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PubMed1984

Contributions and limitations of epidemiological knowledge in occupational health.

Although epidemiological principles and methods in occupational medicine have been used for many years, it is only recently that the term "occupational epidemiology" has begun to appear in the field of occupational health. In fact, this is only the 3rd meeting of "occupational epidemiology" of a scientific subcommittee of PCIAOH. Thus, the importance of epidemiology in occupational health has been recognized among not only scientists but other members of the field and by the general public. This is indeed a desirable trend and will promote the practice of occupational health. However, epidemiology is not "almighty", not an absolute science. The misuse of epidemiological results can provide wrong information and may even cause grave confusion and misunderstanding in the protection of the health of workers and relevant legislative action. The use of epidemiology can be broadly categorized as follows: Search for a cause of occupational disease--Cause and-effect relationship of an event among workers: Occupational cancer and other diseases; Industrial injuries; Absenteeism; Detection of subclinical and psychological conditions due to job; and Occupational fatigue. Dose-effect, dose-response relationship of toxic chemicals. Practical application of epidemiological results: Establishment of criteria for the maintenance of health; Industrial hygiene; and Policy making for prevention and compensation--regulation and legislation. There are many problems, issues and conflicts in the uses of occupational epidemiology. These will be discussed in the text.

Absenteeism↗
PubMed1982

[Economic effectiveness of using a live measles vaccine in an agricultural area of the Ukrainian SSR].

Economic effectiveness of vaccination against measles in an agricultural region of the Ukrainian SSR has been studied. At the period preceding vaccination expenses for each measles patient in the country were three times as low as those in towns. At the period of vaccination a considerable decrease in expenses covering the payment of sick-leave certificates given to mothers taking care of their sick children, in losses connected with absenteeism, in expenses for gamma globulin prophylaxis and the hospital treatment and outpatient servicing of measles patients was observed due to the sharp drop of the total morbidity rate and the increased number of school children among measles patients. In urban and rural areas the equalization of expenses for each patient occurred. In spite of increased expenses for each measles patient, the considerable economy of sums spent for controlling measles was achieved: about 70,000 rubles per annum.

Absenteeism↗
PubMed1982

The 12-hour weekend plan--does the nursing staff really like it?

After nursing administrators at one Boston hospital implemented a new system for weekend coverage, they surveyed the staff's response to the trial plan. Here the author explains their system, what they learned when they measured its effects, and how they used staff responses to improve it. They proceed to examine the new system's effects on recruitment and absenteeism. The experiences shared here should assist other nursing administrators who are looking at new scheduling approaches and their viability in resolving staffing problems.

Absenteeism↗
PubMed1980

Control programmes for streptococcal disease among rural school children.

Rheumatic fever remains important in New Zealand, and rheumatic heart disease is common. In a high risk area, a study of primary preventive strategies was undertaken among primary school children. The principal aim was to reduce beta-haemolytic streptococcal throat carriage. Subordinate aims were to reduce sickness-related absenteeism and the clinical incidence of streptococcal disease. The strategies compared included (1) identification and treatment of asymptomatic carriers at three-monthly surveys; (2) between-survey home visits of a nurse to identify infections and encourage prompt referral to the family doctor; (3) an exercise programme intended to increase general and respiratory fitness. Some benefit resulted from each strategy but the exercise programme was the least costly. The benefits of treatment of carriers and home visiting are probably insufficient to make them worthwhile.

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PubMed1981

Employee withdrawal and job satisfaction in community residential facilities for mentally retarded persons.

This study was conducted to provide information concerning employee stability in community residential facilities serving mentally retarded persons. Information was collected on turnover, length of service, absenteeism, job satisfaction, and increased overhead costs as a consequence of the turnover rate for 21 randomly selected small and large community residential facility organizations that operated a total of 47 living units in Tennessee. Subjects included all house managers (full-time and relief) and administrator/supervisors in the 21 organizations for fiscal year 1978-1979. The results revealed a significant problem of controllable turnover of direct-service employees. The major factors contributing to this problem appeared to be (a) a lack of effective methods to orient, integrate, and maintain new staff members, (b) low pay and wide variations for amount and kind of work to be accomplished, and (c) a lack of training and support systems to deal with behavior problems presented by some residents.

Absenteeism↗
PubMed1981

Epidemiology of adolescent dysmenorrhea.

Dysmenorrhea is the leading cause of recurrent short-term school absenteeism among adolescent girls. Controversy surrounds the relative role of psychologic and biologic variables in the pathogenesis of dysmenorrhea. Therefore, data from 2,699 menarcheal adolescents, drawn from a national probability sample of 12 to 17-year-old girls (the National Health Examination Survey), were analyzed by bivariate and multivariate analytic techniques for biologic, psychologic, and demographic correlates of dysmenorrhea. Of 1,611 adolescents (59,7%) who report dysmenorrhea, 14% frequently miss school because of cramps. The greatest proportion of variation of independent variables in a stepwise multiple regression analysis in this study was predicted by gynecologic or postmenarcheal age. Preparation for menarche, a psychologic variable, did not predict either dysmenorrhea or subsequent school absence. Socioeconomic status was positively correlated with dysmenorrhea although race was not. However, black students (23.6%) miss more school because of dysmenorrhea than white students (12.3%) even when socioeconomic status is held constant. Data in this study suggest that biologic variables play a substantial role in the pathogenesis of dysmenorrhea.

Absenteeism↗
PubMed1978

Comparative absence experience among employees covered by a prepaid or a Blue Cross/Blue Shield health insurance program.

Health maintenance organizations report lower hospitalization and surgical experience than fee-for-service practice. If this is true, then sickness absence should be less. This pilot study compared morbidity experience of 247 pairs of Mountain Bell Telephone Company employees--HMO-enrolled employees matched with employees covered only by Blue Cross/Blue Shield. The study period extended before and after enrollment of the HMO subjects. Rates for the HMO group for hospitalization and surgery decreased after enrollment, whereas rates for the Blue Cross/Blue Shield group increased. The absence disability rate for the HMO group remained constant but increased for the BC/BS group. Differences in absenteeism may exist due to the type of medical insurance. The potential impact of such a difference upon absence costs is considerable.

Absenteeism↗
PubMed1978

Morbidity among persons employed in styrene production, polymerization and processing plants.

BASF has been producing styrene and polystyrene since 1931. An investigation of morbidity was undertaken for 84 workers employed in the styrene plant and exposed for 1--36 years and 93 workers employed in the polystyrene plant and exposed for 1--38 years. In all groups the concentration of styrene in the atmosphere was measured at various points of the workplace. All workers underwent a thorough physical examination and also extensive laboratory tests, including the determination of urinary mandelic acid. The absenteeism and accident rates were also taken into consideration in both plants. Blood samples were also taken and mandelic acid tests made on a small group of 16 persons employed in polyester processing plants not attached to the BASF.

Absenteeism↗
PubMedDate not supplied

Prevalence and consequences of smoking, alcohol use, and illicit drug use at five worksites.

Employers are becoming increasingly concerned about the consequences and costs of substance use in their workplaces. Despite this heightened awareness, little information is available to guide them in setting up worksite-based prevention and assistance programs. Most estimates of the prevalence or consequences of substance use are derived from large national surveys of households or individual persons. The primary contribution of this research to the public health literature is the empirical results from a unique data set. In particular, this study presents results of a survey administered to more than 1,200 employees at five different worksites. Descriptive statistics for the prevalence of smoking, alcohol and illicit drug use, prescription drug misuse, and workplace consequences, such as reduced performance and absenteeism, are reported, as well as findings from a multivariate analysis of substance use prevalence and consequences. Compared with national averages, workers at these five sites tended to have substance use profiles similar to or slightly lower than estimates from large national surveys. The study's estimates may help employers identify the extent of a substance abuse problem in their worksites and specific areas to target for possible intervention.

Absenteeism↗
PubMed1976

Trial of an oral antigen against upper respiratory-tract infection. Results in the second year (1973-74).

A double-blind trial in two randomly structured groups of boarders (44 girls and 66 boys) aged 7 to 13 years was undertaken in two Bristrol schools. Dosage was 1 ml a day of fluid (antigen or placebo) orally for the first four weeks of the autumn term, absenteeism being the main parameter measured, using a structured recording code. There was a highly significant difference in the number of days lost from upper respiratory-tract infection in the treated as opposed to the placebo group (x2 = 40-00 P less than 0-001 (v = 1). The number of colds was also significantly lower in the treated group (x2 = 8-05 P less than 0-005 (V less than i)).

Absenteeism↗
PubMedDate not supplied

Economic effects of insomnia.

Insomnia affects up to 40% of the general population yearly and is a significant cause of morbidity and mortality. The direct and indirect costs of insomnia place a tremendous economic burden on society and employers. In addition to the cost of medical treatment and drugs, measurable costs of insomnia include reduced productivity, increased absenteeism, accidents, and hospitalization, as well as medical costs due to increased morbidity and mortality, depression due to insomnia, and increased alcohol consumption. This article reviews the literature on the economic costs and effects associated with insomnia. Based on the data reviewed, a conservative estimate of the total annual cost of insomnia was calculated at $92.5 to $107.5 billion. Early recognition and treatment of insomnia can reduce the costs associated with the condition, as well as possibly prevent other illnesses.

Absenteeism↗
PubMed1994

Cost to industry of illnesses related to alcohol and smoking. A study of Telecom Australia employees.

OBJECTIVE: To estimate the direct cost to industry of absenteeism attributable to drinking alcohol and smoking. DESIGN: Review of sick leave and superannuation data in the staff records of Telecom Australia (nearly 80,000 staff) for the financial year 1991-92 to identify illnesses related to alcohol or smoking. Costs were calculated by reference to tables of aetiological fractions, which statistically attribute a proportion of an illness to alcohol or smoking. MAIN OUTCOME MEASURE: The cost of employee absences attributable to alcohol or smoking expressed in the value of the person's daily salary. RESULTS: Illness attributable to smoking or alcohol accounted for 25% of sick leave. The estimated costs were $5,500,000 for alcohol and $16,500,000 for smoking. The total cost of $22,000,000 averages $275 per employee per year. If this cost is extrapolated to the rest of the Australian workforce, the total would exceed $2,000,000,000 a year. CONCLUSION: Limitations in the data mean that our results are likely to be underestimates. The direct costs to industry of ill health caused by alcohol and smoking are substantial and warrant preventive and rehabilitative programs.

Absenteeism↗
PubMed1994

Alcohol problems in employment: epidemiology and responses.

A review is presented of evidence related to the epidemiology of alcohol-related problems in employment and of policies to prevent or curb such problems. It is concluded that, although alcohol use is associated with accidents, absenteeism and inefficiency, epidemiological data from most countries are scarce. Available evidence is so limited that estimates of the extent or cost of alcohol-related problems in the workplace are of dubious value. National responses to alcohol problems in employment have been variable. A significant proportion of relevant published evidence relates to the U.S.A. It appears that even there very few workplace initiatives have been subjected to rigorous assessment. Limited evidence suggests that Employee Assistance Programmes for problem drinkers have reduced subsequent health-care costs.

Absenteeism↗
PubMed1993

The economic burden of depression in 1990.

BACKGROUND: We estimate in dollar terms the economic burden of depression in the United States on an annual basis. METHOD: Using a human capital approach, we develop prevalence-based estimates of three major cost-of-illness categories: (1) direct costs of medical, psychiatric, and pharmacologic care; (2) mortality costs arising from depression-related suicides; and (3) morbidity costs associated with depression in the workplace. With respect to the latter category, we extend traditional cost-of-illness research to include not only the costs arising from excess absenteeism of depressed workers, but also the reductions in their productive capacity while at work during episodes of the illness. RESULTS: We estimate that the annual costs of depression in the United States total approximately $43.7 billion. Of this total, $12.4 billion-28%-is attributable to direct costs, $7.5 billion-17%-comprises mortality costs, and $23.8 billion-55%-is derived from the two morbidity cost categories. CONCLUSION: Depression imposes significant annual costs on society. Because there are many important categories of cost that have yet to be estimated, the true burden of this illness may be even greater than is implied by our estimate. Future research on the total costs of depression may include attention to the comorbidity costs of this illness with a variety of other diseases, reductions in the quality of life experienced by sufferers, and added out-of-pocket costs resulting from the effects of this illness, including those related to household services. Finally, it may be useful to estimate the additional costs associated with expanding the definition of depression to include individuals who suffer from only some of the symptoms of this illness.

Absenteeism↗
PubMed1993

[Tasks of caregivers in a nursing home. A study of tasks and reactions of caregivers].

This paper describes a study on the task perceptions of enrolled nurses in a nursing home and the relationships between task perceptions and reactions such as burnout, job satisfaction, experienced job significance and absenteeism (Harmsen, 1991). In our study a comparison is made on the one hand between the task perceptions of three different functions in the nursing home, namely the unit heads, the graduated and the student nurses, and on the other hand between the task perceptions of enrolled nurses working on two types of wards, namely somatic and psycho-geriatric wards. Concerning the relationships between task perceptions and reactions, the results of our study show that activities regarding the 'nursing record', the 'nursing report', the 'stimulation of self-care' and 'social contact' usually have a positive relationship with the experienced job significance of enrolled nurses. On the contrary, activities concerning daily care are evaluated negative. Finally, tasks in the area of 'instrumental activities', 'caring for the dying' and 'caring for the privacy of the client' appear to have positive as well as negative effects.

Absenteeism↗
PubMed1993

Influence of mothers on school adjustment of continuous ambulatory peritoneal dialysis children.

In school children on continuous ambulatory peritoneal dialysis (CAPD), school adjustment is regarded as an important indicator for comprehensive medical care. The aim of the present study was to examine the influence of mothers on school adjustment of CAPD children. The children tended to indicate school maladjustment with school absenteeism and poor relationships with friends. The mothers were characterized by poor independence, poor achievement orientation, strong emotional reliance, and lack of social self-confidence, indicating emotional instability. The family environment, including the mother's psychological condition, was strongly associated with the children's maladjustment to school. The results suggested the necessity of comprehensive medical care for these children and their mothers.

Absenteeism↗
PubMed1993

Attendance and absence control: whose responsibility?

Absence control is a management responsibility, nevertheless, OH can make a valuable contribution to the creation of a supported system. Kit Artus examines management and employee attitudes to absenteeism and presents an argument for a multi-disciplinary approach to the problem.

Absenteeism↗
PubMed1993

[Influence of sex, age, and profession on transient work disability at a health center].

OBJECTIVE: To analyse whether the variables of gender, age and type of job of those in full-time work affect short-term unfitness for work (SUW) in a study undertaken within our health area. DESIGN: A prospective and retrospective study of all the SUW. SETTING: Primary Care. An urban Health Centre. PARTICIPANTS: Those people with full-time jobs registered at the Centre. MAIN MEASUREMENTS AND RESULTS: The entire 1098 certificates of SUW issued in 1990 were processed. The population pyramid and job distribution among those in full-time work was obtained by a random sample of 5% of the active population. When time off for maternity (TOM) was excluded, women accounted for 44.8% of SUW and men 55.2%. There were no significant differences with the percentages these figures represent for the active population as a whole. The number of SUW per 100 people in work was 15.9 for men and 21.5 and 17.4 for women (including and excluding TOM, respectively). The average length of SUW, excluding maternity, was 27.06 days for men and 26.8 for women. On the question of age, those under 19 and over 40 contributed least to the SUW percentage. Additionally, those under 19 and over 60 were the proportions of the population least prone to SUW. On the question of type of job, we found a higher contribution to absenteeism than expected within Groups 3 and 4 and less in Groups 0/1, 5 and 7/8/9. The longest average length of time for SUW was in Group X (84.2 days/SUW). CONCLUSIONS: Excluding TOM, gender does not appear to be a variable that affects SUW. Age group and type of job are variables affecting SUW. It will be necessary to undertake research into whether there are additional social or labour factors which might explain.

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