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PubMed1990

Occupational carbamate pesticide intoxication in three farm workers. Implications and significance for occupational health in Jamaica.

The importance of occupational health practice principles in the delivery of health care to the working population is stressed by the authors' management of an incident of occupational pesticide poisoning. The clinical management of the patients involved, as well as the occupational and environmental health management of that incident, is discussed. An illustrative case report is used to describe an occurrence of carbofuran pesticide poisoning in three female farm workers in Jamaica. This report highlights the implications and significance of this incident in terms of the sensitivity of the medical profession to similar occupational health problems.

Adult↗
PubMed1989

[Consequences from key technologies for content and profile of skilled worker occupations as well as for the occupational fitness of youths].

Nearly 85% of youths start their professional life with vocational training. New technologies almost make an increase of contents as well as integration of functions in existing occupations without lost of traditional abilities and skills. New vocational contents make one's way into curriculi of all occupations in different way, only 15 professions get a new profile. Representations about origin of many new profession in consequence of new technologies didn't come true in science and practice. Conclusions for occupational fitness and medical health care of youths follow various demands to physical and psychic fitness under rising chances of development the individuality. We need more knowledge about psychic performance of healthy and disadvantaged youth, when we will use the health-promotive potential of occupations.

Adolescent↗
PubMed2005

Comparison of asbestos exposure assessments by next-of-kin respondents, by an occupational hygienist, and by a job-exposure matrix from the National Occupational Hazard Survey.

BACKGROUND: Assessments of occupational exposures in case-control studies of rapidly fatal illnesses often rely on data from next-of-kin respondents, which may be inaccurate. METHODS: Three methods for assessing exposure to asbestos from case-control data on mesothelioma, including next-of-kin assessment, expert assessment, and use of a generic job-exposure matrix (JEM). Interview data [Spirtas et al. (1994): Occup Environ Med 51:804-811] were reviewed to determine exposure status by an occupational hygienist (C.R.) who was unaware of disease status. Exposure odds ratios were calculated using standard methods, and measures of agreement included the kappa statistic and conditional and marginal odds ratios. RESULTS: Expert assessment detected higher proportions of exposed subjects than the next-of-kin respondents or JEM methods. The disease-exposure odds ratios were highest for respondents, perhaps because of recall bias, and lowest for the JEM method. The agreement was highest between the respondent and expert assessments. A combination of respondent's assessment and JEM assessment led to the best prediction of the expert's assessment. Results for spouse respondents were similar to those for other "next-of-kin" respondents. CONCLUSIONS: Expert assessments were the most plausible, but the data indicate that disease associations could also be detected with the other exposure assessment methods. Using some combination of the proxy respondent's assessment and the JEM assessment, one can predict the expert's assessment. A strategy that relied on the respondent's assessment when it was positive and otherwise obtained an expert assessment could reduce costs with little error, compared to expert assessment on all subjects.

Adult↗
PubMed1992

Occupational lead exposure in Los Angeles County: an occupational risk surveillance strategy.

To better understand occupational lead exposures in Los Angeles County, we undertook a questionnaire survey of lead-using industrial facilities not previously identified by county health department staff. Previously our staff had identified 112 lead-using companies with approximately 2,000 lead-exposed workers countywide. For this survey, we developed a database of 1,353 possible lead-using industrial facilities from several sources, including community "right-to-know" databases, air pollution or sewer permit records, or other environmental databases. A questionnaire interview was completed with 1,001 (81%) of these companies, yielding 178 previously unidentified facilities employing 7,734 workers with potentially significant occupational lead exposures. Compliance with the OSHA lead standard was often poor in these facilities, particularly for workplaces with 20 or fewer employees. Devoting more public health resources to targeted identification of such industrial facilities and to educational outreach would likely help control occupational lead exposure.

Air Pollutants, Occupational↗
PubMed1992

Reasons for participating in occupational therapy groups: perceptions of adult psychiatric inpatients and occupational therapists.

Little is known about the attitudes of psychiatric patients towards the specific role of occupational therapy within the overall context of hospital-based treatment. The present study examined this issue by asking 102 adult psychiatric inpatients to indicate their reasons for participating in an occupational therapy group programme, and comparing their responses to those of 31 occupational therapists. Both groups gave high ratings to "reasons for participation" that were related to the achievement of positive therapeutic outcomes, although therapists rated these items significantly higher. The patients, on the other hand, gave higher ratings than therapists to items related to escaping the hospital routine (e.g., "to decrease boredom"), and to achieving "secondary gains" (e.g., to get passes to leave the hospital). The results emphasize the importance of preparing patients for participation in therapy groups in order to enhance the therapeutic value of these experiences.

Adult↗
PubMedDate not supplied

National Institute for Occupational Safety and Prevention (ISPESL): role in occupational health and safety.

The article explains the role of the Italian National Institute for Occupational Safety and Prevention (ISPESL), a public research body dealing with occupational and environmental health. Its organization, institutional roles, activities, facilities, and resources are outlined. Especially important is ISPESL's participation in national and international occupational safety and health networks. The Institute is active in epidemiologic surveillance of workers exposed to physical, chemical, and biological hazards.

Accidents, Occupational↗
PubMed1989

The role of occupational health clinics in surveillance of occupational disease.

Academic occupational health centers can support state-based occupational disease surveillance by playing a role in case identification and management, physician education, workplace investigation, and surveillance case criteria development. The existing centers can also serve as models for developing new clinics. As plans for developing surveillance continue, the role of these centers should be explicitly defined, and they should be included in helping to develop mechanisms for reporting. In all these ways, the centers can significantly enhance the development of a national surveillance system for occupational disease.

Education, Medical↗
PubMed1990

Sentinel Health Events (Occupational): analysis of death certificates among residents of Nassau County, NY between 1980-82 for occupationally related causes of death.

Death certificates for residents of Nassau County, New York dying between 1980 and 1982 were examined for causes of death defined as Sentinel Health Events (Occupational) (SHE(O]. Of 16,193 deaths from all causes, 2,286 (14.1 percent) were identified as SHE(O) deaths; 142 (6.2 percent) of these were matched for occupational and/or industry, 13 (9.2 percent) of which required no further match [corrected] because the cause of death was inherently related to the occupation or industry. Malignant neoplasms of the trachea, bronchus, or lung were the most frequently occurring SHE(O), accounting for 60 percent of all SHE(O) deaths and 81 percent of matched SHE(O) deaths. The construction industry was associated with the vast majority of such deaths.

Adolescent↗
PubMed1999

[Significance of the label "risk duplication" in occupational medicine expert opinion and redefinition of occupational diseases].

Referring to scientifically well-founded epidemiological statistical parameters for characterising probabilities of causal relationships, a critical assessment is given of the use of the parameter 'doubling risk' in research and expert evidence in occupational medicine. When assessing single cases, the attainment of this frequency level can serve as an appropriate additional argument for assuming a corresponding relationship; but even if lower frequency levels are attained, such a relationship cannot be excluded. In addition to the statistical data, any conspicuous features from the occupational history and from the course of the disease must be included in the analysis. In the investigation of causal relationships, the exclusive consideration of research results with enhanced frequencies dose to the doubling risk value would imply an illegitimate neglect of existing important information and would thus possibly lead to a misjudgement of the real situation. In the author's opinion, this would also result in set-backs both in legislation concerning occupational diseases and in the realm of labour protection.

Germany↗
PubMed2001

Training of occupational physicians in The Netherlands with regard to occupational health services delivered to the population.

In the Netherlands, the need for a basically new approach to education and training in occupational medicine was felt by professionals, students, schools and occupational health services (OHS) in the early 1990s. After an inventory of the problems and shortcomings of the traditional curriculum, the Netherlands School of Occupational Health defined the framework for a new curriculum. In this article the background, principles and structure of the new curriculum are described. Three principles shape the curriculum: the needs of OHS; professional standards; and the state-of-the-art. The characteristics of the new curriculum are: interaction between theory and practice; students' self-management of the learning process; co-makership with OHS; and multidisciplinarity. The curriculum consists of a course/theory and a practical part. Most of the theoretical part is presented to so called core group of 12 students, which is to be maintained during the full course period of 4 years. The adage for the practical part to be spent in a certified OHS institution is: "the best teaching OHS are learning OHS". In 1999, the first group of students entered the renewed curriculum. First impressions of the experience gained are presented.

Curriculum↗
PubMedDate not supplied

[Dermatomycoses as occupational diseases. The causative agents, sources of infection and the involved occupations].

Fungal diseases of the skin can be occupational dermatoses. This applies in particular to diseases due to microorganisms acquired from animals. A discussion of the relationship between occupation and disease, however, is not only pertinent in regards to dermatophytoses due to zoophilic fungi but also with those due to geophilic and--to a certain extent--even anthropophilic ones. The same is true of candidiasis. The present review deals with the various standpoints concerning the role of occupation in the development of cutaneous mycoses. In addition casuistic evidence for the various types disease, is compiled and discussed.

Arthrodermataceae↗
PubMed1987

[Occupational medicine insight into the problem of occupational stress in the construction industry].

According to the present study, in addition to the high accident rate, work in the building trade is characterized by intense muscle strain and constrained physical posture. In bricklaying, for example, a worker moves by hand up to seven tons of stone per shift. Consequently, various health complaints occur far more frequently in this occupation than in the other occupational groups, for instance, back complaints (71%), severe fatigue (58%), pain in the arms and hands (42%), headache (40%) and leg pain (34%). The most complained of factors include effects of the weather (74%), draft (50%), noise (55%), air pollution via dust (53%), skin contact with dirt and harmful substances (47%), moving heavy objects by hand (53%), adverse posture during work (47%), and a high risk of accidents (47%). Besides technical and organizational measures, the prevention of health impairments in employees in the building trade should be promoted by purposive care by works services of occupational medicine.

Accidents, Occupational↗
PubMed1996

[Pregnancy and occupational environment. Counseling of pregnant women in the department of occupational medicine during the period 4 January--31 December 1992].

Since the new Sickness and Maternity Benefit Act was introduced in Denmark 1981, it has been possible to provide maintenance allowance for pregnant women working under conditions that might be harmful to the unborn child. The assessment of the risk is primarily undertaken by the general practitioner, but in cases of doubt, the pregnant women can be referred to the Department of Occupational Medicine. The assessment at the Department of Occupational Medicine is made one or two weeks after referral. It consists of a careful work history, which includes characterization of exposure, both qualitatively and quantitatively and a decision whether the exposure entails a risk to the foetus and which steps should be taken for the rest of the pregnancy. The purpose of this study was to describe the practice of risk assessment at the Department of Occupational Medicine in Denmark. Over a period of nine months all cases of pregnant women referred to 12 out of 14 departments were reviewed. Out of 60,000 births per year only 250 pregnant women were referred, which is less than 1%. Main risk factors in the assessment were of chemical (80%) or ergonomic (17%) origin. Forty-three percent were advised to leave work on maintenance allowance and 15% were advised to stay at work, on condition that the work environment was changed or they could be moved to a job without risk exposure. The study revealed big differences in referral incidence between the different counties as well as differences in risk assessment practice. It is concluded, that the best way to secure pregnant women and their foetus is by primary prophylactic measures at the workplace. Hopefully the new EU Directive 92/85 will be a step in that direction.

Counseling↗
PubMed2004

Reducing occupation-based disparities related to tobacco: roles for occupational health and organized labor.

BACKGROUND: Persistent and growing occupation-based disparities related to tobacco pose a serious public health challenge. Tobacco exacts a disproportionate toll on individuals employed in working class occupations, due to higher prevalence of smoking and exposure to secondhand smoke among these workers compared to others. METHODS: We provide an overview of recent advances that may help to reduce these disparities, including research findings on a successful social contextual intervention model that integrates smoking cessation and occupational health and safety, and a new national effort to link labor unions and tobacco control organizations around their shared interest in reducing tobacco's threat to workers' health. CONCLUSIONS: Implications of these efforts for future research and action are discussed.

Health Priorities↗
PubMed2005

Pesticide exposure of non-occupationally exposed subjects compared to some occupational exposure: a French pilot study.

Data about non-dietary exposure to different chemical classes of pesticides are scarce, especially in France. Our objective was to assess residential pesticide exposure of non-occupationally exposed adults, and to compare it with occupational exposure of subjects working indoors. Twenty unexposed persons, five gardeners, seven florists and nine veterinary workers living in Paris area were recruited. Nineteen residences, two greenhouses, three florist shops and three veterinary departments were then sampled. Thirty-eight insecticides, herbicides and fungicides were measured in indoor air with an air sampler for 24 h, and on hands by wiping them with isopropanol-wetted swabs. After extraction, samples were analysed by gas and high-performance liquid chromatography. Seventeen different pesticides were detected at least once in indoor air and twenty-one on the hands. An average of 4.2+/-1.7 different pesticides was detected per indoor air sample. The organochlorines lindane, alpha-endosulfan and alpha-HCH were the most frequently detected compounds, in 97%, 69% and 38% of the samples, respectively. The organophosphates dichlorvos and fenthion, the carbamate propoxur and the herbicides atrazine and alachlor were detected in more than 20% of the air samples. Indoor air concentrations were often low, but could reach 200-300 ng/m(3) in residences for atrazine and propoxur. Propoxur levels significantly differed between the air of veterinary places and other places (Kruskal-Wallis test, p<0.05) and dieldrin levels between residences and workplaces (p<0.05). There was a greater number of pesticides on hands than in air, with an average of 6.3+/-3.3 different pesticides detected per sample, the most frequently detected being malathion, lindane and trifluralin, in more than 60% of the subjects. Maximal levels (up to 1000-3000 ng/hands) were observed either in the general population or in workers, depending on the pesticide. However, no significant difference was observed between workers and general population handwipe pesticide levels. As expected, gardeners were exposed to pesticides sprayed in greenhouses. Florists and veterinary workers, whose pesticide exposure had not been described until now, were also indirectly exposed to pesticides used for former pest control operations. Overall, general population was exposed to more various pesticides and at levels sometimes higher than in occupational places. The most frequent pesticides in residences were not the same as in US studies but levels were similar. These preliminary results need to be confirmed in a greater number of residences from different parts of the country, in order to better assess pesticide exposure of the general population and its influencing factors.

Acetamides↗
PubMed2006

Occupational health nursing practice in Australia: what occupational health nurses say they do and what they actually do.

This study investigated current activities of occupational health nurses (OHN) in Australia related to the applicability of and their involvement in emergent role, wellness-based practices and traditional role and illness-based practices. A questionnaire encompassing the eight Areas of Practice as articulated by the Australian College of Occupational Health Nursing (ACOHN) competency standards was used to obtain data from 93 OHNs affiliated with ACOHN. More traditional role Areas of Practice such as treatment services, health assessment and rehabilitation services were seen as more applicable to their practice and a substantial amount of time was spent on them. Managing occupational health and safety (OH&S) service' was the only emergent area that was a substantial part of the OHN's role. Less time was devoted to other emergent and pro-active areas of OHN practice, such as illness and injury prevention, health promotion, health education and research into OH&S. While less time was allocated to emergent Areas of Practice, and they were ranked more lowly they were considered to be applicable to practice. The findings of this study suggest that OHNs in Australia may not be engaging fully in all Areas of Practice that have been articulated by the ACOHN, particularly emergent role activities. Although Australian OHNs perform all the activities articulated in the ACOHN Areas of Practice, their focus is still primarily illness and injury based, and also management. While the profession is supportive of emergent role activities, there is a need to debate possibilities, undertake research into barriers and supports for emergent role activities, more clearly articulate future directions for the OHN role, and develop strategies to support OHNs as they develop their professional role.

Adult↗