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The impact of allergies and allergy treatment on worker productivity.

Allergic disorders are a chronic and highly prevalent condition in the general population and the workforce. Their effect on workers and corporate costs go beyond the direct cost of treatment, as the condition can lower a worker's productivity. Previous research includes estimates of the decrease in productivity associated with allergic disorders. None of these studies, however, offered an objective measure of how worker productivity is affected by allergic disorders. In the present study, the productivity of telephone customer service representatives suffering from allergic disorders is examined before, during, and after the ragweed pollen season. In addition, these workers were surveyed as to the type of medication they used in response to their condition. A significant correlation was observed between an increase in pollen counts and a decrease in productivity for workers with allergies. Compared with workers without allergies, employees with allergies who reported using no medication showed a 10% decrease in productivity. No differences were observed among workers with allergies using different types of medications, although the medication groups had significantly higher productivity than the no-medication group. The expected lowered productivity of those workers with allergies who used sedating antihistamines may have been offset by their relatively lower level of symptom severity and by the nature of the job and the productivity measures used.

Absenteeism↗

Are African-American nuclear workers at lower mortality risk than Caucasians?

This study investigated disparities in worker mortality across race at the Savannah River site (SRS) nuclear facility in Aiken, South Carolina. Standardized mortality ratios were calculated stratified by race (Caucasian, African-American) and gender for specific causes of death, and by race, gender, duration of employment, and follow-up for overall mortality. Race-specific standardized mortality ratios for African-American male workers generally were lower than those for Caucasian male workers, although both groups showed strong healthy worker effects. Nevertheless, African-American male workers generally had higher absolute mortality rates. Understanding why SRS African-American male workers are substantially healthier than their reference population as compared with Caucasian male workers but are less healthy in absolute terms than the SRS Caucasian male workers may provide clues for prevention or intervention. Further, the standardized mortality ratios at the SRS were lower than at the Hanford and Oak Ridge nuclear facilities, which warrants investigation.

Adult↗

Prevalence of preinvasive and invasive lesions of the cervix in sexual workers.

OBJECTIVE: To determine the prevalence of preinvasive and invasive lesions of the cervix in sexual workers. MATERIALS AND METHODS: A total of 438 prostitutes were analyzed. Each prostitute had a clinical history, gynecological examination, Pap smear, and a colposcopic examination of the cervix. A cervical biopsy was taken under colposcopic guidance when there was abnormal epithelium. RESULTS: The sexual workers' mean age was 32.2 + 8 years (mean + SD), age of first sexual intercourse was 15.9 + 2 years, parity mean was 4.1 + 2, births were 3 + 3, and age of first delivery was 16.6 + 4.7 years. Cervical biopsies were taken from 84 patients because of atypical epithelium under colposcopic examination. Sixty-four (76.2%) patients had preinvasive and invasive lesions: 41(64%) had cervical intraepithelial neoplasia (CIN) 1, 12 (18.8%) had CIN 2, 8 (12.5%) had CIN 3, 2 (3.2%) had microinvasive carcinoma (Ca), and 1 (1.5%) had invasive Ca 1. Sexual workers with cervical pathology were younger (p < .05) and had their first sexual intercourse experience earlier than those sexual workers who did not have lesions (p < .02).Preinvasive lesions were found in sexual workers in their 30s, and invasive lesions were found in sexual workers under the age of 40. CONCLUSIONS: Preinvasive lesions of the cervix have increased 2-fold in Venezuelan sexual workers and the invasive lesions are stable but found in younger sexual workers.

Journal Article↗

Back pain exacerbations and lost productive time costs in United States workers.

STUDY DESIGN: Cross-sectional with follow-up case-control component. OBJECTIVES: To measure the prevalence of back pain (BP) and back pain exacerbations, describe BP features and functional impairment, estimate BP-related lost productive time (LPT) and costs, and assess the relation between pain exacerbations and lost productive time. SUMMARY OF BACKGROUND DATA: BP is associated with substantial lost work time. However, little is known about the extent to which BP with or without exacerbation explains lost work time. METHODS: A national telephone survey of the U.S. workforce identified 320 workers 40 to 65 years of age with BP defined by NHANES I criteria and 91 matched non-BP controls. Participants self-reported pain characteristics, lost productive time (absenteeism and presenteeism) in the previous 2 weeks, activity limitations, and demographics. A population-weighting adjustment was applied to estimates to account for selection bias and ensure that estimates of certain sample demographic subgroups' totals conformed to the Current Population Survey. RESULTS: The 2-week period prevalence of BP was 15.1%; 42% of workers with BP experienced pain exacerbations. BP prevalence was associated with demographic factors, but BP exacerbations were not. BP was reported by 42.6% of all workers. Workers with exacerbations reported more days with BP than those without exacerbations. Workers with exacerbations were significantly more likely than those without such exacerbations to report activity limitation (88.4% vs. 60.7%; P < 0.0001) and BP-related LPT (22.1% vs. 13.0%; P = 0.0259). BP in workers 40 to 65 years of age costs employers an estimated $7.4 billion/year. Workers with BP exacerbations account for 71.6% of this cost. CONCLUSIONS: Workers with BP exacerbations account for a disproportionate share of the cost of BP-related lost productive time.

Absenteeism↗

Immunological findings in a group of coke-oven workers exposed to polycyclic aromatic hydrocarbons.

Coke-oven workers are exposed to a high concentration of polycyclic aromatic hydrocarbons, which may change the immunologic responses. In this study, we evaluated humoral immunity by measuring serum IgA, IgE, IgG, and tumor necrosis factor-alpha in 251 coke-oven workers and 89 rolling steel workers in Taiwan. Mean values of serum IgE and tumor necrosis factor-alpha levels were 178.8 IU/mL and 8.4 pg/mL in coke-oven workers, respectively, which were significantly higher than in rolling steel workers (102.6 IU/mL and 2.0 pg/mL; P=0.003 and <0.001). In contrast, serum IgA levels were significantly lower in coke-oven workers than in rolling steel workers (mean=264.7 vs 312.0 mg/dL, P<0.001). Our findings suggest that polycyclic aromatic hydrocarbons exposure may alter the immune responses in coke-oven workers.

Adult↗

Total dust and endotoxin in poultry operations: comparison between cage and floor housing and respiratory effects in workers.

OBJECTIVE: The objective of this study was to assess respiratory outcomes and environmental exposure levels of workers in cage-housed and floor-housed poultry operations. METHODS: Poultry operations were evaluated for total dust, endotoxin, and ammonia, and respiratory symptoms and lung function tests of workers were conducted. RESULTS: Workers in floor-housed poultry operations had significantly greater exposures to total dust and ammonia, whereas workers from cage-housed poultry operations reported greater frequency of current and chronic symptoms overall and significantly greater current and chronic phlegm (39% vs 18% and 40% vs 11%, respectively). Endotoxin concentration (EU/mg) was a significant predictor (P = 0.05) of chronic phlegm for all poultry workers. CONCLUSIONS: Greater endotoxin concentration in the presence of significantly lower total dust, in conjunction with greater respiratory symptoms in workers from cage-housed poultry operations, as compared with workers from floor-housed poultry operations, appears to indicate that differences in environmental exposures may impact respiratory outcomes of workers.

Adult↗

Queen and worker policing in monogynous and monandrous colonies of a primitively eusocial wasp.

Kin-selection theory predicts that a worker prefers to produce her own sons in a colony with monandry and monogyny because relatedness to her sons (0.5) and nephews (0.375) exceeds that to brothers (0.25). In spite of this prediction, recent studies reveal that workers police each other (mutual-worker egg removal) even in monandrous and monogynous colonies. We conducted field and laboratory studies to evaluate queen and worker policing in queen-right colonies of the primitively eusocial wasp Polistes chinensis antennalis. Genetic studies using microsatellite markers, as well as extensive observations of natural colonies, revealed that both queen and workers removed both queen- and worker-laid eggs in monogynous and monandrous colonies. The queen's eggs survived to hatching more successfully than those of the workers (88.5% versus 1.4%). We discuss the likely factors to explain these worker-policing behaviours.

Animals↗

Why don't all termite species have a sterile worker caste?

No general theory explains why a sterile worker caste is not found in all species of both Hymenoptera and Isoptera (Insecta). Recent empirical finding show that, in the termites (Isoptera), feeding outside the nest correlates well with the evolution of the sterile (true) worker caste from the non-sterile (false) worker caste. Here we explain the connection between food-nest separation and true worker evolution in termites, providing a general theory on the restricted distribution of the sterile worker caste in the Isoptera. A cost-benefit model suggests that there is a critical level of nest stability above which natural selection favours true workers over false workers, irrespective of genetical relatedness. Because food-nest separation tends to increase nest stability, this theoretical result implies that the less a termite species consumes its nest as food, the more likely is its nest stability to fall above the critical level and a true worker caste will evolve.

Animals↗

The health promotion of aging workers from the perspective of occupational health professionals.

OBJECTIVES: This study defines and describes, from the perspective of occupational health professionals, (a) the aging worker, (b) health promotion for aging workers, (3) employees' health-promoting activities, (4) workplace health promotion factors, (5) occupational health promotion activities, (6) co-partners supporting the health promotion, and (7) the impact of health promotion activities for older workers. A model is proposed, based on these issues. DESIGN: A cross-sectional, qualitative design was used to analyze e-mailed essays. Content analysis of the essays yielded themes that were validated by an independent research colleague. SAMPLE: Ten group essays from 16 occupational health professionals who had participated in the Health Promotion Project of Aging Workers in Northern Karelia, Finland were received. RESULTS: An aging employee was defined as a mature worker. Health promotion was defined as early prevention of the influence of health hazards. Workers can improve their health through living habits, positive attitude, personal relationships, and education. Individual work arrangements, good work atmosphere, and appreciative leadership were essential factors for the health of workers. Occupational health professionals supported workers by health examinations, workplace visits, counseling, and organizing activities. CONCLUSIONS: The impacts of health promotion activities were better health, productivity, and work satisfaction.

Adult↗

Factors affecting the occurrence of urothelial tumors in dye workers exposed to aromatic amines.

BACKGROUND: Past studies have analyzed individual jobs in dyestuff factories, materials manufactured and handled, age at exposure, and the duration of exposure in factories as factors related to the occurrence of urothelial tumors. None of these studies was based on long-term observation, and the factors involved in the occurrence of urothelial tumors remain controversial. In this study, various factors that may affect the occurrence of urothelial tumors in dye workers were assessed by multivariate analysis. METHODS: Three hundred and sixty-three workers in nine member factories of the Dyestuff Industrial Cooperative Association were included the study. Factory A is a large dyestuff chemical factory in Wakayama City with 218 dye workers. The other eight smaller factories employ a total of 145 dye workers. Correlations of tumor occurrence with a variety of factors, such as dyestuff intermediates manufactured and handled, types of job in the factory, age at the beginning of occupational exposure, and the duration of exposure were examined by multivariate analysis using multiple logistic models. RESULTS: Urothelial tumors were found in 58 (16.0%) of the 363 dye workers in the nine member factories of the Cooperative Association examined in the present study. The incidence in workers in Factory A, 5.5% (12 patients), was significantly (P < 0.01) lower than the overall incidence, while that in the eight small factories, 31.7% (46 patients), was significantly (P < 0.01) higher than the overall incidence. The risk factors significantly related to tumor occurrence in the 363 dye workers were benzidine (odds ratio, 8.302) as a dyestuff intermediate, manufacturing work (odds ratio, 4.631), and a long period of exposure (odds ratio, 1.018). Correlations of the tumor occurrence with the various factors were examined by multivariate analysis using multiple logistic models. In the total of 363 workers, benzidine as an intermediate (P < 0.05), manufacturing work (P < 0.01) and the duration of exposure (P < 0.01) were found to have contributed to the urothelial tumor occurrence. In Factory A, benzidine as an intermediate (P < 0.01) and duration of exposure (P < 0.05) contributed significantly to tumor occurrence. CONCLUSIONS: 1) The manufacturing and handling of benzidine and duration of exposure contribute significantly to the occurrence of occupational urothelial tumor, the former more strongly than the latter; 2) the contribution of different job types to tumor occurrence may be dependent upon the industrial health and safety practices in each factory.

Adolescent↗

Maintaining sexual health in commercial sex workers in Australia: condom effectiveness, screening, and management after acquiring sexually transmissible infections.

OBJECTIVE: To provide practical advice to health care providers and public health practitioners regarding screening and management of sexually transmitted infections (STIs) in sex workers, and to examine the effectiveness of condoms in reducing transmission of STIs. METHODS: Medline search using the key words sex workers, prostitutes, condoms and these terms in conjunction with pregnancy, sexually transmitted infections (including the names of individual STIs), infectivity, exclusion periods. Additional articles were identified from cited references. Articles were selected on the basis of information provided on efficacy of condoms in STI prevention, prevalence of STIs in sex workers and changes following condom promotion, and advice about management of STIs in infected workers. RESULTS: Condoms offer some protection (30-90%) against STIs passed in semen, urethral, vaginal or cervical secretions (such as HIV, gonorrhoea, chlamydia). They give little to no protection (0-30%) against diseases due to skin-to-skin contact such as genital herpes and genital warts. Transmissibility of STIs varies according to the sex of the exposed person and the sexual practice. Condom effectiveness against STIs also varies with gender, and experience and consistency of condom use. CONCLUSIONS: Sex workers require regular screening for STIs as condom use is not fully protective. Management of sex workers identified with infection requires understanding of the issues faced by sex workers, biological characteristics of the infective organism, treatment efficacy, and test sensitivity and specificity. Advice on frequency of STI testing, supply of medical certificates, management of condom breakage, and management of infected sex workers is proposed.

Australia↗

A needle in a haystack? Uninsured workers in small businesses that do not offer coverage.

OBJECTIVE: To describe the insurance status of workers at small businesses, and to describe the status of uninsured persons by the employment characteristics (employment status, firm size, and whether the employer offers insurance) of the head of household. DATA SOURCES: Data from the March and February 2001 Current Population Survey, and a survey of 2,830 small businesses in San Diego County conducted in 2001. STUDY DESIGN: The survey of small businesses was undertaken as part of a project testing the response of employers to offers of subsidized coverage. Employers were asked whether they offered insurance, and about the insurance status of their employees. The merged February-March 2001 CPS was used to identify the employment status, firm size, and employer-offering status for uninsured persons in the U.S. DATA COLLECTION: Telephone interviews with small businesses in San Diego County. PRINCIPAL FINDINGS: Only 21 percent of the uninsured in the U.S. are full-time employees (or their dependents) in small businesses (<100 employees) that do not offer insurance. The employment status of the uninsured is heterogeneous: many work for large employers, small employers who do offer insurance, or are self-employed, part-time workers, or have no workers in the household. Although there are many small businesses in San Diego that do not offer coverage, most of them have very few uninsured workers. Over 50 percent of businesses that do not offer coverage have either zero or one uninsured worker. There are very few small businesses that do not offer coverage and that have substantial numbers of uninsured workers. These businesses are not quite as rare as a needle in a haystack, but they are very difficult to find. CONCLUSIONS: If all small businesses that do not offer insurance now could be persuaded to start offering coverage, and if all the full-time workers (and their dependents) in those businesses accepted insurance, the number of uninsured would decline by 21 percent--a significant decline, but leaving 80 percent of the problem untouched. If the prime target for programs of subsidized insurance are small businesses that do not offer coverage now and that have substantial numbers of uninsured workers, the target is very small.

California↗

Prevalence of dental caries among workers in the sweets industry in Israel.

The purpose of the present study was to assemble data on the prevalence of dental caries among workers in the sweets industry. Three confectionaries were selected for the study. Most employees consented to be examined and were included in the study. The participants were distributed into two main groups: production line workers (228 participants) and non-production line workers (195 participants). The control group consisted of a group of production line workers from five textile industrial establishments; 812 in all. The results indicate that the mean DMFT values recorded for the sweets industry workers were significantly higher than those recorded for the control group. Significantly higher mean DMFT values recorded in the production line workers, as compared with the non-production line workers, in the confectionary industry were assumed to be attributed to a higher consumption of sweets and closer exposure to sugar dust. Mean DMFT values were found to increase significantly in relation to the duration of exposure to the effect of carbohydrates in both groups of workers in the sweets industry.

Adult↗

Synergistic neurotoxicity of carbon tetrachloride/carbon disulfide (80/20 fumigants) and other pesticides in grain storage workers.

Neurophysiologic, neurobehavioral, and neuropsychologic profiles in 17 grain storage workers, 1 grain inspector, and 4 malting laboratory workers are described. The effects of CS2 toxicity as seen in viscose rayon workers as well as in experimental animals is remarkably similar to the clinical profile of our grain storage workers. CS2 use explains the dysfunction of peripheral axons, auditory nerve, the optic nerve, and the extrapyramidal system, as well as altered behavior and cognition changes. The signs and symptoms in these workers seem to be dose-related and we note that workers separated out from the areas where fumigation took place reported improvement not seen by fellow workers who continued the fumigant treatment routine. Likewise, malting laboratory workers exposed only to the grain dust from 3 to 7 years showed only minimal symptoms. Though a number of mechanism have been suggested for the alteration of neuropsychological function, the chelating ability of DDC derived from CS2 and its ability to markedly increase copper and zinc within the central nervous system suggests a mechanism of toxicity analogous to copper intoxication as in Wilson's Disease and may explain the production of extrapyramidal symptoms in these patients. Chelation of copper might prove therapeutic in CS2 poisoning. It is obvious that both basic and clinical research will be necessary to sort out the questions raised. We applaud the EPA's decision to ban the use of 80/20 fumigants and also methyl bromide, and trust that similar toxic substances be carefully studied before their selection for replacing these previous toxic agents. We further decry the technique of re-introducing grain dust into the food chain rather than destroying it, since the dust contains very high residues of fumigant material. We speculate on the possible role of CS2 and other pesticides in the food chain and the incidence of Parkinsonian symptoms in these patients and the general public.

Adult↗

Ethnic health workers in primary health care.

Ethnic health workers were employed to increase the access of communities of non-English-speaking background to health services, but their role has remained unclear in a national health system that has been criticised for being slow to respond to the needs of these communities. Interviews and a questionnaire were used to survey a convenience sample of 40 South Australian ethnic health workers, how they should perform their roles and their ability to fulfil them. Interviews with 11 staff from the New South Wales Ethnic Health Worker Program then provided a broader perspective to the South Australian findings. High-priority roles were to provide help to solve immediate health problems. Roles included providing access as well as services. There were pressures on ethnic health workers to become service providers: clients from non-English-speaking backgrounds expected assistance with a wide range of problems, and mainstream staff lacked competence in meeting these needs. Ethnic health workers' involvement in needs assessment and health agency change was limited by these pressures, by ethnic health workers' separation from the work of mainstream staff and because systematic planning of services to non-English-speaking communities was lacking. The appropriate role for an ethnic health worker is as an access provider, with a greater emphasis on needs assessment and agency change. Agencies need to develop culturally appropriate service plans and training so that ethnic health workers and mainstream staff are better able to work together.

Australia↗

Respiratory symptoms and airflow limitation in asphalt workers.

BACKGROUND: Asphalt workers are exposed to bitumen fume and vapour, and to exhaust from engines and passing traffic. AIMS: To assess the occurrence of respiratory symptoms and signs of airflow limitations in a group of asphalt workers. METHODS: All 64 asphalt workers and a reference group of 195 outdoor construction workers from the same company participated in a cross-sectional study. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were administered. Respiratory symptoms and lung function were adjusted for age and smoking. RESULTS: The FEV1/FVC% ratio was significantly lower in the asphalt workers than in the referents. Symptoms of eye irritation, chest tightness, shortness of breath on exertion, chest wheezing, physician diagnosed asthma, and chronic obstructive pulmonary disease (COPD) were all significantly more prevalent among the asphalt workers. CONCLUSION: In asphalt workers there is an increased risk of respiratory symptoms, lung function decline, and COPD compared to other construction workers.

Adult↗

Six year observational cohort study of the effect of carbon disulphide on brain MRI in rayon manufacturing workers.

AIMS: To clarify whether the current occupational exposure limit (OEL) for carbon disulphide (CS2) is low enough to prevent the occurrence of adverse effects on the cerebrovascular system. METHODS: A total of 432 male workers exposed to CS2 and 402 male referent workers in 11 Japanese viscose rayon factories were studied at baseline; 750 of these were followed up. Brain MRI was performed at both baseline and follow up surveys. Changes in the number of hyperintense spots in T2 weighted images (HIS), which point to so-called "silent cerebral infarctions", were evaluated over six years. A total of 666 subjects (217 exposed, 125 ex-exposed, and 324 referent subjects) who twice received brain MRI were subjected to analysis. Mean duration of exposure to the end of the study was 19.6 years for the exposed workers. The geometric mean CS2 (ppm) and TTCA (mg/g creatinine) concentrations for the past six years were 4.9 and 1.6 for all exposed workers, 5.8 and 1.9 for spinning/refining workers, and 2.7 and 0.9 for other exposed workers, respectively. RESULTS: Exposed subjects showed a significantly higher risk for an increase in the number of HIS over six years. Odds ratios adjusted for possible confounders in the exposed and ex-exposed workers were 2.27 (95% CI 1.37 to 3.76) and 1.33 (95% CI 0.70 to 2.54), respectively. No exposure-response relations were observed in a number of analyses among the exposed workers. CONCLUSIONS: Exposure to CS2 under the current Japanese OEL, 10 ppm, might increase the number of HIS in brain MRI. However, results should be interpreted with caution.

Adult↗

Hepatitis E, Helicobacter pylori, and gastrointestinal symptoms in workers exposed to waste water.

BACKGROUND: Workers exposed to sewage may have an increased risk of infection by Helicobacter pylori and hepatitis E virus (HEV). AIMS: To assess the prevalence of clinical hepatitis E (HE) and peptic ulcer disease as well as the seroprevalence of antibodies to H pylori and HEV in workers with and without sewage exposure and to look for symptoms due to exposure to endotoxin. METHODS: In the first year of a prospective cohort study 349 sewage exposed workers and 429 municipal manual workers (participation: 61%) underwent a complete medical examination. Travelling to endemic areas, socioeconomic level, age, country in which childhood was spent, and number of siblings were considered as the main confounding factors. RESULTS: Peptic ulcer disease and clinical HE did not occur more often in workers exposed to sewage. Prevalence of antibodies to HEV was 3.3% and overall prevalence of IgG antibodies to H pylori was 42% with large differences between subgroups. Logistic regression did not show an increased risk of seropositivity or antibodies to parietal cells in sewage exposed workers, but disentangling the effect of exposure from that of confounders was extremely difficult. No increase of symptoms due to exposure to endotoxin was found in sewage workers, with the exception of diarrhoea. CONCLUSIONS: No clear increased risk of infection by H pylori or by HEV in workers exposed to sewage was found in this cross-sectional study, but these results need to be confirmed by follow up.

Adult↗