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PubMed2000

Seroepidemiology of hepatitis B virus markers among hospital health care workers. Analysis of certain potential risk factors.

OBJECTIVES: To determine, the prevalence of hepatitis B virus markers among hospital health care workers, to determine the influence of some risk factors on such prevalence and to outline the specific policies to tackle such problems among hospital health care workers. METHODS: Hepatitis B virus markers including hepatitis B surface antigen, anti-hepatitis B surface antigen and anti-hepatitis B core antigen were determined from sera samples collected from 459 hospital health care workers at different hospital departments. The prevalence of hepatitis B virus among these employees was correlated by a variety of risk factors such as gender, age, blood transfusion, and needle-stick and sharps injuries, and previous history of jaundice using logistic regression analyses. RESULTS: Of the hospital health care workers studied 143 (31%) of employees showed evidence of previous hepatitis B virus infection, including 17 (4%) carriers. The highest incidence was among those who were working at infectious diseases departments where 22 (43%) employees were found to be seropositive, followed by 26 (41%) employees from surgical departments. The risk factors, which were found to influence seropositivity, include age over 40 years old, needle-stick and sharps injuries and previous blood transfusion. Other factors such as gender, and previous history of jaundice were statistically insignificant. CONCLUSION: The hepatitis B virus infection was high among the hospital health care workers studied. This was influenced by certain potential occupational risk factors. As there is emerging evidence that vaccination among health care workers was infective. Specific measures should be implemented to reduce such risk. These may include strict policies on sharps and considering any blood or other body fluids being a potential risk. Education, clinical advice and health insurance should be available for health care workers who are at a higher risk of contracting hepatitis B virus infection.

Adolescent↗
PubMed2000

Respiratory function in female workers occupationally exposed to organic dusts in food processing industries.

Respiratory consequences of work in food processing industry were studied in 764 female workers exposed to organic dusts associated with the processing of green and roasted coffee, tea, spices, dried fruits, cocoa and flour. A group of 387 female workers not exposed to respiratory irritants served as controls for the prevalence of acute (during work shift) and chronic respiratory symptoms. A greater prevalence of all acute and chronic respiratory symptoms was consistently found among exposed workers than among control workers. The highest prevalence of chronic respiratory symptoms was recorded for chronic cough (40%), followed by acute symptoms of dry cough (58.7%). The difference in the prevalence of chronic respiratory symptoms between the exposed and control workers was in general significant (p < 0.01 or p < 0.05). Mean acute reductions of lung function over the work shift were recorded in all of the studied groups; the mean across-shift decrease as a percentage of preshift values was particularly marked in FEF25 (-26.7%), FEF50 (-21.6%), followed by FEV1 (-9.9%) and FVC (-3.7%). The preshift (baseline) values of ventilatory capacity were decreased in comparison to the predicted ones, and were lowest for FEF50 and FEF25. This finding indicated an effect of organic dust on small airways. Our analysis suggested that both dust exposure and smoking history contributed independently to these respiratory findings. Disodium cromoglycate (DSCG) significantly diminished across-shift reductions for FEF50 and FEF25 in a subgroup of the examined workers. Our data suggested the female workers employed in food processing industry to be at risk of developing both acute and chronic respiratory symptoms as well as ventilatory capacity impairment as the result of occupational exposures.

Adolescent↗
PubMed2000

Older workers' progression from private disability benefits to Social Security disability benefits.

People with medical conditions that limit their ability to work tend to receive short-term disability benefits initially and may then move to long-term and eventually to permanent disability benefits. The progression of older workers (those aged 55 to 64) along that continuum of benefits is documented here with data from a large disability insurance company. The data show that older workers who receive short-term medical disability benefits are three times as likely as younger workers to progress to receipt of Social Security Disability Insurance (SSDI) benefits, although a slight reversal of that trend occurs as workers pass age 62. Musculoskeletal conditions are the most frequent basis of short-term disability claims among older workers, with circulatory conditions running a close second. Furthermore, although all medical conditions are more likely to lead to SSDI benefits among older workers, circulatory conditions do so most frequently. This article discusses industry standards for the management of disability claims at each level of severity. It also addresses common and emerging disability management practices that may reduce the likelihood of impaired workers developing long-term or permanent financial dependence on disability benefits programs.

Adolescent↗
PubMed2001

[Sickness absence among workers with occupational locomotor system diseases].

A long-term analysis of the data on temporary incapacity for work may be useful in identifying the most essential changes in the pattern of the causes of the disease-related incapacity for work and give the alert for taking necessary measures to protect the human health. The aim of the analysis is to define the causes of temporary incapacity for work prior to the diagnosis of chronic diseases of the locomotor system induced by the way the job is performed and the work overload in workers' groups of the highest disease incidence. The sickness absence study was carried out in the group of 395 workers with the locomotor system diseases due to the above-mentioned causes, diagnosed during the years 1996-1997. The analysis was based on numbers of days of work disability, numbers of cases and the average duration of disease. The rates of work disability days in the study group were compared with relevant rates in the occupationally active population of Poland. The analysis of sickness absence during a five-year period before the certification of the occupational diseases of the locomotor system revealed the sickness absence higher by 52% in male workers and by 60% in female workers than the average sickness absence in the general population. In this group, the diseases of the musculoskeletal system were the major cause of work disability, being responsible for 48% of sickness absence. The highest work disability was found in male workers with shoulder pain syndrome (about 49 days/person/year) and female workers with tenosynovitis and bursitis (45 days/person/year). As to the selected occupational groups, the first place was occupied by the group of workers engaged in metal processing (53 days/person/year), in which diseases of the musculoskeletal system made over 50%. In miners, besides locomotor diseases, a high level of sickness absence was due to the diseases of the nervous system and sense organs (17% of absence). In the group of dentists, the circulatory system diseases were the major cause of work disability in men (38% of absence), and the musculoskeletal system diseases in women (36% of absence). The study indicates that sickness absence can prove to be a substantial parameter that renders it possible to identify persons with enhanced risk of occupational disease by physicians involved in prophylactics and to take necessary preventive measures.

Aged↗
PubMed2001

Current status of imported parasitic infection among foreign workers in northern Taiwan (1999-2000).

In the present study, a simple, economic and practical technique was employed for stool examination. Of a total of 6,146 fecal samples from foreign workers in Northern Taiwan between 1999 and 2000 were examined, 615 were found to be positive for parasitic infection and the overall infection rate was 10%. Newly arriving foreign workers had a significantly higher infection rate (15%) than those who had worked in Taiwan for 6-12 months (8%). The foreign workers came from Indonesia, Philippines, Thailand, Malaysia, and Vietnam. Except for the small number of workers from Malaysia which was not included, the infection rate order by nationality was Vietnamese (21%) > Indonesian (13%) > Philippino (10%) > Thai (4%). The female examined workers were about 3-fold of males and their infection rate (11%) was also significantly higher than the males (5%). The order of rates by age was 20-30 years (11%) > 31-40 years (8%) > 41-50 years (5%). According to the species of parasites, 569 foreign workers were infected with 1 species (9%) > with 2 species (0.7%) > with 3 species (0.1%). Totally, 14 species (10 helminths including 1 plant nematode, Heterodera and 4 protozoa; hookworm might include 2 or 3 species, but counted as one species here) were found, of which 10 species were pathogenic (9 helminths and 1 protozoa) and 4 non-pathogenic. Foreign workers from Indonesia harbored 12 species of parasites > from the Philippines, 9 species > from Thailand, 8 species > from Vietnam, 7 species.

Adult↗
PubMedDate not supplied

[Work capacity evaluation in workers with arterial hypertension].

The aim of this study was to show the results of working ability estimation of the workers with arterial hypertension. The estimation included 313 workers with arterial hypertension estimated by Disability Commission during 1999. Arterial hypertension was a leading diagnosis in 30.9% cause of working ability estimation. The majority of workers belonged to the 41-60 years age group and were with arterial hypertension with complications on the fundus and on the heart. In the examined group the majority of workers was declared as first category invalid (35.8%), while 32.3% of hypertensive workers had to change the working place. The majority of the first category invalids were among the hypertensive workers from textile and chemical industry, as well as among the professional drivers. The changing of the working place was more frequently suggested to the workers in textile and metal industry and in printing firms. These results could be explained by the influence of professional noxious agents on the onset and development of arterial hypertension.

Adult↗
PubMedDate not supplied

Injection safety: knowledge and practice among health workers.

The increase in the spread of human immune-deficiency virus (HIV) infection among our population calls for measures to check its transmission. Health workers are at risk especially those in clinical practice who work with needles and other sharp objects that could aid transmission of the virus. Professionalism is at its lowest at Primary Health Care level and workers responsible for giving immunization with injections need clear understanding of principles of safe injection. To appreciate how to formulate a training programme, the knowledge and practice of injection safety among the workers were assessed through the use of a questionnaire. Fifty eight percent thought only children receiving immunization were at risk of a disease, 58.3% know the diseases transmissible by needle stick injury. On reasons for prevalence of unsafe injection practices, 27% suggested inadequate provision, 18.3% poverty, 17.7% ignorance, 17.2% improper disposal, 11.8% lack of surveillance and health supervision for workers and 8% negligence. On syringes and needles disposal, 53.2% suggested burning only, 2.1% burying and 44.7% both burning and burying. Less than 9% knew that auto-destruct syringes exist while 38.9% were aware of the joint WHO and UNICEF statement on "bundling approach" in vaccine packaging. Only about 50% of respondents had facilities for disposal of needles and syringes in their health centers, 45.6% wear protective clothing during service delivery. On making injection safer 33.7% suggested re-training of health workers, 22% retraining of workers and public re-education, 16.8% suggested planning budgeting and purchasing of auto-destruct syringes, 16.5% social mobilization and advocacy and 11% suggested the provision of facilities for disposal. It was concluded that awareness on safe injection practices was low among the health workers and that their practices could put them at greater risk of needles stick injury and hence the spread of HIV and other infection among them. Training on safe injection practices is therefore recommended.

Disposable Equipment↗
PubMed2002

Serum aluminium in alumina exposed workers.

This study was performed after skepticism occurred in 1994 when alumina, or aluminium oxide, was thought to be the cause of sickness and death for certain workers at the Northern Industrial Park, Lumphun province, Thailand. Zeeman-graphite furnace atomic absorption spectrometric method has been developed to quantify the aluminium (Al) levels in the serum of 399 workers and 500 blood donors. The results showed that Al levels in the directly (n = 62) exposed workers was significantly different from the indirectly exposed (n = 130) and non-exposed (n = 207) workers and donors. However, symptoms found in the directly exposed workers were not significantly different from those in the indirectly exposed workers. In addition, a high percentage of headache and fatigue found in both directly and indirectly exposed workers suggested that more than one hazard could be involved in the incidence of alumina.

Adult↗
PubMedDate not supplied

Occupational deaths in West Virginia's older workers: 1980-1998.

West Virginia has an average of 69 work-related deaths per year from 1980 through 1998. Seventeen percent of these deaths occurred in workers age 55 or older. The death rate among these workers was 12.5 deaths per 100,000 workers compared to 9.5 for workers ages 16-54. Older workers died from traumatic machinery-related incidents at a rate nearly three times higher than that for younger workers and from homicide at a rate 2.3 times higher than the younger group. With a workforce that is increasingly older, it is important for employers to identify occupations and job activities that place older workers at risk, and to develop appropriate intervention strategies to protect them from injury.

Accidents, Occupational↗
PubMed2003

Polymorphisms for vinyl chloride metabolism in French vinyl chloride workers.

Genetic polymorphisms of aldehyde dehydrogenase 2 (ALDH2) and cytochrome P450 2E1 (CYP2E1) have been shown to influence the degree of genetic damage in Taiwanese workers exposed to the carcinogen - vinyl chloride(VC). Certain French VC workers have been found to express biomarkers of mutant forms of cancer-related proteins (ras-p21 and p53) that have been related to their exposure. ALDH2 and CYP2E1 polymorphisms were investigated in 211 of these workers in an attempt to correlate differences in VC metabolic capacity with differences in the presence of these biomarkers. All of the workers were found to have the normal, wild-type ALDH2 gene, and none of them were found to be homozygous for the variant CYP2E1 allele. Sixteen workers were found to be heterozygous for the variant CYP2E1 allele. After adjusting for age, smoking, drinking and cumulative VC exposure, the odds ratio for the presence of either the mutant ras-p21 or the mutant p53 biomarker in these heterozygous workers was found to be statistically significantly increased in comparison to their homozygous, wild-type counterparts (OR = 5.05; 95% CI = 1.10-23.25). However, as opposed to the case in Taiwanese workers, these polymorphisms are relatively uncommon, and thus differences in ALDH2 and CYP2E1 can account for only a small proportion of the variability in mutagenic response to VC exposure in a Caucasian population.

Adult↗
PubMedDate not supplied

[Prevalence of HCV in health care workers in Southern Italy].

PURPOSE: To assess the prevalence of hepatitis C virus (HCV) in the population exposed to biological risk of two hospitals in southern Italy. PATIENTS AND METHODS: All health care workers of two main hospitals of Sicily, potentially exposed to biological risk underwent health surveillance. Health care personnel were arranged into seven occupational group, and five age bands (< 30, 31-40 years, 25-30 years, 41-50, 51-60 years, > 60 years). We estimated the prevalence of hepatitis C infection in 1800 healthcare workers by means of nucleic acid amplification and genotype by means of sequencing, the workers were also tested for liver function. RESULTS: The overall prevalence of anti-HCV was 2.1%, corresponding to 39 persons. The prevalence in health workers was higher in nurses than in surgeon, group perceived to be at greatest risk of occupational exposure, and higher in elderly workers (> 45 years) than in younger ones. CONCLUSION: Prevalence of anti-HCV in our study was higher than in blood donors, and lower than in general population in southern of Italy. The 45% of HCV infected healthcare workers were unaware of their condition and their potential to infect patients. Testing for HCV infection should be routinely performed for health care workers to detect the infection, which frequently results in a chronic asymptomatic carrier state for many years before the development of symptomatic liver disease, and perform precocious therapy with interferon.

Adult↗
PubMed1992

Assessment of PAH-exposure among coke oven workers.

Coke oven workers are exposed to high concentrations of polycyclic aromatic hydrocarbons. Only recently have methods been developed to try to assess the individual, biologically significant exposure. The only coke oven plant in Finland started to function in 1987, in Raahe, enabling the implementation of a cohort study among the workers to determine the usefulness of some currently available biomonitoring methods, e.g. methods of measuring PAH-DNA adducts. Urine and blood samples were taken several times from a sample of workers starting from before they worked at the plant. A questionnaire (smoking, diet, former and current occupations) was filled in by the workers at every sampling, and air samples (personal and stationary) were collected at the same time. The mean values of both benzo(a)pyrene diolepoxide (BPDE)-DNA adducts were measured by synchronous fluorescence spectrophotometry (SFS) and the antibodies to these adducts increased somewhat after the work at the plant started. However, all the adduct values were low, and no differences between the smokers and non-smokers at any time point were detected. Battery workers had slightly increased means of BPDE-DNA adducts compared to non-battery workers. Also, coke oven workers had slightly higher adduct values than age, sex and smoking matched controls.

7,8-Dihydro-7,8-dihydroxybenzo(a)pyrene 9,10-oxide↗
PubMed2003

[Migrant workers: evolution of the Israel health system approach to the new social issue].

The immigration of workers from poor countries to Israel began in earnest in 1993, and by 2003 their number had reached 250,000, the majority without work permits. In this article we describe the evolution of the Israeli approach to providing health services to migrant workers, noting particularly the swings between exclusion and inclusion, ranging from providing only the most minimal services to providing a complete health services package. The National Insurance Institute was the first to provide benefits to documented migrant workers, mandating compensation benefits for those injured at work or in terrorist incidents. The health care sector provided an ever-increasing package of health benefits for documented migrant workers, culminating in the Foreign Workers Law of 2000 obligating employers to insure workers with a health package similar to that of Israeli citizens. The provision of health services to undocumented migrant workers and their families arose more gradually, but ultimately included the full range of mother and child preventive health services, school health services, provision of ambulatory medical care by volunteer physicians members of human rights organization, the possibility of enrolling their children at a reduced premium in Meuchedet Health Fund, free diagnostic and treatment services for tuberculosis and sexually transmitted diseases, free antiretroviral treatment of HIV-positive pregnant women, and, finally, the ability to obtain gas masks for a token deposit prior to the Iraq War of 2003

Delivery of Health Care↗
PubMedDate not supplied

Uptake of influenza vaccine by healthcare workers in an acute hospital in Ireland.

Healthcare workers are recommended to receive influenza vaccination. The aims of this study were to assess the uptake of the influenza vaccine by healthcare workers in an acute hospital setting and ascertain factors as to why health care workers availed of the vaccine or not. The vaccine was available free of charge and the times when and the locations where the vaccine was available were well advertised. A questionnaire was distributed to a presenting sample of 300 healthcare workers at the end of December 2001 when the campaign was completed. A total of 228 (76.0%) responded. Almost two-thirds, 146(64.0%), had seen the notices about the availability of the vaccine and 175(76.8%) were aware that the vaccine was available free of charge. Forty (17.5%) received the vaccine. Professionals allied to medicine were more likely to have been vaccinated than other healthcare workers, whilst nurses were less likely to be vaccinated. The most common factors associated with not getting vaccinated were that the healthcare workers did not consider themselves at high risk and a fear of side effects of the vaccine. Nurses were more likely than other staff to cite side effects of the vaccine as a reason for not getting vaccinated (p < 0.03). A third of those who did not get the vaccine stated that they would consider getting the vaccine the following year compared to 26(65.0%) of those who got it in the current year. The main reason for getting the vaccine was to avoid influenza infection. If high uptake rates of influenza vaccine are to be achieved in healthcare workers creative and enduring methods will have to be employed.

Acute Disease↗
PubMed2002

[The retrospective survey of malignant tumor in weapon workers exposed to 2,4,6-trinitrotoluene].

OBJECTIVE: To investigate the occupational health risk level of workers exposed to 2,4,6-trinitrotoluene (TNT) in arms industry, so as to provide basis for revising the standard of diagnosis for chronic TNT poisoning, and making protective measures for workers. METHODS: The retrospective study about the morbidity of total malignant tumor was taken on the male workers exposed to TNT over one year from eight military factories during 1970 to 1995. RESULTS: The morbidity of total malignant tumor in male TNT exposed workers were markedly higher than that of controls, and the relative risk (RR) was 2.32. Compared with the total malignant tumor mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, the standardized mortality ratio(SMR) were 71.8 and 179.6 respectively, the CI of 99% was 71.8-144.2, indicating that the morbidity of malignant tumor of male workers exposed to TNT was higher than that of normal populations. Liver cancer morbidity was 31.91% of the total malignant tumor, and its mortality was 3.97 times of the controls. Compared with the liver cancer mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, SMR were 150.5 and 381.6 respectively, these data were significantly different, and CI of 99% was 59.3-184.0. The average death age of the TNT exposed workers (51.7 years old) was younger than that of the same factory control(54.1 years old) and male populations(55.6 years old) in large and medium cities. The incidence of liver cancer was closely related to the length of service, the kinds of job in a factory and the level exposed to TNT, and alcohol consumption was synergistic with TNT carcinogenesis. CONCLUSION: The morbidity of malignant tumor of male workers exposed to TNT was markedly higher than that of normal populations. Liver cancer was the most remarkable malignancy, and its incidence was closely related to the length of service and the kinds of job and the level exposed to TNT.

Humans↗
PubMedDate not supplied

Chronic psychological effects of exposure to mercury vapour among chlorine-alkali plant workers.

BACKGROUND: Quantitative assessment of nervous system function is essential in characterising the nature and extent of impairment in individuals experiencing symptoms following work-place mercury vapour exposure. OBJECTIVES: The purpose of this study was the application of standardised tests of behavioural, psychomotor and memory function to understand the neuropsychological effects of mercury in occupationally exposed chlorine-alkali plant workers. SUBJECTS AND METHODS: The study comprised 45 workers at a chlorine-alkali plant with the mean age of 39.36 +/- 5.94 years, who had been exposed to daily inhalation of mercury vapour over long-term employment of 16.06 +/- 4.29 years. The cumulative mercury index was 155.32 +/- 95.02 micrograms/g creatinine, the mean of urinary mercury concentrations on the first day of the study was 119.50 +/- 157.24 micrograms/g creatinine, and the mean of urinary mercury concentrations 120 days after cessation of exposure was 21.70 +/- 26.07 micrograms/g creatinine. The analysis included tests of behavioural, psychomotor and memory function. The behavioural test battery consisted of: Environmental Worry Scale (EWS), Minnesota Modified Personal Inventory (MMPI-2), Purdue standard 25 minute test, and adapted, 10 minutes test, Bender's Visual-Motor Gestalt test (BGT), and Eysenck Personality Inventory (EPQ). The data were compared to a control group of 32 not directly exposed workers. RESULTS: In the mercury vapour exposed workers with relatively high level exposure to inorganic mercury vapour (TWA/TLV = 0.12 mg/m3/0.025 mg/m3) we identified somatic depression-hypochondria symptoms with higher scores for scales: hysteria (P < 0.001), schizoid and psycho-asthenia (MMPI-2). The mercury-exposed workers had introvert behaviour (EPQ, MMPI-2). The cognitive disturbances in mercury-exposed workers were identified as: concentration difficulty, psychomotor, perceptual and motor coordination disturbances, and brain effects. We identified fine tremor of the hands in 34 out of 45 mercury-exposed workers (BGT). CONCLUSIONS: The results point to a relationship between the duration of mercury exposure and the long-term, probably irreversible, psychological disturbances.

Adult↗
PubMed2004

Urinary biomarkers in charcoal workers exposed to wood smoke in Bahia State, Brazil.

Charcoal is an important source of energy for domestic and industrial use in many countries. Brazil is the largest producer of charcoal in the world, with approximately 350,000 workers linked to the production and transportation of charcoal. To evaluate the occupational exposure to wood smoke and potential genotoxic effects on workers in charcoal production, we studied urinary mutagenicity in Salmonella YG1041 +S9 and urinary levels of 2-naphthol and 1-pyrenol in 154 workers of northeastern Bahia. Workers were classified into three categories according to their working location, and information about socio-demographic data, diet, alcohol consumption, and smoking was obtained using a standard questionnaire. Spot urine samples were collected to evaluate urinary mutagenicity and urinary metabolites. Urinary mutagenicity increased significantly with exposure to wood smoke and was modified by smoking. The prevalence odds ratio was 5.31, and the 95% confidence interval was 1.85; 15.27 for urinary mutagenicity in the highly exposed group relative to the nonexposed group. The levels of urinary metabolites increased monotonically with wood smoke exposure and were associated with the GSTM1 null genotype, which was determined previously. The prevalence odds ratio (95% confidence interval) for higher levels of 2-naphtol among the highly exposed was 17.13 (6.91; 42.44) and for 1-hydroxyprene 11.55 (5.32; 25.08) when compared with nonexposed workers. Urinary 2-naphthol was the most sensitive indicator of wood smoke exposure. This is the first reported measurement of internal exposure to wood smoke among charcoal workers, and the results showed that these workers receive a systemic exposure to genotoxic compounds.

Adult↗
PubMedDate not supplied

[Nutritional evaluation of health shift workers from the Canary Islands].

OBJECTIVE: Shift workers are known to have increased morbidity associated to wrong habits. In this study we have evaluated the nutritional status, food habits and physical activity in health shift workers. SUBJECTS: 207 permanent morning-shift workers and 210 shift workers (3-shift system) were randomized selected from the 2,100 workers of the North Area of the Canary Island Sanitary Health System. METHODS: Dietary intake was assessed by a self-registered food frequency questionnaire. We also assessed Body Mass Index, blood lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides), physical activity, age and sex. RESULTS: Shift workers shown higher intake of red meat, eggs, fruit juices and pasta. No differences were observed in lipid levels, weight status and physical activity in relation to the shift working status. 62% of men and 37.2% of women were overweight or obese. 46% of the subjects were sedentary. CONCLUSIONS: Shift work system seems to have little influence on the food habits of health workers.

Adult↗