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PubMed1997

Poison Information Service of the Nofer Institute of Occupational Medicine in Lódź. Types of toxicological inquiries 1991-1994.

The National Poison Information Centre and the physicians of the Clinic of Acute Poisonings, the Nofer Institute of Occupational Medicine in Lódź, provide telephone toxicological information to the medical professions and the general public. The most frequently offered advice was for drugs, pesticides, solvents, corrosives and mixtures. The most frequent drug inquiries concerned tranquillizers, hypnotic and psychotropic drugs. Advice to the public most frequently involved the toxic action and composition of various agents. At present, much effort is devoted at the National Poison Information Centre to develop a system of toxicologic information for the general public.

Adolescent↗
PubMed1999

[Occupational hazards in the Moroccan craft sector and proposal for occupational health services].

The absence of occupational health services, the numerous occupational hazards and the high number of people working in the handicraft sector have sparked this study. Descriptive, cross-sectional epidemiological studies were carried out throughout 1996 for different artisan activities: iron-work, jewellery making, rug making, tannery, "zellige", pottery, and woodworking. The study included 449 artisans and consisted of an analysis of work conditions, a medico-social questionnaire, a clinical examination and among certain artisans, a biological check-up, a respiratory check-up (thoracic x-ray and lung function testing), and a toxicological check-up. Poor work conditions and the absence of any technical protection (collective or individual) are common to all the workshops visited. Multiple risks as well as various and frequent pathologies were observed for all the artisan activities. The most common ailments are those linked to posture and musculo-skeletal problems (67.6%), oral (58.2%), ocular (46.9%), dermatological (35.7%), ear/nose/throat (35.3%), respiratory (31.1%), digestive (21.1%) and neurological (20.7%). Often the same artisan showed several simultaneous conditions linked to work. The legislative texts related to occupational health and safety are many and dispersed, and would profit by being updated and regrouped within a work code which would make them easier to consult and would allow all partners in the social sector to get to know them. In addition, this legislation which has been strengthened, is unfortunately not enforced. We should support every initiative focused on developing the prevention of occupational hazards and the spirit of safety within artisan workshops. The concern for occupational risks within the artisan milieu owes its importance to their abundance, the diversity of the professions involved, and the number of different risks to which artisans are exposed. The role of a worksite doctor is therefore considerable, and his field of intervention in this milieu is vast. The broader goal of occupational health services is to protect and improve the physical, mental, and social well-being of its workers; it is natural that these services should give more attention to general health promotion (vaccinations, health education...). Given that the artisan sector is organised around its structures of production, it seems urgent to introduce medical coverage and to improve health and safety conditions within the sector.

Humans↗
PubMed1987

Human rights abuses and the medical profession.

Allegations of torture are on the increase and the medico-legal and ethical problems can no longer be ignored by the medical profession. While jurists fail to give effective legal guidelines as to what amounts to 'torture', reports indicate that doctors are often engaged in activities which are difficult to reconcile with any conception of medical ethics. There is a clear need for the medical profession to re-evaluate their involvement in circumstances that are a direct antithesis of their professional occupation. The skills of doctors with forensic expertise allow detection of human rights abuses and thereby its potential reduction. There is scope for the reduction torture or ill-treatment, if the profession maintain high standards of medical practice and ethics.

Ethics, Medical↗
PubMed2000

Cancer in veterinarians.

OBJECTIVES: Veterinarians come into contact with several potentially carcinogenic exposures in the course of their occupation. These exposures include radiation, anaesthetic gases, pesticides (particularly insecticides), and zoonotic organisms. This review aims to summarise what is known about the carcinogenic risks in this profession. METHODS: The levels of exposure to potential carcinogens in the veterinary profession are examined and evidence is reviewed for carcinogenesis of these substances in humans at doses similar to those experienced by veterinarians. The few published studies of cancer in veterinarians are also summarised. RESULTS: Veterinarians have considerable potential for exposure to several known and potential carcinogens. Risks may be posed by work in clinics with poorly maintained x ray equipment, by use of insecticides, and from contact with carcinogenic zoonotic organisms. The few studies available suggest that veterinarians have increased mortality from lymphohaematopoietic cancers, melanoma, and possibly colon cancer. CONCLUSIONS: The exposures examined in this review are not unique to the veterinary profession, and, as a consequence, information gathered on the carcinogenic risks of these exposures has implications for many other occupations such as veterinary nurses, animal handlers, and some farmers, as well as dentists, radiographers, and anaesthetists.

Anesthetics↗
PubMedDate not supplied

[Social crisis and occupational fatigue among health professionals: warnings and resources].

Due to the crisis of the welfare state, the smashing of the state budget and the labour flexibility, the "helping professions" (health service, education, etc.) are the main assistance for the poor, the elderly people and the victims of violence. This result in the emergence of occupational pathologies, mainly in the health workers, such as burnout, secondary traumatic stress or empaty caused fatigue, mobbing or moral harassment -all of them affecting not only the quality of life of professionals but also the body health. The corporal disorders may begin with mild malfunctions, considered as "natural" facts of life, then becoming severe illness. The professional may attempt to meliorate the situation with the use of alcohol, tobacco, ansiolitics, etc. thus worsening the whole health. At the moment there are not legal regulations for this emergent pathologies. We have to pay attention to the signals in order to be able to overcome the dysfunctional defense mechanisms and to activate the preventive and protective resources, such as reflexion groups at workplaces.

Argentina↗
PubMed1979

Professionalism: rise and fall.

Historically, the early professionalization movements in medicine and the law appear as organizational projects which aspire to monopolize income and opportunities in markets of services or labor and to monopolize status and work privileges in occupational hierarchies. Their central task is to standardize training and link it to actual or potential markets of labor or services, a linkage that is structurally effected in the modern university. The second wave of professionalization has different protagonists than the older "market professions": placed in a different structural situation, the bureaucratic professions transform the model of profession (which they adopt as a strategy of collective ascension) into an ideology. The import of the ideology of professionalism is examined in relation to two issues: the relationships between professional occupations and bureaucratic organizations; and the position of professional occupations within the larger structure of inequality. Analysis of the first point requires consideration of the distinctions between professional occupations in the public and private sectors, the use of professional knowledge and the image of profession in bureaucratic organizations, and the specific characteristics of professions that produce their own knowledge. In the discussion of the second point, professional occupations and their ideology are examined in relation to other occupations and to the possibilities of political awareness generated by uncertain professional statuses.

Certification↗
PubMed2004

["They'll never come back...""--Expectations and reality of occupational reintegration of teachers unfit for service].

AIM OF THE STUDY: The reactivation of teachers with experience of both life and the profession who have become unfit for work is regarded by politicians not only as a suitable measure against the imminent lack of teaching staff, but also as a promising strategy for reducing the cost of health care. The aim of our study was to gather new evidence- based information on the occupational reintegration of teachers who took early retirement and to investigate to what extent official medical reactivation examinations are an effective instrument of tertiary prevention. DATABASE AND METHODS: In a prospective total assessment (the entire state of Bavaria) over the period of 1997 - 1999 all official medical examinations in the public health centres (Gesundheitsamter und Medizinische Untersuchungsstellen der Bezirksregierungen) were evaluated with regard to the reactivation of teachers unfit for work. The analysis included e. g. socio-demographic/occupational factors, the morbidity spectrum, rehabilitation and the assessment of performance. The answers given in a standardised, anonymous questionnaire provided the database. Evaluation was carried out by means of descriptive statistics. RESULTS: Of the 1465 teachers studied, 64 % (n = 939) were women and 36 % (n = 526) were men. The median age was 53 years (range: 31 - 63 years), and the proportion of over 60-year-olds was 5.5 %. 22 % of those who took early retirement were recognised as being severely disabled. In 77 % of cases, examination of unfitness for work was carried out at the order of the authorities. 57 % (n = 835) of the teachers had taken part in at least one medical rehabilitation measure, 13 % (n = 190) in at least one occupational rehabilitation measure. Within the morbidity spectrum, psychic and psychosomatic illnesses (F-ICD10) took first place with a share of 59 % the prevalence in female teachers of such illnesses was significantly higher than that in male teachers (p < 0.05). Among the psychiatric diagnoses, depressive illnesses dominated (share: 35 %). The most frequent somatic diseases were muscular/skeletal disorders (M-ICD10) in 12 % of cases, then cardiovascular disorders (I-ICD10) in 7 % and malignant tumours (C-ICD 10) in 5 % of cases. In 33 % of cases multi-morbidity was found. 93 % (n = 1,360) of the teachers investigated in follow-up examinations were again classified as unfit for work. In only 7 % (n = 105) reactivation was recommended by the physician; the lowest reactivation quotas were found among teachers with psychic illnesses and grammar school teachers. In who teachers that returned to work, compared to those still unfit for work, a lower age and lower prevalence of severe disability, multi-morbidity and psychic disturbances were objectified. CONCLUSIONS: Teachers who take early retirement return to the profession only in exceptional cases. The time and expense needed for reactivation examinations should be critically compared with the benefits. The same applies to the quality of the results of intervention and rehabilitation measures for restoring psychological and physical health. In this context problem-oriented disability management appears superfluous.

Adult↗
PubMed2003

Impact of the changing health care environment on fieldwork education: perceptions of occupational therapy educators.

To investigate how clinical fieldwork educators and academic fieldwork coordinators view the impact of the changing health care environment on student fieldwork education, current practice, and future of the profession, a 48-item questionnaire assessing the influence of recent changes in the health care system on fieldwork education was sent to 125 occupational therapy fieldwork educators and coordinators (response rate 62.4%). Differences between fieldwork educators and coordinators were analyzed statistically using nonparametric methods. Alpha level was set at p < 0.01 for all statistical comparisons. Fieldwork educators and coordinators agreed productivity expectations, number of hours worked, and time spent in documentation have increased, while job security, time for continuing education, and quality of patient care under the current reimbursement system have decreased, but diverged on several other issues. Fieldwork educators believed reimbursement issues did not affect their ability to accept fieldwork students, whereas academic coordinators believed declining reimbursement had negatively affected fieldwork educators' ability to accept students. Factors thought to facilitate the fieldwork shortage included cost reductions, changes in reimbursement, and increased productivity demands on clinicians.

Allied Health Personnel↗
PubMed1999

[The toxic effect of mercury in occupational exposure].

The paper addresses the problems of environmental and occupational exposures to mercury compounds. Mercury and its compounds are very toxic. Occupational exposure and environmental pollution are the major sources of hazard to human health. Metallic mercury evaporates at room temperature producing inorganic and organic compounds, and forms amalgams with many metals. In more than 50 professions, workers may be exposed to mercury, particularly in the mining and chemical industries and in agriculture. Occupational poisoning is rarely acute but it is usually chronic. The symptoms result from the damage to the central nervous system, and the kidney, as well as from the impairment of erythrocyte metabolism, coagulation and immune response. Mercury may also induce allergic reactions. Chronic mercury poisoning is diagnosed on the basis of the clinical picture in the presence of the occupational exposure. Inorganic mercury poisoning is treated specifically with chelating agents.

Adolescent↗
PubMed1999

The impact of 'Project 2000' educational reforms on the occupational socialization of nurses: an exploratory study.

There is much in both nursing and sociological literature concerning the socialization of students into health care professions. In the case of nursing, concern has been expressed at the disparity between the values espoused by the educational establishment and those in the clinical areas. This study aimed to explore the changes in nursing occupational socialization since the implementation of recent educational reforms. Ethical approval was obtained from the local Research and Ethics Committee. The sample (n = 18) was drawn from qualified nurses working in a range of departments within three Welsh hospitals, half had undergone traditional training and half had received Project 2000 education. Data collection and analysis techniques were based on a grounded theory approach; this approach was deemed appropriate in that it allows the possibility of developing fresh perspectives on the subject without being too constrained by earlier studies. A strongly emerging theme from the data was that the nature of nursing socialization was related to the work contexts in which it was experienced; in particular respondents offered sharply contrasting accounts of nursing culture in 'acute' and 'chronic' areas of health work. The process of socialization was found to be harsher in acute areas with numerous instances of negative sanctions used to ensure compliance to ward culture, whilst in chronic areas occupational socialization was a more satisfactory process and nurses experienced less dissonance between ward and educational establishments. The size of this study mitigates against any firm conclusions; however, the early indications suggest that it would be a fruitful area for further research with a wider sample group drawn from diverse areas. This exploratory study suggests that the location of nursing work, in terms of whether it is in acute or chronic areas, is a determining factor in the experience of contemporary occupational socialization of nurses.

Education, Nursing↗
PubMed2001

[Recognizing pain in geriatric patients by an interdisciplinary team. Reliability of judgment and factors of influence].

The prevalence of chronic pain increases with age. The awareness of pain in geriatric patients is more difficult than in younger people because of various reasons. The occupational groups of the geriatric team might be different in respect of discerning symptoms of pain. 126 geriatric patients were enrolled in this study. They were asked if they had pain today and in the last seven days. At the same time the members of the geriatric team (old people's nurses, nurses, physicians, physio-, occupational and speech therapists) were asked the same questions with respect of their patients. Items possible influencing the answers were recorded: patient's characteristics: age, cognition (Folstein's minimental state) and duration of hospital stay before this interview; employee's characteristics: age, days of care in the past 7 days, weekly working hours, occupational years and years working in this geriatric hospital. The judgement of the geriatric team varied widely. It was dependent on the profession, days of care, weekly working hours and professional experience. Changes of care in the last 7 days have an negative effect in all occupational groups. Other features will be discussed in details. The handing of the patient's pain should be improved within the occupational groups.

Aged↗
PubMed1977

Occupational incidence rates of mental health disorders.

This study attempted to provide occupational health professionals with an empirical basis for identifying and selecting specific occupations for further research into the relationship between job stress and worker health. Specifically, this involved an examination of the admission records of community mental health centers throughout one state (Tennessee) to determine the incidence rate of diagnosed mental health disorders for 130 major occupations (i.e., occupations employing 1,000 or more workers in the state). These occupations were then rank-ordered by incidence rate to provide a general scheme for evaluating the relative frequency of mental health disorders among the select occupations. The results indicated a disproportionate incidence of mental health anomalies among the hospital/health care professions. Some tentative explanations of this finding are presented, and suggestions are made for future research efforts.

Adolescent↗
PubMedDate not supplied

[Significance of revision of the occupational illness legislation for evaluating intervertebral disk damage].

QUESTION: Are there any radiological criterions which are able to indicate the profession related disease No. 2108? METHODS: The medical documents and x-rays of the whole spine of 390 back pain patients who applied for a profession related disease of the spine were evaluated. Those patients who fulfilled the professional claims for acknowledgement of the profession related disease were compared to those who didn't fulfill these conditions. RESULTS: Concerning the segmental alterations of the cervical and the lumbal spine specific allocation frequencies were found. The dominance of L3/4 in the comparison group was conspicuous. Looking at the allocation frequencies of the cervical and lumbal disc alterations in view of affection heaviness it was obvious, that the predominating slight alterations mainly were located in the central parts of the cervical and the lumbal spine whereas bad alterations mainly were found in the lower parts. Regarding this matter test and comparison groups behaved the same way. Looking at the allocation frequencies concerning single respectively multiple alterations it was found that in the comparison group single respectively bisegmentale alterations could be recognized even in duplicate than in the test group in which the multiple alterations were dominant. The comparison of the cervical and the lumbal spine regarding chondrotic? spondylotic, slight and bad alterations in all mentioned features the next deeper located segment was affected particularly in the test group. Therefore a distal shift of the chondrotic alterations could be recognized. In case of the spondylotic affections it was the other way round: a cranial shift was conspicuous. CONCLUSION: After doing heavy labour for years only a few isolated multiple affections of the lumbal spine are found. On the strength of this fact the proof of exclusively in the lumbal spine located alterations doesn't allow the acknowledgement of a profession related disease. However, a distal shift of osteochondrotic alterations respectively a cranial shift of spondylotic affections in the lumbal spine is suspicous for being job-related. L3/4 takes a very special place in the differential diagnosis of profession related disease of the spine. In the test group this part of the lumbal spine showed bad alterations much more frequent. The affection of L3/4 pleads against a considerable participation of mechanical influences and therefore against a profession related disease. Singular or bisegmental disc affections are out of question for being a profession related disease because these alterations are seen much more frequent in the comparison than in the test group.

Adult↗
PubMed1979

Human development through occupation: a philosophy and conceptual model for practice, part 2.

The development of a philosophy of practice called "human development through occupation" is described in this paper. This philosophy was developed through study and identification of generic concepts in four major theoretical frameworks for occupational therapy described in a preceding article. The philosophy of practice proposes a view of Man, a view of human health, and a view of the profession. These theoretical and philosophical resources are then used to construct a conceptual model of the content and sequence of the occupational therapy practice process. It is believed that the four theoretical frameworks, philosophy of practice, and conceptual model detailed in these two papers can provide direction for general practitioners and specialists in service, education, and research. Examples of application are included, together with suggestions for further investigation.

Health↗
PubMed1993

Graded activity: legacy of the sanatorium.

Occupational therapists in all areas of practice grade therapeutic activities to help patients progress toward their goals. It is proposed in this paper that the concept of graded activity originated in German tuberculosis sanatoria in the late 1800s, when patients were required to walk on graded (sloped) land for exercise. British physician Marcus Paterson included work, as well as walking, in his graduated exercise program for tuberculosis patients and was honored for this innovation at the founding meeting of the National Society for the Promotion of Occupational Therapy (NSPOT). George Barton, Susan Tracy, and Herbert Hall were among the NSPOT members who contributed to the development of graded activity as a principle in occupational therapy intervention. The military rehabilitation programs established during World War I provided additional impetus, and by the mid-1920s, graded activity was recognized as central to the profession.

Europe↗
PubMed1992

[Detergent enzymes: has the risk of occupational sensitization disappeared?].

Occupational allergy to enzyme detergents had almost disappeared by the use of preventive measures, both individually and in industries. The occurrence of 8 new cases of asthma in a detergent factory has led to a prospective clinical and aetiological enquiry. Although there was no documentation using the specific provocation test or by measuring respiratory function whilst at work, the occupational character of this asthma seemed possible after taking a history. Sensitization to the enzymes used (Savinase, Maxatase and Biozym P 300 S) was shown by skin tests (8 positive to all the enzymes) and the level of specific IgE to Rast (8 times greater than class 3 for Savinase and Maxitase) and for HBDT for Maxatase and Biozym P 300 S (greater than 50% in 8 patients). From another stand point the incomplete application of preventive measures within the factory did not seem to totally explain the origin of this sensitization. In fact, it was the study of the morphology of the enzyme grains, which had been introduced into the factory which helped us to explain the mechanism. In effect it was the capsules of the grain which were fissured and thus allowed allergen contact. The replacement of these grains whose envelope was intact, led to the disappearance of the symptoms and confirmed our hypothesis. There remains a continuing risk from occupational sensitization to asthma and it is suggested that there is continued collaboration between the medical profession and industry.

Adult↗
PubMed1991

A comparison of craft use and academic preparation in craft modalities.

The purpose of this study was to compare the use of crafts in psychiatric occupational therapy practice with the actual craft-related training received by occupational therapy students. Two questionnaires were developed, one related to the crafts used in clinical practice, the other related to the amount and type of craft training received in educational programs. One thousand occupational therapists who work in psychiatry and 139 accredited and developing educational programs were asked to complete the questionnaire appropriate to their setting. The final analysis involved 121 educational programs (87% response rate) and 384 clinical programs (38% response rate). The results suggest that there may be substantial differences between craft-related training and actual clinical use of crafts. The findings imply that educational programs must reevaluate the types of crafts taught and the method by which they are integrated into the total curriculum. Implications for the profession include the need to clarify the role of crafts as a therapeutic modality and to reflect on the future direction of the profession.

Art Therapy↗
PubMed1994

Increasing occupational therapy research: is it time to try something new?

Lack of substantial occupational therapy research is a recognized and persistent problem; which is often discussed throughout the literature but not truly addressed. Action must be taken to involve clinicians in the effort to substantiate the efficacy of treatments through outcome studies. We offered several proactive recommendations that could be implemented on a national level to encourage hesitant practitioners to conduct research. Past recommendations have not tapped the expertise of a large segment of our profession. Our recommendations will enhance the accessibility of research to a greater percentage of occupational therapy professionals by specifically targeting problems related to money, education, and time.

Education, Continuing↗