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OBJECTIVES: This study examined, through kinematic analysis, the effect of occupational form on reaching performance. The hypothesis was that reaching performance would show an enhanced quality of movement in materials-based occupation (i.e., pick up a pencil and prepare to write one's own name) than in imagery-based occupation (i.e., pretend to pick up a pencil and prepare to sign one's own name) and in exercise (i.e., move the arm forward). It was further hypothesized that imagery-based occupation would elicit better performance than exercise. METHOD: The reaching performance was measured, using WATSMART (Waterloo Spatial Motion Analysis & Recording Technique), by the variables including reaction time, movement time, number of movement units, total displacement, the amplitude of peak velocity, and percentage of reach in which peak velocity occurred. A repeated-measures counterbalanced research design was used with 37 female college students. Contrast analysis was used to test the hypotheses. RESULTS: Materials-based occupation elicited enhanced quality of movement performance, as compared with imagery-based occupation and exercise. However, exercise seemed to elicit better performance than imagery-based occupation. CONCLUSION: The practical implication is that materials-based occupation might be used to elicit enhanced quality of reaching movement in occupational therapy intervention.
BACKGROUND: Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. METHODS: MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. RESULTS: Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. CONCLUSIONS: Research is needed to improve and promote clinical occupational health preventive services.
OBJECTIVES: The aim of this study was to evaluate the associations between occupational health behaviors and occupational dental erosion. METHODS: Using data for 943 workers among 34 factories, selected by three-stage stratified cluster sampling from 888 factories using acids, two sets of modified case-control studies were performed. The cases were 242 workers with any dental erosion (G1-5) and 78 with severe dental erosion (G3-5); the controls were 701 workers with no erosion (GO) and 864 workers with no or mild erosion grades, GO-2, respectively. The main explanatory variables were behaviors such as wearing a respiratory mask and gargling at work. The results were adjusted for employment, age, sex, knowledge, and opinion about occupational health, attrition, and abrasion. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The odds of overall occupational dental erosion (G1-5) was 0.63 (95% CI = 0.42, 0.94) for respiratory mask wearers compared to nonwearers; the odds of severe occupational dental erosion (G3-5) was not significantly less in respiratory mask wearers (OR = 0.94; 95% CI = 0.53, 1.67). Gargling did not show a significant association with occupational dental erosion in this study. CONCLUSIONS: Among occupational health behaviors, wearing personal protective respiratory masks in work was significantly associated with less overall occupational dental erosion.
We compared occupational health related laws and occupational health systems on ethics in Germany, France, USA, UK, and Japan, and reviewed them. The duties of appointment of occupational physicians, competence of occupational physicians, responsibility for maintaining the confidentiality of the medical records, professional independence of occupational physicians, employment and dismissal of occupational physicians, etc. were discussed. Concerning maintaining the medical privacy of workers, the Japanese law and system are thought to be different from those of other countries. Concerning the professional independence of occupational physicians, the Japanese law does not have this point of view. We hope that Japanese occupational physicians express their opinions on these issues.
The International Classification of Diseases popularly referred to as 'ICD' has significantly improved accessibility to and promoted distribution of medical information. In the field of occupational health, the use of a standardized occupational classification system is also necessary for similar reasons. Recording occupational information in a standard format, when routinized, will certainly result in the combining of such information with other health relevant data. However, the innumerable occupational categories prevalent in modern industrialized society cannot be encompassed by a single occupational health staff. The tendency of Japanese people to answer in an indirect manner to questions regarding their present occupation or job history complicates the situation. Because of these circumstances, the need to construct an aiding system to compile bits of vague information into a definite standardized job category was recognized. The computerized system under development focuses especially on a person-to-person interview where the interviewer is required to gather information on the respondent's job history. The system is designed to supplement the insufficient understanding of the entire occupation system, thus aiding in occupational health interviews. A description of a prototype is also given.
The objectives of this study were to assess the current occupational hygiene practices of occupational health nurses and to assess their attitudes to the identification and initial quantification of workplace hazards. A questionnaire was mailed to all occupational health nurses registered with the South African Society of Occupational Health Nurses. Responses were obtained from 221 (53.7%). Responders and non-responders did not differ on key characteristics. Only 14 (6%) of the respondents performed occupational hygiene tasks as part of their routine work and only 31 (14%) volunteered hazard identification and quantification as tasks that would significantly improve practice. Nevertheless, when asked directly, 120 (54%) agreed that occupational hygiene fell into the ambit of occupational health nursing. Over 70% were positive about receiving theoretical and practical hygiene training. Constraints to greater hazard identification included limited time and resources and concern about intruding into the domains of other practitioners. Sufficient numbers of occupational health nurses were interested in identifying hazards in the workplace for training courses to be planned and offered now; however, restraints to practice need to be clarified and removed for these new skills to be used effectively.
1. As a country that is both agricultural by nature, and moving toward new industrialization, Thailand is increasingly facing work related health problems. Major occupational illnesses are pesticide poisoning, silicosis, byssinosis, lead poisoning, and occupational injuries. 2. Although the demand for occupational health services is high, occupational health services in Thailand are still not comprehensive. 3. Because of the lack of role perception and inadequate preparation, Thai occupational health nurses have limited functions in providing occupational health services. The services are primarily directed at curative measures rather than prevention. 4. Occupational health nursing in Thailand is currently undergoing intensive development in education, practice, research, and legislation.
On December 6, 1991. The Occupational Health and Safety Administration (OSHA) issued its final regulation concerning occupational exposure to bloodborne pathogens (29 CFR 1910.1030). OSHA has determined that workers in a variety of settings face a significant health risk as the result of occupational exposure to blood and other body fluids. The pathogens that are of the most concern include human immunodeficiency type 1 (HIV) and hepatitis B virus (HBV). OSHA concludes that the hazard can be minimized via engineering and work practice controls, personal protective equipment, HBV vaccination, training and education, and appropriate use of signs and labels. Occupational health professionals, including physicians, nurses, industrial hygienists, and safety officers, are faced with the challenge of writing and periodically updating exposure control plans that are unique to their settings, as well as advising colleagues in other settings. They are charged with identifying the appropriate at-risk groups within their workplace, and providing them with the appropriate training to enable employees to understand the rationale for the safety procedures that prevent exposures to blood-borne pathogens. This review of HIV/HBV articles pertinent to the occupational setting analyzes six topics including: (1) occupational risk of transmission of HIV, (2) occupational risk of transmission of HBV, (3) special concerns of dental practices, (4) risk of HIV/HBV outside the hospital, medical, or dental office setting, (5) legal and ethical issues involved in HIV testing, and (6) the United States Public Health Service postexposure HIV/HBV prophylaxis/treatment recommendations.
The incidence and mortality rates of primary liver cancer (PLC) among residents of Brooklyn, New York, were studied for 1976 through 1983. Standardized race and sex-specific incidence and mortality rates and rate ratios were computed and compared with overall US rates as reported by the Surveillance, Epidemiology, and End Results (SEER) program. The results indicate a significant excess of PLC among all race and sex groupings. A comparison of the degree of agreement between incidence and mortality data for Brooklyn residents showed excellent agreement among male patients with PLC and adequate agreement among female patients with PLC. Next, the effect of occupation on PLC mortality among Brooklyn residents was assessed. Specific occupations found to be at excess risk for PLC are private household workers (ratio of observed to expected cases [O/E] = 4.34; P less than 0.0001), non-domestic cleaning and food and beverage service workers (O/E = 2.59; P less than 0.0001), protective service workers (O/E = 1.78; P = 0.035), and transport equipment operatives (O/E = 1.52; P = 0.027). Since the distribution of Brooklyn workers employed in these occupations was found to be similar to the distribution of all US workers employed in these occupations, it is unlikely that these occupational risk factors can explain the observed excess of PLC among Brooklyn residents. The effects of non-occupational risk factors for PLC were then assessed using multiple regression analysis. The only non-occupational risk factor found to be associated with PLC among Brooklyn residents was cirrhosis of the liver (P = 0.0072). It is interesting that of the four occupations found to be at excess risk for PLC in this study, three have been previously shown to be at excess risk for cirrhosis mortality. Moreover, Brooklyn residents have cirrhosis mortality rates that are approximately two times higher than US rates. These facts, coupled with the findings of this study, support the hypothesis that the excess of PLC observed among Brooklyn residents might be related to an excess of cirrhosis of the liver in the same population, and thus provide support for an etiologic role of cirrhosis in the pathogenesis of PLC.
PURPOSE OF REVIEW: This review, an assessment of the role of inhalational challenge testing in the diagnosis of occupational asthma, focuses on the difficulties associated with making the correct diagnosis of occupational asthma. This report contrasts the apparent discrepancy between the clinical diagnosis and the diagnosis made by inhalational challenge testing, the 'gold standard'. This disparity has been pointed out by a number of authors, yet this approach to making the diagnosis of this illness continues. RECENT FINDINGS: Because of the disparity between the clinical mode for diagnosis and using specific challenge testing for diagnosis, awarding compensation to a worker based on the clinical diagnosis of occupational asthma, or using this clinical approach to identify the incidence or prevalence of occupational asthma in a population, is suspect. In the absence of specific inhalational challenge, physicians have attempted to understand changes in flow rates over time through the use of serial peak-flow assessments, a relatively cost-effective way to sort out the diagnosis. Yet, there is an increasing body of knowledge which presents information casting concern on the adequacy of these measurements. In addition, recent data suggest that chest physicians, occupational medicine physicians, and allergists most often make a diagnosis of occupational asthma by usual clinical methodology, which is a routine part of their hospital's pulmonary function laboratory. SUMMARY: The apparent lack of training in the approach to specific inhalation challenge testing in fellowship programs, the relatively few specialized centers, and the apparent lack of recognition by many physicians who are presented with a patient with suspected occupational asthma means that the use of routine methods to make the clinical diagnosis may often be incorrect, making it unlikely that this approach to the diagnosis of occupational asthma will change in the near future.
AIMS: To examine, from occupational surveillance reporting data, whether scheme reporters considered nickel exposure to play a role in occupational contact dermatitis (OCD) in the UK. METHODS: Data on occupational skin disease in the UK are collected by two occupational disease surveillance schemes, EPIDERM and OPRA. Cases of OCD believed to have relevant nickel exposure reported to EPIDERM or OPRA from February 1993 to January 1999 were studied. RESULTS: An estimate of 1190 cases of occupational contact dermatitis thought to have relevant nickel exposure (12% of total estimated OCD) was derived from reports by dermatologists, an average of 198 per year. The highest incidence rates were seen in hairdressers (23.9/100 000 workers/year), bar staff (4.7), chefs and cooks (4.4), retail cash and checkout operators (2.8), and catering assistants (2.5). From May 1994 to January 1999, 158 cases of nickel associated dermatitis (1.9% of total OCD cases) were estimated; the most frequently reported occupations were electronic assemblers, nurses, sales assistants, and general assemblers. From July 1997 to January 1999, 547 positive patch tests to nickel were reported; in 195 cases (36%), nickel was felt to be a relevant occupational allergen (for example, coin handling). In hairdressers, nurses, cooks, and beauticians, nickel was usually considered, if relevant at all, to be only one of several causes of dermatitis. CONCLUSIONS: Up to 12% of total estimated cases of OCD were thought to be due in part to nickel. Results suggest that nickel hypersensitivity is one of several contributors to OCD in subjects with multiple occupational exposures. Coin handling may be a source of OCD to nickel.
The adaptive functions of occupation during the phylogenetic history of the human species and the ontogenetic development of individual primates re examined through a review of relevant research of wild and captive nonhuman primates. This review suggests that the effectiveness of occupation as a therapeutic medium throughout life span development is fundamentally tied to humankind's phylogenetic history. It is accordingly argued that there is considerable justification to maintain occupational therapy's historical commitment to therapeutic occupation as the profession's primary treatment modality. To support this commitment, questions to guide practice and research are identified that emanate from the primate literature and that are highly germane to the therapeutic process in occupational therapy. These questions address: (a) the relationship between the press of the various environments in which occupational therapists practice and subsequent opportunities availed to patients for engagement in occupation; (b) the relationship between the extent to which patients are or are not empowered to exert real control over their use of time and their eventual development of disabling conditions; and (c) the therapeutic efficacy of occupation as compared with other treatment approaches that are not comparably holistic.