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A severe attack of farmer's lung developed in a dairy farmer after a workplace challenge. The patient showed full recovery after corticosteroid therapy. If a workplace challenge is considered necessary in the diagnosis of farmer's lung, care should be taken to avoid unnecessarily heavy exposure to the offending antigens.
Two thousand four hundred and forty workers from 2 plants were enrolled in a mass survey for colorectal cancer using a single immunological fecal occult blood test as screening. The occult blood test was positive in 71 (4.0%) out of 1,759 subjects in whom the test was conducted. A further investigation, including total colonoscopy or barium enema, was performed on 52 (73.2%) of the 71. Colon cancer was detected in 5 cases: 1 with advanced cancer and 4 with early cancer (cancer in the adenoma). The advanced cancer was successfully resected by surgery and the early cancers were removed by endoscopic polypectomy. Adenomas were found in 21 cases, 11 of which were polypectomized. From these results, it can be seen that a survey for colorectal cancer at the workplace is important, and by expanding the number of subjects for the survey in the workplace we can expect more and earlier detections of colorectal cancer.
Much needless anxiety and misinformation about AIDS exists today. Many people are concerned that they can "catch" AIDS in the workplace through casual contact with co-workers. AIDS is hard to get. It is not spread by nonsexual, person-to-person contact among workers, clients, and consumers in offices, schools, factories, or other workplaces. Managers of corporations should institute AIDS policies, addressing discrimination, confidentiality, infection control, and education, before the first cases of the disease emerge in the organization. It is predicted that about 90 percent of HIV-positive individuals are presently in the labor force; every American employer will have to come in contact with HIV/AIDS-infected employees in the near future. Any attempt to communicate positive messages--and reduce fear and confusion--leads to a more productive work environment, less discrimination, and more sensitivity regarding AIDS issues.
During the period of transformations and restructuring of workplaces in Poland, the reduction of employment becomes quite common, what seems to make a considerable impact on sick absenteeism. The analysis presented aimed at defining how far the risk of sick absenteeism increases among workers under termination of employment because of different reasons, and indicating morbidity causes in case of which sick absenteeism is most extensive. The study was carried out in one of the largest plants of the motor car industry (before the process of restructuring), and it covered a cohort of 5,373 men and 3,215 women employed during the years 1989-94. The workers who terminated their employment during those years made 77% of the whole cohort under study. The case index, calculated as the ratio of the number of cases to the number of man-days under observation, was taken as an analysis parameter. Poisson regression model involving a number of variables (age, departments, current workers, workers discharged according to particular reasons, and the period preceding the termination of employment) was used in the statistical analysis. The study indicated an increased risk of sick absenteeism in the group of workers approaching the termination of employment in comparison with that among current workers. The highest risk of work disability, both among men and women, was observed in persons leaving their jobs because of long-lasting illness or disability pension. The highest risk indices were noted in men whose sick absenteeism was caused by neoplasms (RR = 14.42); endocrine secretion disorders (RR = 4.83); cardiovascular disorders (RR = 3.60); mental disorders (RR = 3.04); and diseases of the musculoskeletal system (RR = 2.95); and in women with neoplasms (R = 6.42); diseases of the musculoskeletal system (RR = 4.01); and cardiovascular diseases (RR = 3.99). Risk of sick absenteeism was over 50% higher among retiring workers than among current workers (RR = 1.50 for men; and RR = 1.53 for women). Among workers discharged because of economic reasons, statistically significant risk of sick absenteeism was also observed (RR = 1.51 for men; and RR = 1.37 for women). In the group of workers leaving their jobs, following the agreement of the parties, an increased risk of sick absenteeism was noted in men (RR = 1.45). The economy transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems or of their own accord, as well as those discharged because of economic reasons belong to the highest risk groups.
Healthcare managers are seeking new ways to increase productivity in the workplace. New technologies, such as word processing, electronic mail, electronic conferencing, calendar management, data base management systems, artificial intelligence, decision support systems, and local area networks, are being developed to help the healthcare manager make the workplace more productive. The challenge therefore is to implement these systems smoothly and address the organizational issues associated with implementation.
Research has shown that three organizational conditions are necessary as environmental support for the encouragement and full release of human competence in the workplace: Collaboration, Commitment, and Creativity. Productive organizations have such supports to a significantly greater degree than do their unproductive matched counterparts. This article reports on the specific managerial behaviors necessary for creating those environmental conditions and the relationship of such managerial practices to both productivity and health in the workplace.
T Employment related exposures are quickly becoming one of the largest liability exposures facing health care organizations, because employment claims as a whole are increasing in the courts and health care employees are usually highly paid professionals. The Americans with Disabilities Act (ADA) presents its own particular exposure implications, particularly because a health care employer's decision as to whether its employed health care professional is qualified to continue working can often affect patient care. The focus of this article is on how Title I of the ADA affects employment decisions in the health care workplace and what a health care employer can do to mitigate its ADA exposure. This article describes the scope and effect that the ADA has on the health care workplace. It also outlines an ADA compliance program with protocols and procedures for addressing ADA issues that arise in a health care practice.
Airflow visualization in the workplace to assess containment, ventilation, or general air movements is often carried out using smoke tracers. The most prevalent method uses a disposable smoke tube that generates a plume of concentrated sulfuric acid fume. However, use of the smoke tube exposes occupational hygienists to the risk of sulfuric acid exposure through inhalation or dermal contact, as well as injury from sharps. Following concern over the potential health hazard associated with smoke tube usage, alternative flow visualization methods and technologies have been reviewed. Methods of generating smoke or bubbles other than using smoke tubes suitable for visualizing air movements include heated element smoke generators, combustion generators, generation of metallic chlorides and ammonium chloride, generation of neutral density bubbles, and water fog generation. Some of these methods are applicable in specific workplace situations. However, there is no commercially available smoke or bubble generator currently available that matches the smoke tube for cost effectiveness, ease of use, and wide applicability, while also reducing the potential health risks associated with smoke tube usage. Despite this, certain technologies, in particular water/glycerol smoke generation using heated element generators, have the potential to be developed into viable alternatives to the smoke tube. Thus, with further development, an air movement visualization method that poses a significantly lower health hazard than the smoke tube is feasible.
Emotions are powerful, free resources for businesses. Just as employee enthusiasm is essential for superior productivity, anger can be harvested for peak performance. An array of psychological and physiological tools have been described to empower employees so they may constructively handle their anger, anxiety, and stress. These tools can be used to reduce health care and workers' compensation costs while creating an effective workplace in which angry outbursts or passive aggressive behavior is rare. Methods for de-escalating angry responses have also been described. Using these techniques can help ensure a nonviolent workplace while inducing a cooperative environment for problem solving and lowering the frustrations of employees.
Exposure to workplace airborne pollutants was examined in a group of 20 workers dealing mainly with welding, polishing, drilling and assembling of stainless steel constructions. Airborne particulate matter (APM) collected using both personal and stationary samplers was analyzed by instrumental neutron activation analysis (INAA). Quality assurance procedures of both sampling and analytical stages are described. Of the elements determined, results are presented for chromium, iron, manganese, molybdenum, nickel and vanadium. The median values of element concentrations exceeded the maximum admissible limits for workplace pollutants only for chromium, while for nickel the limit was exceeded in several individual cases. Sampling of hair, nails, blood, urine and saliva to be used for biological monitoring of the exposed and control groups is also described.
1. Both biological and chemical weapons (BCW) could potentially be used in future terrorist attacks on U.S. workplaces and communities. 2. Threats of BCW terrorism may lead to anxiety, adverse health effects, and the exacerbation of psychiatric symptoms and syndromes in workers and managers. 3. Actual BCW attacks will likely cause both acute and chronic mental disorders in a significant number of surviving victims who may also be employees or employers. 4. Occupational health nurses can help prevent or remediate maladaptive psychological responses by educating themselves and their work forces, assisting in a risk assessment of the workplace, understanding disaster planning, and assisting management in policy formulation and psychosocial triage.
Stress is a costly and significant source of health problems and mental distress--with work cited as a primary stressor. This pilot study supports the effectiveness of a new workplace stress intervention: Chicken Soup for the Soul at Work Employee Groups. In this program, employee-participants met during nine weekly meetings to read inspirational workplace stories, comment, and share their own stories. A leader, chosen from and by the group, guided meetings. Utilizing a wait-list control group design, participants were randomly assigned to an experimental or wait-list group. Participants completed pretests and posttests (Coping Resources Inventory, Occupational Stress Inventory-Revised, Job Descriptive Index, Pressure Management Indicator, survey). Statistical interaction effect for subtests was evaluated using a two-way repeated measures analysis of variance. Participants exhibited improved total coping resources, cognitive/rational coping, state of mind, confidence and home/work balance. Participant comments and their continued participation in a similar company-sponsored program bolster these empirical results.
A model of the attitudinal outcomes of the occurrence and severity of occupational injuries was developed and tested. The model postulates that workplace accidents result in a perceived lack of influence and a distrust of management, with the former also affecting the distrust of management. Both are hypothesized to predict job dissatisfaction. Exit (turnover intentions) and voice (perceptions of union instrumentality) are hypothesized as outcomes of job dissatisfaction. A sample of 9,908 employees was tested with the 1995 Australian Workplace Industrial Relations Survey database. Structural equation modeling provided strong support for the model with respect to accident occurrence, and the model was replicated across 8 different occupational groups. There was less support for the model with respect to accident severity.
Mailed questionnaires administered to employers of graduates and to graduates of the Ontario Veterinary College in 2000 and 2001, 7 to 10 months after convocation, surveyed new graduate performance in the workplace. Proficiency at 9 species-specific (in 4 practice contexts) and 7 nonspecies-specific clinical activities were rated as "high," "some," or "low." Fifteen nonvocation-specific attributes, reflecting interpersonal, communication, and business skills, and the new graduate's competence to do his/her job were rated as "very good," "good," or "poor." Ninety or more percent of employers reported "high" to "some" proficiency in 8/9, 5/9, 3/9, and 1/9 activities relative to small animal, food animal, equine, and exotic animal practice, respectively, and in 5/7 nonspecies-specific clinical activities. Ninety or more percent of employers assessed workplace proficiency as "very good" to "good" in 13/15 nonvocation-specific work skills and overall competence to do the job for which the new graduate had been hired.
OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed.
With the new year 2003 the new Polish "Law on Social Security Insurance in case of Workplace Accidents and Occupational Illness" came into force, which annulled the previous "Law on Benefits in case of Workplace Accidents and Occupational Illness", dating from 1975, together with its executive provisions, which contained as an Appendix a table for determining the percentage of health loss in a given case. This article, comparing the previous and current laws, analyzes their influence on the process of delivering certificates in legal medicine. In the area of direct interest to the legal medicine practitioner there is practically no difference caused by the introduction of the new law, but because of the lack of executive provisions to the new law, the former directive concerning the principles and mode of issuance of loss-of-health certification, including the health loss percentage table, will continue to be applied.
This investigation aimed at evaluating the prevalence of active smokers in hotel workers to underline the need for a non-smoking campaign at the workplace. Data on smoking habit were collected in a questionnaire which included 398 subjects of whom 170 were men and 228 women aged in average 29 and 35 years, respectively. Seventy-six men and 134 women declared themselves regular tobacco smokers. In average, they started to smoke at the age of 17 and 18, respectively and had been smoking for 21 and 16 years, respectively. Although the number of smokers was high, it is encouraging that 29% of men and of 51% women tried and did not succeed in quitting smoking, whereas 30% of men and 12% of women did quit smoking. The authors advocate reducing tobacco use and controlling environmental tobacco smoke exposure at the workplace, which should include a non-smoking company policy, implementation of smoking cessation programmes, social support programmes, trade union support, as well as the assistance of health professionals during regular check-ups.
As the US workforce continues to age, organized labor and management will have to work creatively to redesign jobs, workflow, and work pace to accommodate older workers. Union-management cooperation in developing safety strategies have been largely unsuccessful because of mutual distrust, animosity left over from contract negotiations and administration, the absence of strong labor legislation that promotes shared governance, injury concealment, and world-wide competitive pressures to reduce labor costs at the expense of worker safety. If workplace injury prevention that focuses on cost-effective and efficient workplace modifications for older as well as for all workers is to become reality, then employers and their unions will need to develop solutions to forge new, more expansive approaches to accommodation.