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PubMed2004

[An assessment of the occupational risk in the occupational medicine: principles, methods, and criteria].

The methodology related with the occupational risk in the medical sphere, which was elaborated with due respect to the WHO and ILO concepts and to the experience of other countries, is described in the paper. It comprises the following: hygienic assessment criteria, classification of labor conditions, methods of structures' analysis, occupational risk categories as well as etiology-and-genesis analysis of the relation "labor conditions--health impairments" and evaluation of the relation "health impairment--occupation" etc. The categories of occupational risk are substantiated according to medical-and-biological parameters. The methodology could contribute to implementing the new labor protection legislation.

Humans↗
PubMed1990

[Occupational medicine in the XXI century--the role and tasks of the Institute of Occupational Medicine in Lódź].

The article presents strategy and goals of study program in occupational health for the years 1991-1995. Five strategy lines and corresponding to them goals have been determined. These are: (1) Development and implementation of detailed programmes for preventing the main occupational and work-related diseases causing the substantial social-economic losses to limit health effects induced by occupational exposure; (2) Development, integration and improvement of chemical safety system to limit environmental exposure to chemicals and to reduce health consequences due to living and working environment pollution with chemicals; (3) Development and implementation of methods of psychophysical effort load evaluation, methods of proper vocational selection and principles of preventive action to limit work strenuosness and changes in health status induced by process and organization of work; (4) Increasing the effectiveness and extension of health care and preventive activities for national economy workers; (5) Development and practical implementation of modern programmes of training in occupational health (under- and postgraduate) together with preparing didactic aids and scientific-technical information. The last line of study programme will be preceded by discussion taking into account the currently available financial means and scientific facilities.

Academies and Institutes↗
PubMedDate not supplied

[Occupational health and the Prevention of Occupational Hazards Act].

A description is given of the main problems currently involved in matters concerning the prevention of occupational hazards, the basic contents of the recently passed Prevention of Occupational Hazards Act (Ley 31/1995), and the challenges that this law pose for the unions, employers, public administration, professionals in prevention and insurance companies for matters concerning occupational hazards and occupational illnesses.

Accidents, Occupational↗
PubMed2000

Selected topics related to occupational exposures. Part V. Occupational cardiovascular disease

Cardiovascular disease is common in the United States. Several occupational exposures, such as carbon disulfide and organic nitrates, are believed to cause occupational cardiovascular disease. In addition some other agents, such as lead and cadmium, may indirectly cause cardiovascular disease through their effects on blood pressure. For other agents (ie, carbon monoxide, solvents, and chlorofluorocarbons), acute exposure and high levels may cause cardiovascular disease but may not cause cardiovascular disease through long-term or low levels. A primary care physician who has a patient with a new or unstable cardiovascular disease should obtain an occupational history to assess whether occupational exposures may be playing a role. An occupational history may indicate potential cardiovascular risks. Such risks can include exposure to certain chemicals and metals, physical factors, exertion, or psychological stress. The primary care physician should be able to assess the situation and advise the patient, as well as the employer, about restrictions or accommodations that may need to be made.

Journal Article↗
PubMed2002

Self-reported hand and wrist arthritis and occupation: data from the U.S. National Health Interview Survey-Occupational Health Supplement.

BACKGROUND: There is a paucity of population-based studies examining occupational hand-wrist arthritis. We examined relationships between hand-wrist arthritis, occupation, and biomechanical exposures in the U.S. National Health Interview Survey-Occupational Health Supplement. METHODS: A randomized, multi-stage, and cross-sectional national prevalence survey was carried out. RESULTS: Self-reported, medically attended hand-wrist arthritis was common among employed persons (period prevalence 1.58%; lifetime prevalence 3.58%). Highest prevalences occurred among technicians, machine operators, assemblers, and farmers, and in the mining, agriculture, and construction industries. Work requiring repetitive hand bending and twisting was associated with hand-wrist arthritis (Odds Ratio 1.43; 95%CI: 1.11-1.84; P = 0.005). Among workers with hand arthritis, 7.4% had made major changes in their work, 7.6% missed work, and 4.5% stopped working or changed jobs because of the problem. CONCLUSIONS: Our study links hand-wrist arthritis to occupation and potentially modifiable workplace ergonomic factors. The spectrum of hand-wrist "cumulative trauma" disorders may considerably exceed that of soft-tissue injuries like carpal tunnel syndrome and tendonitis, and may include arthritis, a widely prevalent, disabling condition.

Arthritis↗
PubMed1991

The Occupational Cancer Incidence Surveillance Study (OCISS): risk of lung cancer by usual occupation and industry in the Detroit metropolitan area.

This case-referent study assesses occupational risk factors associated with lung cancer, utilizing colon and rectum cancer referents. Complete occupational and tobacco use histories were obtained by telephone interview for 5,935 incident lung cancer cases and 3,956 incident colon and rectum cancer referents. The analysis included 43 usual occupational groups and 48 usual industry groups comprised of at least 10 cases. Among all cases, there were significant elevated risks for excavating and mining workers (OR = 4.01), furnace workers (OR = 3.11), armed services personnel (OR = 3.10), agricultural workers (OR = 2.05), driver sales (OR = 2.21), mechanics (OR = 1.72), painters (OR = 1.96), and drivers (OR = 1.88). Industries with significant elevated lung cancer risk included farming (OR = 2.21), mining (OR = 2.98), and primary ferrous metals manufacturing (OR = 2.43). Analyses of white and black men separately revealed that the excess of lung cancer among mechanics is restricted to black males (OR = 4.16). The risk of lung cancer among armed services personnel is higher among black men (OR = 10.54) than among white men (OR = 3.06). Five of the occupations observed more often among lung cancer cases have probable exposure to diesel exhaust.

Adult↗
PubMed1997

Exposure assessment in occupational epidemiology: measuring present exposures with an example of a study of occupational asthma.

The aim of the present paper is to present a comprehensive review of the issues involved in exposure assessment for occupational epidemiology studies and to provide an example. Exposure assessment for occupational epidemiology studies is becoming more quantitatively refined. This paper discusses important issues that need to be taken into account for exposure assessment, with particular reference to occupational asthma. It discusses issues such as survey design, data collection, the effect of measurement error and data interpretation. It presents recently developed methodology to evaluate exposure variability and its effect on the attenuation of risk estimates. It also presents methodology to control for such variability. It uses examples from a recent cohort study of flour millers and bakers. This example shows various characteristics of exposure and demonstrates that various measures of exposure, such as peak and full-shift exposure measurements, are regularly correlated, which has consequences for the analyses of exposure-response relationships. This paper stresses the importance of the recognition and evaluation of exposure variability and its effect on risk estimates and shows that with different exposure grouping schemes, different health risk estimates can be obtained. Quantitative exposure assessment is generally difficult, time-consuming and expensive and many issues need to be taken into account, but it can be rewarding and has become an absolute necessity for many occupational epidemiology studies. Evaluation of components of exposure variance is absolutely necessary. Exposure variability could lead to serious attenuation of risk estimates.

Asthma↗
PubMed2006

Environmental and biological monitoring of exposure to organophosphorus pesticides: application to occupationally and non-occupationally exposed adult populations.

The purpose of the study was to assess non-dietary exposure of workers and the general population in the Paris area to some organophosphorus (OP) pesticides. In total, 21 workers from different occupational places (two greenhouses, three florist shops and three veterinary departments) and 20 subjects assumed to be non-occupationally exposed were recruited. Indoor air, hand wipes, and three first morning urine samples were collected. Seven OPs were measured by GC/ECD and GC/TSD, and six urinary dialkylphosphate metabolites by GC/PFPD. All indoor air samples from the workplaces and only one-third of the samples from the residences contained at least one of the seven OPs. However, almost all participants were dermally exposed to OPs. Total OP indoor air and cutaneous levels were significantly higher for workers than for the general population (air median = 185 pmol/m3 versus nondetectable, P < 0.0001; hands median = 1250 pmol/hands versus 475 pmol/hands, P = 0.03). From the air, gardeners and florists were mainly exposed to methyl-OPs and veterinary staff to ethyl-OPs (mainly diazinon). From their hands, all subjects were exposed to methyl-OPs, with gardeners and florists exposed to somewhat but not significantly higher levels. Ethyl-OPs were more found frequently and at higher levels on the hands of veterinary workers. Total OP levels in indoor air and from hand wipes were significantly correlated (Spearman R = 0.34, P = 0.03). DAP detection frequencies and levels were not different between workers and the general population (workers median=168 nmol/g creat and general population median = 241 nmol/g creat, P = 0.31), and did not correlate with air or hand levels. Subjects not occupationally exposed showed significant residential exposure to OPs, more frequently from their hands than from the air. Different occupations were associated with different exposure profiles and levels. The lack of differences in DAP levels between the different groups of exposure suggests that dietary exposure to OP residues and exposure to other OPs are involved.

Adult↗
PubMed2005

School staff members' and occupational health nurses' evaluation of the promotion of occupational well-being - with good planning to better practice.

This paper describes occupational health nurses' and school staff members' experiences of work ability maintenance carried out at schools and the development of ideas to promote the collaboration between occupational health care and school community and to enhance work ability maintenance. The data were collected in a baseline situation of an action research project to further plan and develop activities. The data were analysed by inductive content analysis. According to the results, school community staff members' work ability maintenance focused on the employee, the school community, school work and the working conditions as well as professional competence. The practical actions involved some individual and school-specific variation, focusing on actions to maintain individual and physical work ability. It seems that the collaboration between the school community and occupational health service for work ability maintenance took place at the individual level, but an obvious need for more structural collaboration emerged by several suggestions made by the participants (e.g. better information exchange between the school and occupational health care, improved collaboration between the school staff and the co-operative partners). The progress in collaboration may lead towards spontaneous collaboration, in which case both actors have the same target and work in a planned, continuous and natural way to ensure work ability maintenance in the school community.

Cooperative Behavior↗
PubMed2000

ACOEM position statement. Spirometry in the occupational setting. American College of Occupational and Environmental Medicine.

This position statement reviews several aspects of spirometric testing in the workplace, where spirometry is employed in the primary, secondary, and tertiary prevention of occupational lung disease. Primary prevention includes pre-placement and fitness-for-duty examinations as well as research and monitoring of health status in groups of exposed workers; secondary prevention includes periodic medical screening of individual workers for early effects of exposure to known occupational hazards; and tertiary prevention includes clinical evaluation and impairment/disability assessment. For all of these purposes, valid spirometry measurements are critical, requiring: documented spirometer accuracy and precision, a rigorous and standardized testing technique, standardized measurement of pulmonary function values from the spirogram, adequate initial and refresher training of spirometry technicians, and, ideally, quality assessment of samples of spirograms. Interpretation of spirometric results usually includes comparison with predicted values and should also evaluate changes in lung function over time. Response to inhaled bronchodilators and changes in relation to workplace exposure may also be assessed. Each of these interpretations should begin with an assessment of test quality and, based on the most recent ATS recommendations, should rely on a few reproducible indices of pulmonary function (FEV1, FVC, and FEV1/FVC.) The use of FEF rates (e.g., the FEF25-75%) in interpreting results for individuals is strongly discouraged except when confirming borderline airways obstruction. Finally, the use of serial PEF measurements is emerging as a method for confirming associations between reduced or variable pulmonary function and workplace exposures in the diagnosis of occupational asthma. Throughout this position statement, ACOEM makes detailed recommendations to ensure that each of these areas of test performance and interpretation follow current recommendations/standards in the pulmonary and regulatory fields. Submitted by the Occupational and Environmental Lung Disorder Committee on November 16,1999. Approved by the ACOEM Board of Directors on January 4,2000.

Female↗
PubMed1992

[The methodological characteristics of calculating the prevented economic loss from disability resulting from occupational diseases in assessing the activities of occupational pathology centers].

Evaluation of prevented economic detriment from the occupational disablement can be used for estimating the economic efficiency of occupational centre activities. Decreased disability pensions as a main item of expenses must be taken into account in evaluation of prevented economic detriment due to the diminished disablement. Regional occupational pathology centre activities aimed at the early diagnosis of complications-free occupational diseases, complete clinical screening, active treatment and control of the adequate employment give a great social and economic effect.

Cost-Benefit Analysis↗
PubMed1992

[Occupational hygiene of railway transport workers as a specific branch of occupational medicine].

Occupational hygiene of the railway transport is a well defined sphere of knowledge. It is closely connected with the general occupational medicine and yet occupies a significant place in the railway medicine. Occupational medicine of the railway transport is based on results of sciences connected with each other and at the same time it serves for the favourable research is included sciences, such as occupational physiology and hygiene pathology, sanitary technics, chemistry, acoustics et al.

Humans↗
PubMedDate not supplied

[Use of statistics in occupational medicine. Analysis of papers presented at the national congresses of the Italian Society of Occupational Medicine and Industrial Hygiene].

The statistical methods used in occupational health studies were evaluated by analyzing the papers published from 1986 to 1990 in the proceedings of the annual meetings of the Italian Society of Occupational Medicine and Industrial Hygiene, in order to calculate the degree of understanding of the readers provided with only one-sided knowledge of statistical subjects and to improve the educational objectives in postgraduate schools of occupational health. Almost 70% of the 1151 articles reviewed contained some kind of statistical analysis: methods more complicated than descriptive statistics were used in about 35%. Student's t test (15%) and chi square (12%) were the most common methods. Other methods were less frequently used, so that it was possible to estimate that the learning of any new method would improve the understanding of about 1-2% of the articles. A wider use of statistical methods in data analysis is recommended; the attainment of a higher level of statistical knowledge should be a priority target in occupational health training.

Education, Medical, Graduate↗
PubMed1990

A model for occupational injury surveillance by occupational health centers.

Injuries account for more than 90% of the reported work-related health problems in the United States. However, a complete and standardized reporting system for occupational injuries does not exist in this country. This paper describes the first year's experience of a clinic-based occupational injury surveillance system involving occupational medicine clinics. During 1988, health and hazard information was collected on 14,156 work-related admissions. An analysis of these cases showed that most patients received care for minor trauma, with 78.4% of the cases classified as cuts or lacerations, sprains or strains, or contusions. Overall, 53.8% of the cases were caused by metal items, boxes, machines, or working surfaces. These preliminary results support the feasibility of conducting clinic-based occupational injury surveillance as a means of assisting employers with the control of work-related conditions.

Adult↗
PubMed1977

[Prognosis of occupational bronchial asthma after change of occupation and elimination of antigen (author's transl)].

In order to eliminate the antigen, 168 patients with metal dust allergy made a complete change of occupation, The number of those who were rehabilitated after change of occupation was in inverse proportion to the duration of exposure to the antigen. Subjects with persistent bronchial asthma showed an increase in the complaints which corresponded to the antigen exposure. So as to be able to detect secondary developments deriving from the allergic changes in the mucous membrane, a few parameters were examined after the change of occupation for their relationship to the duration of exposure. Such relationships were found for secondary inflammatory processes in the airways (detection of pathogenic organisms in the sputum, concomitant sinusitis and pleural residues from inflammatory processes). The duration of exposure to the antigen also affects the frequency of persistently increasing bronchospastic irritability after change of occupation.

Asthma↗
PubMed1980

An occupation and exposure linkage system for the study of occupational carcinogenesis.

Studies of the adverse effects of occupational exposures are most informative when jobs can be classified according to the specific chemical or physical agents involved. However, information sufficiently detailed to permit this is not often available. In such instances a study usually will be based on subjects classified according to industry or task, effectively ignoring the specific agents to which exposure occurred. Such crude classification tends to reduce or obscure associations between specific exposures and disease. In response to this problem, the authors have developed an occupation and exposure linkage system with particular reference to carcinogenesis. Occupations were classified by industry and by task within the industry. Lists of suspect carcinogens were developed and each suspect carcinogen was linked to industries and tasks in which it has been used. These links make it possible to place in the same exposure category all study subjects whose employment history suggests contact with a particular agent. Epidemiologic analysis then can be based on chemical and physical exposures, rather than on industries or tasks. The linkage system enhances the value of information on occupation obtained from death certificates, cancer registries, medical records, and questionnaires.

Amines↗
PubMed1993

[Occupational and occupationally determined diseases].

Medical definitions of occupational and professionally conditioned pathology are given in the article together with relevant examples. With the view to account appropriately occupational pathology in accordance with its severity classification based on the degree of working capacity loss is presented. Notions of acute occupational disease (intoxication) and professional accident are determined. International list of occupational diseases is considered. Suggestions intended at promotion of safe working conditions are made on perfection of the Ukrainian list.

Absenteeism↗
PubMed1997

Association of occupational and non-occupational risk factors with the prevalence of self-reported carpal tunnel syndrome in a national survey of the working population.

To compare the association of occupational versus personal, nonoccupational risk factors with the prevalence of carpal tunnel syndrome (CTS), data from the 1988 National Health Interview Survey, Occupational Health Supplement, were analyzed. When both occupational factors (bending/twisting of the hands/wrists [B/T] and use of hand-held vibrating tools) and personal nonoccupational factors (gender, race, age, body mass index [BMI], smoking, education, and family income) were included in a multivariate logistic regression model, adjusted odds ratios (AORs) of these factors for reporting medically called CTS (MC-CTS) were: exposure to B/T, 5.5; exposure to vibration, 1.9; white race, 16.7; female gender, 2.3; BMI > or = 25, 2.0; history of cigarette smoking, 1.6; age > or = 40, 1.2; education > 12 years, 1.2; and annual family income > or = $20,000, 1.5. Although both occupational and nonoccupational factors are associated with reporting of CTS, repetitive bending/twisting of the hands/wrists and use of vibrating tools remain important risk factors for work-related carpal tunnel syndrome.

Adult↗