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Pulmonary function tests--a comparison between urban industrial and rural agricultural workers of Andhra Pradesh.

Physical parameters and pulmonary function tests (VC, FEV1, FEV1% and FEF25-75%) were collected in 112 urban industrial workers and 104 rural agricultural workers. These average values, values according to age and smoking habits were compared between urban and rural workers. Inspite of no differences in age, rural workers average height, weight, BSA is significantly lower than urban workers. A significant increase in VC value to the extent of 0.22 lit (7.1%), significantly lower FEV 1% value by 4.7% and reduce FEF25-75% value (4.7%) is demonstrated in rural than urban workers. Smoking is shown to produce airway obstruction in both urban and rural workers. A wide variation of PFT values between the present workers and other reported values in India is observed. This study indicates rural workers have better pulmonary capacity and less flow rates than their urban counterpart.

Adult↗

The noise exposed factory workers: the prevalence of sensori-neural hearing loss and their use of personal hearing protection devices.

A total of 524 industrial workers were studied. They consisted of 442 noise exposed and 82 non-noise exposed workers. The purpose was to compare the prevalence of sensori-neural hearing loss among the noise exposed and the non-noise exposed workers, to study their knowledge on the hazard of noise to hearing and the workers' attitude towards the hearing protection devices. The prevalence of sensori-neural hearing loss was significantly higher among the noise exposed workers, i.e., 83% versus 31.7% (p < 0.01). However, the prevalence of hearing impairment was much lower for both groups, being 30.1% for the noise exposed and 3.7% for the non-noise exposed group. Although hearing protection devices were provided to 80.5% of the workers, only 5.1% were wearing them regularly. The possibility of developing hearing loss due to exposure to excessive noise was only known by 35.5% of the noise exposed workers. This awareness was found to have a positive correlation with the workers' compliance to the hearing protection devices. Our findings highlight the need for workers to be educated on the hazards of excessive noise exposure to hearing.

Auditory Threshold↗

[Criteria for the reintegration to their jobs of workers with musculoskeletal pathologies of the upper limbs based on preliminary practical experiences].

The report presents a preliminary study on the return to the workforce of employees with WMSDs of the upper limbs, and their reallocation to jobs with "low exposure". The study, which is still underway, involves a large engineering firm and includes some 100 workers affected by WMSDs. The trial envisages: providing a definition of the criteria for characterising "accommodating" jobs (i.e. frequency of action < or = 20 actions per minute; virtual absence of other risk factors such as force, posture, inadequate pauses, etc.); concretely identifying jobs meeting such criteria (or jobs which, with minimal modifications, could be made suitable); classifying WMSDs workers, according to the type and severity of the disorder; matching WMSDs workers with the jobs best suited to them; specific training for the workers and their supervisors; carrying out a follow-up of the return of WMSDs workers to the workforce in organisational terms (i.e. need for further modifications to equipment or procedures) and clinical terms (i.e. symptom patterns, acceptability of the condition). The preliminary results, 6-12 months after the start of the trial, are extremely encouraging, and show that when workers return to the workforce in jobs that fully meet defined criteria, a significant prevalence of "improvements" are reported among the involved workers. The investigation will need to be extended, but already it shows quite convincingly that it is possible for workers with what can be described as a "reduced working capacity" to remain "productive" (albeit in jobs featuring a lower exposure potential than the acceptable threshold for "healthy" workers).

Arm↗

[Job strain, social support and mental health: a study on the male heavy manufacturing workers].

OBJECT: The aim of this study is to explore the influence of work experience on workers' psychological function. Specifically, the researchers will examine the effect of job demand, decision latitude, job strain, and social support at worksite on the mental health status of male heavy manufacturing workers. METHOD: By purposive sampling, from October 1994 to March 1995, the present investigators implemented a self-administered questionnaire survey on the workers in southern Taiwan. The Karasek job strain model and its measure were embedded in the questionnaire to evaluate workers' perceptions of their job conditions. In addition, Chinese Health Questionnaire (CHQ) was utilized to evaluate the workers' status of mental health. RESULT: Totally, 1,117 workers were selected for this survey. An unviriate analysis showed the younger the workers, the lower their monthly income, and the newer their employment, were more likely to be classified as high risk in mental health status. The workers with more decision latitude and higher social support would be better in mental health status. In addition, it also showed that workers under high job strain were more likely to be in poor mental health status. Result from multivariate logistic regression showed those who served longer, had more decision automony, and had higher social support, were less likely to be in poor mental health status. Instead, those who sustained high job strain were more likely to be in poor mental health status. DISCUSSION: The implication from those findings for the implementation of health promotion program. would be raised, and the limitation of this inference would also be discussed.

Adolescent↗

The ageing worker.

In Singapore, the age for retirement has increased from 55 years to 60 years, and will eventually reach 67 years. At the same time, the proportion of workers aged above 45 years will continue to increase. The World Health Organisation has reported that in 1980, 32% of the working population were older than 45 years of age in countries of the Organisation for Economic Co-operation and Development (OECD). This proportion is expected to rise to 35.5% in the year 2000 and 41.3% in the year 2055. What are the implications of the emergence of an ageing workforce? This population represents a special group of individuals in the workforce that have special health, occupational and environmental needs. On the one hand, they have the problem of a reduction in physical work capacity, decreased adaptability, and a generally lower health status. On the other, ageing workers are more experienced and have greater expertise. They are also usually more motivated and may generally have a more positive attitude when compared with younger workers. Society, as well as health care professionals, needs to respond to this issue of an ageing workforce. The response should be three pronged. Firstly, prevention of the premature decline of physical capacities and adaptability of the worker could be addressed by health promotion and continuing job training. Secondly, some measures for adjusting work demands in accordance with functional capacities of the individual are needed. Thirdly, employers and fellow workers should be educated on the strengths of the ageing worker, and the capacity of such workers to continue contributing because of their experience, motivation and skills. If implemented, these measures would ensure a path towards productive ageing. The end results would be that ageing workers would have their functional capacity maintained, the concept of "age-adjusted workload" would be a reality, and ageing workers would not be discriminated against, but instead have their contributions to society maximised.

Aged↗

[Respiratory function in textile workers involved in the processing of synthetic fibers].

The study included 308 female workers employed in processing synthetic stockings and 160 controls. The mean age of the exposed workers was 38 years with the mean exposure of 16 years. Most workers did not smoke while 41% of smokers consumed about 10 cigarettes a day. The data on acute and chronic respiratory symptoms were taken from all workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves with readings on forced vital capacity (FVC), one-second forced expiratory volume (FEV1), and maximum expiratory flows at 50% and the last 25% (FEF50, and FEF25, respectively). Textile workers manifested a higher prevalence of chronic respiratory symptoms than did the controls, although the differences were statistically significant only for sinusitis, dyspnoea, and nasal catarrh. Occupational asthma was found in 3 (0.9%) textile workers. The prevalence of acute symptoms in the exposed workers was particularly high during shift, especially with regard to dryness of the nose (53%), dryness of the throat (49%), headache (47%), cough (47%), and the eye irritation (46%). Textile workers showed a significantly lower FEF25 than predicted. Our study on textile workers indicates that inhalation of synthetic fiber dust may impair the respiratory function.

Adolescent↗

Healthcare Access and Safety Training Gaps Among H-2&#xa0;A Visa Agricultural Workers in Georgia.

The H-2&#xa0;A Temporary Agricultural Workers Program, which supplies seasonal labor essential to U.S. food security, has grown over 230% in the past decade but is excluded from the National Agricultural Workers Survey. Although safety training is federally mandated and H-2&#xa0;A workers are eligible for Affordable Care Act (ACA) marketplace coverage, compliance and healthcare access among these workers remain poorly documented. The aim of this pilot study was to assess workplace safety training, heat acclimatization practices, health insurance awareness and enrollment, and healthcare utilization among H-2&#xa0;A workers in Georgia. In summer 2024, bilingual research assistants orally administered a cross-sectional Spanish-language survey to 51&#xa0;H-2&#xa0;A workers at a South Georgia laundromat, in partnership with the Latino Community Fund Georgia. The survey assessed demographics, occupational characteristics, safety training, heat acclimatization, health insurance awareness and enrollment, and healthcare utilization. Findings are self-reported. Among participants, 41% reported not receiving federally mandated pesticide safety training, and 59% received heat illness prevention training. Heat acclimatization was inadequate for 53% (29% received none). Additionally, 53% did not know the nearest hospital, 43% reported having health insurance, and 25% were unsure of their health insurance status. Overall, 71% had never visited a doctor's office, and of 22 insured workers, only 1 (2%) had used benefits this season. Substantial gaps in workplace safety training, heat acclimatization, and healthcare access were observed in this pilot study, consistent with prior evidence of persistent disparities in this population. Community-based outreach, bilingual health navigation, and market-based labor accountability models warrant further investigation to improve protections for H-2&#xa0;A workers.

Agricultural workers↗

Respiratory function in vineyard and orchard workers.

A group of 174 male vineyard and orchard workers was studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. In addition, 115 male control workers were studied for the prevalence of chronic respiratory symptoms. There was a significantly higher prevalence of dyspnea and chest tightness in exposed compared to control workers. In particular, exposed nonsmokers had significantly higher prevalences of dyspnea and chest tightness than controls this was found for exposed nonsmokers with both short (< or = 10 years) and long (> 10 years) exposure. Smokers exposed for more than 10 years had significantly higher prevalences of chronic cough, chronic phlegm, chronic bronchitis, and chest tightness than smokers with shorter exposures (p < 0.01 or p < 0.05). Workers employed for more than 10 years had higher prevalences of most of the acute (shipt-related) symptoms than those workers with shorter employment; however, the differences were significant only for cough in smokers (p < 0.05). Significantly lower than predicted FVC values were measured in smokers and nonsmokers after both short and long duration of employment. Differences between measured and predicted FEV1, FEF50, and FEF25 were significant for workers employed for more than 10 years. A separate analysis of individual data as a percent of predicted values demonstrated that many workers had FVC (5.2%), FEV1 (6.3%), FEF50 (27.6%), and FEF25 (40.2%) lower than 70% of predicted values. These data suggest that vineyard and orchard workers may develop acute and chronic respiratory symptoms and lung function changes which are, in part, related to environmental factors and to cigarette consumption.

Adolescent↗

Do worker's compensation patients with neck pain have lower SF-36 scores?

Poorer outcomes of treatment are reported in patients with spinal disorders who receive worker's compensation. The reason for their suboptimal outcomes is unclear. No study has examined the relationship between worker's compensation and SF-36 health status of patients with neck pain. The aim of our study was to compare the self-perceived health status of patients with neck pain receiving worker's compensation, with that of patients not receiving worker's compensation. A cross-sectional study was conducted on 2356 patients with neck pain who were evaluated at the 27 centers comprising the National Spine Network, between January 1998 and April 2000. The outcome measures used were the eight individual and two component scores of the SF-36 health survey. Of the 2356 patients, 171 (7%) were receiving worker's compensation. Bivariate analyses revealed seven individual scores (except General Health) and two summary scores of the SF-36 were significantly lower in patients receiving worker's compensation. After controlling for confounding covariates, worker's compensation status was a significant predictor of lower SF-36 scores for Physical Functioning ( P<0.05). The results of this study indicate that worker's compensation status is associated with poorer Physical Functioning in patients presenting with neck pain. Another significant finding of the study is that confounding factors can exert major effects on the SF-36 scores obtained on normal validated instruments.

Adult↗

Nail gun injuries among construction workers.

Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate the occurrence of nail gun-associated injuries among construction workers and to identify preventable work-related factors associated with these injuries. Nail gun-related injuries occurring among a cohort of 13,347 carpenters in Ohio who worked union hours during the time period January 1, 1994, until September 30, 1997, were identified by matching the cohort with workers' compensation claims made to the Ohio Bureau of Workers' Compensation. We also analyzed workers' compensation claims for North Carolina Home Builders Association members for the period July 1996-November 1999 to identify nail gun-related injuries. Analyses included stratified analyses of claims by nature and body part injured, calculation of nail gun injury rates, and analyses of free text descriptions of injuries. Overall, nail gun injuries were responsible for 3.9 percent of workers' compensation claims with 8.3 percent to 25.5 percent of claims involving paid lost work time. The overall rate of nail gun injuries (cases per 200,000 work hours) was 0.33 in North Carolina and 0.26 in Ohio, reflecting the greater concentration of wood frame construction workers in the North Carolina population studied. Higher rates of injury were observed for carpenters in North Carolina and among residential carpenters in Ohio. The predominant body part injured was the hands/fingers, with 80 to 89 percent of injuries being nail punctures. Analyses of free text information for puncture injuries found approximately 70 percent of injuries to occur during the framing/sheathing stage of construction. Our data suggest that approximately 69 percent of puncture injuries may be due to an inadvertent gun discharge or misfire, preventable in large part by the use of sequential triggers. Worker training and education also are important components of nail gun injury prevention.

Accidents, Occupational↗

Incentive effects of workers' compensation.

Economic theory and evidence indicate that workers, employers, and healthcare personnel respond to the incentives built into state workers' compensation systems. Although empirical studies cannot provide precise estimates of the quantitative effects resulting from specific policy changes, research is useful in evaluating the qualitative effects of alternative policies. Studies show that workers' compensation claims are higher the more generous the level of benefits, the shorter the waiting period, and the more readily available is information on benefits to workers. States that decrease real benefit levels and lengthen the period required before workers are compensated for lost earnings can constrain future growth in workers' compensation costs, while continuing to provide partial compensation for workers with the most serious injuries. The most difficult problem facing policymakers is to design and implement reforms that take into account what are often the incompatible incentives of workers, employers, and medical care providers.

Eligibility Determination↗

Socioeconomic outcomes of combined spine surgery and functional restoration in workers' compensation spinal disorders with matched controls.

STUDY DESIGN: A longitudinal cohort study (n = 448) comparing functionally restored discectomy (n = 123) and fusion (n = 101) workers' compensation patients to matched, unoperated control patients (n = 123 and n = 101, respectively). OBJECTIVES: To determine successful treatment outcomes uniquely important in a workers' compensation environment when spine surgery is combined with comprehensive tertiary rehabilitation, to optimize anatomic and social sequelae. SUMMARY OF BACKGROUND DATA: Multiple recent studies confirm suboptimal socioeconomic outcomes for spinal surgery for degenerative conditions in a workers' compensation venue. In other musculoskeletal regions, there is a clear relationship between the quality of postsurgical rehabilitation and the impact on disability, recurrent injury, and future health care use. It is hypothesized that poor surgical outcomes in compensation injuries may result from outmoded postoperative methods, rather than failures of patient selection or surgical technique. No previous combination of surgery plus rehabilitation has been carefully evaluated with disabled workers undergoing spine surgery. Functional restoration is an individualized medically directed, interdisciplinary program using quantitatively directed exercise progression, psychotherapeutic interventions, and monitoring of specific socioeconomic outcomes for chronically disabled workers. METHODS: This study prospectively evaluated a cohort of consecutive functional restoration program graduates (n = 1202). Two surgical groups, discectomy (n = 123) and fusion (n = 101) were matched to two groups of unoperated control patients, control/discectomy and control/fusion, selected from the same cohort of patients with chronic spinal disorders based on age, gender, race, length of disability, and workers' compensation jurisdiction. A structured clinical interview was administered 12 months after program completion, with a contact rate of 95% to 98%. RESULTS: Socioeconomic outcomes for work return, health care use, and recurrent lost-time injury were assessed. All groups demonstrated a return-to-work incidence of more than 85%, but work retention at 1 year was higher for the fusion group than for the discectomy or control/fusion groups. Health care use was significantly higher for the discectomy group than the control/discectomy or fusion groups for reoperation (8% vs. 4%/ 2%), as well as other factors. All groups showed comparable recurrent lost-time injury rates (2-3.3%), and made comparable improvements in prospectively collected physical and psychological measures. CONCLUSIONS: Discectomy patients had work, health care utilization, and recurrent injury outcomes comparable with those for unoperated control patients. Fusion patients had better outcomes of work retention, reoperation, and health care use compared with the unoperated control patients and even with discectomy patients, in spite of more cases of previous surgery and greater duration of disability. The discectomy and fusion cohorts of operated chronic spinal disorder compensation patients with subsequent functional restoration had the best documented outcomes found in the literature for this population. In spite of the common presumption that spine surgery patients fare poorly in a workers' compensation environment, these results demonstrate that such patients can show remarkably successful objective outcomes if accompanied by effective rehabilitation, documenting efficacy and clinical utility. A new clinical approach is required to evaluate prospectively the combination of surgery and rehabilitation in chronic pain/disability workers' compensation patients, in which the surgical role is to correct an anatomic lesion, but the socioeconomic outcomes either occur spontaneously or are effected through some form of rehabilitation.

Adult↗

Use of community health workers in research with ethnic minority women.

PURPOSE: To explore roles and effectiveness of community health workers in research with ethnic minority women in the United States (US). METHODS: Medline (1966-2002) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) databases were used to locate published research studies on the use of community health workers with ethnic minority women in the US. Key words for searches were community health workers, community health aides, health promoters, and community workers. RESULTS: An integrative analysis of 24 studies showed that, despite varying roles and functions, evidence indicates that community health workers are effective in increasing access to health services, increasing knowledge, and promoting behavior change among ethnic minority women. Other advantages of using community health workers are to provide social support and culturally competent, cost-effective care. Recommendations for future directions of research with community health workers and ethnic minority women include improved conceptualization of the community health worker role, theoretical frameworks for research designs, enhanced methods for evaluating effectiveness, and increased community involvement.

Clinical Competence↗

Knowledge, attitude, practice, and toxicity symptoms associated with pesticide use among farm workers in the Gaza Strip.

AIMS: To assess knowledge, attitude, practice, and toxicity symptoms associated with pesticide use and exposure among 189 farm workers in the Gaza Strip. METHODS: A cross section of agricultural farm workers in the Gaza Strip were asked to fill in a questionnaire on knowledge, attitudes, practice towards pesticide use, and associated toxicity symptoms. RESULTS: Farm workers reported high levels of knowledge on the health impact of pesticides (97.9%). Moderate to high levels of knowledge were recorded on toxicity symptoms related to pesticides. Most farm workers were aware of the protective measures to be used during applying pesticides. However, no one took precautions unless they knew about the measures. Burning sensation in eyes/face was the commonest symptom (64.3%). The prevalence of self reported toxicity symptoms was dependent on mixing and use of high concentrations of pesticides. The highest percentage of self reported toxicity symptoms was found among the farm workers who returned to sprayed fields within one hour of applying pesticides. CONCLUSIONS: Farm workers in the Gaza Strip used pesticides extensively. Despite their knowledge about the adverse health impact of the pesticides, the use of protective measures was poor. Most had self reported toxicity symptoms, particularly the younger workers. It would be useful to minimise the use of pesticides and encourage alternative measures. Prevention and intervention programmes regarding the use of protective measures and monitoring the health status of farm workers should be implemented.

Adult↗

Managed care in workers' compensation plans.

Workers' compensation plans have lagged behind most public and private health care plans in the adoption of managed care techniques. This is largely attributable to the underlying differences between workers' compensation and group health plans. Managed care techniques were developed within group health plans with the objective of health at the lowest cost. In workers' compensation, managed care must address a different objective-restoring a worker to health and productivity at the lowest cost. It is this fundamental difference that makes the application of managed care techniques to workers' compensation plans contentious and at times inappropriate. Research on the impact of managed care on the health and welfare of injured workers is sparse, and important questions remain about the appropriateness of care delivered under workers' compensation managed care plans. In this paper, we discuss the application of managed care to workers' compensation, and highlight the barriers to effective implementation.

Gatekeeping↗

Effects of smoking and occupational exposure on peripheral airway function in young cereal grain workers.

We studied two groups of young male cereal grain elevator workers: 82 lifetime nonsmoking grain workers (2.5 +/- 1.2 yr of dust exposure) who were 22.7 +/- 3.5 yr of age, and 82 smoking grain workers (6.1 +/- 4.1 pack-years of smoking) individually matched to the nonsmoking grain workers for age (22.7 +/- 3.3 yr) and years of work in the grain industry (2.6 +/- 1.3 yr). We also studied the following groups of community control subjects: 82 nonsmoking community control subjects individually matched to the nonsmoking grain workers for age (22.8 +/- 3.7 yr), and 82 smoking community control subjects individually matched to the smoking grain workers for age (22.7 +/0 3.6 yr) and smoking history (6.0 +/- 4.0 pack-years). We measured forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC %, the maximal mid-expiratory flow rate (FEF25-75), the flow at 50% (Vmax50) and 25% (Vmax25) of a maximal expiratory flow-volume maneuver, the percent increase in the maximal expiratory flow at 50% FVC breathing a mixture of 80% helium-20% oxygen as compared with air (delta Vmax50), and the slope of Phase III of the single breath nitrogen test (delta N2/L). We also assessed the prevalence of respiratory symptoms from responses to a standardized questionnaire. Smoking was associated with an increased prevalence of cough, wheezing, and dyspnea, and a mildly decreased FEV1/FVC %. Two variables were used as indexes of small airway dysfunction, a lower delta Vmax50 and a higher delta N2/L. Only the group of workers who both smoked and were occupationally exposed to grain dust had evidence of small airway dysfunction. The differences in delta N2/L and delta Vmax50 were greater than was expected from an additive model, suggesting that the combined effects of occupational exposure to grain dust and inhalation of cigarette smoke may have a synergistic effect leading to small airway dysfunction in young cereal grain workers.

Adult↗

Outcome of surgery for thoracic outlet syndrome in Washington state workers' compensation.

OBJECTIVE: To determine the predictors of outcome of thoracic outlet syndrome (TOS) surgery in a population-based cohort of injured workers. METHODS: All injured workers in the Washington State Workers' Compensation system who received TOS surgery during 1986 to 1991 were identified by computerized bill payment records and validated by medical record review (n = 158). The main outcome measure was work disability status 1 year after surgery. Additional functional status and quality of life outcomes were determined by telephone survey an average of 4.8 years after operation. A sample of workers with a TOS diagnosis who did not receive surgery during 1987 to 1989 were identified as a comparison group (n = 95). RESULTS: Sixty percent of workers were still work disabled 1 year after surgery. The strongest predictors of remaining disabled were the amount of work disability before surgery (OR = 1.85; 95% CI, 1.51 to 2.28), longer time between injury and TOS diagnosis (OR = 1.34; 95% CI, 1.09 to 1.64), and older age at injury (OR = 1.07; 95% CI, 1.00 to 1.13). There was no relationship between type of surgery, presence of any provocative tests, or experience of surgeon and work disability outcome. In follow-up surveys an average of 4.8 years after surgery, 72.5% of workers still reported they were "limited a lot" in vigorous activities. Compared with a nonsurgical sample of TOS patients, those receiving surgery had 50% greater medical costs and were three to four times more likely to be work disabled. CONCLUSIONS: The outcome of TOS surgery among injured workers is worse than has generally been reported. The nonspecific neurogenic TOS diagnosis, the complexity of workers' compensation cases, and the adverse event profile are likely substantial contributors to the worse outcomes reported here. Well-designed prospective studies and randomized trials are required to elucidate any role of TOS surgery in nonspecific TOS.

Adult↗

Dermatological illnesses of immigrant poultry-processing workers in North Carolina.

The authors designed this study to assess skin ailments among male Latino poultry-processing workers in one plant in North Carolina. Because conditions in poultry plants expose workers to multiple agents affecting the skin, the number of skin ailments was expected to be high. A visual skin examination was conducted by a single board-certified dermatologist for 25 male workers. Dermatological Life Quality Index scores and self-reported skin treatment data were obtained through interviews. Each worker had at least one dermatological diagnosis. Infections were most common (onychomycosis, 76%; tinea pedis, 72%), followed by inflammatory diagnoses (acne, 64%). No workers had sought medical treatment. Dermatological Life Quality Index scores indicated impaired quality of life. Worker self-reports were not strongly associated with dermatologist diagnoses. Skin diseases are common among poultry workers and impact workers' quality of life; reasons for lack of medical care should be investigated.

Adult↗