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PubMed2005

Anxiety and depression in the workplace: effects on the individual and organisation (a focus group investigation).

BACKGROUND: While the prevalence of anxiety and depression has increased, little is known of the impact on working life. The aim of this study was to explore the effects of anxiety and depression and the treatment for these conditions on performance and safety in the workplace. METHOD: Nine focus groups were conducted with employees who had suffered anxiety and depression. A further 3 groups comprised staff from human resources and occupational health. The sample comprised 74 individuals aged 18-60 years, from a range of occupations. Results were presented to a panel of experts to consider the clinical implications. RESULTS: Workers reported that the symptoms and medication impaired work performance, describing accidents which they attributed to their condition/medication. Respondents were largely unprepared for the fact that the medication might make them feel worse initially. Employees were reluctant to disclose their condition to colleagues due to the stigma attached to mental illness. LIMITATIONS: People who had experienced problems with managing their symptoms and medication at work are more likely to volunteer to participate in such a study than those who had a satisfactory experience. Also, the researchers had no background information on severity of mental health problems of participants. CONCLUSIONS: Anxiety and depression were associated with impaired work performance and safety. The authors consider the implications for health care and the management of mental health problems at work.

Adolescent↗
PubMed2004

Creating safer workplaces: assessing the determinants and role of safety climate.

PROBLEM: Although there has been considerable interest in safety climate, relatively little attention has been given to the factors that determine safety climate or to testing the hypothesized mediating role of safety climate with respect to safety-related outcomes. METHOD: Questionnaire responses were obtained from 2,208 employees of a large national retail chain in 21 different locations. RESULTS: After controlling for demographic variables, three factors: environmental conditions, safety-related policies and programs, and general organizational climate, accounted for 55% of the variance in perceived safety climate. Interestingly, organizational climate made a significant contribution to safety climate, even after controlling for the other more safety-relevant variables. Partial correlations showed that safety policies and programs had the largest observed correlation with safety climate, followed by two of the dimensions of organizational climate (communication and organizational support). Using Baron and Kenny's (J. Pers. Soc. Psychol. 51 (1986) 1173) procedures, the principal effects of the various work situation factors on perceived safety at work were found to be direct rather than mediated by safety climate. Safety climate influenced perceived safety at work, but its role as a mediator was limited. IMPACT ON INDUSTRY: These results are discussed in terms of other recent findings on safety climate and the growing interest in understanding management and organizational factors in the context of workplace safety.

Accident Prevention↗
PubMed2004

A case-control study of eye injuries in the workplace in Hong Kong.

OBJECTIVE: Eye injury in the workplace is common worldwide. This study proposed to explore both risk and preventive factors re eye injuries in Hong Kong. DESIGN: Case-control study. PARTICIPANTS: A total of 239 work-related eye injury patients, and 253 subjects without a history of any eye injury as controls. METHODS: Patients with all incident cases of work-related eye injuries attending the ophthalmology clinics of 3 major public hospitals in Hong Kong during the first 3 months of 2000 were invited to participate. Controls were selected from the general population and were frequency matched to patients based on gender. Patients were interviewed face-to-face by trained interviewers in the ophthalmology clinics, using a structured questionnaire. Telephone interviews were used for controls. MAIN OUTCOME MEASURES: Risk and protective factors associated with eye injuries. RESULTS: Among eye injury cases, 158 patients (66.1%) reported having incurred 1 episode of eye injury during employment, 49 (20.5%) having suffered 2 episodes, and 32 (13.4%) having experienced >/==" BORDER="0">3 eye injuries at work. Most of the patients (85.4%) did not wear any protective devices at the time of injury. Subjects who wore safety glasses regularly were less likely to have eye injuries (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.14-0.62). Having a safety requirement for wearing safety glasses was negatively associated with eye injuries (OR = 0.31, 95% CI = 0.15-0.62). Multivariate analysis indicated that exposures to certain work hazards and working in the construction industry were positively associated with eye injuries. Subjects who worked longer in their current job, who reported having received job safety training before employment, or whose machines or equipment were maintained or repaired regularly by employers were at lower risk of experiencing eye injuries. CONCLUSIONS: Construction workers and those exposed to multiple hazards may get eye injuries at work. They should be provided with protective devices that are effective in preventing such exposures. Health education and safety training are important in preventing eye injuries. Maintenance and repair of machines and equipment may effectively reduce or eliminate the sources of exposures.

Accidents, Occupational↗
PubMed2005

Effects of a workplace physical exercise intervention on the intensity of headache and neck and shoulder symptoms and upper extremity muscular strength of office workers: a cluster randomized controlled cross-over trial.

The purpose of the study was to examine the effects of a workplace physical exercise intervention on the perceived intensity of headache and the intensity of symptoms in the neck and shoulders, as well as on the extension and flexion strength of the upper extremities. The study was a cluster randomized controlled trial. The cross-over design consisted of physical exercise intervention (15 weeks) and no-intervention (15 weeks). The subjects (n=53) were office workers (mean age 46.6 (SD 8.4)) who reported headache (n=41) symptoms in the neck (n=37) or shoulders (n=41), which had restricted their daily activities during the last 12 months. Pain symptoms were measured using the Borg CR10 scale and muscular strength with a 5RM test. Statistical analyses were based on linear mixed models. Physical exercise intervention resulted in a slight, but statistically significant, decrease in the intensity of headache and neck symptoms, as well as an increase in the extension strength of the upper extremities. The mean decrease in headache during the 5-week period was 0.64 CR10 (95% CI 0.28-1.00) (P=0.001) or 49% (95% CI 22-77), and 0.42 CR10 (95% CI 0.11-0.72) (P=0.002) or 49% (95% CI 13-85) in the intensity of neck symptoms. The mean increase in the extension strength of the upper extremities was 1.3 kg (95% CI 0.5-2.1) (P=0.001) or 4% (95% CI 1-6). The intervention had no effect on the intensity of shoulder symptoms or the flexion strength of the upper extremities. Specific exercise may be clinically important to alleviate headache and neck symptoms.

Activities of Daily Living↗
PubMedDate not supplied

Training efforts to reduce reports of workplace violence in a community health care facility.

The objective of this study was to measure reports of workplace violence (WPV) after an online training program on WPV for health care workers. Recognition of the prevalence of WPV (physical, emotional-verbal, and sexual) suggests a great need for employers to provide training to all health care workers as a first-line effort to reduce or prevent WPV. A 3-hour online training program for WPV was offered to 43 workers attending an informational session. Volunteers included 22 participants designated for training and 21 volunteers designated to serve as control subjects. Pretraining WPV work area assessments were completed by all participants and compared between training participants and control subjects. At 6 months, comparisons were made between 3 groups: Group A, those who completed the training; Group B, control subjects; and Group C, those who did not complete the training within the designated period. Group C was defined as a separate group because some participants within this group were workers from the same work areas as were Group A participants. Comparisons of preassessments and postassessments of WPV for Group A and assessments of WPV across the three groups were made. Participants reported 200 WPV events over a 6-month period before training. Pretraining reports of WPV were statistically different between training participants and control subjects for total and emotional-verbal WPV events. At 6 months after the training, a reduction in sample size and reports of all types of WPV was noted across the three groups (i.e., those who completed the training, those who did not complete it, and control subjects). Owing to the small number of reported physical and sexual WPV events, only total and emotional-verbal WPV events were examined. No difference was noted between the three groups for total events; however, emotional-verbal abuse was statistically significant between the groups. In addition, a statistically significant difference was noted among participants before and after the completion of the online training. Despite the reported prevalence of WPV, a significant number of health care workers did not make training a priority. Participants who were designated for training and who subsequently completed it reported the most number of events before and after training. Proportionately per number of participants after training, fewer total WPV events were reported; however, because of the attrition rate and group sample size, significance was not reached. Reports of emotional-verbal abuse remained high after training, which could suggest a heightened awareness of this type of WPV with a personal redefinition of WPV or a heightened staff and administration sensitivity to reporting. Although differences existed among training participants and control subjects before training, significance could not be achieved among the three groups owing to validity threats, including subject mortality, diffusion between groups, selection bias, and small sample size. However, the finding that training can make a difference is important and encourages replication of this study with a larger sample size and a larger setting. Finding high rates of emotional-verbal abuse across work areas and support for training benefits enhance the need for training programs with an increased focus on emotional-verbal WPV.

Adult↗
PubMed2005

Characterization of dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the atmosphere of different workplaces of a sinter plant.

This study investigated concentrations, contents and congener profiles of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the workplaces of a sintering plant. Air samples were collected from the charging zone, the sintering zones of the sintering grate and the rough roll shredder, and the control room. The charging zone was found to have a higher total suspended particulate (TSP) but lower PCDD/F concentrations (=4969 microg nm(-3) and 7.61 pg nm(-3), respectively) than the sintering zone (=1422-1448 microg nm(-3) and 19.16-23.17 pg nm(-3), respectively). The TSP and PCDD/F concentrations were lowest in the control room (=98 microg nm(-3) and 1.75 pg nm(-3), respectively). However, the above concentrations were within the range of a typical urban-industrial area. Quite similar PCDD/F contents were found in particles in the sintering zones and control room (=11.72-14.30 and 15.85 ng g(-1), respectively) suggesting that the sintering zone and the control room are very similar. In both charging and sintering zones, 2,3,4,7,8-PeCDF contributed 40-60% to the total I-TEQ in both the gas phase and particle phase. However, in control room, both congeners 2,3,4,7,8-PeCDF and 2,3,7,8-TCDD were the main contributors; the later contributed 30% of the total I-TEQ in gas phase. In control room, the contribution of 2,3,7,8-TCDD to the total PCDD/F concentration in the gas phase greatly exceeded that in particle phase (=5.5% and 0.8%, respectively). Therefore, solutions must be sought to avoid the transfer of not only the particle-phase but also the gas-phase PCDD/Fs from the sintering zone to the control room in the future.

Air Pollutants↗
PubMed2005

The association between lead contamination on the hand and blood lead concentration: a workplace application of the sodium sulphide (Na2S) test.

OBJECTIVES: Lead is one of the major causes of workplace poisoning and lead contamination on skin is a possible route of lead absorption. Using a colourimetric method with sodium sulphide (Na2S), we examined whether the lead on skin represents longer-term lead exposure. METHODS: This cross-sectional study of 119 lead-handling workers in a battery recycling plant in Japan was conducted in July 2004. The main outcome measure was skin-colour darkening on the workers' hands, visualised by wetting the seemingly clean hands of the workers with 1% Na2S solution (128 mmol/L): the Na2S test. This study then examined the relationships between the Na2S test results and workers' blood lead concentration (BLC) and hygiene activities. RESULTS: The Na2S test produced skin-colour darkening of the hands of 92 (77%) of the lead workers, although 88 of them had washed their hands with soap and 50 had bathed before taking the test. In the bivariate analyses, a positive result in the Na2S test was associated with not washing hands (p=0.009), not bathing (p=0.061), and a higher BLC (p=0.008). The association between the results of the Na2S test and BLC was still significant in the multivariate linear regression analysis adjusted for age and hand washing (p<0.001). CONCLUSIONS: Lead contamination on workers' hands, otherwise unapparent, was clearly demonstrated by the Na2S test. The result of this test was associated with BLC in addition to the hygiene activities after the last work with lead. As the lead contamination on the hand is persistent, simply encouraging hand washing may not be sufficient to reduce lead intake into body.

Cross-Sectional Studies↗
PubMed2006

DNA damage and repair capacity by comet assay in lymphocytes of white-collar active smokers and passive smokers (non- and ex-smokers) at workplace.

The comet assay has been widely used to quantify DNA damage in isolated lymphocytes from subjects exposed to several environmental or occupational substances, especially for estimation of oxidative damage in the DNA, which is well-known to be induced by tobacco smoke. Passive smoking or environmental tobacco smoke (ETS) has been included among those substances that cause cancer with sufficient evidence in humans. In this study, we analyzed, by the alkaline version of comet assay, the lymphocyte DNA damage of white-collar active smokers and non- and ex-smokers exposed to ETS at the workplace. We investigated basal DNA damage, DNA oxidation by formamidopyrimidine glycosylase (Fpg), the repair capacity H2O2-induced DNA damage by kinetics studies and lymphocyte GSH levels, the major intracellular defense against exogenous oxidative stress imposed by cigarette smoking. Our results indicated high basal DNA damage with clear significant correlations with urinary nicotine and cotinine, number of cigarettes/day, and an inverse significant correlation with GSH cellular content in active smokers. Significant Fpg-sensitive sites were found in smokers (> 85%), considerably high but not significant in passive non- and ex-smokers (> 51% and 37%, respectively). The DNA repair capacity had seriously decreased in non-smokers > smokers > ex-smokers, while the same damage was repaired in a short time in never smokers.

Adult↗
PubMed2006

Epilepsy and workplace discrimination: population characteristics and trends.

This study investigates the nature of allegations of workplace discrimination made by job seekers and workers with epilepsy. Demographic characteristics of individuals making allegations were consistent with those of individuals with epilepsy nationwide. Approximately three-fourths of allegations were related to post-hire issues, such as discrimination in promotion and termination, disciplinary actions, and harassment. The lowest rate of merit allegation was related to discrimination in hiring. Comparison of merit allegations before and after the U.S. Supreme Court's Sutton decision revealed that claimants have had higher rates of success following the decision, suggesting that the Sutton decision has had no negative effect on claimants with epilepsy.

Adult↗
PubMed2004

The Los Angeles Lift Off: a sociocultural environmental change intervention to integrate physical activity into the workplace.

PURPOSE: To present the development and feasibility testing of a sociocultural environmental change intervention strategy aimed at integrating physical activity into workplace routine. DESIGN: Randomized, controlled, post-test only, intervention trial. Setting. Los Angeles County Department of Health Services' worksites. PARTICIPANTS: Four hundred forty-nine employees, predominantly sedentary, overweight, middle-aged women of color, distributed across 26 meetings. INTERVENTION: A single 10-min exercise break during work time involving moderate intensity, low-impact aerobic dance and calisthenic movements to music. MEASURES: Primary-level of participation, particularly among sedentary staff; secondary-self-perceived health status, satisfaction with current fitness level, and mood/affective state. RESULTS: More than 90% of meeting attendees participated in the exercises. Among completely sedentary individuals, intervention participants' self-perceived health status ratings were significantly lower than controls' (OR = 0.17; 95% CI = 0.05, 0.60; P = 0.0003). Among all respondents not regularly physically active, intervention participants' levels of satisfaction with fitness were more highly correlated with self-ranked physical activity stage of change (r = 0.588) than the control participants' (r = 0.376, z = -2.32, p = 0.02). Among the completely sedentary, control participants reported significantly higher levels of energy than did intervention participants (P < 0.01). CONCLUSIONS: Captive audiences may be engaged in brief bouts of exercise as a part of the workday, regardless of physical activity level or stage of change. This experience may also appropriately erode sedentary individuals' self-perception of good health and fitness, providing motivation for adoption of more active lifestyles.

Adolescent↗
PubMed2005

A probabilistic effect assessment model for hazardous substances at the workplace.

A major problem in risk assessment is the quantification of uncertainties. A probabilistic model was developed to consider uncertainties in the effect assessment of hazardous substances at the workplace. Distributions for extrapolation factors (time extrapolation, inter- and intraspecies extrapolation) were determined on the basis of appropriate empirical data. Together with the distribution for the benchmark dose obtained from substance-specific dose-response modelling for the exemplary substances 2,4,4-trimethylpentene (TMP) and aniline, they represent the input distributions for probabilistic modelling. These distributions were combined by Monte Carlo simulation. The resulting target distribution describes the probability that an aspired protection level for workers is achieved at a certain dose and the uncertainty associated with the assessment. In the case of aniline, substance-specific data on differences in susceptibility (between species; among humans due to genetic polymorphisms of N-acetyltransferase) were integrated in the model. Medians of the obtained target distributions of the basic models for TMP and aniline, but not of the specific aniline model are similar to deterministically derived reference values. Differences of more than one order of magnitude between the medians and the 5th percentile of the target distributions indicate substantial uncertainty associated with the effect assessment of these substances. The probabilistic effect assessment model proves to be a practical tool to integrate quantitative information on uncertainty and variability in hazard characterisation.

Alkenes↗
PubMed2000

Postulating a dermal pathway for exposure to anti-neoplastic drugs among hospital workers. Applying a conceptual model to the results of three workplace surveys.

Dermal exposure to anti-neoplastic drugs has been suggested as a potentially important route of exposure of hospital workers. Three small-scale workplace surveys were carried out in several hospitals focusing on contamination by leakage from IV infusion systems; contamination by spilled urine of patients treated with anti-neoplastic drugs and particulate phase anti-neoplastic drugs in the air of outpatient and nursing clinics. A new visual scoring technique using a fluorescent tracer was developed. The method showed a very low limit of detection (0.02 microl of contamination) and a very high inter-observer agreement (ICC=0.99). Evaluation of IV systems and connectors showed distinct differences between the systems. It was estimated that 0.5-250 microg of a drug can become available for contamination during each infusion. Differences in average contamination between nurses were negligible in the experimental set-up. Widespread and frequent contamination due to spillage of contaminated urine was revealed and appeared not to be restricted to the patient's room. Airborne particulate concentrations went undetected for 80% of the measurements. However, in a few cases concentrations up to 2 ng/m(3) of cyclophosphamide were measured predominantly in a room of a patient treated with this anti-neoplastic drug. Based on these results and a recently proposed conceptual model for dermal exposure a most likely exposure scenario was postulated both for nurses involved in administering drugs and nurses caring for treated patients. Estimation of all relevant mass transport rates will be a challenge for the near future.

Air Pollutants, Occupational↗
PubMed1998

Comparison of methods for monitoring solid particulate surface contamination in the workplace.

This paper reports an assessment of various methods for sampling particulate surface contamination for use in the field. The results from the study will be used to develop guidance for monitoring particulate surface contamination in the workplace. Three types of adhesive tape, two manual and two 'semi-automatic' wipe methods, and one Smair method were assessed. A field assessment of selected methods was carried out in two stages. In stage one, the manual wipes, semi-automatic wipes and adhesive tape (Scotch Tape) were compared. In stage two, the adhesive tape (Scotch Tape), black forensic tape, clear forensic tape and Smair were compared. Visits were made to ten metal processing facilities and particulate contamination was sampled from six locations at each site. Sampling locations were chosen for their potential as points of worker dermal contact and also to represent a range of surface characteristics. The metal content of the samples were analysed using Atomic Absorption Spectrophotometry (AAS) and X-ray Fluorescence Spectrometry (XRF). It was found that the Smair method proved to be inefficient in removing surface contamination, particularly where the surface was damp or greasy. Tape methods were found to be the most satisfactory and have considerably greater efficiency than wipe sampling. The black forensic tape is the preferred sampling medium as it is highly efficient, reproducible and easy to use.

Environmental Monitoring↗
PubMed1997

A neural network-based system for classification of industrial jobs with respect to risk of low back disorders due to workplace design.

Despite many years of research efforts, the occupational exposure limits of different risk factors for development of low back disorders (LBDs) have not yet been established. One of the main problems in setting such guidelines is the limited understanding of how different risk factors of LBDs interact in causing the injury, as the nature and mechanism of these disorders are relatively unknown phenomena. The task of an industrial ergonomist is complicated because the potential risk factors that may contribute to the onset of LBDs interact in a complex way, and require an analyst to apply elaborate data measurement and collection techniques for a realistic job analysis. This makes it difficult to discriminate well between the jobs that place workers at high or low risk of LBDs. The main objective of this study was to develop an artificial neural network-based diagnostic system which can classify industrial jobs according to the potential risk for low back disorders due to workplace design. Such a system could be useful in hazard analysis and injury prevention due to manual handling of loads in industrial environments. The results show that the developed diagnostic system can successfully classify jobs into the low and high risk categories of LBDs based on lifting task characteristics.

Back Injuries↗
PubMed1997

Non-specific symptoms in response to hazard exposure in the workplace.

Recent concerns in occupational health have shown a shift in emphasis from the study of diseases with well-established pathology toward the investigation of conditions characterized by a range of nonspecific symptoms. Exposure to potential hazards differing widely in terms of their physical nature or chemical composition, for example, electromagnetic fields, organophosphate-based pesticides, and organic solvents, frequently results in the reporting of a relatively consistent group of symptoms. Furthermore, these symptoms may arise among groups of workers where no specific physical or chemical cause can be implicated; for example, in many cases of sick building syndrome. The role of psychosocial factors in the expression of ill-health has been well-documented in the psychological literature. Important modifying factors include the attitudes and belief systems of the individuals concerned, certain personality and behavior patterns, and the presence of current stress or pre-existing psychological distress. In addition, social processes may be involved in the generation and reinforcement of health concerns at the group level. These include the workers' perceptions of the competence and credibility of managers and professionals, and the influence and involvement of the media, pressure groups, and the legal system. A proper understanding of the association between putative hazards and the reporting of nonspecific symptoms therefore requires consideration not only of the direct physical pathway between hazard and harm, but also an assessment of factors which may modify the relationship between exposure and symptom reporting. The results of such investigations have important implications for determining the focus of any management and control strategies which may subsequently be implemented in the workplace.

Attitude to Health↗
PubMed2001

Breastfeeding in the workplace.

More than 50% of women of reproductive age are employed, and most return to work post partum at a time when exclusive breastfeeding is the ideal. Public health efforts target a goal of increased breastfeeding initiation and duration rates. To be successful at integrating the roles of breastfeeding mother and employee, women need practical advice, the encouragement and support of health care providers, and societal and workplace support. This article discusses the current state of employed breastfeeding women and provides practical guidelines for assisting women to be successful at meeting breastfeeding goals.

Breast Feeding↗
PubMedDate not supplied

Directly observed therapy for tuberculosis given twice weekly in the workplace in urban South Africa.

Effective models of delivery of directly observed therapy (DOT) for tuberculosis in resource-poor settings are needed. Intermittent chemotherapy may be an important component of DOT delivered in the community as it means fewer visits to supervisors. There is no published evidence on the efficacy of twice weekly therapy given from the start of treatment without an intensive daily phase. We analysed data from 3 large cohort studies in a migrant, urban workforce in South Africa between 1975 and 1983. All patients received 4 drugs (isoniazid, rifampicin, pyrazinamide and streptomycin) twice weekly under direct observation by a nurse in the workplace. Of 444 patients, 378 (85.1%) completed treatment. Cure could be assessed in 362, and 348 (96.1%, 95% confidence interval 93.7-97.8%) were bacteriologically cured. Sputum status was assessed at 2-3 months in 343 patients and 309 (90.1%) were sputum negative. Eighteen patients relapsed (5.7%; 2.9/100 patient-years of observation). DOT can be effectively delivered to a migrant, urban workforce, and 4-drug therapy given twice weekly under direct observation is efficacious.

Adult↗
PubMed2004

Legislation with respect to dioxins in the workplace.

Legislation of chemicals is complex and doubts have often been expressed as to its effectiveness, but there are many problems involved in regulating chemicals from synthesis and use through to disposal. Using dioxins as an example of a chemical currently with complicating factors surrounding its control, this paper reviews its occupational legislation, chemistry, formation, toxicity, occurrence, and disposal in industrial situations, and sets this information in context by reference to its environmental occurrence and associated legislation. The role and limitations of legislation to control chemicals like dioxins, which are micropollutants and not intentionally produced, are discussed. Dioxins were chosen as the example because they are widespread, exposure occurs through a variety of routes, and they possess a reputation that ensures public concern. Because dioxins are ubiquitous and are predominantly produced by incineration, whether accidental or deliberate, intake is a total of all exposures from diet, environment and occupation. Occupational exposure is only one factor in this total, but this exposure may push total intake above recommended levels. Although overall exposure is reducing, public concern is rising, and this may be a consequence of greater scientific knowledge. Potential workplace exposures have been evaluated, and a sampling survey was recently undertaken in some of these sectors. The legal options are discussed, and the reasons for some decisions explained. Regulators have an unenviable task, and I believe there is only a fine balance between effective control and over-complicated prescriptive legislation.

Data Collection↗