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News from throughout the world illustrates how disasters are impacting people during their commute and at the workplace. Now more than ever employers must ensure that personnel have the tools to deal with the impacts of these critical events. This article outlines how organizations can build psychological infrastructure in their corporate culture to foster resilience in the workplace.
In the present setting of fiscal and other constraints placed upon the business world during economically challenging times, there exists both intentional and unintentional opportunities for unfair and illegal treatment of employees. Hospitals and other health care facilities or organizations are not immune. In fact, given the demographics of our field and the general "graying" of our colleagues, a disproportionately higher number of perfusionists reside within the age-protected guidelines established by both federal and state law. Not coincidentally, the pressures on hospitals to stay solvent in the presence of decreasing reimbursement and declining revenues may well create a prescription for unfair treatment of employees. This article will explain the basic concepts of the protections afforded employees by law with regard to freedom from harassment and discrimination in the workplace. Matters related to the hostile workplace environment; age, sex, and race discrimination; and adverse employment actions will be explained and illustrated by applicable case law. In this regard, it is intended that this article will enhance the opportunity for perfusionists to be cognizant of both the express and implied behaviors (both verbal and nonverbal) that may be detrimental to an employment situation, as well as to be cognizant of some of the remedies at law available regarding adverse employment circumstances.
The purpose of this study was to compare the epidemiology of musculoskeletal injuries and workplace ergonomics among rural-based sonographers compared to urban-based sonographers. The authors also tested the use of a biomechanical software program to assess load on the spine and upper extremity joints. A mail-in survey was sent to all practicing sonographers in rural Manitoba, and on-site video-taped ergonomic and biomechanical evaluations were completed for four sites. Rural-based sonographers appear to have greater work stress related to waiting lists, use of outdated and non-adjustable equipment, and high client load. They also do not advocate for better working conditions because they are few in number and geographically distant from one another. Use of the biomechanical software proved minimally useful. Information related to industry standards and greater collaboration is needed to promote workplace health for sonographers.
There has been aproliferation of genetic information in the last 25 years resulting in a spectrum of existing and potential uses in the workplace. These uses of have different issues and implications which may be more clearly considered in a framework that identifies three distinct uses (research, practice, and regulation/litigation) for inherited genetic factors and acquired genetic effects. Inherited genetic factors pertain to the characteristics of the genes, and acquired genetic effects to the impact on genes and chromosomes of environmental and constitutional factors. Critical in assessing the issues involving genetics in the workplace is attention on the rights of workers, validity and clinical utility of genetic information, cost pressures on employers, and societal implications. Genetic information may provide mechanistic and diagnostic insight into occupational diseases and allow for targeting high-risk groups, improving risk assessments, and providing early indicators of risk. However, these benefits are more likely to be realized and problems avoided when the different uses are considered in a framework that distinguishes them by type and content. The application of such a framework makes it easier to assess whether there is a sufficient evidence base and worker safeguards in place for any particular use of genetic information.
Occupational health department of a large private enterprise located in India launched Project CASH--Change Agents for Safety and Health, at manufacturing units of the enterprise to bring about a positive change in work environment and improvement in work practices to reduce occupational health risk. Multidisciplinary teams of change agents were constituted and were given intensive training inputs. Reduction in exposure to noise, dust and heat stress were identified as specific objectives after a baseline survey of the work environment. Occupational safety and health knowledge and training was imparted to all field personnel to improve their work practices and attitudes. The focus of the actions was on engineering control measures and process engineering changes necessary for workplace improvement. Noise levels were reduced by an average of more than 9dBA in most of the top ten high noise locations. Out of two locations identified for dust exposure, one was fully eliminated and dust levels at other location were significantly reduced. Heat stress was reduced in all three identified locations with an average reduction of more than 3 degrees C in WBGT levels. Thus, final evaluation of workplace environments revealed significant reduction in exposure to all identified agents, viz noise, dust and heat fulfilling the project objectives. Educating and empowering the team led to reduction of occupational health risks in the work environment. There was positive attitudinal and behavioural change in safety and occupational health awareness & practices among employees. The monetary savings resulting from improvements far outweighed the investments. Success of this pilot project was followed up with further similar projects and their number has grown in geometric proportion for the last three years indicating the sustainability of the project.
Cultural diversity issues affect the health care workplace and nursing practice. The Lowenstein-Glanville conflict model can be used for assessing and intervening in racial and status conflict in hospital settings. Implications for nursing practice include recognizing that cultural diversity will continue to grow in the health care workplace. Nurses must increase sensitivity, become aware of cultural nuances and issues, and make cultural assessment a routine part of their assessment and planning, not only for patient care, but also with their co-workers and subordinates.
Homicide is now the cause of 12 percent of deaths in the workplace, and workplace violence by disgruntled employees or former employees continues to increase. The family physician may be the first or only professional to examine such persons before an act of violence occurs. The assessment of a potentially violent employee includes evaluating for threats, a history of violence, paramilitary interests, access to weapons, paranoia, substance abuse and a sense of having no future or no alternative to violence. A shame-rage cycle that may include a sense of evernarrowing options often precedes the violent act and may reveal warning signs that represent potential opportunities for intervention before the act is committed. Initial interventions include ensuring the immediate safety of potential victims, initiating measures to reduce acute shame and rage in the person at risk and facilitating an effective referral. Preventive strategies at the organizational level include preemployment screening, explicit nonharassment policies, employee counseling, physical security measures and the establishment of an organizational clearinghouse for reporting and assessing threatening behaviors.
The proponents of drug and alcohol testing advance several safety and productivity arguments in support of their position. It is asserted that persons who test positively for drug and alcohol at the workplace experience higher levels of absenteeism and use sick leave to a much greater extent than non-users. Moreover, it is claimed that they have levels of productivity from 10 to 60 per cent lower than persons who do not test positively for drugs or alcohol. Perhaps the greatest argument advanced by those in favour of testing, however, is the safety element. Persons who abuse drugs or who consume alcohol to excess are involved in significantly more accidents than those who test negatively. In other words, proponents take the position that persons who test positively for the presence of drugs or alcohol form a category of individuals and that being in this category is grounds for labelling them as problematic employees. Moreover, so the reasoning goes, the only way to find out if an employee is a member of the category of drug or alcohol users is to test. Opponents of alcohol testing feel that the goal of ensuring a drug- and alcohol-free workplace is reached at too high a social cost and that the testing process constitutes an unwarranted invasion of the privacy of the individual. The provision of urine for analysis is a search, which, if conducted without consent or reason, would constitute an assault. Some opponents to testing feel that the real motivation for testing is controlling employee behaviour. Enterprises impose behavioural constraints on employees that may extend to off-duty times. Moreover, it is advanced that the testing process itself is humiliating to many people. In order to obtain a sample for testing, the person being tested must urinate in the presence of an attendant or supervisor. Often, medical standards are not used. Another moral issue is the implication of discrimination as a result of drug or alcohol testing. Perhaps the greatest concern is the systemic discrimination against disabled persons, persons with acquired immunodeficiency syndrome (AIDS), visible minorities and pregnant women that testing may engender. Again, different countries have addressed the discrimination issue in varying ways. Finally, opponents to drug and alcohol testing question the need to test. It is asserted that all testing shows is that, at some point in time, the person being tested ingested the screened substance.(ABSTRACT TRUNCATED AT 400 WORDS)
This survey aims to determine the number and profile of private workplaces in Singapore which have a smoking restriction policy. The response rate was 43%. Of the companies which responded, 59% had some form of smoking restriction. Private companies are more likely to have a smoking restriction policy: (a) where smoking poses inherent fire risks, such as those dealing with inflammable chemicals or gases; (b) where smoking poses inherent detrimental effects to the quality of the products, such as those dealing with precision electronic microcomponents, where a smoke-free and dust-free environment is essential; (c) are larger companies; and (d) have strong management support in initiating and enforcing smoking restriction. Future programmes should give more emphasis to the service industries such as construction, insurance, banking and finance, and smaller companies (with fewer than 100 employees). They should involve the management who play an important role in implementing smoking restriction at their workplace.
The NHS in Scotland has been set the target of reducing the proportion of people drinking beyond the safe limits of alcohol by 20% by the year 2000. Much emphasis has been placed on development of local initiatives, including workplace alcohol policies, and guidelines were issued in 1989. In 1992 all Scottish health boards were asked for a copy of their policy and 13/15 replied (87%); 12 had policies (one in draft form only), and one did not have a policy. All regarded alcohol problems as a health issue and set out the procedures that managers should follow. However, only four addressed the use of alcohol on health board premises, and only one expressly banned drinking prior to duty and during breaks. Only four policies acknowledged the need to educate the employees about alcohol, and only three stated that the policy's effectiveness would be evaluated. This review of workplace alcohol policies shows that most Scottish health boards are not exemplar employers, and raises doubts as to whether the national target on alcohol consumption will be achieved.
OBJECTIVE: To determine the relative exposure to environmental tobacco smoke for bar and restaurant employees compared with office employees and with nonsmokers exposed in the home (part 1) and to determine whether this exposure is contributing to an elevated lung cancer risk in these employees (part 2). DATA SOURCES: MEDLINE and bibliographies from identified publications. STUDY SELECTION: In part 1, published studies of indoor air quality were included if they reported a mean concentration of carbon monoxide, nicotine, or particulate matter from measurements taken in one or more bars, restaurants, offices, or residences with at least one smoker. In part 2, published epidemiologic studies that reported a risk estimate for lung cancer incidence or mortality in food-service workers were included if they controlled, directly or indirectly, for active smoking. DATA EXTRACTION: In part 1, a weighted average of the mean concentration of carbon monoxide, nicotine, and respirable suspended particulates reported in studies was calculated for bars, restaurants, offices, and residences. In part 2, the relative lung cancer risk for food-service workers compared with that for the general population was examined in the six identified studies. DATA SYNTHESIS: Levels of environmental tobacco smoke in restaurants were approximately 1.6 to 2.0 times higher than in office workplaces of other businesses and 1.5 times higher than in residences with at least one smoker. Levels in bars were 3.9 to 6.1 times higher than in offices and 4.4 to 4.5 times higher than in residences. The epidemiologic evidence suggested that there may be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco smoke exposure in the workplace. CONCLUSIONS: Environmental tobacco smoke is a significant occupational health hazard for food-service workers. To protect these workers, smoking in bars and restaurants should be prohibited.
In order to provide detailed documentation of faculty and staff experiences of perceived mistreatment, this article reports the findings of an institutional survey of mistreatment. From a random sample of 1,585 (11%) of one university's workforce, 810 (51%) responses were received. Of the total responses, 187 (23%) met criteria used to define cases of perceived workplace mistreatment. Equal proportions of women and men reported incidents of mistreatment. Mistreatment was perceived to come from coworkers as well as superiors. For the sample as a whole, job satisfaction was severely affected by experiences of mistreatment. The highest proportion of reported mistreatment was 38% for professional staff (at-will employees), followed in order by 25% for classified staff (covered by civil service protection), and 11% for faculty. These findings indicate that mistreatment occurs at all levels in institutions of higher education. The negative consequences of mistreatment for individuals in the workplace, as well as for the institution as a whole, are substantial.
Endoscopic interventions require a multitude of technical devices, like gas-insufflators, cameras, light sources, high-frequency scalpels and others. The devices available today represent stand-alone "function-insulas" from the view-point of systems technique. They have to be placed in the operating theatre and set-up right before each specific intervention. From each of these single devices supplies, cables and hoses lead to the body of the patient and have to be connected on both sides within the sterile and the non-sterile field. This not only requires a long setup time in the OR but also restricts the mobility of the operative personnel. Besides the ergonomic and the hygienic weakness of the contemporary solution, significant functional problems limit the efficiency of the OR environment. One of the major drawbacks lies in the lack of direct control of the devices by the surgeon and the confusing display of parameters and technical status. Against this background the systematic revision of the current endo-surgical workplace appears to be a major requirement for further technical and surgical progress. As a result of close cooperation between surgeons and engineers a systems workplace for minimally invasive surgery, OREST, has been developed and clinically tested. It integrates all devices into a mobile cabinet. The single devices are connected to a central computer and can be remote controlled directly by the surgeon from the table. A special display continuously informs about the system status. The lines and cables are guided into the sterile field by means of a swivel arm from one side of the patient. Multi-plugs are used to connect all lines at a central terminal within the sterile area. Clinical application of the first prototype OREST I started in 1993. OREST II is now available as a series product. Further development is focused on the integration of advanced sub-systems like tactile devices and advanced vision system.
1. Assault directed against psychiatric staff is emerging as a serious occupational health problem. Governmental regulatory agencies, unions, and academic research have identified workplace assault in the psychiatric setting as a serious workplace health issue. 2. Violence directed against psychiatric nursing personnel is increasing. Increases in assault are related to shorter hospitalizations, cutbacks in mental health services, and the increasing number of clients with criminal histories and personality disorders. 3. Reduction in staff assault can best be accomplished using an injury epidemiology occupational health focus. Identifying hazards, energy transfer mechanisms, and other environmental factors contributing to staff injuries can reduce or eliminate the morbidity associated with client assault.
Workplace violence has become a problem in modern American society. Health-care workers are particularly vulnerable because of the nature of their jobs dealing with clients, many of whom are emotionally disturbed. A brief review of the Occupational and Safety Health Administration (OSHA) "Guidelines for Preventing Workplace Violence Among Health Care and Social Workers" that was published in 1996 is presented. Some sensible ways to implement the OSHA guidelines are also discussed.
1. It is important for workers, management, and health and safety personnel to recognize a history of domestic violence may place an individual at risk for acts of violence at work. 2. Employers and unions are beginning to recognize domestic violence may impact the economic well being of a workplace by decreasing productivity and attendance, and by increasing insurance and health care costs. 3. Few companies have policies related to general safety, general workplace violence, or specifically to domestic violence. All departments within the corporation or business should help to develop and implement these policies, and training in the policies must include all levels of the business.
Recognition of the mortality and morbidity associated with prostate cancer has resulted in employer based screening programs. This retrospective cohort study identified the employer costs of prostate cancer screening and referrals due to abnormal test results. The subjects were 385 men enrolled in a workplace screening program at a single employer between 1993 and 1995. Screening consisted of digital rectal examination (DRE) annually for enrolled employees aged 40 years and older, plus annual prostate specific antigen (PSA) testing for those 50 and older, and those 40 and older and considered at high risk. Data related to the health care and lost productivity costs of screening and referrals for abnormal test results were collected and analyzed. The total cost of screening was $44,355, or approximately $56 per screening encounter (788 DREs; 437 PSAs). Abnormal screening tests resulted in 52 referrals. Upon further evaluation, 42% were found to have an enlargement, 29% a node, and 12% benign prostatic hyperplasia. Only one malignancy was found. The total cost of additional referrals was $31,815, or 42% of the cost of screening plus referrals. As the cost per screening encounter was low, prostate cancer screening in the workplace is an efficient alternative.
OBJECTIVE: To assess the prevalence, content, and growth of state and city laws restricting smoking in public places and workplaces in the United States and to identify factors associated with their passage. DESIGN: A mailed survey of city clerks in US cities with a population of 25,000 or greater (N = 980) and review of existing data sources confirmed the status of smoking restrictions in 902 (92%) of the cities in the sample. State laws were identified by contacting each state's Legislative Reference Bureau (100% response). Content of laws was coded using previously developed categories. MAIN OUTCOME MEASURES: Prevalence, comprehensiveness, and cumulative incidence of no-smoking laws in states and in cities with a population of 25,000 or greater. RESULTS: By July 1989, 44 states and 500 (51%) of the cities in our sample had adopted some smoking restriction, but content varied widely. While 42% of cities limited smoking in government buildings, 27% in public places, 24% in restaurants, and 18% in private workplaces, only 17% of cities and 20% of states had comprehensive laws restricting smoking in all four of these sites. The number of city no-smoking laws increased tenfold from 1980 to 1989. City no-smoking laws were independently associated with population size, geography, state tobacco production, and adult smoking prevalence. Laws were more common in larger cities, Western cities, and states with fewer adult smokers. Laws were less common in tobacco-producing states and in the South. CONCLUSIONS: No-smoking laws are more widespread than previously appreciated, especially at the local level, reflecting a rapid pace of city government action in the 1980s. Nonetheless, comprehensive laws, which are most likely to provide meaningful protection from environmental tobacco smoke exposure, remain uncommon and represent a major gap in smoking control policy. Laws are most needed in smaller and non-Western cities and in states that produce tobacco and have a higher proportion of smokers.