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PubMed1991

The development of a test system for investigating the performances of personal aerosol samplers under actual workplace conditions.

The performances of new "total" aerosol samplers for use in workplaces are required to match the inhalability criteria as contained in the latest recommendations of the International Standards Organization (ISO) and the American Conference of Governmental Industrial Hygienists (ACGIH). In the past, practical evaluations have been carried out under idealized conditions in wind tunnels, and there is now the need to extend these to more realistic workplace conditions. This paper describes a new test system that was designed and built for this purpose. It consisted of a life-size mannequin mounted on a trolley so that it can be taken to and wheeled around in workplaces. The mannequin itself incorporated a robotic arm so that, under joystick control, it can be made to simulate a range of worker movements, orientations, and attitudes. An electronically controlled, compact breathing machine provided a range of typical breathing parameters for the mannequin. The pump also provided air movement for a number of personal samplers that were mounted on the torso of the mannequin and tested in that position. Sampler performance should be assessed by comparing directly the aerosol collected by the sampler with that inhaled by the mannequin (and collected on filters inside the head).

Aerosols↗
PubMed1992

Toxicological index and the presence in the workplace of chemical hazards for workers who breast-feed infants.

The increasing number of women in the workplace has made it more important than ever to ensure a safe work environment, particularly with respect to mothers who choose to breast-feed their babies. The Quebec Commission de la santé et de la sécurité du travail (CSST) Toxicological Index is fully involved in the provincial program for the protective reassignment of workers who breast-feed infants. The Infotox database provides peer-reviewed information concerning chemicals identified in the workplace that may appear in the mother's milk, possibly to be ingested by the breast-fed infant. Data extracted from the CSST computer system that holds information on 5,500 substances are presented. A total of 153 chemicals (2.7%) are recognized as being involved in some milk transfer. The strength of evidence is assessed with reference to strong or weak association (excretion or detection) in humans or in animals. Such an effect provides a useful basis for administrative decision involving protective reassignment as well as evaluation of work environment. Database users must be well informed about the identification of chemicals in breast milk because this is an essential step for the evaluation of the hazards of transferring chemicals encountered in the workplace from mother to baby. Actually, the main problem is that there are very few data in the scientific literature concerning milk transfer.

Breast Feeding↗
PubMed1995

OSHA inspections. Workplace inspections.

The Occupational Safety and Health Act of 1970 requires that every worker be provided with a safe and healthful workplace and authorizes the Occupational Safety and Health Administration (OSHA) to conduct workplace inspections. OSHA conducts workplace inspections in hospitals and checks for compliance with the Bloodborne Pathogens Standard, the Enforcement Policy and Procedures for Occupational Exposure to Tuberculosis, and the Hazardous Chemicals Standards, among others. The hospital epidemiologist bears considerable responsibility for developing and implementing plans to protect employees from occupational exposures to infectious hazards such as bloodborne pathogens and tuberculosis. To prepare for an inspection, the hospital epidemiologist must understand the basis on which OSHA operates and must proceed in a thoughtful, coordinated manner.

Blood-Borne Pathogens↗
PubMed1994

Levels of workplace exposure.

A brief description was presented of the evolution of workplace exposure monitoring. Measurements began in the 1930s and developed through particle counting to the introduction of the membrane filter, light microscope method in the mid-1960s. It is important to be aware that most data from the past were collected in relation to workplace control. The membrane filter phase contrast microscope method provides an index of exposure. Fibres with diameters less than 0.2 microns are unlikely to be counted. The method is not capable of analysing individual fibre types and consequently all fibres are counted. There have been several changes to the detail of the membrane filter method. The possible effect of these changes were presented. The Asbestos International Association (AIA) has implemented a fibre counting performance trial and also an annual return of workplace monitoring data. A WHO project is in progress with the objective of harmonizing the membrane filter method for fibre counting of all fibre types using phase contrast microscopy.

Asbestosis↗
PubMed2004

Gloves and dermal exposure to chemicals: proposals for evaluating workplace effectiveness.

There are standardized laboratory tests for chemical protective gloves that provide estimates of breakthrough time and steady-state permeation flux. However, there is evidence to suggest that these tests may not be completely relevant to glove usage in the workplace. There is no consensus about how glove workplace effectiveness should be assessed, although a few studies have attempted to measure the effectiveness of chemical protective gloves. We have used a conceptual model of dermal exposure to help analyse how workers' skin may become exposed while wearing gloves, and propose a new glove workplace protection factor (PFgloves), which is based on the ratio of the estimated uptake of chemicals through the hands without gloves to the uptake through the hands while wearing protective gloves. Mathematical simulations demonstrate that glove protection factor is unlikely to be constant for a glove type, but will be strongly influenced by the work situation and the duration of the exposure. This has important consequences for the selection of protective gloves.

Gloves, Protective↗
PubMed1999

Investigating clusters in the workplace and beyond.

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.

Australia↗
PubMed1999

Health surveys in the workplace: comparison of postal, email and World Wide Web methods.

Health surveys in the workplace are an important part of epidemiology, needs assessment and health promotion. Since the workplace is changing rapidly with the use of computer networks, we examined the feasibility, validity and cost of health surveys using e-mail and the World Wide Web (WWW). Five hundred systematically sampled university staff in a convenience sample of 10 English universities were surveyed using either e-mail alone, e-mail plus a WWW form or postal questionnaire. Response rates, speed of response, validity and costs were examined. The postal survey obtained the best response rate: 72% as compared with 34% for e-mail alone and 19% for the WWW, but it was also the most expensive at 92p per reply, with 35p for e-mail, and 41p for the WWW. Most of the electronic responses were made within five days. In 1997, the increased response rate justified the higher cost of postal questionnaires. e-mail and WWW surveys are easy, quick and inexpensive to administer, and despite low response rates may be useful for pilot studies. The rapid changes in the spread and use of information technology means we have to keep reassessing the methods we use for health surveys in the workplace.

Feasibility Studies↗
PubMed2005

Medical students' evaluation of a teaching session in occupational medicine: the value of a workplace visit.

BACKGROUND: Undergraduate teaching in occupational medicine in UK medical schools is in decline. We developed a teaching programme for the new curriculum at our medical school, and then used student evaluation to tailor it to students' perceived learning needs. AIMS: To examine medical students' perception of a teaching session in occupational medicine after changes made in the light of earlier student evaluation, and in particular their views on the inclusion of a workplace visit. METHODS: Questionnaire evaluation feedback completed immediately after teaching sessions, triangulated with a student focus group session conducted by an external facilitator to explore what students valued most and least and why. Comparison of student evaluations before and after changes introduced in the light of student evaluations. RESULTS: Students' perception of the usefulness and relevance of the session significantly improved after the changes. Students consistently identified the use of case scenarios as helpful but demonstrated a dichotomy of opinion about the value of a workplace visit. Overall, students valued the brevity of the session that resulted from removing the workplace visit. CONCLUSIONS: It is possible to enhance students' perception of the value of a teaching session by modifying the session in the light of student-based evaluation.

Attitude of Health Personnel↗
PubMed2002

A passive radon dosemeter suitable for workplaces.

The results obtained in different international intercomparisons on passive radon monitors have been analysed with the aim of identifying a suitable radon monitoring device for workplaces. From this analysis, the passive radon device, first developed for personal dosimetry in mines by the National Radiation Protection Board, UK (NRPB), has shown the most suitable set of characteristics. This radon monitor consists of a diffusion chamber, made of conductive plastic with less than 2 cm height, containing a CR-39 film (Columbia Resin 1939), as track detector. Radon detectors in workplaces may be exposed only during the working hours, thus requiring the storage of the detectors in low-radon zones when not exposed. This paper describes how this problem can be solved. Since track detectors are also efficient neutron dosemeters, care should be taken when radon monitors are used in workplaces, where they may he exposed to neutrons, such as on high altitude mountains, in the surroundings of high energy X ray facilities (where neutrons are produced by (gamma, n) reactions) or around high energy particle accelerators. To this end, the response of these passive radon monitors to high energy neutron fields has been investigated.

Air Pollution, Indoor↗
PubMed1997

Incidence of non-fatal workplace assault injuries determined from employer's reports in California.

Although fatal work-related assault assault injury rates are routinely reported in the United States, reports of non-fatal injuries are not routinely examined. Non-fatal workplace assault injuries can be reported through many agencies. One of the most common reporting mechanisms in California is the Employer's Report of Occupational Illness and Injury. Employer's Reports filed from October 1, 1994 through January 31, 1995 in the state of California were the source of workplace assault information for this study. All reports indicating an assault-related injury were identified and characterized by gender and occupation of the victim, type of assault and weapon used, and industry. Annual rates were determined based on the number of estimated annual reports and the civilian working population. The estimated annual rate of workplace assault injuries for California based on Employer's Reports is 72.9 per 100,000 workers, which is approximately 50 times the fatal rate. Rates differed by industry, with retail, hospital, transportation and police workers exhibiting the highest rates. Assaults were predominantly Type I, which involve criminal activity, and Type II, which involve an assault by a client, patient, or inmate. The rates of non-fatal work-related assault injury are much greater and have different characteristics than fatal injuries. These non-fatal injury patterns need to be considered when estimating the burden of assault injuries on businesses, and can help identify the most effective prevention strategies.

Absenteeism↗
PubMed1998

Absenteeism among employees who participated in a workplace influenza immunization program.

To assess the effectiveness of a free workplace immunization program at 3M's St. Paul, Minnesota locations, we examined the difference in sick leave hours taken from November 15, 1996, through March 15, 1997, for employees who had and did not have an influenza vaccination prior to the previous year's four-month influenza season (November 15, 1995-March 15, 1996). Among the 2,622 employees who self-reported that they were not immunized in the previous year, there were, on average, 1.2 fewer hours of sick leave taken during the 1996-1997 influenza season than the comparable time period one year earlier (P < 0.05), although the exact reason for the absenteeism was not determined. In particular, we observed that female employees younger than 50 years of age with two or more children took 3.1 hours less sick leave in the year they were immunized, compared with the preceding year (P < 0.0001). Among the 895 subjects who were immunized in both years, employees took 0.7 hours more sick leave during the 1996-1997 influenza season than the previous year (P = 0.46). Based on our findings, consideration should be given to workplace immunization programs. However, we urge caution in applying a "one-size fits all" approach to any cost-savings analysis from a company-sponsored immunization program because the workplace is not a homogeneous [corrected] environment, with regard to employees' age, gender, medical history, and home environment. All of these factors may directly or indirectly contribute to the risk of acquiring influenza and any of its complications.

Absenteeism↗
PubMed2004

Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness.

This report presents an overview of methodological issues in estimating the indirect workplace costs of illness from data obtained in employee surveys using the World Health Organization Health and Work Performance Questionnaire (HPQ). The HPQ is a brief self-report questionnaire that obtains three types of information: screening information about the prevalence and treatment of commonly occurring health problems; information about three types of workplace consequences (sickness absence, presenteeism, and critical incidents); and basic demographic information. The report considers two sets of methodological issues. The first set deals with measurement. The rationale for the HPQ approach to measurement is described in this section. In addition, data are presented regarding the accuracy of HPQ measures, documenting that the HPQ has excellent reliability, validity, and sensitivity to change. The second set of methodological issues deals with data analysis. A number of analysis problems are reviewed that arise in using self-report nonexperimental survey data to estimate the workplace costs of illness and the cost-effectiveness of treatment. Innovative data analysis strategies are described to address these problems.

Absenteeism↗
PubMed2004

Hearing loss and perceptions of noise in the workplace among rural Australians.

OBJECTIVE: To compare measured hearing levels of individuals regularly exposed to noise in their workplace to self-reported and family-reported hearing loss. To compare the attitudes and preventative actions adopted by individuals who are more aware of the potential for hearing loss to less aware individuals. DESIGN: The project examined the perceptions of rural workers concerning noise, noise exposure and hearing. The subjects completed a 'Noise at Work' questionnaire and some demographic data at the time of audiometric testing. SETTING: The subjects were recruited when attending their rural health clinic for audiometric testing. PARTICIPANTS: Participants comprised 113 men and 23 women (20-65 years, mean = 39.6, SD = 11.4) working across a range of activities at different levels in their workplaces. The range in current employment was from 0.5 to 45 years (mean = 13.8, SD = 10.7). RESULTS: Hearing tests were compared with perceptions of noise annoyance, hearing damage risk and preventative action. Self- and family-reported hearing loss and conversational difficulties in noise correlated well with measured audiograms. Perceptions of workplace noise tended to be more positive if people felt they had hearing problems. There was no difference in preventative action between those who did and did not feel they had hearing problems. Both groups rated barriers to action and lack of self-efficacy in a similar negative way. CONCLUSIONS: There is a need for specific training to ensure that rural workers have skills to take more positive action in reducing noise exposure at work.

Adult↗
PubMed1992

The workplace and problem drinking as seen by two novices.

Based on a selective review of the occupational alcoholism literature, a number of difficulties with the research regarding the effects of the workplace on problem drinking were identified. The identification of these difficulties led to an alternative model being proposed. The alternative emphasizes interactions between predispositional factors and the workplace and does not advocate continuing to search for main effects of the workplace on problem drinking. The paper closes with 10 recommendations for future research.

Alcohol Drinking↗
PubMed1990

Where there's smoke...carbon monoxide exposures in smoking and smoke-free workplaces.

Comparisons of expired air carbon monoxide levels in non-smoking staff in six licensed clubs (a smoking workplace) were made with those of non-smoking staff of a large public hospital (a smoke-free workplace). There was a significant difference between clubs and hospital in levels of CO at end of work. The average concentration of club workers was 8.7 ppm (Hospital, 5.3 ppm). Approximately one third of these non-smokers in licensed clubs exceeded 10 ppm putting them in the 'light smoker' category according to the manufacturer of the monitoring equipment. Club workers increased their CO level during work time by four times the increase of Hospital staff. This study suggests that there are significant gains to be made in reduction of intake of harmful passive-smoking products by removing tobacco smoke from workplaces.

Australia↗
PubMed2006

Healthcare use before and after a workplace injury in British Columbia, Canada.

OBJECTIVES: There is growing evidence that occupational injuries influence workers' emotional and physical wellbeing, extending healthcare use beyond what is covered by the Workers' Compensation Board (WCB). METHODS: The authors used an administrative database that links individual publicly funded healthcare and WCB data for the population of British Columbia (BC), Canada. They examined change in service use, relative to one year before the injury, for workers who required time off for their injuries (lost time = LT) and compared them to other injured workers (no lost time = NLT) and individuals in the population who were not injured (non-injured = NI). RESULTS: LT workers increased physician visits (22%), hospital days (50%), and mental healthcare use (43% physician visits; and 70% hospital days) five years after the injury, relative to the year before the injury, at a higher rate than the NI group. For the NLT workers, the level of increased use following the injury was between that of these two groups. These patterns persisted when adjusting for registration in the BC Medical Service Plan (MSP) and several workplace characteristics. CONCLUSIONS: Although the WCB system is the primary mechanism for processing claims and providing information about workplace injury, it is clear that the consequences of workplace injury extend beyond what is covered by the WCB into the publicly funded healthcare system.

Accidents, Occupational↗
PubMed1999

Risk of stomach cancer associated with 12 workplace hazards: analysis of death certificates from 24 states of the United States with the aid of job exposure matrices.

OBJECTIVE: To investigate the risk of gastric cancer associated with 12 workplace exposures suspected or discussed as aetiological agents in previous reports. METHODS: A case-control study was conducted based on the death certificates of several million deaths in 24 states of the United States in 1984-96. Overall, the data base included 41,957 deaths from stomach cancer among subjects aged > or = 25 years. These were 20,878 white men, 14,125 white women, 4215 African American men, and 2739 African American women. Two controls for each case were selected from among subjects who died from non-malignant diseases, frequency matched to cases by geographic region, race, sex and 5 year age group. Each three digit occupation and industry code listed in the 1980 United States census was classified for probability and intensity of exposure to asbestos, inorganic dust, metals, lead, polycyclic aromatic hydrocarbons (PAHs), nitrogen oxides, nitrosamines, sulphuric acid, fertilisers, herbicides, other pesticides (including insecticides and fungicides), and wood dust. These job exposure matrices were subsequently applied to the occupation-industry combinations in the death certificates of study subjects, separately by sex and race. RESULTS: Risk of stomach cancer showed a modest association with occupational exposure to inorganic dust (odds ratio (OR) = 1.06; 95% confidence interval (95% CI) 1.03 to 1.11) with significant increasing trends by probability and intensity of exposure overall and by cross classification of the two exposure matrices. Workplace exposure to nitrosamines also showed a modest association (OR = 1.06; 95% CI 1.01 to 1.11), but the excess risk was even smaller after adjusting for inorganic dust exposure. Risk of gastric cancer was not associated with any of the other workplace exposures considered in this study. CONCLUSIONS: Non-differential misclassification of exposure may have caused negative findings in this study, and inorganic dust may be a partial surrogate for exposure to other unknown risk factors. Alternatively, our results suggest that occupational factors contribute little to the aetiology of gastric cancer. Inorganic dust might act through non-specific mechanisms, similar to those proposed for salt, aspirin, and heat by other authors.

Adult↗
PubMed2003

Physician diagnosed asthma, respiratory symptoms, and associations with workplace tasks among radiographers in Ontario, Canada.

BACKGROUND: Medical radiation technologists (MRTs) or radiographers have potential exposure to chemicals including sensitisers and irritants such as glutaraldehyde, formaldehyde, sulphur dioxide, and acetic acid. AIMS: To determine the prevalence of asthma and work related respiratory symptoms among MRTs compared with physiotherapists, and to identify work related factors in the darkroom environment that are associated with these outcomes. METHODS: As part of a two component study, we undertook a questionnaire mail survey of the members of the professional associations of MRTs and physiotherapists in Ontario, Canada, to ascertain the prevalence of physician diagnosed asthma, and the prevalence in the past 12 months of three or more of the nine respiratory symptoms (previously validated by Venables et al to be sensitive and specific for the presence of self reported asthma). Information on exposure factors during the past 12 months, such as ventilation conditions, processor leaks, cleanup activities, and use of personal protective equipment was also collected. RESULTS: The survey response rate was 63.9% among MRTs and 63.1% among physiotherapists. Most analyses were confined to 1110 MRTs and 1523 physiotherapists who never smoked. The prevalence of new onset asthma (since starting in the profession) was greater among never smoking MRTs than physiotherapists (6.4% v 3.95%), and this differed across gender: it was 30% greater among females but fivefold greater among males. Compared with physiotherapists, the prevalence of reporting three or more respiratory symptoms, two or more work related, and three or more work related respiratory symptoms in the past 12 months was more frequent among MRTs, with odds ratios (ORs) (and 95% confidence intervals) adjusted for age, gender, and childhood asthma, of 1.9 (1.5 to 2.3), 3.7 (2.6 to 5.3), and 3.2 (2.0 to 5.0), respectively. Analyses examining latex glove use indicated that this was not likely to account for these differences. Among MRTs, respiratory symptoms were associated with a number of workplace and exposure factors likely to generate aerosol or chemical exposures such as processors not having local ventilation, adjusted OR 2.0 (1.4 to 3.0); leaking processor in which clean up was delayed, 2.4 (1.6 to 3.5); floor drain clogged, 2.0 (1.2 to 3.2); freeing a film jam, 2.9 (1.8 to 4.8); unblocking a blocked processor drain, 2.4 (1.6 to 3.7); and cleaning up processor chemical spill, 2.8 (1.9 to 4.2). These outcomes were not associated with routine tasks unlikely to generate exposures, such as working outside primary workplace, loading film into processor, routine cleaning of processors, or removing processed film. Males reported that they carried out a number of tasks potentially associated with irritant exposures more frequently than females, consistent with the marked increase in risk for new onset asthma. CONCLUSIONS: These findings suggest an increase of work related asthma and respiratory symptoms shown to denote asthma among MRTs, which is consistent with previous surveys. The mechanism is not known but appears to be linked with workplace factors and may involve a role for irritant exposures.

Adult↗