Jun 2009 10:02:49 -0000
Abstract Purpose The primary aim of this prospective study was to investigate whether working despite illness, so called “sickness presenteeism”, has an impact on the future general health of two different working populations during a follow-up period of 3 years. Methods The study was based on two bodies of data collected at a number of Swedish workplaces from 1999 to 2003. The first material comprised 6,901 employees from the public sector and the second 2,862 subjects from the private sector. A comprehensive survey was issued three times: at baseline, after 18 months and after 3 years. Apart from the explanatory variable sickness presenteeism, several potential confounders were considered. The outcome variable was good/excellent versus fair/poor self-reported health. Results Sickness presenteeism at baseline was consistently found to heighten the risk of fair/poor health at both the 18-month and 3-year follow ups even after adjusting for the detected confounders. Conclusions To the best of the authors’ knowledge, this study is the first to show that sickness presenteeism appears to be an independent risk factor for future fair/poor general health. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-009-0433-6Authors Gunnar Bergström, Karolinska Institutet Division of Intervention and Implementation Research, Department of Public Health Sciences 171 77 Stockholm SwedenLennart Bodin, Karolinska Institutet Division of Intervention and Implementation Research, Department of Public Health Sciences 171 77 Stockholm SwedenJan Hagberg, Karolinska Institutet Section for Personal Injury Prevention, Department of Clinical Neuroscience Stockholm SwedenTomas Lindh, Stockholm County Council Department of Occupational and Environmental Health, Centre for Public Health Stockholm SwedenGunnar Aronsson, Stockholm University Department of Psychology Stockholm SwedenMalin Josephson, Uppsala University Section of Occupational and Environmental Medicine, Department of Medical Sciences Uppsala Sweden Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Occupational Therapy International
Unilateral and bilateral upper extremity weight-bearing effect on upper extremity impairment and functional performance after brain injury
Timothy Reistetter, Beatriz C. Abreu, Jane Bear-Lehman, Kenneth J. Ottenbacher Tue, 23 Jun 2009 04:04:00 -0000
The purpose of the study was to investigate the effect of upper extremity (UE) weight bearing on UE impairment functional performance of persons with acquired brain injury (BI).A quasi-experimental design was used to examine a convenience sample of 99 persons with acquired BI and 22 without BI (WBI) living in a community re-entry centre. A computerized force-sensing array pressure map system was used to determine the UE pressure during unilateral and bilateral conditions. Differences between groups were examined using t-tests. Correlations were computed between UE weight bearing and hand function, and functional performance as measured by the Fugl-Meyer scale and functional independence measure (FIM) scale.The group of people with BI exerted significantly lower UE weight bearing during unilateral conditions as compared with persons WBI [left: t (119) = 2.34, p = 0.021; right: t (119) = 4.79, p = 0.043). UE weight-bearing measures correlated strongly with FIM motor scores with bilateral UE conditions yielded the highest significant correlation (bilateral left r = 0.487, p < 0.001; bilateral right r = 0.469, p < 0.01).The results indicated that UE weight-bearing pressure differs in unilateral and bilateral conditions, between persons with and WBI and between persons with stroke and traumatic brain injury. These findings may have implications for occupational therapists that use unilateral versus bilateral motor training for rehabilitation.There is a need to replicate the study design with a randomized and stratified sample of persons with BI. Copyright © 2009 John Wiley & Sons, Ltd.
Occupational therapy and neuromotor interventions
Gerry E. Conti Wed, 10 Jun 2009 09:13:00 -0000
No abstract.
A review of bilateral training for upper extremity hemiparesis
Mary Ellen Stoykov, Daniel Corcos Wed, 10 Jun 2009 09:13:00 -0000
Upper extremity hemiparesis is the most common post-stroke disability. Longitudinal studies have indicated that 30-66% of stroke survivors do not have full arm function 6 months post-stroke. The current gold standard for treatment of mild post-stroke upper limb impairment is constraint-induced therapy but, because of the inclusion criteria, alternative treatments are needed which target more impaired subjects. Bilateral arm training has been investigated as a potential rehabilitation intervention. Bilateral arm training encompasses a number of methods including: (1) bilateral isokinematic training; (2) mirror therapy using bilateral training; (3) device-driven bilateral training; and (4) bilateral motor priming. Neural mechanisms mediating bilateral training are first reviewed. The key bilateral training studies that have demonstrated evidence of efficacy will then be discussed. Finally, conclusions are drawn concerning clinical implications based on the reviewed literature. Copyright © 2009 John Wiley & Sons, Ltd.
Occupational Medicine - current issue
OCCUPATIONAL MEDICINE CALENDAR
Tue, 26 May 2009 00:00:00 -0000
In this issue of Occupational Medicine
Beach, J. Tue, 26 May 2009 00:00:00 -0000
Consensus on work-related asthma
Tarlo, S. M., Rowe, B., Liss, G. M., Lemiere, C., Beach, J. Tue, 26 May 2009 00:00:00 -0000
pubmed: 0355-3140
Attributable risk of carpal tunnel syndrome in the general population: implications for intervention programs in the workplace.
Roquelaure Y, Ha C, Fouquet N, Descatha A, Leclerc A, Goldberg M, Imbernon E Related Articles Attributable risk of carpal tunnel syndrome in the general population: implications for intervention programs in the workplace. Scand J Work Environ Health. 2009 Jul 2; Authors: Roquelaure Y, Ha C, Fouquet N, Descatha A, Leclerc A, Goldberg M, Imbernon E OBJECTIVE: Carpal tunnel syndrome (CTS) represents one of the most significant and costly health problems occurring in the working population. An estimation of the potential impact of CTS prevention programs in the workplace would be useful for public policy. The aim of this study was to assess the work-related population-attributable fraction (PAF) of CTS in industrial sectors and occupational categories at high risk of CTS in the general population. METHODS: All cases of CTS occurring in patients living in a French region were included prospectively between 2002-2004. Using a mailed questionnaire, we gathered medical and occupational history from 815 women and 320 men. We calculated the age-adjusted relative risks and PAF of CTS in relation to industrial sectors and occupational categories. RESULTS: The PAF for women was higher in lower-grade, white-collar workers (24%, 95% CI 19-29) than blue-collar workers (19%, 95% CI 15-22). The PAF was higher for the service industries sector (16%, 95% CI 8-22) than manufacturing (10%, 95% CI 7-13) or agricultural (5%, 95% CI 3-7) sectors. The PAF was high for men in blue-collar workers (50%, 95% CI 41-57) and in the construction (13%, 95% CI 9-18) and manufacturing industries (17%, 95% CI 10-23). CONCLUSION: The study suggested that 5-50% of CTS cases might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industrial sectors. PMID: 19572088 [PubMed - as supplied by publisher]
Annals of Occupational Hygiene - current issue
How Safe is Control Banding? Integrated Evaluation by Comparing OELs with Measurement Data and Using Monte Carlo Simulation
Tischer, M., Bredendiek-KAmper, S., Poppek, U., Packroff, R. Fri, 03 Jul 2009 00:00:00 -0000
The present study aims to explore the protection level that can be achieved by the German control banding (CB) tool Einfaches Massnahmenkonzept Gefahrstoffe, ‘Easy-to-use workplace control scheme for hazardous substances’. The rationale of our integrated approach is based on the Bewertungsindex (BWI), which is the quotient of the exposure level and the occupational exposure limit (OEL), with BWI <1 indicating compliance. The frequency distributions of the BWI were calculated in order to reflect statistically the variability of workplace conditions. The corresponding statistical values of the frequency distributions (percentiles etc.) are interpreted as an indicator of the level of protection that is achieved. The occupational exposure data sets used in the calculation of the BWI frequency distribution were mainly collected from Bundesanstalt für Arbeitsschutz und Arbeitsmedizin field studies. The data sets taken into account were selected according to the criteria ‘hazard band, exposure potential, control approach’. Such a combination is called the ‘control banding scenario’ (CBS). Measurement data are only available for two CBS: in the case of the CBS ‘hazard band A, EPL3, CS1’ the only data that are available (n = 220) relate to propane-2-ol as used in the area of offset printing. Only 0.4 % of the BWI are above 1, this indicating a high level of compliance. In the case of the CBS ‘Hazard band B, EPL2, CS1’, exposure data are available from screen-printing firms (n = 50), optician workshops (n = 49), and from the area of furniture production (n = 13). The frequency distributions of the BWI reveal almost no instances of values being exceeded in the three branches. In a subsequent step, a Monte Carlo Simulation was employed to explore whether the BWI frequency distributions can be generalized using a probabilistic model. The frequency distributions of the exposure levels and the OELs were used as the input data for the model. The simulation results show that the model distribution, called Modellierter Bewertungsindex distribution, can reproduce the BWI distribution if the data basis is homogeneous (data from one branch) and less correlated. In case of a heterogeneous data set (pooled data from different branches), the simulation results can be interpreted as generic statements about the attainable protection level. It was found that CB does not (at least potentially) guarantee compliance in either case. On the other hand, the generic simulation showed that compliance was high for volatile liquids used in closed systems (CBS: ‘hazard band C, EPL3, CS3’) and for solids in the presence of local exhaust ventilation (CBS: ‘hazard band B, EPS3, CS2’).
Evaluation of COSHH Essentials: Methylene Chloride, Isopropanol, and Acetone Exposures in a Small Printing Plant
Lee, E. G., Harper, M., Bowen, R. B., Slaven, J. Fri, 03 Jul 2009 00:00:00 -0000
The current study evaluated the Control of Substances Hazardous to Health (COSHH) Essentials model for short-term task-based exposures and full-shift exposures using measured concentrations of three volatile organic chemicals at a small printing plant. A total of 188 exposure measurements of isopropanol and 187 measurements of acetone were collected and each measurement took ~60 min. Historically, collected time-weighted average concentrations (seven results) were evaluated for methylene chloride. The COSHH Essentials model recommended general ventilation control for both isopropanol and acetone. There was good agreement between the task-based exposure measurements and the COSHH Essentials predicted exposure range (PER) for cleaning and print preparation with isopropanol and for cleaning with acetone. For the other tasks and for full-shift exposures, agreement between the exposure measurements and the PER was either moderate or poor. However, for both isopropanol and acetone, our findings suggested that the COSHH Essentials model worked reasonably well because the probabilities of short-term exposure measurements exceeding short-term occupational exposure limits (OELs) or full-shift exposures exceeding the corresponding full-shift OELs were <0.05 under the recommended control strategy. For methylene chloride, the COSHH Essentials recommended containment control but a follow-up study was not able to be performed because it had already been replaced with a less hazardous substance (acetone). This was considered a more acceptable alternative to increasing the level of control.
Ultrafine Particle Characteristics in Seven Industrial Plants
Elihn, K., Berg, P. Fri, 03 Jul 2009 00:00:00 -0000
Ultrafine particles are considered as a possible cause of some of the adverse health effects caused by airborne particles. In this study, the particle characteristics were measured in seven Swedish industrial plants, with a special focus on the ultrafine particle fraction. Number concentration, size distribution, surface area concentration, and mass concentration were measured at 10 different job activities, including fettling, laser cutting, welding, smelting, core making, moulding, concreting, grinding, sieving powders, and washing machine goods. A thorough particle characterization is necessary in workplaces since it is not clear yet which choice of ultrafine particle metric is the best to measure in relation to health effects. Job activities were given a different order of rank depending on what particle metric was measured. An especially high number concentration (130 x 103 cm–3) and percentage of ultrafine particles (96%) were found at fettling of aluminium, whereas the highest surface area concentration (up to 3800 µm2 cm–3) as well as high PM10 (up to 1 mg m–3) and PM1 (up to 0.8 mg m–3) were found at welding and laser cutting of steel. The smallest geometric mean diameter (22 nm) was found at core making (geometric standard deviation: 1.9).
Exposure to Hazardous Substances in a Standard Molecular Biology Laboratory Environment: Evaluation of Exposures in IARC Laboratories
Chapot, B., Secretan, B., Robert, A., Hainaut, P. Fri, 03 Jul 2009 00:00:00 -0000
Working in a molecular biology laboratory environment implies regular exposure to a wide range of hazardous substances. Several recent studies have shown that laboratory workers may have an elevated risk of certain cancers. Data on the nature and frequency of exposures in such settings are scanty. The frequency of use of 163 agents by staff working in molecular biology laboratories was evaluated over a period of 4 years by self-administered questionnaire. Of the agents listed, ethanol was used by the largest proportion of staff (70%), followed by ethidium bromide (55%). Individual patterns of use showed three patterns, namely (i) frequent use of a narrow range of products, (ii) occasional use of a wide range of products, and (iii) frequent and occasional use of an intermediate range of products. Among known or suspected carcinogens (International Agency for Research on Cancer Group 1 and 2A, respectively), those most frequently used included formaldehyde (17%), oncogenic viruses (4%), and acrylamide (32%). The type of exposure encountered in research laboratories is extremely diverse. Few carcinogenic agents are used frequently but many laboratory workers may be exposed occasionally to known human carcinogens. In addition, many of the chemicals handled by staff represent a health hazard. The results enabled the staff physician to develop an individual approach to medical surveillance and to draw a personal history of occupational exposures for laboratory staff.
Role of Associated Mineral Fibres in Chrysotile Asbestos Health Effects: The Case of Balangeroite
Turci, F., Tomatis, M., Compagnoni, R., Fubini, B. Fri, 03 Jul 2009 00:00:00 -0000
Objectives: To evaluate the biodurability of balangeroite, present as contaminant of chrysotile asbestos in the Balangero mine, in order to have indication whether it might have been a confounding factor in the association of the mesothelioma cases reported among mine workers and employees. Methods: The modifications taking place following incubation of the fibres in simulated phagolysosomal fluids have been measured on balangeroite, on one pure chrysotile sample (Val Malenco), on one chrysotile from Balangero with some associated balangeroite, and on two tremolite samples. Results: The incubation modifies both chrysotile and balangeroite with substantial release in the medium of the metal ions which occupy the octahedral site in the mineral structure of the fibre while tremolite is virtually unaffected. Conclusions: Considering the profound differences between the structure of balangeroite and amphiboles, previous results and observations on the poor ecopersistence of balangeroite, and the present data, we conclude that balangeroite traces may contribute to the overall toxicity of the airborne fibres in Balangero, but may not be compared to tremolite nor considered the sole responsible for the excess of mesothelioma found in Balangero.
A Survey of Occupational Exposure to 4,4'-methylene-bis (2-chloroaniline) (MbOCA) in the UK
Cocker, J., Cain, J. R., Baldwin, P., McNally, K., Jones, K. Fri, 03 Jul 2009 00:00:00 -0000
Objectives: The main objective of the study was to gather information about the current controls and levels of exposure to 4,4'-methylene-bis (2-chloroaniline) (MbOCA) in a representative cross section of workplaces that use it to manufacture polyurethane elastomers. The study also aimed to investigate whether controls and guidance could be improved and to investigate exposure to isocyanates in these workplaces using biological monitoring. Methods: An occupational hygienist and a field scientist visited the two UK suppliers and 20 out of the 25 workplaces known to be using MbOCA in the UK during 2005 and 2006. They collected air samples, surface wipes, gloves, and urine samples and made observations to assess exposure and the adequacy of controls. All samples were analysed for MbOCA and urine samples were additionally analysed for isocyanate metabolites. A statistical analysis was made of the results. Results: Only 2.5% of the 80 personal inhalation exposures to MbOCA exceeded the workplace exposure limit of 5 µg m–3 8-h time-weighted average and 84% were below the limit of detection (LOD). Surface samples (n = 334) were collected from MbOCA users and suppliers and 60% had detectable levels of MbOCA ranging from 0.019 to 400 µg cm–2. The highest levels were around a hopper, ovens, and the weighing and pouring areas. MbOCA was also detected in 8 of the 75 samples collected from areas not likely to be in contact with MbOCA. At the two suppliers, samples (n = 28) were collected from the outside surfaces of recently imported kegs, pallets, and the floor around kegs. Six samples had detectable levels and four of these (0.2, 0.8, 1, and 6 µg cm–2) were from the floor and pallets in both suppliers. The other two positive results were found on the outside rim (18 µg cm–2) and side (23 µg cm–2) of a keg at one supplier indicating contamination by the manufacturer. Urine samples (n = 79) were collected and 49% were below the LOD for MbOCA and only three samples had levels of MbOCA that exceeded the biological monitoring guidance value (BMGV) of 15 µmol mol–1 creatinine. The highest urinary MbOCA concentrations were in samples from workers casting and moulding. The 90th percentile of the urine MbOCA results was 8.6 µmol MbOCA per mol creatinine. Urine samples were also analysed for the diamine metabolites of toluene diisocyanate and hexamethylene diisocyanate and 33% had detectable levels with 22 and 13% of results, respectively, above the BMGV for isocyanates (1 µmol isocyanate-derived diamine per mol creatinine). The maximum urinary concentration of toluene diamine and hexane diamine were 15.6 and 10.1 µmol mol–1 creatinine, respectively. Conclusions: The survey found that the measures used to control exposure to MbOCA could be improved. Although air levels of MbOCA were generally low, there was evidence of spread of surface contamination and poor maintenance of controls such as local exhaust ventilation. A BMGV based on the 90th percentile of data from workplaces with good control would be less than the 90% value of 8.6 µmol mol–1 creatinine found in this study and suggests that the current BMGV of 15 µmol mol–1 creatinine is no longer acting as a stimulus to reduce exposure. The metabolites of isocyanates found in urine samples in this study could arise from inhalation exposure to isocyanates or from dermal exposure to either isocyanates or their diamine breakdown product and need further investigation.
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