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PubMed1995

A systematic approach to health surveillance in the workplace.

This paper reviews the range of health surveillance activities which can be utilized in the workplace by occupational health professionals for assessing fitness for work and contributing to the prevention of occupational illness and promotion of good health. The systematic approach described categorizes health surveillance procedures into occupational or non-occupational, risk-based or unfocused, and as primary, secondary or tertiary preventive measures. All categories of health surveillance are currently being practised to some extent, but the type of surveillance may not match the needs of the workplace in some situation. In order to aid health professionals in deciding which procedures should be implemented, recommendations based on an assessment of health risks are made. The key proposal is to establish a minimum level of periodic health surveillance for all workers based on a targeted lifestyle health risk assessment and a structured health questionnaire. Additional procedures can then be added sequentially as appropriate to manage any health risks in the workplace. The role of the unfocused periodic general medical examination is discussed in the context of the systematic approach and allows occupational professionals to critically appraise its usefulness.

Health Promotion↗
PubMed2003

Investigating and analysing workplace clusters of diseases: a Health & Safety Executive perspective.

BACKGROUND: Clusters of disease arising in workplaces cause concern among the management of the company, the workers affected and their families and friends. Chance is the most likely explanation for their occurrence, although a number of real workplace hazards have been identified through their observation and investigation. Employers have a duty to investigate such occurrences in order to assess whether some unknown or unidentified hazard is at work and to take the appropriate action. Several papers have been published over the last 15 years or so that set out a method for investigating workplace clusters of disease. Aims This paper presents the steps in the approach taken by the Health & Safety Executive in Great Britain. METHOD: An initial step identifies the relevant stakeholders at the outset, in order to maintain a realistic expectation of what the investigation can hope to achieve and to open a dialogue. The main steps in the assessment are: (1) identifying cases; (2) determining the other parameters of the investigation; (3) statistically assessing the cluster; (4) examining potential exposures and assessing their biological plausibility; and (5) determining the overall significance of the cluster. The approach is illustrated throughout by examples.

Cluster Analysis↗
PubMed2005

Prevalence, management and impact of urinary incontinence in the workplace.

BACKGROUND: The few prior studies of urinary symptoms in the workplace have been small investigations of women in specific occupations (e.g. nursing) or industries (e.g. pottery manufacture). In this study, the aims were to describe the prevalence, management and impact of urinary incontinence for a large cross-section of employed women in the USA. METHODS: Five-page questionnaires were mailed to 5130 American households selected from the National Family Opinion survey panel during the spring of 2004. Usable questionnaires were returned by 3364 women in the target age range of 18-60 years. RESULTS: About 37% of the 2326 employed respondents reported urine loss during the last 30 days. The most common strategies for managing incontinence at work included frequent bathroom breaks and wearing pads. The use of urine control methods increased with the severity of urine loss. The effect of incontinence on workplace activities also increased with the severity of urine loss: 88% of employed women with the most severe symptoms reported at least some negative impact on concentration, performance of physical activities, self-confidence or the ability to complete tasks without interruption. CONCLUSION: Urinary incontinence is prevalent among employed women. Those who experience severe symptoms report that it has a negative effect on aspects of work. Programs on the prevalence and impact of urinary incontinence would help educate both employers and employees, and may lead to the development of better management techniques in the workplace.

Adolescent↗
PubMedDate not supplied

Thermal burn fatalities in the workplace, United States, 1992 to 1999.

The purpose of this study was to present the epidemiology of thermal burn fatalities in the workplace in the United States between 1992 and 1999. Data on fatal thermal burn injuries in the United States between 1992 through 1999 were obtained from the Bureau of Labor Statistics Census of Fatal Occupational Injuries. Between 1992 and 1999, 1,189 fatal thermal burns occurred in the workplace (0.11 deaths/100,000 workers per year). Mortality increased with age, with those over 65 years of age having the greatest rate of death (0.20/100,000). Workers in the mining industry and transportation and public utilities had the highest rates of fatal thermal burns. Occupational categories with the highest rates included "extractive occupations" (eg, miners, explosives workers) and "transportation and material movers" (eg, truck drivers). The specific occupations with the highest rates were airplane pilots and navigators, furnace, kiln, and oven operators, and firefighters. Most decedents were operating vehicles or involved in "other transportation operations" at the time of the incident. The majority of injurious incidents occurred on "industrial premises" or the "street and highway." Efforts to prevent fatal occupational thermal burn injuries should focus on older workers and those in occupations with frequent exposure to potential sources of thermal injury. Further study of nonfatal thermal burns in the workplace is needed because patterns of fatal burn injury may not reflect patterns of occupational burn injury overall.

Accidents, Occupational↗
PubMed2006

Workplace incivility: state of the science.

The financial cost of workplace violence is 4.2 billion dollars a year. Workplace incivility may initiate a spiral that for 1,000 people a year ends in death at work. If an initial minor incident such as incivility could be mitigated, then the financial and human capital that could be realized by the healthcare organization is immense. This article is an in-depth look at the literature and theoretical frameworks related to workplace incivility.

Aggression↗
PubMed1995

What is health promotion? How does it relate to the workplace? A background paper to support the Conference in Berlin on 29-30 September, 1994.

Can workplaces be successful health promotion settings? Undoubtedly they can, in both direct and indirect ways. Directly, in being cost effective for companies, and indirectly, in improving the health and well being of all who work in a company. Under European directives the workplace has a responsibility to promote health promotion: this goes beyond health and safety, and protection of the workforce. Using WHO healthy policy principles, workplaces can be seen as a microcosm of society and therefore the principles of health promoting policies can be used to encourage healthy companies.

Community Participation↗
PubMed2001

Mental health issues in the workplace: a case for a new managerial approach.

Anger, stress, and depression in the workplace are growing concerns among management. Traditionally, health outcomes have functioned under the realm of workplace health professionals. This study assessed whether a traditional worksite health promotion program had an impact on mental health factors. The results suggested that worksite health promotion programs play a limited role in ameliorating work-related mental health outcomes. Rather, management must play a greater role in addressing workplace stress, anger, and depression.

Anger↗
PubMed2002

Effectiveness of a workplace risk assessment team in reducing the rate, cost, and duration of occupational injury.

This study evaluated the effectiveness of a consultative workplace risk assessment team in reducing the rate and severity of injury among cleaners within a 600-bed hospital. Cohorts of Cleaning Services and Orderly Services staff ever employed within both a 4-year preintervention and a 3-year postintervention period were assigned to the intervention and comparison groups, respectively. The date, compensation claims' cost, and hours lost from work were obtained for each injury during the study period. Age, gender, work experience, and hours worked were ascertained for every subject whether injured or not. Reductions of two thirds in injury rate, 73% in cost rate, and 43% in duration rate were evident in the intervention group. In comparison, the orderlies experienced a postintervention increase in all three rates. The success of the workplace risk assessment team intervention supports the adoption of a participatory approach to reducing the rate and consequence of workplace injury.

Accidents, Occupational↗
PubMedDate not supplied

Responding to threats of workplace violence: the effects of culture and moral panic.

Healthcare organizations, like all organizations, are increasingly more concerned about workplace violence. This paper discusses the collision of a cultural context that encourages macho posturing and moral panic related to highly publicized violence in schools and workplaces. At issue is the need for healthcare organizations to react to evidence of potential workplace violence but not to overreact.

Adult↗
PubMed2003

Workplace accommodations for people with disabilities: National Health Interview Survey Disability Supplement, 1994-1995.

As American workers age, workers with impairments and functional limitations make up a larger percentage of our workforce. This investigation presents data from the National Health Interview Survey Disability Supplement 1994-1995 (NHIS-D) describing the nature of workplace accommodations in the American workforce and factors associated with the provision of such accommodations. Of a nationally representative sample of workers aged 18 to 69 years with a wide range of impairments, 12% reported receiving workplace accommodations. Males (odds ratio (OR) 0.64: 95% confidence interval (CI) 0.53-0.78) and Southerners (OR 0.57; 95% CI = 0.47-0.70) were less likely than others to receive workplace accommodations. Those with mental health conditions were less likely than others to receive accommodations (OR 0.56; 95% CI = 0.44-0.70). College graduates (OR 1.53; 95% CI = 1.22-1.91), older workers, full time workers (OR 3.99; 95% CI = 2.63-3.87), and the self-employed (OR 1.76; 95% CI = 1.28-2.41) were more likely than others to receive accommodations.

Activities of Daily Living↗
PubMed2004

Workplace violence in Oregon: an analysis using workers' compensation claims from 1990-1997.

One of the most serious occupational problems in the workplace is the occurrence of violent assaults. This study examined 2028 workers' compensation claims of workplace violence from Oregon between 1990 and 1997, and used Current Population Survey data for risk analysis. The rate of workplace violence was 1.86 per 10,000 employees annually (95% confidence interval, 1.78-1.94), with females and workers under 35 years of age experiencing the most violence. The average claim resulted in approximately 40 days of indemnity and $6200 in costs. Workers on evening and night shifts had significantly higher rates of being victims of violence, as did those working on weekends. Preventative interventions should be targeted at younger workers and those with less tenure. Special measures should be focused on ensuring the safety of evening/night-shift workers and weekend employees.

Adult↗
PubMedDate not supplied

Workplace social support and ambulatory cardiovascular activity in New York City traffic agents.

OBJECTIVE: This study examined the associations of social support from coworkers and supervisors to workday ambulatory blood pressure and heart rate. Specifically, analyses examined the association of work-related social support to the following measures: 1) baseline blood pressure and heart rate at the start of the workday, 2) blood pressure and heart rate during high stress periods, 3) blood pressure and heart rate levels throughout the workday. METHODS: Participants included male (N = 36) and female (N = 34) New York City Traffic Enforcement Agents. Mixed-model regression analyses were used to assess the effects of self-reported measures of workplace social support on workday ambulatory blood pressure. RESULTS: Workplace support was associated with workday ambulatory blood pressure levels, with the effects depending on the source of support and the gender of the participant. For women, immediate supervisor support was negatively associated with workday systolic blood pressure level, and a similar negative trend was found for workday diastolic blood pressure level. For men, coworker support was negatively associated with workday systolic blood pressure level. We found an interaction of social support with stress level (ie, baseline vs. high stress) such that immediate supervisor support was negatively associated with systolic blood pressure during high-stress conditions, but no effects were found under resting conditions. CONCLUSIONS: These findings suggest that workplace social support is associated with workday ambulatory blood pressure, especially during stressful work periods.

Adult↗
PubMed2005

Understanding the workplace culture of a special care nursery.

AIM: This paper presents findings from the first phase of a research study focusing on implementation and evaluation of emancipatory practice development strategies. BACKGROUND: Understanding the culture of practice is essential to undertaking effective developments in practice. Culture is a dominant feature of discussions about modernizing health care, yet few studies have been undertaken that systematically evaluate the development of effective practice cultures. METHOD: The study intervention is that of emancipatory practice development with an integrated evaluation approach based on Realistic Evaluation. The aim of Realistic Evaluation is to evaluate relationships between Context (setting), Mechanism (process characteristics) and Outcome (arising from the context-mechanism configuration). This first phase of the study focuses on uncovering the context (in particular the culture) of the Special Care Nursery in order to evaluate the emancipatory practice development processes and outcomes. Data collection methods included survey, participant observation and interview. Cognitive mapping, constant comparative method and coding were used to analyse the data. Findings. Four key categories were identified: Teamwork, Learning in Practice, Inevitability of Change and Family-Centred Care and collectively these formed a central category of Core Values and Beliefs. A number of themes were identified in each category, and reflected tensions that existed between differing values and beliefs within the culture of the unit. CONCLUSION: Understanding values and beliefs is an important part of understanding a workplace culture. Whilst survey methods are capable of outlining espoused workplace characteristics, observation of staff interactions and perceptions gives an understanding of culture as a living entity manifested through interpersonal relationships. Attempts at changing workplace cultures should start from the clarification of values held among staff in that culture.

Adult↗
PubMed2006

Workplace health promotion: the role and responsibility of health care managers.

The World Health Organization's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Workplace movement emerged. Here, an extensive review of the available workplace-related health literature provides the basis for critical discussion and recommendations for health care managers. The findings suggest that health care managers, who practice in all health service settings, should be aiming to initiate and promote radical health promotion reform as set out in the WHO settings-based movement. Developing and implementing sustainable health promotion-orientated and organization-wide healthy workplace policy initiatives represent the most effective way for health care managers to directly benefit from the desirable outcomes that come from creating and maintaining a healthy workforce.

Health Promotion↗
PubMed2004

Implementation of HaemScreen, a workplace-based genetic screening program for hemochromatosis.

There is debate as to whether community genetic screening for the mutation(s) causing hereditary hemochromatosis (HH) should be implemented, due to issues including disease penetrance, health economic outcomes, and concerns about community acceptance. Hemochromatosis is a common preventable iron overload disease, due in over 90% of cases to C282Y homozygosity in the HFE gene. We are, therefore, piloting C282Y screening to assess understanding of genetic information and screening acceptability in the workplace setting. In this program, HaemScreen, education was by oral or video presentation in a group setting. C282Y status was assessed by polymerase chain reaction (PCR) and melt-curve analysis on DNA obtained by cheek-brush sampling. Of eligible participants, 5.8% (1.5-15.8%) attended information and screening sessions, of whom 97.7% (5571 individuals) chose to be tested. Twenty-two C282Y (1 : 253) homozygotes were identified and offered clinical follow-up. There were 638 heterozygotes (1 : 8.7). The determinants for participation have been analyzed in terms of the principles outlined in the Health Belief Model. Widespread screening for HH is readily accepted in a workplace setting, and a one-to-many education program is effective. The level of participation varies greatly and the advertizing and session logistics should be adapted to the specific features of each workplace.

Adolescent↗
PubMed1997

Prevalence of workplace smoking bans in Victoria.

Restrictions on smoking in the Victorian workplace have been measured since 1988. This paper investigates whether the trend of increasing prevalence of total bans found between 1988 and 1992 has continued. Estimates are based on workers' reports of the restrictions on smoking that apply at their workplaces. For indoor workers a total ban on smoking restrictions in the workplace has increased from 58% in 1992 to 66% in 1995. White collar workers continue to enjoy a higher rate of protection than blue collar workers. Factories, warehouses, hotels and restaurants are the worksites least likely to have restrictions. Bans result in considerable exiled smoking: half the smokers reported going out to smoke during working hours on their last work day.

Data Collection↗
PubMed1998

Carbon monoxide exposures in Australian workplaces could precipitate myocardial ischaemia in smoking workers with coronary artery disease.

BACKGROUND: Quite low levels of carbon monoxide (CO) exposure have been shown experimentally to induce myocardial ischaemia in subjects with coronary artery disease. This study examines the actual exposure levels in Australian workplaces under normal operating conditions, to assess whether the resulting carboxyhaemoglobin (COHb) levels are high enough to present a risk of myocardial ischaemia in any workers who may have recognised or unrecognised coronary artery disease. METHODS: A total of 84 workers took part in the study, 60 of whom were working in an environment where a combustion process was taking place indoors and were therefore classified as exposed to CO. Ambient CO levels and end-expiratory CO levels (the latter as a predictor of COHb) were measured two-hourly and the number of cigarettes smoked over an eight-hour shift recorded. RESULTS: Mean workplace CO levels throughout the shift ranged between three and 12 ppm. Mean COHb ranged between 0.7% and 2.1% in non-smokers and 2.1%-7.6% in smokers, except for a single reading of 12.5% in forklift operations (one smoker). Exposed workers had significantly higher COHb levels than the non-exposed, both for smokers and non-smokers. Smoking also had an important independent effect on COHb. CONCLUSION: Under workplace conditions prevailing in industries where combustion processes are occurring indoors, CO exposures are unlikely to be high enough to cause myocardial ischaemia in non-smokers. However in a worker whose COHb is already raised from smoking, an increment from such occupational environments could be sufficient to induce myocardial ischaemia in workers with coronary artery disease.

Australia↗
PubMed2006

Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK Survey.

OBJECTIVE: To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004. DESIGN: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8-9 months after the law (December 2004 to January 2005). MAIN OUTCOME MEASURES: Respondents' reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law. RESULTS: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a "good" or "very good" thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit. CONCLUSION: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.

Adolescent↗