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PubMedDate not supplied

[Late sequelae of recurrent occupational lead poisoning--the status of the nervous system].

In 44 men with a history of repeated occupational lead poisoning multidisciplinary clinical and laboratory investigations were carried out. The number of lead poisoning episodes was from 2 to 7. Apart from peripheral hypalgesia on the extremities (in 6 cases) no other neurological abnormalities were found. The motor nerve conduction velocity in the median, ulnar, radial, peroneal and tibial nerves was slightly slower in 27 cases and considerably slower in one case. Slowed down conduction velocity was most often observed in 2 nerves (12 cases) and in one nerve (9 cases), less frequently in three (4 cases) and four (2 cases) nerves. In one case this slowing down was found in all five studied nerves. Conduction changes were found in 21 peroneal nerves, 15 ulnar nerves, 12 median nerves, 7 tibial nerves and 2 radial nerves. The authors think that for the evaluation of the condition of the peripheral neuron in cases of past lead poisoning it would be sufficient to determine the conduction velocity in the ulnar and peroneal nerves. Plumbism neuropathy have the character of subclinical lesions not impairing motor skill.

Humans↗
PubMed1997

Socioeconomic status in ankylosing spondylitis: relationship between occupation and disease activity.

OBJECTIVE: To identify the socioeconomic status through occupation of a large cohort of patients with ankylosing spondylitis (AS) and to determine possible relationships between occupation and clinical variables. METHODS: We analyzed the employment status of 1,044 patients with AS. RESULTS: 85% of patients (890 of 1,044) were in full employment at the time of the assessment compared to 15% who were unemployed. When 50 employed patients were compared to 50 unemployed cases, the latter had increased disease activity and lower psychosocial well being. CONCLUSION: Employed patients from the higher occupational group (I), had less disease activity, and lower pain and depression than patients from the lowest occupational group (IV).

Adult↗
PubMedDate not supplied

Associations of functional ability with health-related behavior and body mass index among the elderly.

The main purpose of this study was to determine whether functional ability among the elderly associates with body mass index (BMI) and health-related behavior. The secondary aim was to examine whether health behavior and BMI can be seen as mechanisms explaining sociodemographic disparities in functional ability. Cross-sectional biennial surveys from 1985 to 2001 were used to study 11,793 Finnish people aged 65-79 years. Associations of activities of daily living (ADL) with BMI, health behaviors (smoking, alcohol consumption, diet, physical activity), time period, previous occupation, marital status and certain diseases were tested using an ordinal regression model. Current and ex-smoking, heavy and non-alcohol use, unhealthy diet, physical inactivity and obesity were associated with inferior ADL. Alcohol consumption among men showed a U-shaped relation to functional ability. Most of the differences in ADL by occupation and marital status vanished after adjustment of multiple factors. The results showed clear associations of ADL with health-related behaviors and BMI when adjusted for multiple factors. The findings suggesting a U-shaped relation between ADL and alcohol consumption among men and the association between diet and ADL add to our previous knowledge of factors related to functional ability.

Activities of Daily Living↗
PubMedDate not supplied

[Impact of occupational stress on health status in Canada].

Studies have shown that high psychological demands and low decision latitude may be involved in the development of major health problems. The objective of the current study was to describe the importance of these factors among the Canadian working population. The sample included 7,250 participants from the National Population Health Survey (NPHS) of 1994-95. Women were significantly more exposed than men to high psychological demands (56% versus 49%), to low decision latitude (61% versus 49%), and to these two factors simultaneously (33% versus 22%). The exposure to each of these factors was more frequent among younger and less educated people. Simultaneous exposure to both factors was more frequent among younger people and those with intermediate education level. There was a socio-economic gradient for the exposition to these factors. Some jobs with the highest exposure were identified.

Adolescent↗
PubMed2003

The McLean-Harvard First-Episode Mania Study: prediction of recovery and first recurrence.

OBJECTIVE: Since improved prediction of illness course early in bipolar disorder is required to guide treatment planning, the authors evaluated recovery, first recurrence, and new illness onset following first hospitalization for mania. METHOD: Bipolar disorder patients (N=166) were followed 2-4 years after their first hospitalization for a manic or mixed episode to assess timing and predictors of outcomes. Three aspects of recovery were measured: syndromal (DSM-IV criteria for disorder no longer met), symptomatic (Young Mania Rating Scale score </=5 and Hamilton Depression Rating Scale score </=8), and functional (regaining of premorbid occupational and residential status). Rates of remission (syndromal recovery sustained >/=8 weeks), switching (onset of new dissimilar illness before recovery), relapse (new episode of mania within 8 weeks of syndromal recovery), and recurrence (new episode postremission) were also assessed. RESULTS: By 2 years, most subjects achieved syndromal recovery (98%, with 50% achieving recovery by 5.4 weeks); 72% achieved symptomatic recovery. Factors associated with a shorter time to syndromal recovery for 50% of the subjects were female sex, shorter index hospitalization, and lower initial depression ratings. Only 43% achieved functional recovery; these subjects were more often older and had shorter index hospitalizations. Within 2 years of syndromal recovery, 40% experienced a new episode of mania (20%) or depression (20%), and 19% switched phases without recovery. Predictors of mania recurrence were initial mood-congruent psychosis, lower premorbid occupational status, and initial manic presentation. Predictors of depression onset were higher occupational status, initial mixed presentation, and any comorbidity. Antidepressant treatment was marginally related to longer time to recovery and earlier relapse. CONCLUSIONS: Within 2-4 years of first lifetime hospitalization for mania, all but 2% of patients experienced syndromal recovery, but 28% remained symptomatic, only 43% achieved functional recovery, and 57% switched or had new illness episodes. Risks of new manic and depressive episodes were similar but were predicted by contrasting factors.

Adolescent↗
PubMed1988

Perceptions of family environments, educational and occupational outcomes: social-status differences.

Regression surface analysis was used to examine relations between various family environment measures and young adults' educational and occupational outcomes. Data were collected from 330 Australians as part of a 10-year longitudinal study. The regression models included terms to account for possible linear, interaction, and curvilinear relationships. In general, the analysis suggests the proposition that parents' aspirations and adolescents' perceptions of parents' support for learning have differential linear and curvilinear associations with the educational and occupational outcomes of young adults from different social-status groups.

Achievement↗
PubMed2004

Mental health status, shift work, and occupational accidents among hospital nurses in Japan.

A questionnaire survey was conducted with questions from the 12-item General Health Questionnaire, among others, targeting 4,407 nurses in 8 general hospitals in Japan, in the hope of improving the work environment of nurses and to provide data that will allow a discussion of the measures necessary for preventing medical errors, thus improving occupational health. For each type of accident, the percentage of those who had made medical errors was significantly higher for the "mentally in poor health" group than for the "mentally in good health" group (p<0.0001). The percentage of nurses in the "mentally in good health" and "mentally in poor health" groups who had experienced occupational accidents over the past 12 months (i.e., whether they were "with errors" or "without errors") was calculated for each of the following four types of medical accident: (1) drug-administration errors, (2) incorrect operation of medical equipment, (3) errors in patient identification, and (4) needlestick injuries. For each type of accident, the percentage of those who had made medical errors was significantly higher for the "mentally in poor health" group than for the "mentally in good health" group (p<0.0001). Multiple logistic regression analyses revealed significant associations between experience of medical errors in the past 12 months and being mentally in poor health, with night or irregular shift work, and age.

Accidents, Occupational↗
PubMed1989

Dysthymic disorder in the aged in the community.

The prevalence of dysthymic disorder and and its relationship to social and health variables were investigated in a Finnish population aged 60 years or over. The prevalence was lower in men (17.2 per 100) than in women (22.9 per 100). In the total population the occurrence was higher in the widowed (24.9 per 100) than in the married (18.3 per 100). In men, dysthymic disorder was more common in those with a lower educational level (22.6 per 100) than with a higher educational level (15.1 per 100), and more common in persons receiving long-term institutional care or home nursing or home help (28.7 per 100) than in persons living independently at home (14.6 per 100). The rate was not related to age, marital status or occupation. In women, the occurrence was not related to age, marital status, education, occupation or form of social and health care. The female rate was higher than the male in the older group (70 yrs. +), in married persons, in those with a higher educational level and in those living independently at home. Underdiagnosing was evident. The occurrence of dysthymic disorder was related to poor health and poor functional status and to the occurrence of social and health stressors. No differences were found in the occurrence of the related factors between persons with dysthymic disorder and persons with major depression. Our results support the conclusion that the majority of cases of dysthymic disorders in the elderly are affective illnesses and not personality disorders.

Aged↗
PubMed1982

Anthropometric indices and measurements on primary school children of contrasting parental occupations.

The nutritional status in relation to parental occupation is a useful undertaking in predicting requirement of population groups. The investigation reported here was conducted to document the nutritional status of children 6-15 years of age of contrasting parental occupations living in Anambra State Community, Nigeria. The main weights of Anambra State boys at 6 years of age were 20.2 kg compared with teachers 19.5 kg and traders 15.7 kg. The weight achievement of the trader's at 15 years of age was 84% those of farmers' children. Similar conclusion may be drawn for height of both boys and girls for the contrasting occupation groups. The arm size of the farmers' children was initially low but hereafter it was similar to that of boys of other occupation groups, however the arm size of other civil servants (girls) was 26.3 cm compared with 21.1 cm for other businessmen's girls. On the other hand, the skinfold estimate of the teachers' boys (3.8 mm) and girls (3.8 mm) aged 10 years was statistically different (p less than 0.01) from the highest values (7.1 mm) for boys and (8.4 mm) girls at same age. Household diets were 90% of safe level of intake for civil servants and most farmers' children; that was accompanied by low dietary intake of riboflavin--81.3% for civil servants and 84% for farmers; thiamin 100% for civil servants and 79.3% for farmers. The Vitamin A intake of civil servants were also 85.7% safe level of adequacy. The information obtained was assessed from the point of view of its usefulness in the area surveyed for both the nutritionists and the clinicians and its long term benefit for Nigeria in National food policy and planning. These can be applied for other countries.

Adolescent↗
PubMed1993

Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey.

A multiple-site case-control study of 15 cancers (stomach; colon; rectum; larynx; lung; melanoma; skin; female breast; male breast; cervix; ovary; uterus; prostate; testis; and bladder) was conducted to evaluate their association with occupational physical activity and socioeconomic status (SES). A hospital-based study population (3,486 male cases and 379 female cases, and 2,127 male and 244 female controls) was established in an oncological treatment center in Istanbul, Turkey, from 1979-84. Assessment of physical activity and SES was based on job titles held by the study subjects. Two measures of physical activity were developed based on energy expenditure and 'sitting time' during working hours. Observed risks were adjusted for age, smoking, and SES. Elevated risks were observed among workers who held sedentary jobs for cancers of the colon (odds ratio [OR] = 1.6), rectum (OR = 1.3), melanoma (OR = 1.9), male breast (OR = 1.4), prostate (OR = 5.0), and ovary (OR = 2.0). Cancers of the cervix and uterus showed significantly decreasing risks with decreased activity. Risks of cancers of the colon, rectum, larynx, ovary, and melanoma were enhanced after risks for physical activity indices were adjusted for SES, while the associations between physical activity and cancers of the prostate, cervix, and uterus were weakened after SES adjustment. Risks of melanoma rose significantly with both activity indices after SES adjustment.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1991

The effects of economic development and world-system on occupational sex segregation.

In order to better integrate women's subordinate status into the world system, the author examined how processes of the new international division of labor and consequent underdevelopment affect women's overall economic status and occupational sex segregation (OSS). For the empirical test, panel regression analyses were used with 71 crossnational cases for the periods of 1960-80 and 1970-80. The results of the analyses clearly show that world-system position and economic development proved to have important consequences for OSS. However, the results unexpectedly showed a negative relation for multinational corporation dependency, which is stronger for the longer term period than for the shorter term. Of the intervening variables, the effects of female labor force participation show a negative effect on OSS, and those of the female share of the service sector show a strong positive effect on OSS at either point in time. Fertility did not show any significant effects on OSS.

Demography↗
PubMed2001

Performance and quality measurement in occupational health services: current status and agenda for further research.

BACKGROUND: There is growing interest in evaluating the impact and effectiveness of occupational healthcare services (OHS). Managed care networks, case and disease management, worker health promotion, and utilization review services have proliferated in OHS, usually without scientifically based, objective measures of their impact on the quality of care, outcomes, or costs. Performance and quality improvement (QI) efforts in OHS are different from those in general health care because the population, range of conditions, setting of care, and primary outcomes of interest differ considerably. However, scientific knowledge resulting from the application of QI in general health care can provide a useful framework for the development of measures in OHS. METHODS: We describe the development, selection, and evaluation of OHS performance and quality measures, and propose a research agenda. CONCLUSIONS: Quality and performance measures in OHS should address common work-related conditions with high costs, suboptimal outcomes, or unclear parameters for ideal practices. They should reflect stakeholder priorities. Measures should be precise and quantifiable, clearly specified, reliable, valid, and sensitive to important changes. They should be based upon data that can be collected and analyzed at a reasonable cost and effort. The focus of measurement should be on situations where improvement can be achieved by those directly involved in OHS delivery, through defined approaches. Appropriate severity and case-mix adjustment may be especially problematic in OHS. Confidentiality, regulatory concerns, and appropriate use of results must be considered in the development and use of OHS measures. Research is needed to identify, develop, and validate OHS-specific measures, to establish risk adjustment methods, and to test the utility of this information in improving OHS.

Health Policy↗
PubMed1999

Sociodemographic determinants of low birthweight in Greece: a population study.

A total population sample of 10,654 singleton births from the Greek National Perinatal Survey of April 1983 was analysed to identify factors independently associated with low birthweight (LBW). The sample was divided into two groups according to the gravidity of the mothers (3368 primigravidae and 7286 multigravidae). Data examined included regional characteristics, marital status, age at and duration of marriage, parental ages at delivery, crowding in the home, insurance status, parental occupational classification and parental education levels. Logistic regression was used to define the socio-economic and demographic characteristics independently associated with the delivery of an LBW singleton baby. Significantly different LBW rates were found among the two groups: 4.3% in the primigravidae and 5.2% for multigravidae. For primigravidae significant associations were found with marital status, maternal occupation and father's education, while for multigravidae significant features were mother's education and place (region) of residence. The study showed little to assist in devising strategies of primary prevention of LBW in Greece.

Adult↗
PubMed2003

Ecological and individual predictors of maternal smoking behaviour. Looking beyond individual socioeconomic predictors at the community setting.

The aim of this study is to examine the prevalence of smoking during pregnancy by the individual mother's sociodemographic characteristics and ecological factors at the community level (suburbs). This analysis combined 1996 Australia Census and data on 3424 women attending Well-Baby-Clinics (WBC) between January 1996 and February 1998 within a region in South Western Sydney (SWS), Australia. The prevalence of maternal smoking was 31%. Maternal factors such as marital status, country of birth, education, occupation, socioeconomic status (SES), and types of antenatal care (ANC) were independent risk factors for maternal smoking. Small area analysis revealed suburbs within SWS with high rates of maternal smoking (47-57%). Community level characteristics such as low income, low educational level, young mothers, and unemployment can explain 85.7% of the variation in maternal smoking in SWS. Smoking during pregnancy is recognised as a serious risk factor to the unborn child. The present study draws attention to local community level factors, other than individual SES, which may be important when developing strategies for maternal smoking prevention programs.

Adolescent↗
PubMed1991

HIV infection among members of the US Army Reserve Components with medical and health occupations.

Over 58,000 members of the US Army Reserve Components tested for human immunodeficiency virus (HIV) antibody had military or civilian medical occupations. The availability of HIV status and occupational information permits the assessment of prevalence and incidence of infection in this population. Levels of infection were not higher among women or among currently married men with medical occupations compared with those with nonmedical occupations. Prevalence and incidence were elevated among never-married men with either military or civilian medical occupations compared with never-married men with nonmedical occupations. Based on reported civilian occupation, male registered nurses and men with other medical occupations, excluding physicians and dentists, had a significantly higher prevalence of infection than men with nonmedical occupations. The patterns of infection suggest that the higher levels of infection found among never-married men with medical occupations may not be entirely due to occupational exposure. These findings may have applications in the design and interpretation of results of health care worker HIV surveillance programs.

Dentists↗
PubMed1997

The impact of aging on cognitive functions. An 11 year follow-up study of four age cohorts.

The literature on longitudinal studies of aging and cognitive performance is reviewed. The review reveals some ambiguity which seems primarily to be due to selection bias in the study groups and insufficient statistical modelling and parameterization. The main purpose of this study was to analyze the impact of aging on cognitive performance of the general adult population. In addition, the following problems are considered: If an aging impact is found, is it then evenly distributed across different age cohorts and different cognitive functions? Is the effect of different subject-related and situational factors on the test parameters stable over time? Is it possible to eliminate the impact of the examiner in cognitive testing? Moreover, do certain background factors such as age (generation), sex, schooling, etc. or test performance in an earlier examination have predicting power for the participation at a later stage in the study? The analysis was made using a longitudinal design with four successive age cohorts born in 1952, 1942, 1932, and 1922. 1,026 subjects were examined in 1982-83 and 711 were re-examined in 1993-94. At both occasions the subjects were tested by means of the Cognitive Function Scanner method. Attrition was found in all four age cohorts but most profound in the oldest cohort. Attrition occurred most frequently among subjects with only primary schooling and low social status. Age (generation), Sex, Schooling, Occupational Activity Status, Smoking Status, Psychic Stress, and questionnaire positive Cardiovascular Disease in the 1982-83 study all had significant relation to non-participation in the follow-up, either because of death, refusal to participate or because the subjects did not turn up on the agreed date for examination. Also a few test parameters, primarily in the attention tests and concentration tests, were found to be significantly related to non-participation in the follow-up. The results of the follow-up study, in which each subject was his own reference, showed two different tendencies. One tendency indicated some decline in performance. It was found in parameters for non-verbal learning and memory, retention of verbal memory, visuomotor and visuospatial speed, concentration, and reaction time. The other tendency indicated some improvement in performance in relation to verbal learning and memory, visuomotor and visuospatial precision, and to visual perception. It was a general tendency that performance becomes more scattered with increasing age. The follow-up study showed that Generation, Sex, and Schooling are the most important subject-related factors to take into consideration in the evaluation of test results. The significant impact of the Generation factor indicates that cognitive performance depends not only on aging but is also modulated to a large extent by generation specific factors. In spite of intensive training and special focus on communication it was evident that the situational Examiner factor plays a significant role in all of the cognitive tests. The strong impact of the Examiner factor makes the use of test norms questionable. Norms should be used only as rough guidelines. In the individual psychological assessment, focus should be on the subject's problem solving strategies. This can be reached by supplementing the traditional psychometric scores with a range of response process observations obtained by recording the natural steps of the subject's response flow combined with latencies for each step, and analyzing the response chains by pattern analysis. The computer is considered the most appropriate tool for recording response flows.

Adult↗