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PubMed2005

Workplace assessment for licensing in general practice.

With the redesign of general practice training implicit in the Department of Health's programme of reform, Modernising Medical Careers, there is the opportunity to bring summative assessment and the MRCGP examination together into a unified assessment framework for licensing. It is likely that assessment in the workplace will play a central role in such a process. Workplace assessment is of high validity and has the potential to reconnect teaching and testing in general practice. Five principles to underpin the design of a workplace assessment are proposed, namely that it should be: competency-based, developmental, evidential, locally assessed, and triangulated. Successful implementation of workplace assessment will not only serve to reduce the current testing burden on trainees, but will also harness the involvement of medical teachers. In doing so, general practice has the opportunity to create a powerful tool for professional development.

Education, Medical, Continuing↗
PubMedDate not supplied

Prevalence and factors related to Canadian workplace health programs.

BACKGROUND: This study documented the prevalence and factors related to workplace health programs in Canada, including Employee Assistance Programs (EAPs), drug testing programs, and Health Promotion Programs (HPPs). METHODS: A representative sample of 565 Human Resources Managers at worksites with 100 or more employees across Canada completed a questionnaire on the worksite characteristics and the types of programs at their workplace (response rate = 79.8%). RESULTS: EAPs were established in 67.8% of sampled worksites (95% CI: 63.9%-71.7%). The proportion of worksites with EAPs varied significantly across work sectors (p<0.001) but not across regions of Canada. Worksites with EAPs had significantly (p<0.001) fewer visible minorities and had more unionized employees (p<0.001) than worksites without EAPs. For drug-testing programs, about 10.3% of Canadian worksites have them (95% CI: 7.8%-12.8%). Significant differences were noted across regions (p<0.001) with Alberta most likely to have such programs (25.4%) and Ontario least likely (4.6%). Also, safety-sensitive worksites and those with United States ownership were significantly (p<0.05) more likely to have drug testing. The most common type of HPP was fitness programs (29.4%) and the least common was day/elder care programs (5.5%). Fitness programs were most common in the Eastern provinces and least common in Quebec. CONCLUSIONS: Overall, Canadian worksites favour a health promotion and treatment approach over a deterrence approach for addressing health and substance use issues in the workplace. Workplace health programs were related to several factors that have created an uneven system of health promotion, treatment and deterrence in Canadian worksites.

Adult↗
PubMed1992

Smoking policies in the workplace in the western Cape.

A postal survey of workplace smoking restrictions among the member organisations of the Cape Chamber of Industries was carried out in 1989. The response rate was 57.1%. Of the 572 respondent organisations, 66.1% had some smoking restrictions. Large workplaces were more likely to restrict smoking than small workplaces: 42.0% of those with fewer than 10 employees had restrictions, increasing to 90.9% of those with more than 500 employees. Organisations producing manufactured goods (other than engineering) were more likely to have restrictions than non-manufacturing concerns. Smoking was commonly restricted on the factory floor (61.3%) and in warehouses (55.8%), but only 7.4% prohibited smoking in shared offices. The reasons for smoking restrictions stated most frequently were the fire hazard (85.3%) and legislation (66.0%). Only 29.1% stated that health care concerns were an important reason for restrictions, while a further 16.3% stated that health was a minor reason for restrictions. Of the respondents, 48.4% expressed a need for guidance in improving their smoking policies. These results indicate that there is considerable potential for intervention to decrease both active and passive smoking in local workplace settings.

Humans↗
PubMed1991

Workplace health promotion programs. An overview.

The development of workplace health promotion programs is a popular trend in corporate America. The workplace is considered to have great potential for health promotion and education because workers spend more than 30% of their waking hours at work. Corporate managers are attracted by the broad claims of benefits made for workplace health promotion programs, which include improving employees' health and fitness; decreasing medical and disability costs; reducing absenteeism; improving job satisfaction; increasing productivity; and enhancing the corporate image. Although these claims are not proven through scientific research, current evidence suggests the workplace health promotion programs can have a positive impact on employees. The trend of increasing numbers of corporations establishing health promotion programs should continue in the future.

Health Promotion↗
PubMed1990

[Investigation of health effects associated with solvents used in dry cleaning workplace (report 1). Tetrachloroethylene concentration in working environment].

Tetrachloroethylene (TCE) level in the working environment was measured at five dry cleaning workplaces. Time weighted average (TWA) concentration of TCE collected using an activated charcoal badge were 2.3-19.1 ppm in summer and 1.3-56.9 ppm in winter. TCE level in the work place measured during the work process showed that when the dry cleaning machine was opened to remove clothes, TCE ranged from 63.2 to 85.6 ppm and while the machine was operating ranged from 50.8 to 143 ppm. TCE levels at the middle of the cleaning cycle ranged horizontally from 0.5 to 11.0 ppm (mean 3.0 ppm, 12 sampling points) in summer and from 7.7 to 85.3 ppm (mean 28.0 ppm. 12 sampling points) in winter. The values varied according to the location of the sampling point. In the living area adjacent to the workplace, TCE was found to be at the same level as the workplace. Therefore in order to prevent other family members from being affected it is recommended that the workplace be separated from the residence.

Air Pollutants, Occupational↗
PubMed1990

Health, equity, and reproductive risks in the workplace.

Potential exposure to occupational reproductive hazards raises complex questions regarding health and gender discrimination in the workplace. On the one hand, growing scientific evidence suggests that workplace exposures to either sex can cause a wide range of disorders ranging from infertility to adverse pregnancy outcomes. On the other hand, policies alleging to protect workers from reproductive risks have often reinforced gender inequalities in the workplace. This article sheds new light on this continuing debate through an examination of the policy insights suggested by a recent study of reproductive hazard policies in Massachusetts. In what ways do policies evidenced in this study reflect or differ from historical patterns of protectionism? The article presents a political-legal review of reproductive hazard policies in the workplace, then examines the policy implications of the Massachusetts study, and finally presents the prescriptions for change that are implied by both the historical and contemporary evidence.

Female↗
PubMed1990

Marketing cardiovascular disease risk reduction programs at the workplace. The Pawtucket Heart Health Program experience.

The workplace offers a unique setting in which to offer CVD risk reduction programs. Marketing these programs involves at least two distinct processes. First, a corporation must agree to accept and support workplace health programming. Second, workplace programs must be effectively marketed to eligible employees, dependents, and retirees. After identifying critical barriers to the effective marketing of workplace programs, a stepwise approach used by the Pawtucket Heart Health Program to successfully overcome these obstacles is used. Using real world examples and practical tips, a discussion of implications for marketing future programs to the corporate and employee audience is shared.

Cardiovascular Diseases↗
PubMedDate not supplied

The psychiatric epidemic in the American workplace.

Several characteristics help distinguish MPI in the workplace from illness outbreaks due to physical causes: no laboratory or physical findings confirming an specific organic cause evidence of specific physical or psychological stressors victims are mostly women and those of lower socioeconomic status in the workplace hyperventilation-type symptoms are prominent apparent transmission by audiovisual cues rapid spread of the illness followed by rapid remission of symptoms, unless symptoms are fixed by physicians and litigation benign morbidity If a physical or chemical cause of the illness is not obvious and if episodes recur, the illness remains a mystery and the workplace becomes a breeding ground for anxiety, confusion, fear, and rumor. Economic pressures to resume normal operations are counteracted by fears that an environmental contaminant still exists. Once all physical explanations have been ruled out, investigators may turn to psychological explanations and focus on mass hysteria, but that explanation is primarily based on the absence of physical evidence rather than the presence of agreed-upon psychosocial conditions. Some reports suggest that the diagnosis of MPI is really an excuse for not conducting an adequate evaluation of low-level environmental contaminants. The disability in some workers is prolonged and points to non-work-related factors that may be contributing. Were it not for the unverifiable physical complaints and the workers' insistence that the symptoms are the result of physical disease and their concern about the complaints and their reactions to dismissal of their complaints, we would not consider these patients to have a mental disorder. These individuals are reinforced in their beliefs by some physicians and attorneys, and resultant litigation tends to fix their symptoms. In fact, a "conspiracy theory" evolves when there are enough convinced people--and enough people trying to dissuade them. Group phenomena reinforce their beliefs and make renouncement tantamount to betrayal. The mass psychogenic illness or psychiatric epidemic that occurs in the workplace offers an opportunity not only to study the elements of a biopsychosocial system, but also offers opportunities for medical anthropological studies that relate the causes and courses of specific episodes of MPI to the cultures of the individuals who develop symptoms and the cultures of the area in which the epidemic occurs.

Disease Outbreaks↗
PubMed1982

Effects on the liver of chemicals encountered in the workplace.

The liver plays a central role in toxicology. It is the primary organ of detoxification and elimination by metabolism of many chemicals. Many workplace chemicals can affect the liver in animals; fewer have been proved to do so in humans. The diverse hepatic effects observed in humans from occupational exposure to chemicals range from fatty infiltration, acute hepatitis and cholestasis to cirrhosis and angiosarcoma. Three important workplace chemicals, prototypes for the toxicities of many others, are carbon tetrachloride, vinyl chloride and the polychlorinated biphenyls (PCB's). These three are described in some detail to highlight principles of occupational toxicology. Most of the hepatic effects produced by chemicals in the workplace have clinical, laboratory and morphological features common to many other forms of liver disease. Therefore, only an astute physician who takes an occupational history will recognize the association between a patient's workplace and liver disease.

Carbon Tetrachloride Poisoning↗
PubMed1993

Managing crises and trauma in the workplace: how to respond and intervene.

1. Health care, human resource, and employee assistance provider professionals must be aware of the impact of trauma in the workplace. 2. Critical Incident Stress (CIS) refers to the work and situations that emergency service professionals face on a regular basis. Trauma in the workplace refers to a work setting, such as an industrial accident, personal injury/illness, or crime taking place in a work setting. The death or injury of an employee outside of the workplace is also considered traumatic for employees. 3. Victims of witnesses of a traumatic incident, a violent crime, physical maltreatment, or sexual abuse may experience Posttraumatic Stress Disorder (PTSD). Individuals of all ages are vulnerable to PTSD. 4. Unresolved CIS or a workplace trauma may result in PTSD for the involved individuals if not handled appropriately.

Crisis Intervention↗
PubMed1995

Pupillary response among VDU users in daylighted workplaces.

Daylighted workplaces can complicate the viewing of visual display unit (VDU) tasks. Incoming direct- and/or reflected-daylight components can distort surface luminance distributions in both the direct- and screen-reflected visual fields. Pupillary response to these sources moreover may differ significantly, for example, between window- and interior-exposures, affecting bilateral depth of field and accommodation. Accordingly, it is hypothesized that pupil diameter is a valid ergonomic indicator of visual comfort for viewing targets at workplaces with varying daylighting exposures. This hypothesis is tested by measuring the pupillary response of four VDU users, each while viewing three targets at each of six different workplaces in a daylighted room. An iriscorder is used to record pupil diameter independently for left and right eyes in response to keyboard, screen, and background-surround surface luminances. The significant differences in pupil diameter among the three targets at the six positions can be explained by the luminance differences rendered by the incoming daylight. On this basis, it is further hypothesized that smaller pupil diameters in response to a limited range of graduated luminances correspond to more comfortable viewing conditions. Provision of these viewing conditions hold implications for VDU workplace layout, work organization, and control of electric lighting and cooling loads.

Adult↗
PubMed1998

Oxidative stress induced by environmental tobacco smoke in the workplace is mitigated by antioxidant supplementation.

Environmental tobacco smoke (ETS) is a pervasive contaminant in the workplace. Previous studies by this laboratory have shown that exposure to workplace ETS results in increased oxidative stress and damage, as measured by increased levels of the antioxidant enzymes superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase. 8-Hydroxy-2-deoxyguanosine, a marker of oxidative DNA damage, was also 63% greater in the exposed group compared with controls. Subjects in the previous study who reported workplace exposure to ETS were given a 60-day supply of an over-the-counter antioxidant formulation consisting of 3000 microg of beta-carotene, 60 mg of vitamin C, 30 I.U. of alpha-tocopherol, 40 mg of zinc, 40 microg of selenium, and 2 mg of copper. After the 60-day supplementation period, blood samples were again drawn, and the results were compared with the presupplementation values. A 62% decrease in 8-hydroxy-2-deoxyguanosine was observed after supplementation. Lipid peroxidation levels were also decreased, as were the antioxidant enzyme activities. The biochemical evidence suggests that exposure to ETS in the workplace increases oxidative stress and that antioxidant supplementation may provide some protection.

Adult↗
PubMedDate not supplied

Impact of curricular change in an undergraduate program for speech pathologists on perceived preparedness for the workplace.

Recently, educational policymakers have emphasized the need for undergraduate programs to develop in their graduates generic skills and attributes beyond discipline-specific skills and knowledge. The generic skills and attributes should mesh with the requirements of the workplaces where the graduates will find employment. The present study examined the impact of curricular revisions to a program of study for speech pathologists on the perceptions of the graduates regarding their preparation in appropriate skill and knowledge domains. The curricular revisions sought to develop independent learning, critical thinking, research and evaluation skills, written and oral communication skills, and skills for seeking and providing support to peers. Seventy-eight graduates of the earlier program and 21 graduates of the revised program offered by the School of Communication Disorders at The University of Sydney completed a 52-item questionnaire concerning the extent to which the program had equipped them for the workplace. Eleven scales were derived from the questionnaire responses, reflecting skills endorsed by university educators and workplace supervisors of allied health professionals as being necessary for success in the workplace. The relative levels of perceived preparation on the 11 dimensions were similar across graduates of the revised program and those of the earlier program. Graduates of the revised program were significantly more positive about their preparation on five of the 11 dimensions, compared with earlier graduates of approximately equivalent age and experience. The dimensions where differences were observed generally reflected those targeted by the curricular revisions.

Adult↗
PubMed2002

Effectiveness of safety measures recommended for prevention of workplace homicide.

CONTEXT: Homicide is the second leading cause of death on the job for US workers. Government agencies recommend that employers prevent violence against workers by adopting interventions originally designed to prevent robbery, but the effectiveness of these interventions is unknown. OBJECTIVE: To investigate the effectiveness of existing administrative and environmental interventions recommended for preventing workplace homicide. DESIGN, SETTING, AND PARTICIPANTS: Population-based case-control study of North Carolina workplaces where a worker had been killed between January 1, 1994, and March 31, 1998, identified through a statewide medical examiner system (cases; n = 105) and an industry-matched random sample of workplaces at risk during the same period, selected from business telephone listings (controls; n = 210). MAIN OUTCOME MEASURE: Risk of death of a worker due to homicide. RESULTS: Among environmental interventions, strong and consistent reductions in the risk of a worker being killed on the job were associated with bright exterior lighting (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.3-1.0). Among administrative interventions, the largest beneficial effect was for staffing practices that prevented workers from being alone at night (OR, 0.4; 95% CI, 0.2-0.9). Keeping doors closed during working hours was also associated consistently with substantially reduced risk (OR, 0.4; 95% CI, 0.1-1.1) but was not statistically significant. Combinations of 5 or more administrative measures were associated with significantly lower levels of risk (OR, 0.1; 95% CI, 0.0-0.5). CONCLUSIONS: We found evidence suggesting that eliminating solo work at night could reduce the risk of homicide for workers. Keeping doors closed and using bright exterior lighting or combinations of administrative interventions also appear to be beneficial, but there was no evidence of effectiveness for a number of other recommended measures.

Case-Control Studies↗
PubMed2006

Workplace air quality and lung function among dental laboratory technicians.

BACKGROUND: Dental laboratory technicians are exposed to dust and/or methyl methacrylate (MMA) in the workplace. Potential effects of the exposures on lung function merit further clarification. METHODS: This study measured lung function of 45 dental technicians, before and after shifts, on 3 workdays and monitored workplace concentrations of particulate matter with aerodynamic diameter less than 2.5 mm (PM2.5) and MMA in five dental laboratories in Taiwan. Base metals in particles were analyzed by X-ray fluorescence. Repeated measurement analysis was applied to estimate potential effects of PM2.5 on pulmonary function. RESULTS: PM2.5 ranged from 26 microg/m3 to 664 microg/m3 and levels of MMA were low in these laboratories. Nickel, cobalt, and chromium were detected in the particles. After controlling for important factors, PM2.5 was associated with a small decrease in forced vital capacity and forced expiratory flow in one second. CONCLUSION: Workplace PM2.5 was associated with a non-significant decrease in lung function of dental technicians.

Air Pollution, Indoor↗
PubMed2000

The Australian National Workplace Health Project: design and baseline findings.

BACKGROUND: This paper describes the study design, recruitment, measurement, and initial recruitment outcomes of Australia's largest workplace intervention trial, the National Workplace Health Project. METHODS: This was a cluster-randomized trial of socio-behavioral and environmental interventions focusing on key behaviors of physical activity, healthy food choices, cigarette smoking, and alcohol consumption, as well as motivational readiness for change. Twenty worksites were randomized separately for each intervention using a two-by-two factorial design. All participants underwent a health risk appraisal and measurements were made at baseline and at 1 and 2 years. RESULTS: The overall response rate for the baseline survey was 73% with 61% attending the health risk appraisal. The sample was predominantly male, English-speaking, married, blue-collar workers. Overall, 12% reported unsafe alcohol consumption, 26% were current smokers, 44% were physically inactive, 74% ate at most one piece of fruit per day, and 26% ate at most one serving of vegetables per day. Intervention and control conditions were similar at baseline for the primary outcomes, except that a higher proportion of the sociobehavioral intervention condition was more physically active (59%) than the corresponding control condition (53%). CONCLUSIONS: This study will permit the rigorous evaluation of the efficacy of sociobehavioral and environ mental intervention approaches to workplace health promotion. Although participants were randomized by worksite, intervention and control conditions were similar at baseline; any differences in the primary out come variables will be controlled for in the analysis.

Adult↗
PubMed2000

Workplace and workforce 2000+ -the future of our work environment.

OBJECTIVES: Research in the Human Resource Department at the University of Mannheim is directed towards the exploration of future work structures and design, and their effects on employees and employment relations. METHODS: The main methods applied are trend extrapolation and simulation in combination with delphi research methodology. The trends observed during the last decade suggest that the workplace and workforce in the new millenium will primarily be affected by flexibilization, decentralization, and globalization. RESULTS AND CONCLUSIONS: Flexibilization will lead to a core group with unlimited full employment and an increasing larger group of short-term limited and/or part-time employees who face severe employment risks, ultimately resulting in stress. Flexibilization will also affect the workplace. Information technologies will dissolve social entities. The virtual company suppresses social interaction and will as a consequence create new forms of alienation. Decentralization will increase the responsibility for business processes. Employees will be regarded as business process owners and will be held responsible for their results, a situation which again creates new stress factors. Globalization enhances competition, which in turn will encourage competitive attitudes at the workplace. Internal market mechanisms will take the place of performance appraisals by management. Market evaluation will substitute leadership styles and communication, which stand for the human side of enterprise. The psychosocial problems arising from these developments will produce new challenges for occupational health professionals.

Forecasting↗
PubMed2002

[Participation--oriented analysis of the anesthesia workplace. A work system for anesthesia in a multidisciplinary operating room].

INTRODUCTION: The aim of this study was the detection and understanding of weak points in the ergonomic design of anaesthesia workplaces in a multidisciplinary operating room facility. METHODS: Analysis of workplaces and of working processes by means of observations, computer-supported task recording and video-photo documentation. During guided interviews the participants were provided with material for naming-by-pointing and drawing. Subsequently, the background of the problems encountered and possible improvements were visualised. RESULTS: Important deficits were devices not positioned within reach and view, difficulties in operating the lines connecting the patient and the devices, and inconsistent workplace layouts. These were caused by erroneous planning of the facility and disregarding ergonomic principles in equipment design. The initial improvements implemented were the development of a new concept for a flexible equipment positioning and the design of a tool for cable handling. DISCUSSION AND CONCLUSION: Although from the very beginning of the study the anaesthesia personnel quoted the handling of the lines connecting patients and devices as the main cause for working difficulties, the external ergonomist could contribute to a broader view of the problems. The method presented here initiated a mutual learning process between ergonomist and users and resulted in a common understanding of the problems and their causes. Compared to the traditional consulting process, more time and efforts were necessary but were offset by the users' acceptance of the improvements and the prevention of design errors.

Anesthesia↗