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PubMed1998

Comparative study of psychiatric morbidity among workers at a paint factory in Nigeria.

Inspite of numerous reports on the neurobehavioural effects of paints, there have been no such studies from Nigeria, where there are now many paint factories. The general aim of this study was, to assess the prevalence of specific psychiatric morbidity among workers in a large paint manufacturing factory. Using the Psychiatric Assessment Schedule (PAS), 60 workers (mean age, 38.1) directly involved in paint manufacture, 60 administrative staff (mean age 41.1) in the factory, and 60 postal workers (mean age 37.7) were assessed. Although higher proportions of factory workers (80%), and postal workers (73.3%) had positive PAS scores compared with administrators (36.7%), there were no significant differences in mean PAS scores across the groups. Two subjects each of factory workers (agoraphobia and dysthymia) and postal workers (dysthymia and generalised anxiety) fulfilled DSM-IIIR criteria for specific diagnosis. However, the paint workers had a wider spread of PAS symptoms, were significantly more likely to experience the symptoms constituting neurasthenia, had many more psychological complaints, experienced a wider variety of spontaneously reported symptoms, and constituted the most frequent users of health services. They had no knowledge of the possible mental health effects of exposure to paint. This level of distress is comparable to many reported findings.

Adult↗
PubMed1998

Blood lead levels in industrial workers in Poland.

Occupational exposure to lead occurs in about 1,300 enterprises in Poland. According to the 1994 data, based on the reports of the State Sanitary Inspectorate, 1,970 persons were employed at that time under conditions of exposure exceeding the Polish MAC level of 0.050 mg/m3. The measurements of workers' blood lead concentrations (Pb-B) were carried out only in 90 factories. In 1996, the Minister of Health and Social Welfare issued a directive stating that the Pb-B determinations in employees occupationally exposed to lead are compulsory. The aim of the present study was to assess lead exposure of workers employed in different branches of the Polish economy, based on Pb-B determinations. The measurements were performed on 2,324 male and 165 female workers of 13 different types of industry, including manufacture of crystal glass, battery industry, copper and zinc smelters, welding in a repair shipyard and some other workposts under conditions of lead exposure. The results of the determinations indicate that exposure to lead continues to be a serious problem in Polish industry. Pb-B concentrations exceeded the newly introduced Polish biological exposure index (BEI) value of 500 micrograms/l for men workers in about 30% of workers examined in 1996. In about 65% of females under 45 years of age the Pb-B concentrations were higher than 300 micrograms/l recommended as BEI for this age group. Considering the WHO-recommended health-based maximum individual biological action level of 400 micrograms/l, the percentage of the employees for whom higher values were found amounted to about 45% for men workers. The results point to the necessity of enforcing the implementation of Pb-B determinations according to the ministerial ordinance as well as of removing from exposure the workers with Pb-B levels exceeding the present BEI values. The improvement of working conditions and the implementation of health education for workers are also the actions to be promptly undertaken. In order to achieve these goals a close cooperation is required between the State Sanitary Inspectorate, the institutes of occupational health as well as the employers and trade unions.

Adult↗
PubMed1998

Low back pain in mineral sand mine workers. Incidence and management.

OBJECTIVES: To establish the prevalence of low back pain suffered by workers in three mineral sand mining companies operating in the south west of Western Australia; to determine what use was made of health care providers by those experiencing low back pain; to derive the perceptions of the value of the treatment for low back pain by health care providers. METHOD: A total of 350 questionnaires were distributed to sand mine workers who were asked to complete the questionnaires which were collected 1 week later. RESULTS: completed questionnaires were returned by 204 workers giving a 58% response rate. Seventy-seven percent of male workers and 60% of female workers could remember suffering low back pain sometime in their lives. Low back pain was experienced by 61% of male sufferers and 57% of female sufferers at least two to three times a month. A total of 16% of men and 12% of women experienced low back pain on a daily basis while 30% of men and 22% of women reported that the type of work they were doing increased their low back pain. Only 19% of all male workers and 6% of all female workers had ever taken time off work due to low back pain with the average time taken off work for an acute episode, being 14 days. Overall, 47% of respondents indicated that the treatment received from general practitioners was ineffective, and only 16% of respondents assessed GPs as being better than average. Chiropractors were rated higher than physiotherapists or general practitioners in providing the most effective treatment for low back pain. Mobilising exercises were considered to be better treatment than analgesics or anti-inflammatory medication. CONCLUSION: Low back pain is a common problem among mineral sand mine workers who preferred the services of the chiropractor or the physiotherapist to the general practitioner. Physical treatment modalities with stretching and mobilising exercises were preferred to pharmacological treatment.

Adult↗
PubMed1997

[Disorders of the respiratory tract in workers in the chemical industry].

This paper studies the prevalence of chronic respiratory symptoms and diseases in 567 chemical workers and in 340 controls as well as their ventilatory capacity. The prevalence of all chronic respiratory symptoms was found to be significantly higher in the exposed workers than in controls (p < 0.01). Workers aged over 40 and those employed for over 10 years demonstrated higher prevalence of chronic respiratory symptoms than the workers up to 40 and those employed for up to 10 years, although the differences were not statistically significant. A large number of chemical workers complained of acute respiratory symptoms manifesting during the shift. The measured values of ventilatory capacity in chemical workers were significantly lower than those predicted. The findings were more pronounced in workers over 40 and in those employed for over 10 years. The measured values of gases and fumes in the working environment were mostly below the recommended values. Our data suggest that, in spite of low atmospheric pollution of the working environment, sensitive workers may develop respiratory impairments.

Adult↗
PubMed1998

Decline in lung function related to exposure and selection processes among workers in the grain processing and animal feed industry.

OBJECTIVES: To follow up workers in the grain processing and animal feed industry five years after an initial survey, and to monitor exposures to organic dust and endotoxin and changes in prevalence of respiratory symptoms and lung function. METHODS: Outcome measures in the present survey were decline in lung function over five years, rapid annual decline in forced expiratory volume in one second (FEV1) above 90 ml.s-1, and loss to follow up. RESULTS: Among 140 workers included in the longitudinal analysis, annual decline in FEV1 and maximal mid-expiratory flow (MMEF) were significantly related to occupational exposure to dust and endotoxin in the grain processing and animal feed industry. Assuming a cumulative exposure over a working life of 40 years with an exposure of 5 mg.m-3, the estimated effect on the FEV1 would be a decline of 157 ml.s-1 (95% CI 13 to 300)--that is, about 4% of the group mean FEV1 and 473 ml.s-1 (95% CI 127 to 800) of the MMEF (about 12%). Workers with a dust exposure > 4 mg.m-3 or endotoxin concentrations > 20 ng.m-3 at the 1986-8 survey had significantly higher risk of rapid decline in FEV1 (odds ratio (OR) 3.3, 95% CI 1.02 to 10.3). The relations between occupational exposure and decline in lung function in this study occurred, despite the selection through the healthy worker effect that occurred as well. Increasing working years was related to decreasing annual decline in FEV1 and fewer people with rapid decline in FEV1 (OR 0.04, 95% CI 0 to 0.61 for over 20 v < 5 working years in the grain processing and animal feed industry). The presence of respiratory symptoms at baseline was a strong predictor of subsequent loss to follow up. Baseline lung function was not found to be predictive of subsequent loss to follow up. However, among workers lost to follow up the number of working years was more strongly negatively related to baseline lung function than among the workers who were studied longitudinally. CONCLUSIONS: The existence of the healthy worker effect implies that an exposure-response relation in the grain processing and animal feed industry may well be underestimated. This should be taken into account when health based recommended limit values are to be developed.

Adult↗
PubMed1998

Low back pain: predictors of absenteeism, residual symptoms, functional impairment, and medical costs in Oregon workers' compensation recipients.

BACKGROUND: Wide variations in disability duration and magnitude have been noted among recipients of workers' compensation for low back pain. Findings from recent studies have indicated that inclusion of a broad array of variables (i.e., physical, occupation, social, economic) is needed to understand differences in workers' responses to occupational low back pain. METHODS: Workers' compensation and questionnaire data from 340 Oregon workers with low back claims were merged to develop multivariate models predicting: (1) absenteeism days, (2) residual symptoms, (3) functional impairment, and (4) medical costs. RESULTS: Forty-two percent of the variation in low back symptoms was explained by: discontinuing physical fitness activities post-injury (beta = -.419), self-reported low energy/high fatigue (beta = -.227), poorer general health (beta = .137), and attorney involvement in claim (beta = .117), (adjusted R2 = .418, p < 0.001). Survival curves revealed significantly longer claim durations among workers who discontinued physical fitness activities post-injury, compared with workers who did not; these differences remained significant even after controlling for severity of the initial injury. CONCLUSION: Continuation of physical fitness activities during the recovery process was found to be a significant predictor in three of four regression models, providing evidence on behalf of a relationship between fitness and positive health outcomes. However, it was not possible to clearly differentiate pre-morbid from post-injury fitness, nor to determine if this relationship was due to a therapeutic effect on the back, the general restorative benefits of remaining active, or represents a proxy variable for workers' self-care efforts during recovery.

Absenteeism↗
PubMed2006

Mortality in a Swedish rubber tire manufacturing plant: occupational risks or an "unhealthy worker" effect?

BACKGROUND: In this cohort study a classification of 12 work categories, with specified common exposures, is used to evaluate the mortality among workers in a Swedish rubber tire plant. METHODS: Mortality among the cohort members is compared with expected values from national rates. Standardized mortality ratios (SMR) were calculated for the total cohort, for sub-cohorts and with the inclusion of a latency requirement. RESULTS: Male workers had increased risks for total mortality, circulatory death, respiratory death, mental disorders, epilepsy, injuries/poisoning, and for alcohol-related death. Many risks were noted among workers exposed to dust, fumes, or vapor. No trend in risk with increasing duration of employment was seen. DISCUSSION: Some established risks for rubber workers could be related to some specified work categories. The highest risks were noted among workers having a very short duration of employment indicating a possible "unhealthy worker effect" associated with life-style factors or to tasks offered to unskilled workers.

Adult↗
PubMed2006

Cancer morbidity in iron and steel workers in Korea.

BACKGROUND: In the iron and steel industry, workers are potentially exposed to a number of carcinogens and are involved in a number of processes of a hazardous nature. The cancer morbidity of iron and steel workers from modern plants in a developing country is described. METHODS: Cancer morbidity at two Korean iron and steel complexes was analyzed using Poisson regression methods. Work histories were merged with the national cancer registry for 44,974 workers who were followed from 1988-2001. RESULTS: Four hundred sixty-four cancers, in 1% of the population, were diagnosed over 14 years. Based on national cancer rates, the cohort exhibited a healthy worker effect for all cancer (SIR = 0.87, 95% CI = 0.79-0.95) reflecting relative good health, particularly for lung cancer (SIR = 0.58, 95% CI = 0. 04-0.82), stomach cancer (SIR = 0.78, 95% CI = 0.64-0.93), and liver cancer (SIR = 0.83, 95% CI = 0.68-1.01). Lung cancer morbidity was significantly elevated at the affiliated plants versus the parent plants (SRR = 2.35, 95% CI = 1.07-4.92), and all-cancer morbidity was significantly elevated for maintenance workers compared to office and production workers (SRR = 1.27, 95% CI = 1.00-1.60). Lymphohematopoietic cancer incidence was higher in the coke plants (SRR = 3.46, 95% CI = 1.02-8.91) and stomach cancer incidence was higher in the maintenance departments (SRR = 1.66, 95% CI = 1.05-2.56). CONCLUSIONS: This recent steelworker cohort exhibits possible excess cancer morbidity in some processing areas. Further follow-up of this cohort and alternate study designs such as case-control study will be needed to elucidate the relationship of exposure and health risks of iron and steel workers.

Healthy Worker Effect↗
PubMed1990

Preventing respiratory disease in swine confinement workers: intervention through applied epidemiology, education, and consultation.

A combined epidemiological and intervention study was conducted on 207 swine confinement farmers with matched comparison subjects. The objectives of the study were to define, in detail, the nature and disease determinants in this exposed group and to explore methods of disease prevention. This 5 year prospective study included three annual medical assessments of workers and complementary work environment assessments. Between the first and second assessment periods, an in-depth educational intervention was conducted. An industrial hygiene consultation intervention was conducted between the second and third measurement periods. Outcome measurements included changes in knowledge, attitudes, and behavior following educational intervention. Additionally, the outcomes measured included changes in medical and environmental assessment over the 3 year assessment periods. Results of the baseline respiratory symptoms assessment are reported here. Nearly 20% of swine confinement workers reported chronic cough, and 25% reported phlegm (American Thoracic Society questionnaire). Both symptoms were significantly more prevalent in the confinement workers compared to a blue collar comparison group, but only phlegm production was more prevalent compared to nonconfinement farmers. Work-related symptoms were reported much more frequently than chronic symptoms (e.g., 87% of confinement workers reported work-related cough). Bronchitis as well as airways reactivity were all significantly more prevalent in confinement workers compared to nonconfinement workers. Smoking seemed to have an additive effect with confinement exposure. Bronchitis and chest tightness symptoms were reported to be more severe upon return to work after an absence of 7 days or more. Finally, 34% of workers reported episodes of organic dust toxic syndrome.

Adult↗
PubMed1995

Work outcome in workers with occupational skin disease.

We carried out a follow-up study of employment outcome for 230 workers with a diagnosis of occupational skin disease who were at least 2 years postdiagnosis. Seventy-eight percent of the workers were working, but 57% of those working had changed jobs, 67% because of their skin problem. Thirty-one percent had lost no time from work because of their skin disease, while 35% had lost at least 1 month. Forty-three percent had applied for workers' compensation benefits, and 87% of those who had applied were successful in their claims. Older workers were more likely to be unemployed and to have applied for workers' compensation benefits. Women were less likely to have lost time from work and to have applied for workers' compensation. Those who had changed their jobs tended to have a better outcome with respect to active dermatitis, though they had lost more time from work and had more often applied for workers' compensation benefits.

Absenteeism↗
PubMed1993

Mortality among workers at a nuclear power plant in the United States.

A second follow-up of 9,000 workers at the Calvert Cliffs Nuclear Power Plant (MD, USA) identified 346 deaths in the years 1969-88, 101 of which were attributed to malignant neoplasms. The original study had the primary purpose of assessing the feasibility of studies of workers based upon individual plant and Nuclear Regulatory Commission records. The average, cumulative, occupational dose through 1984 was low, only 21 mSv, but ranged up to 470 mSv, with 12 percent of the workers receiving more than 50 mSv. Mortality from most causes of death was low and there was a deficit of deaths from diseases of the circulatory system. Ionizing radiation exposures were not related to the probability of death from neoplasms generally or from any specific form of cancer. There were only two deaths from leukemia, whereas four were expected at population death rates. Larger numbers of workers, followed for longer periods of time, are needed to determine the mortality risk to workers in the nuclear power industry. The difficulties in obtaining dose information for transient workers were so great, and so time consuming, as to make questionable the practicability of studying the workers at a large number of power plants in this way.

Adult↗
PubMed2003

Risk factors for physical assault. State-managed workers' compensation experience.

BACKGROUND: The estimation of incidence and evaluation of risk factors associated with nonfatal occupational assault injuries have rarely been documented in a statewide population context. A state-managed workers' compensation system can provide estimates of incidence of such injuries and allow evaluation of risk factors. METHODS: Using claims data from the state-managed West Virginia Workers' Compensation, the incidence rates of workplace injuries resulting from physical assault were estimated for the period 1997-1999. Data on potential risk factors were obtained from the claim-related electronic data files, and the risk associated with each factor was assessed using proportional injury ratios (PIRs). RESULTS: During the study period, 2122 compensated injuries were associated with workplace violence. The incidence of assault injuries was 108.2 cases per 100,000 employee years. Women sustained a higher incidence than men. Healthcare workers, public safety workers, and teachers accounted for almost 75% of all assault injuries. Workers in these occupations also differed from each other with regard to seasonality and timing of assault, perpetrator-victim relationship, and types of injury. Evidence of gender-occupation interaction indicated higher risk of assault injury in men compared to women across the three leading occupations. Nighttime work shifts were associated with greater risk of assault for female healthcare workers (PIR=1.8; 95% confidence interval, 1.09-2.87). CONCLUSIONS: The healthcare sector sustained the bulk of assault injuries in West Virginia. Although the majority of healthcare-sector employees were women, the risk of assault injuries was higher in male employees. Risk factors and injury characteristics identified in this study, particularly for three high-risk occupations, should help develop strategies for preventing workplace violence. Protecting female healthcare workers on night-shift duty, especially in nursing home settings, appears to be an important target for intervention.

Female↗
PubMedDate not supplied

Migrant farm workers' access to pesticide protection and information: Cultivando Buenos Habitos campaign development.

Formative evaluation of south Georgian migrant farm workers' access to information and products to promote pesticide protection and understanding of cancer risk associated with pesticide exposure was conducted using field observation, in-depth interviews of Georgia's Migrant Health Program's outreach workers, and structured face-to-face surveys of migrant farm workers. The data indicated that fewer than one-third of the pesticide products reviewed contained messages about pesticide use and exposure risk for humans. Risk information on products appeared in English only. Few protective devices were available for purchase. Migrant farm workers were aware in a very general sense of health risks posed by pesticides, but they were specifically unaware of the reach of pesticides sprayed, as illustrated by their field behaviors. Findings also demonstrated the need to educate outreach workers about migrant farm workers' cancer risk, so that they may act as migrant farm workers' health advocates to reduce the adverse effects associated with pesticide exposure.

Adolescent↗
PubMed2006

The influence of observation and setting on community health workers' practices.

OBJECTIVE: To determine whether results from an evaluation that involved observation of community health workers while they performed patient consultations in a hospital reflected normal everyday practices. DESIGN: Comparison of two samples of ill-child consultations: (i) consultations performed during an evaluation in which we observed community health workers in a hospital in-patient and outpatient department from February to March 2001 and (ii) consultations performed under no observation in villages and documented in clinical registers within the 90 days before the hospital evaluation. SETTING: Siaya District Hospital and villages in Kenya. STUDY PARTICIPANTS: Community health workers. MAIN OUTCOME MEASURE: Treatment error indicator, defined as the percentage of consultations where at least one recommended treatment (where recommended treatments were those that were indicated based on community health worker assessments of the child's condition) was not prescribed. RESULTS: We analyzed data on 1132 consultations (372 from the hospital evaluation and 760 from the community) performed by 103 community health workers. For all types of consultations combined, the difference between treatment error indicators (hospital minus community) was -16.4 [95% confidence interval (CI): -25.6, -7.1]. CONCLUSIONS: We found that community health workers made treatment errors less frequently when they were observed in a hospital in-patient or outpatient department than when they were not observed in the community. Evaluations that involve the observation of community health workers in a hospital setting might overestimate the quality of care that they normally give in their villages.

Clinical Competence↗
PubMed2004

The impact of shift work on the risk and severity of injuries for hospital employees: an analysis using Oregon workers' compensation data.

BACKGROUND: While past research on health care workers has found that shift work can lead to negative physiological and psychological consequences, few studies have assessed the extent to which it increases the risk of specific work-related injuries, nor quantified and compared associated types, severity and costs. AIMS: This study aimed to derive and compare the rates, typologies, costs and disability time of injuries for various hospital worker occupations by day, evening and night shift. METHODS: This study used Oregon workers' compensation claim data from 1990 to 1997 to examine the differences in hospital employee claims (n = 7717) by shift and occupation. Oregon hospital employee claim data, hospital employment data from Oregon's Labor Market Information System and shift proportion estimates derived from the Current Population Survey (CPS) were used to calculate injury rate estimates. RESULTS: The injury rate for day shift per 10,000 employees was estimated to be 176 (95% CI 172-180), as compared with injury rate estimates of 324 (95% CI 311-337) for evening shift and 279 (95% CI 257-302), night shift workers. The average number of days taken off for injury disability was longer for injured night shift workers (46) than for day (38) or evening (39) shift workers. CONCLUSION: Evening and night shift hospital employees were found to be at greater risk of sustaining an occupational injury than day shift workers, with those on the night shift reporting injuries of the greatest severity as measured by disability leave. Staffing levels and task differences between shifts may also affect injury risk.

Adult↗
PubMed2004

Management of sick children by health workers in Ballabgarh: lessons for implementation of IMCI in India.

The aim of this study was to determine the impact of training of health workers in the management of pediatric morbidity in terms of reduction in infant mortality rate (IMR) a 2-year period in rural Ballabgarh with a present IMR of 37 per 1000 live births. The study was designed as a pre- and post-intervention trial. The intervention was started in November 1999 and the outcome measured for the years 2000 and 2001. A sample size of 4000 was estimated for a power of 80 per cent at 5 per cent significance level. The training of the workers was for 4 days and included didactics, video-films, patient demonstrations, etc. Data on under-fives' deaths and their causes using a verbal autopsy tool was done as a part of the routine data collection system. The workers management of pediatric morbidity was assessed based on the post-training knowledge gain, forms filled by them, and referrals seen at the secondary level. The knowledge of the workers on disease and their management improved after the initial training but reached a plateau at a 50 per cent score. A review of 948 forms showed that the workers' disease classification and management was not satisfactory, especially for pneumonia and sick neonates. It was better for fever, measles, dysentery, and diarrhoea. A review of 11 cases referred by workers confirmed this. There was no impact on IMR. A look at the cause of death revealed that malnutrition, diarrhoea, and pneumonia to be the main causes among post-neonatal deaths and birth-asphyxia and prematurity as the main cause of deaths in the neonates. While implementing Integrated Management of Childhood Illnesses (IMCI) in India through the health workers, increased emphasis needs to be placed on training and supervision. Community level issues, such as healthcare seeking, female neglect, etc., may limit the scope of reduction in IMR due to implementation of IMCI.

Child, Preschool↗
PubMed1996

Surgical treatment of patients with back problems covered by workers compensation versus those with other sources of payment.

STUDY DESIGN: The present study examines relationships between workers compensation coverage and the surgical treatment of patients with low back problems. OBJECTIVES: To examine the mix of surgical procedures, reoperation rates, and resource use among patients receiving workers compensation and these with other sources of payment. SUMMARY OF BACKGROUND DATA: There is evidence that patients with low back pain who receive workers' compensation have poorer clinical outcomes than other patients with back problems. METHODS: The authors used data from Washington State's automated hospital discharge system for 1988 through 1991. The study group included 1502 patients receiving workers compensation and 2674 patients not receiving workers compensation. RESULTS: If the patients were covered by workers' compensation, they were 1.37 times more likely to undergo surgery involving fusion (95% confidence interval, 1.04-1.80) and almost twice as likely to have a subsequent reoperation within 3 years of the index surgery (odds ratio, 1.80; 95% confidence interval, 1.50-2.15. CONCLUSIONS: In Washington state, patients receiving workers' compensation have higher rates of low back fusion surgery and reoperations than other patients.

Adult↗
PubMedDate not supplied

Quantification and risk analysis of occupational burns: Oregon workers' compensation claims, 1990 to 1997.

This study examined all accepted Oregon workers' compensation claims for occupational burn injuries during the period of 1990 to 1997 (N = 3,158). The Current Population Survey was used to derive employee population baselines for establishing rate estimates. It was estimated that the average occupational burn claim rate was 2.89 per 10,000 workers (95% confidence interval [CI] 2.76, 3.02). The majority of claimants (71.7%) were males, the largest proportion (32.6%) was aged 25 years or less, and almost half (48.7%) had less than 1 year of job tenure. The most frequent burn type cited was heat/scald burns (78.9%) followed by chemical burns (19.3%). Costs averaged over 1.6 million dollars annually. The average indemnity period was 16 days. Higher relative risks were found for evening workers (2.97, 95% CI 2.96, 2.98) and night workers (2.13, 95% CI 2.12, 2.13) compared with dayshift workers. Kitchen workers had the highest burn rate of all occupations, with 62.5 claims per 10,000 workers.

Accidents, Occupational↗