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PubMed1989

Part of the yellow dog: U.S. coal miners' opposition to the company doctor system, 1936-1946.

By the mid-1930s, U.S. coal miners could no longer tolerate company doctors. They objected to the misuse of preemployment and periodic medical examinations and to many other facets of employer-controlled health benefit plans. The rank-and-file movement for reform received critical assistance from the Bureau of Cooperative Medicine, which conducted an extensive investigation of health services in 157 Appalachian communities. This study not only substantiated the workers' indictment of prevailing conditions but illuminated new deficiencies in the quality and availability of hospital and medical care as well. The miners' union curtailed the undemocratic, exploitative system of company doctors and proprietary hospitals by establishing the United Mine Workers of America Welfare and Retirement Fund in 1946.

Appalachian Region↗
PubMed1986

Employee voice and employee retention.

This study investigates the relationship between the extent to which employees have opportunities to voice dissatisfaction and voluntary turnover in 111 short-term, general care hospitals. Results show that, whether or not a union is present, high numbers of mechanisms for employee voice are associated with high retention rates. Implications for theory and research as well as management practice are discussed.

Communication↗
PubMedDate not supplied

[Disability management: a new approach to prevention].

Disability Management (DM) is a workplace prevention and care strategy aimed at having healthier and more productive workers and improving company competitiveness. The DM process consists of 4 phases: wellbeing promotion, preventive measures, early intervention and case management. To be successful, DM requires a team approach which co-involves DM experts, employees, supervisors, human resource management staff, union representatives, physicians and other health operators.

Accidents, Occupational↗
PubMed1993

Staff participation in administrative decision-making.

Victoria Hospital Corporation in London has adopted a collaborative management model that involves the participation of medical, union and non-union staff in the administrative decision-making process within predetermined parameters. Reactions have been favourable from all sides--positive feedback from the groups involved and minimal negative public response to the sensitive decisions made concerning downsizing. Early indicators suggest increasing further the participation of union and non-union staff in decision-making on multiple levels, but with clearly defined "boundaries of responsibility."

Decision Making, Organizational↗
PubMed1994

Hazardous waste worker education. Long-term effects.

This study illustrates how a union education center successfully integrated adult empowerment education principles into the teaching methods and curriculum of a health and safety training program. The 12-month follow-up phone survey involved 481 local union respondents each representing a separate plant site and a group of 50 manager trainees. The evaluation shows that the training manual continued to be used by more than 70% of respondents, more than 70% taught coworkers, more than 50% of union trainees went on to train their managers, and more than 90% identified problems at work and sought and obtained changes in programs, training, or equipment. More than 20% reported that major spills had occurred following training. The majority stated that the handling of the spills improved. More than 80% stated that the training better prepared them for their health and safety duties. The managers' data substantially supported union members' reports.

Accidents, Occupational↗
PubMed1991

South African nurses' opinions of different organizations: policy implications.

There has been considerable debate in South Africa as to what type of organization would best represent the interests of nurses and facilitate their contribution to the achievement of changes in health care. This paper reports their background to and findings of the opinions of nurses in South Africa of different organizations, namely a professional nursing association, a health worker organization and a trade union. The results of the survey show that the South African Nursing Association has performed reasonably in meeting nurses' professional needs, but poorly in meeting their socio-economic needs. There is dissatisfaction with some of the Association's policies, widespread ignorance about trade unions and health worker organizations and resistance to strike action. The policy implications of the findings for the future organization of nurses in South Africa are explored.

Attitude of Health Personnel↗
PubMed1998

Predicting likelihood of seeking help through the employee assistance program among salaried and union hourly employees.

AIMS: This research investigated belief, social support and background predictors of employee likelihood to use an Employee Assistance Program (EAP) for a drinking problem. DESIGN: An anonymous cross-sectional survey was administered in the home. Bivariate analyses and simultaneous equations path analysis were used to explore a model of EAP use. SETTING: Survey and ethnographic research were conducted in a unionized heavy machinery manufacturing plant in the central states of the United States. PARTICIPANTS: A random sample of 852 hourly and salaried employees was selected. MEASUREMENTS: In addition to background variables, measures included: likelihood of going to an EAP for a drinking problem, belief the EAP can help, social support for the EAP from co-workers/others, belief that EAP use will harm employment, and supervisor encourages the EAP for potential drinking problems. FINDINGS: Belief in EAP efficacy directly increased the likelihood of going to an EAP. Greater perceived social support and supervisor encouragement increased the likelihood of going to an EAP both directly and indirectly through perceived EAP efficacy. Black and union hourly employees were more likely to say they would use an EAP. Males and those who reported drinking during working hours were less likely to say they would use an EAP for a drinking problem. CONCLUSIONS: EAP beliefs and social support have significant effects on likelihood to go to an EAP for a drinking problem. EAPs may wish to focus their efforts on creating an environment where there is social support from coworkers and encouragement from supervisors for using EAP services. Union networks and team members have an important role to play in addition to conventional supervisor intervention.

Adult↗
PubMedDate not supplied

Managing national nurses' associations: the UK example.

As the trend to restructure health systems takes momentum, there is a demand for effective management systems and managers capable of delivering quality care. Similarly, skillful management of national nurses' associations (NNAs) is essential if NNAs are to be successful in meeting their responsibilities to membership, the profession and society. Below a look at how the Royal College of Nursing, as the UK's principal professional union, has improved conditions for nurses while at the same time identifying and focusing on the "professional" issues and assuring that those who use the health services receive the highest care.

Education, Nursing↗
PubMed1976

Nurses and trade unions in Britain.

The nature of the negotiating body for pay and conditions of nurses in Britain and some of the reasons for the body's past failure to negotiate a substantial pay increase for nurses are described in this article. A description is given of a series of events, including strike action by nurses during 1974, which led to a substantial pay raise. The pay award, however, represented only a partial success for the trade unions and the negotiating body. Methods of nurses' organization and the roles of their representative unions and professional body indicate some of the reasons for only a partial success. The lack of unity between the National Health Service trade unions and the reactionary role of the professional body were notable. However, many important political and organizational lessons were learned by nurses in this struggle. We are now facing savage cuts in National Health Service expenditure, leading to a reduction in the number of nurses employed. These lessons are clearly useful for the nurses and their organization with the labor movement in fighting these cuts in National Health Service expenditure.

Economics, Nursing↗
PubMed2001

Mortality among unionized construction plasterers and cement masons.

BACKGROUND: Plasterers perform a variety of duties including interior and exterior plastering of drywall, cement, stucco, and stone imitation; the preparation, installation, and repair of all interior and exterior insulation systems; and the fireproofing of steel beams and columns. Some of the current potential toxic exposures among plasterers include plaster of Paris, silica, fiberglass, talc, and 1,1,1-trichloroethylene; asbestos had been used by the plasterers in the past. Cement masons, on the other hand, are involved in concrete construction of buildings, bridges, curbs and gutters, sidewalks, highways, streets and roads, floors and pavements and the finishing of same, when necessary, by sandblasting or any other method. Exposures include cement dust, silica, asphalt, and various solvents. METHODS: Proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were calculated for 99 causes of death among 12,873 members of the Operative Plasterers' and Cement Masons' International Association who died between 1972 and 1996 using United States age-, race-, and calender-specific death rates. Statistical significance (P value) of results was based upon the Poisson distribution. RESULTS: Among plasterers, statistically significant elevated mortality was observed for asbestosis, where the PMR reached 1,657 (P < 0.01) with eleven observed deaths and less than one death expected, for lung cancer (PCMR = 124, P < 0.01), and for benign neoplasms (PMR = 210, P < 0.05). Among cement masons, statistically significant elevated mortality was observed for cancer of the stomach (PCMR = 133, P < 0.01), benign neoplasms (PMR = 132, P < 0.01), and poisonings (PMR = 159, P < 0.05). Except for poisonings, which were not thought to be occupationally related, all of the statistically significant results occurred among those members who entered the union prior to 1950. However, the risk for lung cancer among plasterers was still elevated among those entering the union after 1970 as was the risk for stomach cancer among cement masons who entered the union after 1950. CONCLUSIONS: The present study suggests that plasterers and cement masons still have elevated risks for certain diseases, especially lung and stomach cancer. Therefore, union members currently living should be screened for asbestos-related diseases and educated about the future risks for these diseases.

Adult↗
PubMed1981

What trustees can do to maintain nonunion status.

Key issues causing hospital employees to seek unionization include wages and benefits, job security, supervision, staffing, and interprofessional relationships. The board should address these issues through board policy, and it should monitor the implementation of that policy in several key areas.

Governing Board↗
PubMed1994

The private funding of public research. New directions in the administration of occupational and environmental health research.

Dr. Cullen: The experience with the new research models, starting with the prototypic experience of the rubber industry studies of the 1970s and expanding to diverse sectors of American industry in the 1980s, has yielded some important lessons for the future. In closing this symposium I shall try to summarize these briefly. Certain strengths of the evolving process seem common to each of the models. Alone and collectively, the new research arrangements have quite apparently served to increase substantially the pool of funds available to the academic sector for the study of occupational health and safety problems. As a consequence, a larger pool of investigators has participated in the research process, greatly strengthening the future academic capability and experience of our fragilely supported teaching centers. Combined with the involvement of the academic centers in the review process, there has been an undeniable broadening and deepening of the nation's research output and long-term capability in occupational health. On the side of the private sector, the new relationships have led to marked progress in the knowledge base about health and safety problems, with a heavily directed focus on those of greatest relevance to the industries involved. The credibility of the knowledge acquired has been enhanced, an important achievement in a society in which perception of truth is often as important as the truth itself! Because of the requirements of the process for broad involvement by the organizations which undertake these activities, health and safety have achieved far greater visibility and attention by corporate and union leaders who may have previously had no involvement in issues of health and safety.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1979

Patients, not unions, first concern of hospitals.

Although the law regarding employee organizational rights in health care institutions has been in a state of flux since 1974, it is now clear that patient care generally takes precedence over employees' rights to organize on hospital premises.

Health Facility Environment↗
PubMed2003

Cancer incidence among union carpenters in New Jersey.

A cohort of 13,354 male union carpenters in New Jersey was linked to cancer registry data to investigate cancer incidence during 1979 through 2000. Surveillance, Epidemiology and End Results data were used to calculate standardized incidence ratios (SIRs). A total of 592 incident cancers were observed among this cohort (SIR=1.07), which was not statistically in excess. However, significant excesses were observed for cancers of the digestive system and peritoneum (SIR=1.24) and the respiratory system (SIR=1.52). Workers in the union more than 30 years were at significant risk for cancers of the digestive organs and peritoneum (SIR=3.98), rectum (SIR=4.85), trachea, bronchus, and lung (SIR=4.56), and other parts of the respiratory system (SIR=11.00). Testicular cancer was significantly in excess (SIR=2.48) in analyses that lagged results 15 years from initial union membership. Additional etiologic research is needed to evaluate possible occupational and nonoccupational risk factors for testicular cancer.

Adult↗
PubMed1998

Pay in the British NHS: a local solution for a national service?

An important component of the reforms of the British National Health Service (NHS) has been devolution of a previously highly centralised pay bargaining system to the local provider level. As the wage bill is by far the single largest item of health care expenditure, the implications of this change may be far-reaching. This article surveys the available theory and evidence from an economic perspective. It reviews the development of pay determination mechanisms in the NHS and the extent to which local pay has been adopted since the reforms were introduced. It then considers the theory of local pay and general evidence on local pay variations in the UK, before turning to the available evidence on local labour markets in the health care sectors of the UK and USA. It concludes with a discussion of the policy and research implications of current developments on local pay bargaining in the NHS. In particular, it suggests that judgements over the success or failure of local pay bargaining will concern: first, whether the weakened monopsony position of the NHS at national level results in higher pay for the more powerful employee groups; second, whether fragmentation of bargaining weakens the negotiating and lobbying power of national trade unions and professional organisations; third, whether competition between providers leads to higher or lower costs; and fourth, whether any efficiency gains from local bargaining outweight the higher transaction costs involved.

Collective Bargaining↗
PubMed1996

Trade unions and the effectiveness of worker representation in health and safety in Britain.

A feature of British legislation on employee representation in health and safety is its restriction to recognized trade unions. This has made British provisions unique within the European Union. New legislative provisions are under consultation and are likely to widen the existing Safety Representatives and Safety Committees Regulations. The approach of the proposed regulations raises a number of questions about the determinants of effectiveness of worker representation in health and safety that are discussed in this article. The significance of trade union support for representation in health and safety is shown to play an important role in determining the effectiveness of health and safety representatives, both through the role of trade unions within the workplace and through their ability to provide support for representation through training and information. Trends in national economies and employment patterns in Europe mean that trade unions' influence is diminishing, but their supportive role in health and safety representation has not been replaced by any alternative form of employee organization. The proposed new British Regulations are discussed in the light of these observations.

Employment↗