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PubMed2006

Practice and potential of economic evaluation of workplace-based interventions for occupational health and safety.

BACKGROUND: We review economic analyses in studies of workplace-based occupational health and safety interventions in order to report on evidence of their financial merits and assess the quality of application of economic evaluation methodologies. The focus of the review is interventions applicable to an office setting. MATERIALS AND METHODS: We draw on several systematic reviews to identify studies that consider both the costs and consequences of an intervention, or simply the consequences in monetary terms. RESULTS: In total, we identified 23 studies which we included in our final synthesis. More than half of these studies considered only the consequences in monetary terms, rather than both the costs and consequences associated with the intervention. CONCLUSIONS: In reviewing the studies, we identified a number of methodological shortcomings which we discuss in detail. A key message from our review is that there is a need for economic expertise in the multidisciplinary research teams evaluating workplace-based occupational health and safety interventions.

Cost-Benefit Analysis↗

PubMed1994

Confirmatory tests for drugs in the workplace by gas chromatography-mass spectrometry.

The Mandatory Guidelines for Federal Workplace Drug Testing Programs require the use of gas chromatography-mass spectrometry (GC-MS) for the confirmation of presumptive positive urine specimens. This review focuses upon GC-MS methods developed specifically for forensic confirmation of amphetamine, methamphetamine, 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (THC-acid), benzoylecgonine, morphine, codeine and phencyclidine in urine for purposes of workplace drug testing. In addition, current laboratory issues pertaining to each drug class are reviewed. Generally, drug assays utilized either liquid-liquid or solid-phase extraction methods, derivatization if necessary, and GC-MS detection operating in the selected ion monitoring mode or by full scan acquisition.

Amphetamines↗

PubMed1993

Workplace drug abuse policy.

An estimated 70 percent of illicit drug users are in the workforce. This paper studies workplace policies relating to drug abuse treatment and testing in a labor market with asymmetric information about worker proclivities to abuse drugs and to incur costs of workplace accidents. Drug abuse has a moral hazard component related to worker choice of treatment or other deterrent activities, and a selection component related to drug testing. We characterize the type and frequency of workers treated and tested in labor market equilibrium. Labor market incentives will generally lead to too little treatment and too much testing.

Data Collection↗

PubMed2005

Gender differences in the causal direction between workplace harassment and drinking.

Data from a longitudinal study of university employees across four waves is used to determine the extent to which workplace harassment predicts drinking or conversely the extent to which drinking predicts workplace harassment, and to address gender differences in these relationships. Mixed effects regression models are used to test the effects of 1) harassment at the previous wave on drinking at the current wave, adjusting for drinking at the previous wave, and 2) drinking at the previous wave on harassment at the current wave, adjusting for harassment at the previous wave. For males, drinking at the previous wave predicts sexual harassment at the current wave, whereas for females, sexual harassment at the previous wave predicts drinking at the current wave.

Alcohol Drinking↗

PubMed2006

Participatory methods effective for ergonomic workplace improvement.

Recent experiences in using participatory methods for ergonomic workplace improvement are reviewed to know how these methods can be effective in different settings. The review covered participatory programmes for managers and workers in small enterprises, home workers, construction workers and farmers in Asian countries. To meet diversifying ergonomic needs, participatory steps reviewed are found to usually follow a good-practice approach easily adjustable according to local needs. These steps are found to usually focus on low-cost improvements. They can thus lead to concrete results particularly by addressing multiple technical areas together. Typical areas include materials handling, workstation design, physical environment and work organization. Further, the review confirms that the participatory methods are always modified according to each local situation. This is done by developing a group-work toolkit comprising action checklists and illustrated manuals and by building a support network of trained trainers. It is suggested that participatory methods taking a good-practice approach by multi-area low-cost improvements through the group use of locally adjusted toolkits are effective for improving small-scale workplaces including those in developing countries.

Agriculture↗

PubMed2005

An analysis of cleaner production and its impact on health hazards in the workplace.

The main focus of this paper is to bring out the cost effectiveness of cleaner production and the role played by cleaner production in minimizing the health hazards of pollutants in the workplace. Improvement in workplace health hazards due to implementation of cleaner production has been illustrated with the results of the study. This study was carried out in 16 Manufacturing units in two states of Maharashtra and Gujarat in India. The results clearly shows with the help of cost benefit analysis that cleaner technologies not only add to the bottom line of the company but also minimize exposure to toxic chemicals like Ammonia, phenol, carbon tetrachloride, toxic dust, etc. The main driving forces motivating the firms to go in for cleaner production are evaluated. It is found that in most of the units safety and health factors were ranked as one among the first four driving forces behind implementation of cleaner technologies. The paper ends with recommendations for the promotion of cleaner technologies.

Hazardous Substances↗

PubMed2004

Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace.

Mobbing, or psychological harassment at the workplace, is usually defined as a situation in which a person or a group of people engage in extreme psychological violence against another person. In Spain, the number of reports for mobbing has increased extraordinarily in the last years. The reports are increasing dramatically not only before the Labour Courts, but also before the Civil Courts, with claims for damages, and before the Penal Court for offences causing physical or moral injury, etc., since at the present time this figure is not typified as an offence in the Spanish Penal Code. The high degree of complexity of this situation has given rise to frequent misuse of the term and to a number of false accusations of mobbing. A recent European Parliament Resolution on harassment at the workplace addressed the devastating consequences of false accusations. In this paper we present a case in which the "false" victim was mentally ill (paranoia) but succeed in generating an extreme dangerous environment of great harassment against the "false" assailants that were "falsely" accused of mobbing. Forensic diagnosis of the psychiatric disorder suffered by the "false" victim was essential to clarify the issue at the Penal Court.

Adult↗

PubMedDate not supplied

Educational needs of employed family caregivers of older adults: Evaluation of a workplace project.

Family members provide 80% of care for older adults in the United States. Many family caregivers are employed either full or part time. For employed caregivers, personal health, job performance, and the ability to advance their career are affected by the weight of their caregiving responsibilities. Some find it necessary to quit their jobs. Employed caregivers report a need for caregiving information; however, they seldom think of their workplace as a valuable resource. Results of the second of a 3-phase research and service project are discussed. Based on a needs assessment completed by employees of a large institution, educational sessions were offered during 3 consecutive months. Thirty-five employees attended 1 or more sessions. The sessions were evaluated highly on a 5-point Likert-type scale for usefulness of information, quality of presentation, and value of session. Sharing project results with the employing institution's human resources department yielded commitment to integrate caregiver education and referral into a newly organized work-life program. When properly managed, such workplace programs can provide needed assistance to employed caregivers. A nurse working with older adults is an ideal provider to initiate and manage this kind of program.

Absenteeism↗

PubMed2005

Effect of subspecialty organization of an academic department of anesthesiology on faculty perceptions of the workplace.

BACKGROUND: Many large academic practices have accepted the notion that subspecialization provides certain benefits-more consistent care, a higher degree of state-of-the-art knowledge, improved teaching, and better working relationships and communication among the subspecialty anesthesia faculty and their surgical and nursing colleagues. But a rigid subspecialty grouping is rarely done in the main body of an academic faculty. STUDY DESIGN: To evaluate if subspecialization provides greater satisfaction for an academic general services anesthesia faculty, a survey about work conditions and perceptions was undertaken before and after reorganization of a large academic practice. Scores for each question were on a scale of 1 to 5. RESULTS: Although there was a sense that excellent expert care was more often delivered after subspecialty reorganization, the overall faculty impression of their workplace was not markedly changed (prereorganization 3.52 +/- .56; postreorganization 3.60 +/- .34 [mean score +/- SD]; p = NS). CONCLUSIONS: The faculty did not perceive an overall benefit from a move to greater subspecialization in the organization of the anesthesia department, despite the leadership's opinion that the workplace had become much more functional and productive.

Academic Medical Centers↗

PubMed2006

A survey of indoor workplace radon concentration in Japan.

Radon ((222)Rn) concentration was measured at indoor workplaces in Japan to estimate effective dose to the public from (222)Rn and its progeny. Measurements were made from 2000 to 2003 at 705 sites in four categories of office, factory, school and hospital. Passive type Rn monitors equipped with two sheets of polycarbonate thin films for measuring radon concentrations were installed at observation sites and replaced every 3 months to observe seasonal variations in (222)Rn concentrations. The range of annual mean (222)Rn concentrations for all sites was 1.4-182 Bq m(-3), with the arithmetic mean and standard deviation were 20.8 and 19.5 Bq m(-3). Annual mean (222)Rn concentration observed at office, factory, school and hospital were 22.6, 10.1, 28.4 and 19.8 Bq m(-3), respectively. Seasonal variations in (222)Rn concentrations at offices, schools and hospitals were similar to those found in dwellings, and variations in factories were similar to those found in outdoor environments. (222)Rn concentration observed in every quarter period was found to decrease as follows: school>office>hospital>factory. The average effective dose to the public due to (222)Rn was estimated to be 0.41 mSv y(-1) weighted by the working population. Considering the (222)Rn exposure in indoor workplaces, effective dose to the general public is estimated to be in the range from approximately 0.42 to 0.52 mSv y(-1).

Air Pollutants, Radioactive↗

PubMed2004

'Choosing' to work when sick: workplace presenteeism.

Presenteeism is a concept used to describe the phenomenon of working through illness and injury. This paper is based on interviews and focus groups undertaken at three different work sites in New Zealand: a small private hospital, a large public hospital and a small factory. The research suggests that presenteeism is a prominent phenomenon in the lives of workers at these different sites, but the way in which it is rationalised and the factors that foster presenteeism are quite distinct. Exploring the way in which presenteeism links to economic and social constraints and workplace cultures provides insights into these rationalisations. The powerful forces promoting presenteeism tempers the research community's concern with absenteeism. A presenteeism discourse needs to be more prominently articulated to oppose both the absenteeism discourse, and to moderate the views taken by some postmodernist theorists on choice in relation to health practices in workplace settings.

Absenteeism↗

PubMed2006

Workplace conflict resolution and the health of employees in the Swedish and Finnish units of an industrial company.

New patterns of working, the globalisation of production and the introduction of information technologies are changing the way we work. This new working environment has eliminated some risks whilst introducing others. The importance of the psychosocial working environment for the health of employees is now well documented, but the effects of managerial style have received relatively little attention. Yet management is an increasingly important aspect of companies' policies. In this paper, we examine the relationship between conflict management in the workplace and self-reported measures of stress, poor general health, exhaustion and sickness absence due to overstrain or fatigue. Our sample consists of non-supervisory employees (N = 9309) working in the Swedish and Finnish plants of a multinational forestry company who were surveyed in 2000. Bivariate analyses show that those who report that differences are resolved through discussion are least likely to report stress, poor general health, exhaustion or sickness absence. Those who report that authority is used or that no attempts are made to resolve differences have quite similar rates across all measures. Binary logistic regression analyses were performed for all health outcomes controlling for age, sex, occupational group, job complexity, job autonomy and support from superiors. Results show significantly lower likelihoods of reporting stress, poor general health, exhaustion or sickness absence amongst employees who report that differences of opinion are resolved through discussion compared to those who report that no attempts are made. No significant differences were found between those who reported that differences were resolved through use of authority and subjects in the 'no attempt' category. These results suggest that the workplace conflict resolution is important in the health of employees in addition to traditional psychosocial work environment risk factors.

Adult↗

PubMed1999

The clinician's role in assessing workplace violence.

Workplace violence can be an area of consultation for psychiatrists. However, the clinician must understand not only the limits of violence prediction, but also the corporate culture in which he or she will become involved. Evaluation of threats may involve review of written notes or taped recordings; the employee may or may not be seen. Corporate consultations sometime involve a split allegiance on the part of the clinician who must both advise the company and render a decision about the employee. The dynamics of violence within the workplace are discussed.

Computer Communication Networks↗

PubMed2002

[Evaluation of a workplace anti-smoking program at a company with 640 employees].

OBJECTIVES: Awareness of the health risks of passive smoking for non-smokers has led to the development of workplace interventions for smokers, although they are still few in our setting. The objective of this study was to evaluate the efficacy of an anti-smoking program among the workers of a company, in function of changes in the pre- and post-intervention prevalence of smoking in the study population. METHOD: A pre-intervention questionnaire on smoking (prevalence and attitudes) was administered at a company with 640 employees (92% men, 8% women). An anti-smoking program was carried out inside the company during working hours over the next nine months. The questionnaire was then repeated (post-intervention) in order to evaluate its efficacy based on changes. For employees who answered both questionnaires, paired variables were analyzed. RESULTS: The pre-intervention questionnaire was answered by 388 employees (60%), 357 men (92%) and 31 women (8%); their mean age was 48.4 years (SD 9.36). The prevalence of smoking was 55%, including daily smokers, sporadic smokers and others. The mean number of cigarettes per day was 17.86 (SD 2.45). The mean level of nicotine dependence measured by the Fagerström test was 3.3 (SD 2.8) out of 10. The post-intervention questionnaire was answered by 206 employees (32%). Among employees who answered both questionnaires (83), analysis of paired data showed a decrease in the prevalence of smoking of 4% and in the number of cigarettes per day from 17.4 (pre-intervention) to 16.4 (post-intervention). The differences were not statistically significant. CONCLUSIONS: Although the workplace is an appropriate setting for anti-smoking interventions that would contribute to improving the health of smokers, such programs are currently underutilized.

Adult↗

PubMed2003

Clinical and workplace factors associated with a return to modified duty in work-related upper extremity disorders.

Return to work following treatment for a work-related upper extremity disorder (WRUED) is affected by a variety of medical, workplace, and personal factors, and returning to modified duty may ease the transition to normal work activities. This study surveyed 165 federal government employees (127 females, 38 males) who were unable to resume their normal work after filing a workers' compensation claim for a WRUED (<90 days from claim filing) and who volunteered for a randomized study of alternative case management strategies. Before randomization, participants completed a baseline survey of upper extremity (UE) symptoms, functional limitations, and workplace factors. At baseline, 58 participants (35%) were working modified duty and 107 participants (65%) were not working. Compared with participants working modified duty, those who were not working were more likely to report: (a). a diagnosis of mononeuropathy, odds ratio (OR)=3.16 (95% confidence interval (CI)=1.37-7.14) versus enthesopathy, (b). higher pain ratings, OR=1.43 (95% CI=1.01-2.01), (c). greater functional limitations, OR=1.63 (95% CI=1.11-2.38), and (d). higher level of ergonomic stressors, OR=1.62 (95% CI=1.09-2.43) in a multivariable logistic regression. Measures of high risk work styles (fast pace and working despite pain) were associated with greater perceptions of ergonomic exposure, but not with work status. The model had 87.9% sensitivity and 43.1% specificity to correctly classify those not working (overall classification 72.1% correct). The results suggest that modified duty for workers with persistent WRUEDs may be enhanced by assessing perceived functional limitation and ergonomic exposure as well as the type and severity of symptoms.

Arm Injuries↗

PubMed2001

Workplace drug testing in Europe.

Not much information is available on workplace drug testing (WDT) in Europe. There is no specific legislation and there are no generally accepted guidelines. Many companies establish a drug policy with little or no provisions for drug testing. Often, testing is performed on-site by occupational physicians, with little or no quality control, no systematic confirmation of positives, no chain of custody and no adulteration testing. In some parts of Europe, e.g. in the United Kingdom and some Scandinavian countries, WDT is increasing in importance, but it is not as widespread as in USA. The most frequently performed tests are amphetamines, cannabinoids, cocaine, opiates and alcohol. The percentage of positives is variable, but seems to decrease with the years following the introduction of WDT. Cannabis is the drug that is most frequently found.Recently, the European Workplace Drug Testing Society (EWDTS) was founded, with the aims to ensure that WDT in Europe is performed to a defined quality standard and in a legally secured way and to provide an independent forum for all aspects of WDT.A working group in the United Kingdom has recently finalised the United Kingdom laboratory guidelines for legally defensible WDT and discussions are under way with the EWDTS to establish common guidelines. Many efforts will be needed to establish WDT as an accepted part of a company policy on drugs: establishing and maintaining the confidence in the results of the laboratory, establishing the legal status of WDT, preserving the privacy and rights of the employees, proving the cost-effectiveness of WDT in a European context, finding a balance between strict guidelines and enough flexibility to tailor testing to the changing needs. It is hoped that the exchange of experience between different countries will contribute to reaching these goals.

Europe↗

PubMed2001

Workplace harassment, active coping, and alcohol-related outcomes.

PURPOSE: While sexual harassment and generalized workplace abuse (GWA) have been linked with alcohol use and abuse, active problem-focused coping has been shown to lessen vulnerability to deleterious mental health consequences of varied social stressors. At the same time, active coping is relatively more efficacious in response to stressors, which are amenable to change by personal actions. However, the moderating role that coping plays in relation to harassment and drinking is unknown. METHOD: Using data from a two-wave survey of university employees (N=2038), we addressed the extent to which (1) active coping was utilized by harassed and abused employees, (2) whether coping impacted on the continuation or cessation of harassment and abuse, and (3) the extent to which nonsuccessful coping was predictive of alcohol use and abuse. RESULTS: Active coping had no significant impact on the ability to end harassing or abusive experiences. Moreover, the use of problem-focused coping that was unsuccessful predicted some drinking outcomes for both men and women, controlling for Wave I drinking and sociodemographic characteristics. IMPLICATIONS: The data suggest that increased institutional attention to the prevention of workplace harassment and abuse might impact on decreasing alcohol use and abuse.

Adaptation, Psychological↗

PubMed1996

Coerced treatment for substance abuse problems detected through workplace urine surveillance: is it effective?

With the advent of on-site urine testing and other initiatives designed to reduce substance abuse at the workplace, employees who are found to have used alcohol and/or drugs have been coerced into substance abuse treatments under threat of job loss. This widespread practice has produced three questions relative to these practices. First, do these employees have significant substance abuse problems or are they merely "recreational users" who have gotten caught? Second, will these employees participate in standard treatments or will they resist them? Finally, will standard substance abuse treatments provide any benefits to these coerced patients relative to other self-referred patients in treatment? We compared the pretreatment problems, during treatment performance and posttreatment outcomes of 96 employed, insured participants who were coerced into treatment at four private treatment programs due to detection of drug use on the job, to the same measures collected on a comparison group of 161 patients from the same job sites who were self-referred admissions to the same four treatment programs. Results showed that the coerced group had significant substance abuse and other life problems at the start of treatment, but that these problems were generally less severe or chronic than those of the self-referred group. Coerced participants were significantly more likely to remain in treatment (either inpatient or outpatient) than the self-referred participants. Posttreatment follow-up of coerced patients indicated marked improvements in alcohol and drug use, employment, medical, family, and psychiatric problems. These levels of improvement were comparable to those shown by the self-referred patients. We conclude that workplace urine surveillance was successful in detecting employees with significant substance abuse related problems, and that referral to standard treatment was associated with substantial improvements in those problems.

Adult↗