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PubMed1994

Management of traumatic injuries in the workplace.

Traumatic injuries in the workplace occur from a variety of mechanisms and may produce a wide range of injuries. Critical to the management of these injuries is the knowledge that life saving interventions for airway, breathing, and circulation must take priority. Controlling external bleeding and managing circulation is imperative in the traumatically injured worker. Inadequate control of hemorrhage leads to cellular shock from which the client may never recover. Extremities should be managed appropriate to the specific injury. Careful monitoring of neurovascular status is significant in limb preservation. Amputated parts must be meticulously cared for, with the vision of replantation in mind. Electrical burns are unique burn injuries, as the complete area of damage is not visible. Monitoring cardiac and respiratory function is essential to detect any life threatening abnormalities in all injuries, but is especially important in the electrically injured client. The occupational health nurse can make a significant difference in the outcome of a traumatically injured client in the workplace. Adequate knowledge of treatment modalities, as well as transfer to the most appropriate trauma care facility, can make the difference in obtaining the best possible outcome.

Accidents, Occupational↗
PubMedDate not supplied

Structural and perceived medical dominance: a study of barriers to nurses' workplace satisfaction.

Current literature on the sociology of healthy views medical dominance as a structural feature of the health division of labour and a body of literature has developed exploring the structural components that contribute to the subordination of the allied health professions. In this paper, Friedson's four factor definition of medical dominance was employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how structural and perceived medical dominance affects nurses' workplace satisfaction. A 69 item questionnaire covering aspects of doctor/nurse, doctor/patient, nurse/patient and nurse/hospital administration relationships was developed. One hundred and thirty nurses completed the questionnaire in which they ranked their own level of professional satisfaction and their perceptions of level of doctors' professional satisfaction. Results indicated that nurses were dissatisfied with many aspects of their work environment, i.e. pay and working conditions and experienced very high levels of dissatisfaction with their professional status. Nurses perceived doctors as being highly satisfied and as having more control over a range of procedures intrinsic to the delivery of health care, and the medical profession to be a more powerful and higher status profession that was held in greater regard by the public and other allied health professionals than nursing. The implications of the perceived discrepancy in nurses' and doctors, workplace satisfaction are discussed in terms of the structural barriers created by medical dominance. Implications of the findings for nurse education and nurse practitioners are also discussed, together with suggestions for further research.

Adult↗
PubMed1993

[Risks attributable to the occurrence of tin, silver and tungsten in the air of the workplace environment--methods of determination].

Tin, silver and tungsten constitute serious threat to the health of the employees of Polish industry. As no standard methods for determination of those metals in the atmospheres of workplaces were available, measurements of their concentrations in the workplace atmospheres were not performed, and, therefore, determination of the resultant risks to the health of the people exposed to those metals was not possible. A spectrophotometric method of determination has been developed for tin, which is based on the formation of coloured Sn(IV)--pyrocatechine complexes in the dilute sulfuric and citric acid medium in the presence of cetyltrimethylammonium bromide (absorbance determined at lambda = 600 nm). The detectability of the method is 0.5 mg/m3. To ensure the selectivity of the method in the presence of foreign cations and acid anions. Sn should be pre-separated from the disturbing ions by the extraction method. For silver determination, a method using atomic absorption spectrometry with air-C2H2 flame has been developed. The detectability of the method is 0.005 mg/m3. The presence of cations of other metals or of acid anions does not affect the results obtained with this method. The new-developed method of tungsten determination involves reaction with calcium thiocyanate in HCl medium in the presence of stannous chloride, followed by assessing the tungsten complex, pre-extracted with izoamyl, alcohol, by spectrophotometry at lambda = 405 nm. This method enables determination of 1 mg/m3 tungsten. The results are affected only by the presence of Mo in quantities exceeding 4 mg/m3 and Al in quantities exceeding 2 mg/m3.

Air Pollutants, Occupational↗
PubMed1995

Improving workplace environments and working conditions at worksites providing school lunch service in Japan.

With the cooperation of All Japan Prefectural and Municipal Workers' Union, we have started an overall program on occupational safety and health from 1984. This program has several strategies aimed at preventing occupational injuries and work-related diseases. At first, we analyzed the relationship between work-related hazards and occupational factors, and to identify dangerous or hazardous factors in the workplace. Second, we have conducted a couple of intervention studies at worksites and evaluated these improvements. Third, we discussed the priority, feasibility and cost of improvements with Workers' Union members and school lunch workers. Fourth, during the last decade, Workers' Union and many researchers have demanded that regulations be implemented which would establish comprehensive safety and health programs. Fifth, we provided the workers with procedures on how to improve working environments and conditions. These education and training programs are provided for small-group working ("safety and health circle"), and demonstrate to workers their abilities to solve occupational safety and health problems and to empower them with respect to health-related issues. Finally, we discussed and evaluated the preventive effects of improving workplace environments and working conditions. The overall program on occupational safety and health at worksites is developing nationwide and is gradually taking effect.

Cooking↗
PubMedDate not supplied

Innovation adoption: introducing I.V. patient controlled analgesia to the nursing workplace.

Technology in the nursing workplace is inevitable but what is not certain is how well these technologies will be initially accepted by nurses. One technological innovation that has appeared in some Canadian hospitals is IV Patient Controlled Analgesia (IV PCA), an innovative technique for pain management, employing the use of a computer-driven pump. Few nursing studies have examined the adoption of technological innovations. This qualitative study examines the incorporation of IV PCA to the nursing workplace and job-related factors that influenced it. A five-phase integration process was identified along with factors impacting on this process. Incorporating IV PCA into nursing practice involved the nurses' judgements of the influence of this innovation on the nurses' comfort with care delivery; the patient/nurse relationship; managing the technology; and the relationship with other health care professionals and patients' family/visitors. Anxiety accompanied the integration process, peaking as IV PCA was introduced to patient care. Findings of this study suggest that actions and decisions initiated by nurse administrators and educators have the potential to influence the successful adoption of this innovation.

Adult↗
PubMed1996

[Carpal tunnel syndrome in primary care. Impact of workplace risks].

OBJECTIVE: To describe a series of cases of carpal tunnel syndrome (CTS) diagnosed at our health centre, with an analysis of the influence of work activity. DESIGN: A retrospective and descriptive study of a series of cases. SETTING: Patients on two medical lists who sought health care. PARTICIPANTS: 27 people diagnosed as having CTS. MEASUREMENTS AND MAIN RESULTS: We selected all the cases of CTS diagnosed according to the NIOSH criteria. We analysed symptoms, signs, additional tests and work risks. 24 out of the 27 cases were women. 100% had suggestive symptoms and 48.15% were affected bilaterally. The Tinell sign was positive in 5 cases, the Phalen in 7 and both in 11. 17.4% tested normal. We could see a diagnostic EMG in 19 cases. 59.2% were aged between 40 and 60. In all the cases we detected workplace risk factors: 18.5% housewives, 14.8% working in canning factories and dressmaking, 11.1% working in canning factories and dressmaking and shops/bars, 7.4% were cleaners, canning and fur operatives and mechanics. 3.7% worked at sewing shoes and in agriculture. As an accompanying pathology we detected 14.8% with obesity, 7.4% tenosynovitis and wrist fractures. For 3.7% CTS was a side-effect of diabetes, cervical arthrosis, ACV and dermatomyositis. 55.5% had non associated pathology. CONCLUSIONS: 1) The population of Molina de Segura can be considered at high risk of developing CTS. 2) In our environment women seek care for CTS much more often. 3) Most of our patients develop the condition in the workplace.

Adult↗
PubMedDate not supplied

Workplace homicide: industries and occupations at high risk.

Homicide is to blame for 20 workplace deaths each week. Although no single intervention strategy will be appropriate in all situations, the author points out that interventions cannot be designed without knowledge of the demographic characteristics of victims and the distribution of workplace violence across industries and occupations. Such data are presented by gender, age, race, geographic distribution, method of homicide, and industry and occupation.

Accidents, Occupational↗
PubMedDate not supplied

Workplace violence: an analysis of bureau of labor statistics data.

Information from the Bureau of Labor Statistics analyzed here reveals interesting findings related to injuries resulting from workplace violence. The data show which workers commonly sustain injuries as a result of violent acts, where the violence occurs, and how it happens. The circumstances differ markedly between workplace homicides and nonfatal assaults.

Accidents, Occupational↗
PubMedDate not supplied

Policies for developing workplace violence prevention strategies.

The paradox that some strategies to prevent workplace violence may actually increase the potential for violence is addressed. Strategies that might prevent crime-related internecine workplace violence are described and several ineffective and even potentially deleterious strategies examined.

Accidents, Occupational↗
PubMedDate not supplied

The law of workplace violence.

In addressing law related to workplace violence and employers' obligations, the authors analyze the quagmire of the often conflicting rights of the victim, the perpetrator, and third parties. The close attention that courts are now giving to workplace violence and the scores of legislative efforts to deal with it are assessed.

Accidents, Occupational↗
PubMed1997

Assessing drug use in the workplace: a comparison of self-report, urinalysis, and hair analysis.

A random sample of 1,200 employees of a steel plant in the western United States was randomly assigned to four different self-report methods of assessing illicit drug use: individual interview in the workplace, group-administered questionnaire in the workplace, telephone interview, and individual interview off the worksite. Urine specimens were collected and analyzed on all 928 subjects participating in the study, and hair analysis was conducted on 307 of the subjects. Although self-reports produced higher prevalence rates than the chemical tests, analyses combining the results of the three assessment methods showed that the actual prevalence rate was approximately 50 percent higher than the estimate produced by self-reports alone. The group-administered questionnaire method produced prevalence rates that were roughly half those of the other self-report methods. The findings cast doubt on the validity of self-reports as means of estimating drug use prevalence and suggest the need for multiple assessment methods.

Adolescent↗
PubMed1996

[A study on the control of air toxic chemicals in workplace for bakelite manufacturing and casting].

Air concentrations of phenol, formaldehyde and ammonia related to the contents of free phenol, formaldehyde in raw material, and solidifying agent-urotropine in bakelite. Due to the solubility of phenol and formaldehyde, in the manufacture process, water was added to lower contents of phenol and formaldehyde in bakelite, and content of urotropine was reduced in bakelite sand presceription to lower air concentrations of phenol, formaldehyde and ammonia. As contents of phenol and formaldehyde in bakelite reduced to 4.9% and 0.037% from 6.32% and 0.062%, respectively, air concentrations of phenol, formaldehyde and ammonia lowered to 0.61 mg/m3, 0.69 mg/m3, and 5.1 mg/m3 from 2.94 mg/m3, 1.72 mg/m3, and 12.9 mg/m3, respectively, and incidence rate of skin disease in the employees of the workplace decreased to zero from 80.2%. It is recommended that a hygienic standard for allowable concentration of mixed toxic chemicals in the workplace air for bakelite manufacturing be formulated as soon as possible.

Air Pollutants, Occupational↗
PubMed1997

Allergic reactions to workplace allergens.

Allergic sensitization to workplace allergens can result in occupational asthma (OA), rhinitis, and dermatoses. Occupational asthma, accounting for 2% to 15% of all new cases of asthma, is caused by more than 240 reactive chemicals or natural proteins. Diisocyanates, used in urethane production and spray painting, are the leading causes of OA. Occupational asthma must be objectively confirmed by demonstrating significant decreases in lung function associated with exposure to a causative agent. An early diagnosis of OA followed by elimination of exposure to a causative agent may be curative and prevent progression to chronic asthma. In the last decade, protein allergens in natural rubber latex gloves have emerged as the leading cause of work-related cutaneous and respiratory allergic disorders in health care workers. In the workplace, occupational allergic contact dermatitis is almost always caused by chemicals, including nickel, chromates, and epoxy resins, whereas contact urticarial reactions are most often due to protein allergens. The primary treatment of occupational allergic disorders is strict avoidance of exposure to the inciting agent.

Allergens↗
PubMedDate not supplied

Management of family and workplace stress experienced by women of colour from various cultural backgrounds.

Minority women identify finances and maintaining cultural values as their most commonly experienced stressors at home and in the work-place. A before and after study of ethnic minority women in focus group sessions led by a trained ethnic minority facilitator examined how social and workplace supports, or lack thereof, impact on the individuals' ability to manage daily life. Creative, effective solutions to stressors were identified by the participants. Outcomes were evaluated in terms of the impact of changes on the participants' coping styles in family and work life. Results indicate that a large percentage of women in this study felt discriminated against based on their culture/race, however, this perceived discrimination decreased after the focus groups. The predominant stress management techniques were prayer and music. Family support was the most influential factor in decreasing stress. The family is a major source of support for the working women, acting as a buffer to workplace pressures.

Adult↗
PubMed1998

[Does physical exercise at the workplace have any effect on sick leave?].

The objective of the study was to ascertain whether physical activity at the workplace reduces the amount of sick leave. The databases Medline and Spri-line, reference lists, and professional expertise were consulted for information on the subject. We included random controlled trials, and controlled trials studying the effect on sick leave of physical activity at the worksite. Four trials were identified, including one carried out in Norway. The small number of trials limits the value of any conclusions and highlights the need for more research. The results of the four trials do not indicate that physical activity at the workplace reduces sick leave.

Controlled Clinical Trials as Topic↗
PubMed1998

[Materials for adjusting MAC of lead in the workplace air].

The authors present materials of clinical and hygienic study checking MAC for lead in the air of workplace. The study covered 506 workers of printing, nonferrous metallurgy plants and storage battery production. The study included examination of cardiovascular, nervous, digestive systems and laboratory values and revealed high diagnostic value of serum lead level and low one of urinary lead level. High number of the groups examined and mathematical processing of incomplete selects (Caplan--Meyer assess) proved that intoxication resulted from higher lead concentrations (0.58-0.8 mg/m3). The lead levels of 0.2 mg/m3 in 23.7% of cases induced changes of 2-3 laboratory values-first signs of lead intoxication--and in 5.2% of cases some symptoms of vegetative sensory polyneuropathy were seen. These lead levels are therefore determined as minimally acting. Calculations of probability parameters for health risk helped to set MAC for lead in the air of workplace at 0.05 mg/m3 (this value is accepted by Russian Health Ministry) with mandatory control of serum lead level.

Air Pollutants, Occupational↗
PubMed2005

Workplace violence: a survey of emergency physicians in the state of Michigan.

STUDY OBJECTIVE: We seek to determine the amount and type of work-related violence experienced by Michigan attending emergency physicians. METHODS: A mail survey of self-reported work-related violence exposure during the preceding 12 months was sent to randomly selected emergency physician members of the Michigan College of Emergency Physicians. Work-related violence was defined as verbal, physical, confrontation outside of the emergency department (ED), or stalking. RESULTS: Of 250 surveys sent, 177 (70.8%) were returned. Six were blank (3 were from retired emergency physicians), leaving 171 (68.4%) for analysis. Verbal threats were the most common form of work-related violence, with 74.9% (95% confidence interval [CI] 68.4% to 81.4%) of emergency physicians indicating at least 1 verbal threat in the previous 12 months. Of the emergency physicians responding, 28.1% (95% CI 21.3% to 34.8%) indicated that they were victims of a physical assault, 11.7% (95% CI 6.9% to 16.5%) indicated that they were confronted outside of the ED, and 3.5% (95% CI 0.8% to 6.3%) experienced a stalking event. Emergency physicians who were verbally threatened tended to be less experienced (11.1 versus 15.1 years in practice; mean difference -4.0 years [95% CI -6.4 to -1.6 years]), as were those who were physically assaulted (9.5 versus 13.1 years; mean difference -3.6 years [95% CI -5.9 to -1.3 years]). Urban hospital location, emergency medicine board certification, or on-site emergency medicine residency program were not significantly associated with any type of work-related violence. Female emergency physicians were more likely to have experienced physical violence (95% CI 1.4 to 5.8) but not other types of violence. Most (81.9%; 95% CI 76.1% to 87.6%) emergency physicians were occasionally fearful of workplace violence, whereas 9.4% (95% CI 5.0% to 13.7%) were frequently fearful. Forty-two percent of emergency physicians sought various forms of protection as a result of the direct or perceived violence, including obtaining a gun (18%), knife (20%), concealed weapon license (13%), mace (7%), club (4%), or a security escort (31%). CONCLUSION: Work-related violence exposure is not uncommon in EDs. Many emergency physicians are concerned about the violence and are taking measures, including personal protection, in response to the fear.

Emergency Service, Hospital↗