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PubMed1995

Risk of hepatitis C seroconversion after occupational exposures in health care workers. Italian Study Group on Occupational Risk of HIV and Other Bloodborne Infections.

BACKGROUND: To determine the incidence of hepatitis C virus (HCV) seroconversion, health care workers reporting an occupational exposure with blood or other risk-prone body materials from a patient known to be seropositive for HCV antibody were enrolled. METHODS: HCV seroconversion within 6 months of a reported exposure was assessed by second-generation enzyme immunoassay and immunoblot assay. RESULTS: From January 1992 through December 1993, 331 (51%) hollow-bore needlesticks, 105 (16.5%) suture needle or sharp object injuries, 85 (13%) mucous membrane contaminations, and 125 (19.5%) skin contaminations were reported. Four HCV seroconversions were observed after hollow-bore needlesticks (1.2%; 95% CI 0.3% to 3.0%); no seroconversions occurred after other routes of exposure. Blood-filled needlesticks and source patient coinfection with HIV appeared to be associated with a higher risk of seroconversion. CONCLUSIONS: The risk of HCV seroconversion after occupational exposure appears to be low but is not negligible. Aggressive implementation of universal precautions is important for preventing risk-prone exposure, but safer devices are also needed.

Adolescent↗
PubMed1993

Expectation and evaluation of occupational health nursing services, as perceived by occupational health nurses, employees and employers in the United Kingdom.

A structured questionnaire was used to investigate the relationship between expectation and evaluation of occupational health nursing services as perceived by providers (nurses) and receivers (employers and employees) in the United Kingdom. The response rate was 66.55% (254) from nurses, 51.32% (194) from employees and 44.97% (170) from employers. Data from 144 triads of nurse, employer and employee were used to test 13 null hypotheses, which were all rejected. The strong positive correlation between nurses', employers' and employees' expectations and evaluations indicates that, on the whole, their expectations were met. However, there were differences in the extent to which this was so and the level of expectation varied between groups. Nurses perceived themselves as not meeting their high expectations as well in non-traditional (care-supportive) as in traditional (care-orientated) services. On the whole, employers had significantly lower expectations than nurses, except in the area of care and treatment. Employees had high expectations of preventive services, but their lower evaluations indicate that these were not met. Discussion of these and other findings suggests that employers need education on the value and scope of occupational health nursing, and a model may assist nurses' conceptual understanding of it.

Adult↗
PubMed1980

Adjustment of occupational exposure limits for seasonal occupations.

A previously reported model for predicting adjustments to permissible exposure limits has been extended to include adjustments for seasonal occupations. On the basis of the model, no "credit" (i.e., increase in exposure limits) may be allowed for a short work season unless the biological half-life in hours of the agent of concern is greater than 38 W, in which W is the number of weeks in the work season. Modifications to PELs due to the longer work-days and work-weeks often associated with seasonal occupations are incorporated into a general equation for estimating PEL adjustments. The adjustments assume no additional exposures the remainder of the year, and so do not apply to workers who merely move to other parts of the country and continue in a similar "seasonal" job.

Air Pollutants↗
PubMed2005

The Occupational Medicine agenda: routes and standards of specialization in Occupational Medicine in Europe.

BACKGROUND: This paper reports on the nature of specialist training in occupational medicine (OM) in Europe from a survey of representatives from the Occupational Medicine section of the European Union of Medical Specialists/Union Européenne des Médecins Spécialistes (UEMS). AIMS: To analyse current differences existing in the education and training requirements to become a specialist in OM in UEMS countries. METHODS: Cross-sectional survey of representatives from 14 European countries. RESULTS: While undergraduate training duration varied slightly, there is marked variation in postgraduate training for OM in UEMS countries. The countries surveyed outlined concerns for the funding of training, continuing professional development, research requirements and recruitment to the specialty. CONCLUSION: There is a marked variation in postgraduate training in OM throughout UEMS countries. The variation between postgraduate training programmes is not consistent with UEMS charter requirements and because of national regulation purposes presents a barrier to the movement of migrant professionals within Europe. This study serves as a focus for further research into training routes and standards of specialization in OM in Europe.

Cross-Cultural Comparison↗
PubMed2006

A family of statistical distributions for modelling occupational radiation doses in low dose occupations.

New statistical distributions have been defined to describe occupational exposures to ionising radiation. These distributions are particularly useful in modelling occupations where most doses are low. The maximum likelihood method was used for parameter estimation and has been adapted to allow doses that are recorded as zero to be included in the calculations. The method can then be applied to estimate true doses from the complete set of recorded dose values when the a priori dose distribution and the dose measurement distributions have been derived previously. This application is important in epidemiological cohort studies where it can improve the accuracy of excess relative risk estimates.

Humans↗
PubMed1997

Occupation and occupational exposure to UV light as risk factors for hairy cell leukaemia evaluated in a case-control study.

To investigate the role of occupation as a risk factor for hairy cell leukaemia a case-control study on 121 male, hairy cell leukaemia (HCL) patients, and 484 controls matched for age and sex, was conducted. We found significantly elevated risk for HCL among building painters (OR, 5.7; 95% CI, 1.6-20.8; based on six cases and four controls) and construction workers (OR, 3.3; CI, 1.2-9.2; based on seven cases and eight controls). Farming has been suggested as a risk factor in HCL. In this investigation farmers had an OR of 1.2 (CI, 0.6-2.3) and farm workers an OR of 1.5 (CI, 0.8-2.8). However, having ever worked in farming yielded an OR of 1.8 (CI, 1.1-2.9). Having grown up mainly in a rural area gave an OR of 1.4 (CI, 0.9-2.4). UV light has been suggested as a risk factor for non-Hodgkin's lymphoma (NHL). To evaluate the impact of UV exposure, classification of occupations as indoor, outdoor or mixed indoor/outdoor was made. Outdoor and mixed outdoor/indoor work yielded ORs of 2.3 (1.0-4.9) and 1.6 (1.0-2.5), respectively. When the effect of outdoor/indoor or mixed indoor/outdoor work was analysed using a scoring system the OR was 2.0 (CI, 0.9-4.4) for farmers compared with 0.8 (CI, 0.3-1.9) among non-farmers in the highest scoring group. There was no clear correlation between socioeconomic status as defined by the Swedish Socio-Economic Classification (SEI), and the risk of HCL. As many comparisons were made, the possibility of associations occurring by chance can not be excluded.

Adult↗
PubMed2006

Occupational exposure to acidic chemicals and occupational dental erosion.

OBJECTIVE: This study investigated the association between occupational acidic chemicals (ACs) exposure and occupational dental erosion. METHODS: A cross-sectional study was conducted in which three dentists surveyed 951 subjects from 42 factories using five types of ACs below Korean Threshold Limit Values (K-TLVs). Subjects agreed to participate by a written consent; 519 were acid exposed workers and 431 were non-exposed. The modified ten Bruggen Cate's criteria was used to classify erosion. Length and type of exposure to ACs were assessed using questionnaires. Logistic regression analysis including interaction terms was applied. RESULTS: ACs exposure was associated with erosion severity. Multiple exposures to ACs were found to be strongly associated with severe erosion. Interaction between wearing masks and AC exposure was significant. CONCLUSIONS: This study showed a clear association between AC exposure below K-TLVs and erosion. Hence, the authors propose to lower K-TLVs of five types of ACs.

Acids↗
PubMed1995

The risk of occupational exposure to blood and body fluids for health care workers in the dialysis setting. Italian Multicenter Study on Nosocomial and Occupational Risk of Infections in Dialysis.

In 1991, to assess the risk of occupational exposure to blood or other body fluids in health-care workers (HCWs) working in the dialysis setting, properly trained interviewers used standardized questionnaires asking the 583 HCWs employed in 19 Italian dialysis units to recall exposures sustained in the previous year. On a total of 208,498 dialyses performed in the previous year, 105 (5 per 10,000 dialyses) needlesticks, and 579 (28 per 10,000 dialyses) skin/mucous membrane contaminations were recalled. Recapping injuries were recalled in 38 cases (1.8 per 10,000 dialyses), but 67 needlestick injuries (4.1 per 10,000 dialyses) occurred during other circumstances (p = 0.006). The highest rate of skin/mucous membrane contaminations were recalled during the dialysis patient care, but more than one third of exposures occurred in other circumstances (break in blood circuit, disposal, contamination with blood-soiled equipment. To minimize the risk of occupational exposure to blood efforts must continue to increase compliance with Universal Precautions; moreover, needle designs incorporating safety features to prevent sticks are needed.

Blood-Borne Pathogens↗
PubMed1999

[Actual conditions of occupational health activities in small-scale enterprises in Japan: system for occupational health, health management and demands by small-scale enterprises].

In order to clarify the real conditions of occupational health services (OHS) in small-scale enterprises (SSEs) in Japan, we analyzed questionnaires recovered from 765 SSEs in the area of a city neighboring Osaka City (recovery rate, 69.3%). The SSEs included 358 SSEs with 1 to 4 workers (46.8% of total SSEs), 203 with 5 to 9 (26.5%), 163 with 10 to 29 (21.3%) and 41 with 30 to 49 (5.4%). The main types of businesses were manufacturing (374, 48.9% of total SSEs), wholesale/retail trade/restaurants (153, 20.0%), community, social and personal services (132, 17.3%) and construction (72, 9.4%). Health examinations were performed in 47.7% of SSEs. The reason for the lack of examinations were "shortage of time" (33.3% of SSEs lacking health examination) and "employees do not want to be examined" (28.1%). Some health promotion measures were conducted in 29.2% of SSEs. Health examination (59.0% of SSEs), health promotion (36.5%), measure of mental health (25.9%) and information service for employers and employees (25.5%) were demanded by SSEs as OHS. Financial subsidies and economical incentives were demanded by 46.4% and 28.8% of SSEs, respectively. Regional occupational health center in this area was poorly known among SSEs (8.2%), but health examination (48.4%), information service (37.5%), assessment of work method and advice to improve (19.8%) and environment measurement (12.4%) are demanded of the center by SSEs.

Female↗
PubMed1983

The treatment of the hospice patient: from occupational history to occupational role.

The nature of hospice care, particularly from the point of view of the occupational therapist, is presented in respect to the treatment of a 26-year-old patient. This case study demonstrates the role of the occupational therapist in helping a patient deal with his feelings of isolation, in helping him cope with severe physical limitations to maintain a maximum level of independence, and in helping him to deal with relationships with his fiance, family, and friends. The reader is given a sense of the quality of communication between therapist and patient. Finally, a view of what the therapist can expect realistically when offering hospice care is considered.

Activities of Daily Living↗
PubMed1996

Use of electronic music as an occupational therapy modality in spinal cord injury rehabilitation: an occupational performance model.

This article describes an electronic music program that allows clients with spinal cord injury (SCI) to form musical bands and play songs while performing therapeutic exercise in an occupational therapy program. Clients create the music by activating upper extremity exercise devices that are connected to a synthesizer through a computer. The bands choose the songs they would like to play and meet twice a week for 1 hr to practice. The 8-week program often concludes with a public performance. The music program is intended to motivate client participation in physical rehabilitation while promoting self-esteem, emotional expression, and peer support. It is based on the model of occupational performance and the theory of purposeful activity. To date, 33 persons have taken part. Client, therapist, and public response has been positive because this program highlights the abilities of persons with SCI, thereby encouraging their reintegration into the community.

Electronics↗
PubMedDate not supplied

Management of occupational therapy services for persons with cognitive impairments (statement). The American Occupational Therapy Association, Inc.

In summary, occupational therapy practitioners play a critical role in helping persons with cognitive impairments establish or maintain meaningful and productive lives within their social and cultural environment. Occupational therapy practitioners effectively address a wide range of cognitive difficulties in clients with a variety of ages and diagnoses. Intervention may be directed toward the individual with cognitive impairments or toward persons who care for or interact with them (e.g., family members, significant others, employers, school personnel, other health care workers). Treatment includes changing the person's skills or behaviors or adapting the task and/or environment to maintain function, ease care-giving, reduce safety hazards, and maximize independence.

Child↗
PubMed1986

A case-referent study of lung cancer, occupational exposures and smoking. III. Etiologic fraction of occupational exposures.

The proportion of lung cancer related to occupational exposure to respiratory carcinogens and other workplace contaminants has been studied in a hospital-based case-referent study of 176 incident cases and 176 referents, recruited from the medical ward of two county hospitals in southern Norway. On the basis of job title and exposure information, three different approaches for the estimation of etiologic fraction were used, all based upon a trichotomous categorization of the exposure variable. Among the definitely exposed subjects, the etiologic fraction for lung cancer related to occupational exposure factors was from 22 to 35%, increasing to 37-47% when the "possibly exposed" categories were included. When asbestos was the only factor to be eliminated, the etiologic fraction estimate suggested a 23% reduction in the lung cancer incidence in the study population. More than 90% of the lung cancer cases would theoretically have been prevented if smoking had been completely removed. The relative merits of preventing one or several of the study factors simultaneously is discussed.

Adult↗
PubMed2001

[Biologic monitoring of occupational and non-occupational exposure to pesticides].

Occupationally or otherwise, much of the population is exposed to pesticides. To obtain information on exposure levels, biological monitoring is often the best choice because it provides data that reflects total exposure by all routes. Biological monitoring has been used to evaluate exposure in agricultural and industrial environments, in subjects poisoned by accidental or voluntary contact, in volunteers for pharmacokinetic studies and in the general population. This paper is based on 100 studies published on this topic and reviews exposure indices for the main classes of pesticides. Methods of sampling and conservation of samples are outlined, together with the analytical procedures used. For compounds such as organophosphate and pyrethroid insecticides, ethylenebisdithiocarbamate fungicides, and phenoxyacetic herbicides, the results of studies on the general population and groups of occupationally exposed workers are reported.

Environmental Monitoring↗
PubMed1992

[Handling and decisions by the authorities of reported occupational tendon injuries of the upper extremities. Occupational diseases' registry E6b].

The aim of this investigation was to show how the Danish National Social Security Office, (the department of industrial injuries insurance (NSS)), handles the cases and makes the final decisions concerning the diseases in tendons in the upper extremity belonging to the list of occupational disorders in the Danish Workers' Compensation Act. Five hundred and nineteen notified cases were followed-up until the final solution and eventual compensation for permanent injury and loss of earning capacity. Two hundred and twenty-six cases had to be excluded because the criteria in the list of Occupational Disorders concerning unusual work and complete or partial inability to work were not fulfilled. Sixty-seven commenced work again after the notification and forty four did not reply to the NSS correspondence. One hundred twenty-seven had to be eliminated for other reasons. Fifty-five cases could be further investigated according to the workload criteria. fourteen were accepted and forty-one were rejected. Eight of these were paid a total compensation for permanent injuries amounting to 200,000 DDK and a capitalized compensation for loss of earning capacity amounting to 1,000,000 DDK. The notified diseases occurred among unskilled workers in their forties, equally frequently in men and women. It takes a long time to obtain the answers to NSS correspondence from doctors as well as the injured persons and therefore a total handling time of up to one year has to be expected. Our conclusion is that it is difficult to have these diseases accepted as being caused by the work because the criteria on the list about "unusual work" and "complete or partial inability to do normal work" exclude many cases from acceptance. Probably the criteria for workload should be changed so that it is based on an objective goal for the workload and the movements to a greater extent compared with the exposure time. Doctors who report the diseases should be more precise in the notified diagnosis, symptoms and the workload responsible.

Denmark↗
PubMedDate not supplied

[Occupational doctors in the public prevention services and qualified occupational doctors: their roles and forms of collaboration].

The occupational docters in public prevention and control services and the qualified occupational doctors who carry out functions of specialized doctors for enterprises, as well as operating according to their individual professional skills, are all part of the polydisciplinary system of collaboration that, while differing in methods, organizations and planning of their activities, have a shared aim: the safeguarding of the health and safety of the workers. The two systems have a mutual obligation to give information, foreseen also by several norms, that require common codes for evaluation and interpretation when exchanging communications, also for going beyond the simple conflictual relationship of "controller" and "controlled". In fact a shared commitment is necessary nowadays to face the lesser known and investigated risks and diseases, to promote the roles and rights of the workers, their representatives and also the employers of the micro-enterprises.

Humans↗
PubMed1990

[Performance spectrum in occupational disability. Causes--occupational groups--age--duration of insurance].

The causes of disability were elaborated in an extensive study. Accidents, coronary heart disease, diseases of the spine, and orthopedic diseases are the four most common diagnoses and account together for 52.4% of all cases of disability. The incidence of other even rarer diagnoses was shown. The average ages differ from diagnosis to diagnosis. While the average of all cases is at age 45.5 years for the beginning of disability and 9.8 years for the duration period there are diagnoses that lead to disability at an earlier age and after a shorter duration period such as for instance schizophrenia, inflammatory bowel diseases, allergies and skin affections. Heart and circulatory diseases and depressions on the other side occur at a later age and after a longer duration period. At the evaluation of risks special attention should be paid to those causes of early disability since they can turn into a claim after a short duration period and therefore can cause great subsequent costs. Some general statements can be made about occupational groups and causes of disability. Diseases of heart and circulation are rarer in physically active occupations such as construction, agriculture, and industry than in white collar workers and liberal professions. On the other side orthopedic diseases and accidents occur more frequently in construction, industry and agriculture. White collar workers tend to have more psychiatric problems which can be explained with a higher potential of conflicts at work.

Adult↗
PubMed1990

[Cataract in welders. Contribution of occupational exposure, references for recognition as an occupational disease and presentation of preventive measures].

An analysis was made of all the cases of eye disease in welders caused by infrared radiation which have been recognized as occupational disease Bk 52 in the GDR by now. A comparative study was conducted and proposals for the definition of criteria for recognition as occupational disease were derived. The determination of exposure by means of suitable radiation measurement devices is described. Both the problems of measurement value acquisition and the evaluation of radiation loads are dealt with. The infrared radiation load of the eyes is quantified for several frequently used welding techniques. Various measuring values obtained in other industries and in the transport sector are given for comparison. Protective measures and the use of suitable face protections are discussed. Conclusions are drawn with regard to the health protection of welders against infrared radiation exposure.

Cataract↗