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Contributions of occupational hazards and human factors in occupational injuries and their associations with job, age and type of injuries in railway workers.

OBJECTIVES: To assess the contributions of environmental hazards, technical dysfunctions, lack of work organization, know-how and job knowledge, and other human factors in occupational injuries and their relationships with job, age and type of accidents in railway workers. METHODS: The sample included 1,604 male workers, having had at least one occupational injury with sick leave during a 2-year period in voluntary French railway services. A standardized questionnaire was filled in by the person-in-charge of prevention, with the injured worker. Data analysis was performed via the chi(2) independence test and adjusted odds ratios (OR) with Mantel-Haenszel test. RESULTS: The environmental hazards were implicated in 24.7%, technical dysfunctions in 16.0%, lack of work organization in 13.7%, lack of know-how in 17.6%, lack of job knowledge in 5.2%, and the other human factors in 31.9% of occupational injuries. The injuries caused by lack of know-how or job knowledge were more represented in workers aged less than 30 (ORs adjusted for job 1.45, 95% CI 1.02-2.06 and 2.06, 1.22-3.49, respectively), those by environmental hazards in energy and electrical traction maintenance operators and train drivers (ORs adjusted for age 2.04, 1.16-3.58 and 1.80, 1.01-3.20, respectively), and those by lack of work organization in mechanical maintenance operators and in energy and electrical traction maintenance operators (ORs adjusted for age 2.24, 1.13-4.45 and 1.83, 1.30-2.57, respectively). The causes considered were strongly related with the type of injuries. CONCLUSIONS: This study found that environmental hazards, technical dysfunctions, lack of work organization, lack of knowledge and other human factors had important contributions in injuries, and they were related to job, age and type of injuries. These findings are useful for prevention. Training is necessary for young workers. The occupational physician could help the workers to be more aware of the risks.

Adult↗

Occupational obstructive disorders: nonspecific airways obstruction and occupational asthma.

Airways obstruction as a result of occupational exposure may be divided into two categories on the basis of whether or not occupational asthma is present. The first category, nonspecific airways obstruction, takes place in the absence of occupational asthma, and demonstrates only modest changes in airways responsiveness. The second category, occupational asthma, usually has a causal relationship to exposure, and demonstrates marked changes in airways responsiveness. These distinctions are of use in diagnosis, treatment, and disability assessment.

Asthma↗

A prospective study of fatal occupational accidents -- relationship to sleeping difficulties and occupational factors.

Very little is known about the association between sleep and (fatal) occupational accidents. This study investigated this relationship using register data of self-rated sleep difficulties, together with occupational and demographic characteristics. The variables were related to subsequent occupational fatal accidents. A national sample of 47,860 individuals was selected at regular intervals over a period of 20 years, and interviewed over the phone on issues related to work and health. The responses were linked to the cause of death register (suicides excluded) and the data set was subjected to a (multivariate) Cox regression survival analysis. One hundred and sixty six fatal occupational accidents occurred, and the significant predictors were: male vs. female: relative risk (RR)=2.30 with a 95% confidence interval (CI) of 1.56-3.38; difficulties in sleeping (past 2 weeks): RR=1.89 with CI=1.22-2.94; and non-day work: RR=1.63 with CI=1.09-2.45. No significant effect was seen for age, socio-economic group, hectic work, overtime (>50 h per week), or physically strenuous work. It was concluded that self-reported disturbed sleep is a predictor of accidental death at work, in addition to non-day work and male gender.

Accidents, Occupational↗

Evaluation of professional competency in occupational hygiene in Canada--the CRBOH program. Canadian Registration Board of Occupational Hygienists.

The Canadian Registration Board of Occupational Hygienists (CRBOH) was established in 1986 to provide a registration system for professional occupational hygienists in Canada. It was decided that registration would be based on a competency examination following an appropriate combination of academic qualification and relevant professional experience. While the examination was being developed hygienists who met certain educational and experience requirements and who held other certifications by examination (such as those of the American Board of Industrial Hygiene, the British Examining and Board in Occupational Hygiene, or the Conseil d'Accrediation en Hygiene Industrielle du Quebec) were registered. In 1989 CRBOH, after much deliberation and review of other existing certification examinations, selected a two-part scheme consisting of both written and oral examinations. The written examination includes both multiple choice and essay style questions. Only those candidates successfully completing the written examination are eligible for the oral examination. The first group of candidates was examined in the fall of 1990. The authors outline the strengths and weaknesses of various forms of evaluation of professional competency. The rationale for the selection of the CRBOH examination format is discussed in relation to forms of evaluation currently being used in the United States and the United Kingdom. The implication of CRBOH registration on the training and education of occupational hygienists in Canada is highlighted.

Canada↗

Adverse work and environmental conditions predict occupational injuries. The Israeli Cardiovascular Occupational Risk Factors Determination in Israel (CORDIS) Study.

This study was designed to test whether the total objective adverse work and environmental conditions, expressed as the ergonomic stress level (ESL), would predict occupational injuries over a 2-year period. The study population consisted of 4,096 men from 21 factories in six industrial sectors who were studied as part of the Israeli Cardiovascular Occupational Risk Factors Determination in Israel (CORDIS) Study, 1985-1987. The ESL (assigned four levels, 1-4) was based on an ergonomic assessment which covered 17 risk factors pertaining to safety hazards, overcrowding, cognitive and physical demands, and environmental stressors. The ESL was found to be a highly reliable measure and stable over a period of 2-4 years. The incidence of injuries among workers in low ESL conditions (level 1) was 10.3%. It increased with higher ESL's: 11.7% in level 2 (relative risk (RR) = 1.13, 95% confidence interval (CI) 0.86-1.50); 21.6% in level 3 (RR = 2.09, 95% CI 1.68-2.62); and 23.8% in level 4 (RR = 2.31, 95% CI 1.85-2.88). After adjustment for age, job experience, educational level, managerial status, and occupational status (white/blue collar), injury occurrence was significantly elevated for those at level 3 (adjusted odds ratio (OR) = 1.46, 95% CI 1.12-1.91) and level 4 (adjusted OR = 1.81, 95% CI 1.39-2.37) but not for level 2 (adjusted OR = 0.87, 95% CI 0.65-1.18). The authors conclude that adverse work and environmental conditions, objectively assessed, can predict occurrence of occupational injuries.

Accidents, Occupational↗

Lichen planus in relation to occupational and non-occupational exposure to chemicals.

Lichen planus-like eruptions are known to be caused by occupational exposure to colour film developing agents that are derivatives of p-phenylenediamine (PPDA), e.g. CD-2 and CD-3. To elucidate whether such chemicals are a cause of lichen planus in patients at a department of general dermatology, 119 lichen planus patients were interviewed about occupational and non-occupational exposure to chemicals. Patch testing with CD-2, CD-3, PPDA and IPPD was performed in 49. No occupational risk group for lichen planus could be identified and no case of contact allergy to the tested substances was found. Patch testing with these substances is only recommended when there is a history of exposure.

Adolescent↗

Collaborative fieldwork education with student occupational therapists and student occupational therapist assistants.

The profession of occupational therapy has a long history of working collaboratively with support personnel. This paper describes the process of a fieldwork education partnership developed between the McMaster University, BHSc (OT) Program and the Mohawk College, Occupational Therapist Assistant and Physical Therapist Assistant Program. Eight student occupational therapists and eight student occupational therapist assistants learned together in a variety of fieldwork settings, either in pairs or in groups. Both groups of students kept weekly journals of the experience and completed a post placement questionnaire. The journals were inductively analysed using a retrospective content analysis. The four emergent themes identified from the data are learning about each other's role, collaborative learning, impact on client care and future practice, and resistance to roles. Recommendations for future collaborations are discussed.

Adult↗

[Mental health in software engineers. II. Classification of occupational stressors, and relationship between occupational stressors and psychiatric disorders].

Occupational stressors and psychiatric disorders were studied in a sample of 101 male software engineers. Psychiatric diagnosis was based on DSM-III (Diagnostic and Statistical Manual of Mental Disorders, Third Edition). The results can be summarized as follows: 1) More than 30% of the subjects were not satisfied with their work. 2) Occupational stressors ascertained in the interview could be classified into "quantity of job," "quality of job," "role in organization," "relations with others," "work conditions," "career development," "reward," "organizational structure and climate," "low social support," and "lack of decision making." "quality of job" (35%), "quantity of job" (30%), and "role in organization" (33%) were the most common stressors for the subjects. 3) Among the occupational stressors, only "quantity of job" was significantly related to psychiatric disorders (p less than 0.05). The results suggest that many software engineers are not satisfied with their work and that "quantity of job" has the greatest influence on their mental health. Some measures should be taken to avoid potential health hazards, for the research findings indicate a relationship between occupational stressors and mental health in software engineers.

Adult↗

Occupational hepatitis C virus infection in Italian health care workers. Italian Study Group on Occupational Risk of Bloodborne Infections.

The risk of exposed health care workers in 16 Italian hospitals becoming infected with hepatitis C virus was assessed through two serosurveys at a 1-year interval and at follow-up. Prevalence, which was 2.2%, was significantly associated with previous acute hepatitis, blood transfusions, housekeeping, and older age (> 46 years) but not with occupational risk factors. After 1 year, 2622 (87%) of the 3006 seronegative health care workers were retested, and 3 (0.1%), who did not acknowledge occupational or community risk factors, seroconverted. Additionally, 133 (97 needlesticks) out of 370 reported occupational exposures were to hepatitis C virus; one pricked nurse seroconverted (0.75%). Although the risk is not negligible, hepatitis C virus infection does not seem to be easily occupationally transmitted.

Adult↗

Comparison of performance in materials-based occupation, imagery-based occupation, and rote exercise in nursing home residents.

Materials-based occupation, imagery-based occupation, and rote exercise have been examined individually by several researchers. The present study compares all three approaches with one another (i.e., kicking a balloon, imagining kicking a balloon, and a control rote exercise) in nursing home residents. The dependent variable was the number of exercise repetitions. The subjects were 12 women and 3 men between 56 and 93 years of age residing in two nursing homes. All subjects experienced the three approaches but in different orders. One-way analysis of variance for related measures indicated a significant difference among conditions (p = .004). The Tukey procedure (Stevens, 1986) determined that the materials-based occupation condition elicited significantly more repetitions than the other two conditions. The difference between the imagery-based occupation and rote exercise was not statistically significant. These findings support our profession's historical emphasis on the use of physical materials to enhance performance.

Activities of Daily Living↗

Influence of the U.S. military and occupational therapy reconstruction aides in World War I on the development of occupational therapy.

The development of occupational therapy was heavily influenced by an early evolved relationship between orthopedists and reconstruction aides during the first World War. Orhopedists were largely responsible for both the presence of occupational therapy in the war and the eventual acceptance (by army personnel) of women fulfilling this military function. As a result of gender issues of that time--characterized by a dearth of employment opportunities for women and by a general resistance to women in military roles--this affiliation with orthopedists in World War I served to promote occupational therapy within the military environment. This affiliation also marked an early willingness by occupational therapists to accept the medical model as one guide for clinical practice.

Female↗

Position paper on the role of occupational therapy in adult physical dysfunction. The Canadian Association of Occupational Therapists.

When an adult suffers from trauma or a condition that results in physical impairment or dysfunction, independence in daily living tasks may be affected. The occupational therapist's perspective and expertise lies in the assessment and treatment of the individual's function/dysfunction in the occupational performance areas of self-care, productivity and leisure. Assessment and treatment is carried out within the context of the individual's lifestage and environment. The occupational therapist facilitates the individual to assume a reasonable degree of responsibility for the rehabilitation process. Through the use of specific treatment approaches and techniques, occupational therapy intervention assists adults with physical dysfunction to restore function, develop new skills, develop adapted techniques, and maintain existing skills.

Adult↗

[Causes of occupational allergy in dental nurses. An analysis based on the material collected at The Institute of Occupational Medicine in Lódź].

The causes of occupational dermatosis were analysed in 27 dental nurses examined at The Nofer Institute of Occupational Medicine during the years 1995-99. Contact sensitisation (at least one positive epidermal test) was found in 18 subjects (66.7%). Occupational allergic dermatitis was induced most frequently by: glutaraldehyde (7 positive patch tests), nickel (7), benzalkonium (4), formaldehyde (4), fragrances (4), chromium compounds (3), glyoxal (3), and thiuram (3). In the authors' opinion, dental nurses are nowadays sensitised to other chemical compounds than it used to be in the past. The present components of disinfectants (aldehydes, quaternary ammonium bases), metals and rubber are the major etiologic agents that induce occupational allergy.

Adult↗

Occupational stress and psychiatric illness in the military: investigation of the relationship between occupational stress and mental illness among military mental health patients.

OBJECTIVE: This was a pilot study aimed at gathering preliminary data on the relationship between occupational stress and mental illness among military personnel. The primary goal of this study was to determine to what extent military mental health patients report suffering from significant occupational stress. METHODS: Eighty-five active duty military mental health outpatients at the Wilford Hall U.S. Air Force Medical Center mental health clinic answered a 65-item survey that included items on the perception of occupational stress and reported life changes. Participation in this cross-sectional study was anonymous, voluntary, and random. The 85 participants represent 83% of those surveyed and approximately 10% of the clinic's total population of military mental health outpatients. The survey incorporated the 43-item Schedule of Recent Experiences (SRE). By adding the weighted values assigned to the 43 items, each respondent was given an SRE score, which is a measure of overall stress that has been shown to be predictive of future illnesses. RESULTS: A majority (60%) reported suffering from significant work stress. A majority (52%) reported that work stress was causing them significant emotional distress. Almost half (42.5%) reported that work stress was a significant contributor to the onset of their mental illness. The average SRE score for all respondents was 266, reflecting increased risk for future illnesses. Generic work stressors were endorsed more frequently than military-specific stressors. CONCLUSIONS: The results reveal that this population of military mental health clinic outpatients perceived that work stress had a strong negative effect on their emotional health. These results raise the possibility that work stress could be a significant occupational health hazard in the U.S. military, a possibility that warrants further investigation. By gathering additional data on the relationship between work stress and emotional health in the military, interventions can be planned to mitigate the effect of stress caused by the military work environment on the mental health of military personnel.

Adult↗

[Occupational exposure to asbestos and recognition of pleural mesothelioma as occupational disease in the province of Genoa].

The present study compares the data of pleural mesothelioma (PM) patients resident in the province of Genoa (Italy) who, in the period 1994-1996, applied to the Italian National Insurance Institute for Work Accident (INAIL), for workers' compensation for asbestos-related diseases due to occupational exposure, with the dataset of PM patients collected by the Mesothelioma Registry of Liguria (REM) in the same period and in the same area. As PM is a malignant tumor of a prevalently occupational origin, it is recognized and acknowledged as such by INAIL when clinical and etiological characteristics are matched. Objectives of this study were to describe observed PM cases, to evaluate completeness of collected data and differences between those who requested compensation and those who did not. The REM describes the incidence of PM among Ligurian residents, proposing patients with a specific questionnaire to assess occupational, environmental and indoor asbestos exposures. The REM collected 199 new cases of PM among the residents of both the city of Genoa (1994-96) and the province of Genoa (1995-96). In the same period, INAIL received 48 (24%) applications for compensation. Among these, 43 subjects were included in a subgroup of 98 patients registered in the REM as cases with definite diagnosis and ascertained asbestos exposure; 32 were awarded compensation, while 11 are under evaluation. The data collected by REM do not show proven asbestos exposure and/or PM diagnosis for five other subjects (two compensated and three under judgment). This study reveals that: a) only a 24% of the patients with a diagnosis of PM and asbestos exposure apply for compensation; b) an exchange of information among institutions involved in primary prevention, in the evaluation of occupational exposures to carcinogens and in insurance compensation is useful.

Aged↗

[Experience of cooperation between Occupational Diseases Department in the Rostov State Medical University and Occupational Diseases Center with Health Ministry Department of the Rostov region].

Over 35 years Occupational Diseases Department in Rostov State Medical University works cooperatively with Occupational Diseases Center with Health Ministry Department of Rostov region. The article deals with experience of this cooperation in occupational therapists training, in qualification courses for professional improvement, in writing scientific and methodic materials, in carrying research work based on the Occupational Center facilities.

Catchment Area, Health↗

[Occupational injuries in Oslo: a study of occupational injuries treated by the Oslo Emergency Ward and Oslo Ambulance Service].

BACKGROUND: There is little reliable information about the incidence and severity of occupational injuries in Norway. MATERIAL AND METHODS: Occupational injuries occurring at worksites in Oslo and treated by Oslo Emergency Ward or Oslo Ambulance Service were recorded over a period of three months. Patients with serious injuries were interviewed about the accident. RESULTS: 1153 injury incidents were registered, 229 (20%) of which were considered serious. Median age of patients was 32 years. Estimated annual incidence of injuries at worksites in Oslo treated by Oslo Emergency Ward/Oslo Ambulance Service was 14 per 1000 employees, for all injuries in Oslo requiring treatment, 20 per 1000 employees. Men had three times the incidence of women. The incidence was highest in the youngest age groups. Of those with serious injuries, 30% had a non-Scandinavian language as their first language. Electricians, carpenters and police officers had the highest observed incidences. 87 injuries (8%) were caused by violence. INTERPRETATION: The incidence of occupational injuries in Oslo is reduced by about 40% since the 1970s. There is, however, no reduction for women. Construction workers are still at high risk. Workers of non-Scandinavian origin are also at high risk, probably because of selection into high-risk occupations. The injury register provides a good overview, but in-depth studies are needed to identify specific risk factors.

Accidents, Occupational↗

[Occupational and non-occupational effects of asbestos].

Forty-eight cases of mesothelioma from the National Cancer Register, and 19 cases of pleural plaques were investigated for non-occupational exposure to asbestos, and compared with results obtained in earlier studies on occupational asbestos-induced lesions. The results of the investigation confirmed reports in the literature indicating that even in the non-occupational area, asbestos represents a non-negligible risk, in particular for diseases of the lungs. Individual causes proved to be the cleaning by members of the family of working clothes contaminated with asbestos in 46% of the cases, followed by the use of asbestos-containing materials in the household (20.9%) or in connection with leisure activities (14.9%). In addition, exposure to asbestos fibre emissions of people living close to an asbestos-processing plant were observed. Recognition of the condition as an occupation-related disease is not possible. The consequence to be drawn from these data is that, in accordance with present regulations, the use of asbestos-free materials in the home and in the area of leisure activities must be promoted. In this way, such lesions can be avoided in the future.

Air Pollutants, Occupational↗