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PubMed1996

Trends in prevalence and acceptance of workplace smoking bans among indoor workers in South Australia.

OBJECTIVE: To compare the reported prevalence and acceptance of bans on smoking in the workplaces of a representative sample of adults in South Australia between 1989 and 1994. DESIGN: Independent cross-sectional representative population surveys. SETTING: South Australian population. PARTICIPANTS: Adults who indicated they were employed mainly indoors, for the years 1989 (875 respondents), 1991 (1472), 1992 (1288) and 1994 (1273). MAIN OUTCOME MEASURES: Percentage reporting total bans on smoking at work; percentage reporting compliance with bans all or nearly all the time; percentage reporting preference for total bans at work. RESULTS: The percentage of indoor workers subject to a total ban on smoking at work increased from 32% in 1989 to 62% in 1994 and preference for a total ban increased during the same period from 26% to 52%. Reported compliance with restrictions and bans was very high. In 1994, 16% of workers still had no restrictions on smoking at work, but only 3% preferred this arrangement. CONCLUSION: The data suggest that smoking bans are now the norm for indoor workers and that further gains in promoting and supporting workplace bans will be made by directing efforts at smaller workplaces, where unrestricted smoking is most prevalent.

Adult↗
PubMed1997

Delayed compensatory cigarette consumption after a workplace smoking ban.

OBJECTIVES: To evaluate the impact of workplace smoking bans on cigarette consumption among continuing smokers over a two-year period. DESIGN: Two cross-sectional surveys and a longitudinal sample of smokers questioned about their smoking behaviour six months and two years after implementation of a workplace smoking ban. SUBJECTS: Workers in 46 government offices in Australia. The cross-sectional survey six months after the ban included 3388 workers, whereas the survey two years after the ban included 3982 workers. The longitudinal cohort study included 107 workers who were identified as current smokers in both surveys. MAIN OUTCOME MEASURES: Smokers were asked to report usual daily cigarette consumption on both workdays and leisure days one month before implementation of the ban, and six months, and two years afterwards. RESULTS: From six months to two years after the ban, the cross-sectional data showed an increase in cigarette consumption of 1.3 cigarettes per day. The longitudinal sample of smokers reported an increase in workday cigarette consumption of 1.7 cigarettes per day. A previous study of workers in the same worksites found a reduction in consumption of 5.2 cigarettes per day from before the ban to six months after. Over a two-year period we estimate that the net effect of the workplace smoking ban was to reduce cigarette consumption by about 3.5 cigarettes per day. CONCLUSIONS: Reductions in cigarette consumption among smokers frequently seen after implementation of a worksite smoking ban may diminish over time. This effect is more likely to occur when the initial response to a smoking ban is a large reduction in cigarette consumption.

Australia↗
PubMed1999

The effects of household and workplace smoking restrictions on quitting behaviours.

OBJECTIVE: To assess the association of household and workplace smoking restrictions with quit attempts, six month cessation, and light smoking. DESIGN: Logistic regressions identified the association of household and workplace smoking restrictions with attempts to quit, six month cessation, and light smoking. SETTING: Large population surveys, United States. SUBJECTS: Respondents (n = 48,584) smoked during the year before interview in 1992-1993, lived with at least one other person, and were either current daily smokers or were former smokers when interviewed. MAIN OUTCOME MEASURES: The outcome measures were an attempt to quit during the last 12 months, cessation for at least six months among those who made an attempt to quit, and light smoking (< 15 cigarettes a day). RESULTS: Smokers who lived (odds ratio (OR) = 3.86; 95% confidence interval (CI) = 3.57 to 4.18) or worked (OR = 1.14; 95% CI = 1.05 to 1.24) under a total smoking ban were more likely to report a quit attempt in the previous year. Among those who made an attempt, those who lived (OR = 1.65, 95% CI = 1.43 to 1.91) or worked (OR = 1.21, 95% CI = 1.003 to 1.45) under a total smoking ban were more likely to be in cessation for at least six months. Current daily smokers who lived (OR = 2.73, 95% CI = 2.46 to 3.04) or worked (OR = 1.53, 95% CI = 1.38 to 1.70) under a total smoking ban were more likely to be light smokers. CONCLUSIONS: Both workplace and household smoking restrictions were associated with higher rates of cessation attempts, lower rates of relapse in smokers who attempt to quit, and higher rates of light smoking among current daily smokers.

Adolescent↗
PubMed2004

Genetic testing in the workplace: ethical, legal, and social implications.

With the completion of the Human Genome Project, it is likely that genetic testing for susceptibility to a wide range of diseases will increase in society. One venue for such increased testing is likely to be the workplace as employers attempt to protect workers from unhealthy gene-environment interactions, improve productivity, and control escalating health care costs. Past and recent examples of genetic testing in the workplace raise serious concerns that such testing could pose a significant threat to workers' privacy, autonomy, and dignity. Thus, defining the ethically, legally, and socially appropriate and inappropriate uses of genetic testing in the workplace presents a major challenge for occupational health professionals in the years ahead.

Genetic Predisposition to Disease↗
PubMedDate not supplied

Importance and effects of altered workplace ergonomics in modern radiology suites.

The transition from a film-based to a filmless soft-copy picture archiving and communication system (PACS)-based environment has resulted in improved work flow as well as increased productivity, diagnostic accuracy, and job satisfaction. Adapting to this filmless environment in an efficient manner requires seamless integration of various components such as PACS workstations, the Internet and hospital intranet, speech recognition software, paperless electronic hospital medical records, e-mail, office software, and telecommunications. However, the importance of optimizing workplace ergonomics has received little attention. Factors such as the position of the work chair, workstation table, keyboard, mouse, and monitors, along with monitor refresh rates and ambient room lighting, have become secondary considerations. Paying close attention to the basics of workplace ergonomics can go a long way in increasing productivity and reducing fatigue, thus allowing full realization of the potential benefits of a PACS. Optimization of workplace ergonomics should be considered in the basic design of any modern radiology suite.

Asthenopia↗
PubMed2003

Ethical aspects of genetic testing in the workplace.

The European Group on Ethics and New Technologies, which advises the European Commission, has published an opinion paper on ethical aspects of genetic testing in the workplace. The paper goes well beyond the usual ethical issues, presenting a summary of genetic testing in the workplace in the United States and Europe and criteria for appropriate testing. Unlike many other documents on ethics, it pays close attention to the problem of false-positive and false-negative test results. Although no genetic tests are currently appropriate for screening workers or applicants for jobs in which occupational hazards exist, inappropriate testing has occurred and regulations are needed to ensure that only appropriate testing is used in the future. Workers or their representatives should be involved in deciding when and how genetic testing in the workplace is done.

Berylliosis↗
PubMed2005

Suicide among regular-duty military personnel: a retrospective case-control study of occupation-specific risk factors for workplace suicide.

OBJECTIVE: The purpose of this study was to examine the epidemiology, phenomenology, and occupation-specific risk factors for suicide among regular-duty military personnel as a model for other professions at risk for workplace suicide. METHOD: Suicide incidence and methods were determined in a retrospective military cohort comprising all deaths (N=732) of regular-duty military personnel in the Irish Defence Forces between 1970 and 2002. A retrospective, case-control study using pair-matched military comparison subjects was conducted to determine occupation-specific risk factors for suicide, particularly by firearm, among military personnel. Risk factors were subjected to chi-square analysis or independent t tests and entered into a binary logistic regression analysis model. RESULTS: The period-averaged suicide rate for the cohort was 15.3/100,000. Firearm suicides accounted for 53% of the cases. Suicides that took place on duty occurred predominantly when personnel were alone shortly after duty commencement in the morning. Bivariate and logistic regression analyses identified psychiatric illness and a past history of deliberate self-harm, morning duty (shortly after duty assumption and consequent access to firearms), and a recent medical downgrading as independent risk factors predicting firearm suicide among military personnel. CONCLUSIONS: Occupation influences suicide method. Access to and opportunity to use lethal means in the workplace are distinct but related occupation-specific suicide risk factors in the military and in other at-risk professions. In professions where access to lethal means is inevitable, moderating opportunity for suicide is crucially important. In regular-duty military personnel, a medical downgrading, combined with risk factors established in civilians such as younger age, male gender, psychiatric illness, and past self-harm, increases the risk of suicide. The findings may be used to guide military harm-reduction strategies and have applicability in strategies for other professions at risk for workplace suicide.

Adolescent↗
PubMed2004

Supplementing supported employment with workplace skills training.

Introduction by the column editors: Supported employment, as designed for persons with serious and persistent mental illness, has been termed individual placement and support. In two randomized controlled trials (1,2), clients who received individual placement and support services were more likely to obtain at least one job in the competitive sector, to work more hours, and to have a higher total income than their counterparts who received more traditional types of vocational rehabilitation. However, individual placement and support did not improve the length of time the employed participants kept their jobs. An adjunctive or additional element of individual placement and support, aimed at improving the job tenure of individuals with mental illness, would be a constructive contribution to the vocational rehabilitation for this population. In a previous Rehab Rounds column, Wallace and colleagues (3) described the development of the workplace fundamental skills module, a highly structured and user-friendly curriculum designed to teach workers with mental illness the social and workplace skills needed to keep their jobs. The workplace fundamental skills module supplements individual placement and support by conveying specific skills that enable workers to learn the requirements of their jobs, anticipate the stressors associated with their jobs, and cope with stressors by using a problem-solving process. The earlier report described the production and validation of the module's content. The purpose of this month's column is to present the preliminary results of a randomized comparison of the module's effects on job retention, symptoms, and community functioning when coupled with individual placement and support. To enable wide generalization of the findings of the study, the program was conducted in a typical community mental health center.

Adolescent↗
PubMed2006

Effects of workplace policy on continuing professional development: the case of occupational therapy in Nova Scotia, Canada.

BACKGROUND: Continuing professional development is essential for professionals to remain competent, and for effective recruitment and retention. PURPOSE: This paper reports a qualitative study of the effects of workplace policy on continuing professional development on a small, dispersed profession in a resource-challenged province, using the case example of occupational therapy in Nova Scotia. METHODS: The study used a multi-methods design, theoretically based on institutional ethnography. Methods were critical appraisal of the literature, interview and focus group data collection with 28 occupational therapists and 4 health services administrators, and a review of workplace policy. RESULTS: The study identified a policy wall. Notable policies were those which defined who is responsible for continuing professional development, and which limited employee benefits and work flexibility options for those with family duties. It appears that a female-dominated profession, such as occupational therapy, may also face gender-based challenges. PRACTICE IMPLICATIONS: Suggestions are offered for workplace policy makers, unions, provincial regulatory organizations, and health professionals. The findings are generally applicable to any small, dispersed health profession operating in resource-challenged conditions.

Anthropology, Cultural↗
PubMed2000

Results of a pilot study reviewing dermatitis claims submitted to the Ontario Workplace Safety and Insurance Board.

BACKGROUND: Workers who develop occupational skin disease are often eligible for workers' compensation benefits; however, there is little known about the decision-making process for adjudicating claims submitted for work-related skin problems. OBJECTIVE: The objective of this pilot study was to test a file abstraction instrument and determine the nature of information that was available for decision-making. METHODS: Files submitted to the Ontario Workplace Safety and Insurance Board (WSIB) in 1995 for dermatitis were identified. The last 51 files were abstracted to collect information concerning demographics, physicians seen, information available in the claim file for decision making, as well as type of claim and outcome of the claim. RESULTS: Approximately 70% of the claims were "no-lost-time" and one-third of total claims were accepted for compensation. Although there was reasonable information related to the clinical status, most claims had no information that related to workplace issues such as exposures or association with work. Claims that were for lost time or were accepted had more information available. CONCLUSIONS: The pilot study has demonstrated that there is a lack of information related to workplace issues that would be important in decision-making. The study will be extended to examine the entire year's claims in order to develop a strategy to enhance the understanding of the WSIB and providers regarding the information necessary for decision-making and to determine methods to facilitate its collection.

Adult↗
PubMed2006

Design and evaluation of a workplace intervention to promote organ donation.

BACKGROUND: A number of efforts have been made to improve rates of deceased organ donation. However, few have been specifically designed for implementation in the workplace. OBJECTIVES: To design and evaluate a workplace intervention to increase documentation of intention to be posthumous organ donors, communication of donation intention to families, and family members' documentation of their donation intentions. METHODS: The study was a randomized controlled trial of corporate employees. Within each corporation, worksites were randomized to a control condition or 1 of 2 educational interventions. Measures included baseline and 1-month postintervention measures of stage of organ donation intention, stage of family notification, and family members' organ donation intention. RESULTS: Across 12 corporations, 40 worksites with a total of 754 participants were randomized. At 1-month follow-up, 495 participants (66%) completed a posttreatment questionnaire. The percentage of participants who signed organ donor cards increased in the 2 intervention groups (29%, P < .001, and 31%, P < .002) but not in the control group (17%, P = .454). The percentage who discussed their donation intentions with family members increased significantly across all 3 arms (39%-47%, P < .001). The mean percentage of participants' family members who signed organ donor cards increased by 14% in the control group (P = .016) and by 17% in the 2 intervention groups (P < .001). CONCLUSIONS: Educational interventions in the corporate workplace setting can be effective in increasing organ donation intention, family notification, and recruitment of family members as potential organ donors.

Adult↗
PubMed2006

Chemical exposures in the workplace: effect on breast cancer risk among women.

Occupational health nurses need to be aware of the current science on breast cancer risks in the workplace because they are risk communicators for employees and their families. Occupational health nurses can serve as advocates for necessary research ultimately leading to risk reduction and prevention strategies in the workplace. Current research suggests exposure to organic solvents, metals, acid mists, sterilizing agents (ethylene oxide), some pesticides, light at night (shift work), and tobacco smoke increases breast cancer risk among women in occupational settings. Animal cancer bioassays conducted by the National Toxicology Program indicate more than 40 chemicals can induce mammary tumors, and most of these are still in production. A variety of occupations worldwide, including health care providers and metal, textile, dye, rubber, and plastic manufacturing workers, have been identified as having some evidence of higher breast cancer risk. Although some chemical exposures are suspected to affect breast cancer risk, estimates of or actual exposures to these chemicals in the workplace often have not been determined. Research needed to better identify breast cancer risks in occupational settings includes monitoring breast cancer incidence in occupations with exposures to suspected carcinogens, characterizing chemical exposures by job type and task, determining whether potential gender differences affect chemical exposures, and using molecular approaches to identify gene-environment interactions.

Age Distribution↗
PubMed2006

Assessing workplace compliance with handling of antineoplastic agents.

Oncology nurses and ancillary support personnel who work in oncology settings are at risk for exposure to antineoplastic drugs in their workplaces. A review of the literature reveals issues of environmental contamination and personal exposure. Although the United States has no formal regulations regarding hazardous drugs, including cytotoxic agents, guidelines have been published and are readily available to improve workplace safety. Oncology healthcare workers must be aware of the serious nature of antineoplastic drug exposure and the avenues available to initiate a simple, highly effective, problem-solving process called SOLVE to make medical workplaces safer.

Antineoplastic Agents↗
PubMed1999

Summary: workshop on health risks attributable to ETS exposure in the workplace.

This 1998 workshop was convened to address the health risks of exposure to environmental tobacco smoke (ETS) in the workplace. It was paired with a 1997 workshop on issues related to ETS exposure in work environments ((italic)1(/italic)). In the 1998 workshop, a multidisciplinary group of participants was charged with reviewing evidence on the quantitative risks to health posed by ETS and to discuss development of risk assessment methodology for the future. The overall charges for the present workshop were to consider various health outcomes and make recommendations regarding those health outcomes to be included in assessment of health risk resulting from ETS in the workplace; to consider available studies addressing these health outcomes and to evaluate the validity of data for estimating risk from occupational ETS exposure; to review and evaluate mathematical models useful for estimating the risk due to ETS exposure; to examine dose-response models and to characterize the models regarding validity and uncertainty in estimating health risk attributable to ETS exposure in the workplace.

Asthma↗
PubMed1999

Epidemiologic evidence for workplace ETS as a risk factor for lung cancer among nonsmokers: specific risk estimates.

Exposure to environmental tobacco smoke (ETS) among individuals who have never smoked tobacco products has been well established as a risk factor for lung cancer. Most of the epidemiologic evidence for this association has come from studies of exposure to a spouse who smokes. Fewer studies have explicitly evaluated this risk relationship for workplace sources of ETS exposure. These are reviewed here in the context of study design issues and their contributions to the overall evidence for risks of ETS exposure in the workplace. Although most studies have low power to detect workplace risk estimates in the modest range suggested by the larger studies, risk estimates tend to be consistent with those for exposure from a smoking spouse.

Epidemiologic Studies↗
PubMed1999

Prescription-type drug misuse and workplace access among nurses.

Access to prescription-type substances in the workplace is a unique feature of the practice of health professionals. Empirical data on the relation between workplace access to substances and prescription-type drug misuse among nurses are limited. Using an anonymous mailed survey, data were collected on three dimensions of access: perceived availability, frequency of administration, and degree of workplace control over storage and dispensing of substances. Each dimension was independently associated with increased use. When these dimensions were combined into an index, nurses with very easy access were most likely to have misused prescription-type drugs (adjusted Odds Ratio = 4.18; 95% Confidence Interval: 1.70-10.30). Level of knowledge of controlled substances was also associated with use, but did not explain the relation between access and use.

Adult↗
PubMed2003

Stress management and workplace disability in the US, Europe and Japan.

Although the health care costs and the number of disability cases across all medical illnesses have increased, disability management programs implementing stress management interventions have been found to improve physical and mental health, reduce costs to employers, and facilitate the reintegration of injured individuals into the work environment. Stress management programs limit the impact and chronicity of disabilities and can be used to reduce and control the cost of disability in the workplace. Providing the most efficacious behavioral interventions thereby allows employers, employees and health professionals to work cooperatively to achieve optimum health and cost effectiveness. This review presents a variety of group and individual interventions, which have been utilized to aid disabled employees in coping with work-related injuries and medical illness. The implementation of stress management interventions in the workplace is described in detail, with special emphasis on the use of cognitive behavioral stress management. Finally, this review outlines a team approach to the application of a workplace stress management intervention aimed at reducing the overall impact of disability.

Persons with Disabilities↗
PubMed2005

A prospective study on the influences of workplace stress on mental health.

The purpose of this study was to clarify the influences of subjective stress in the workplace on mental health according to work contents in subjects without mental health problems. In a survey in fiscal 1997, 1,246 (84.6%) of all 1,363 workers of a manufacturing company in Japan, responded to a questionnaire including questions on subjective stress and GHQ60, and 1,135 workers answered all questions (effective response rate, 83.3%). In fiscal 1997, there were 705 "mentally healthy" workers with a GHQ score of 16. Of the 705 workers, 603 (85.5%) could be followed up by another survey 2 yr later (fiscal 1999). According to the contents of the work, multiple logistic regression analysis was performed using the status of mental health in fiscal 1999 as a dependent variable and subjective workplace stress, sex, age, smoking, and alcohol usage in fiscal 1997 as explanatory variables. The statistically significant items relating to problematic mental health for "factory work" were "too much competition", "feel pressed for time", and "cannot keep up with new technology" (Table 4). For "too much competition", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 4.04 (1.39-11.76) and 1.85 (0.92-3.70), respectively. For "feel pressed for time", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 2.40 (1.08-5.35) and 0.98 (0.46-2.06), respectively. For "cannot keep up with new technology", the odds ratio (95% CI) of "always" and "sometimes" to "do not feel" were 6.54 (0.37-116.36) and 2.52 (1.34-4.77), respectively. The statistically significant items relating to problematic mental health for "research and development or office work" were "too much trouble at work" and "feel pressed for time". For "too much trouble at work", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 3.92 (1.41-10.93) and 1.44 (0.67-3.09), respectively. For "feel pressed for time", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 2.69 (1.04-6.93) and 2.09 (0.94-4.67), respectively. Our study suggests that subjective stress items aggravating mental health are different among work contents. If we could identify items of workplace stress influencing mental health by work contents, we could utilize the results for a mental health promotion program.

Adult↗