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PubMedDate not supplied

Do shoulder patients insured by workers' compensation present with worse self-assessed function and health status?

The purpose of this study was to test the hypothesis that patients whose shoulder problems are covered by workers' compensation insurance perceive worse shoulder function and health status than do comparable patients whose problem is not covered by workers' compensation. Each of 1063 consecutive patients presenting with shoulder problems to an individual consultant completed 2 questionnaires: the Simple Shoulder Test inventory of shoulder function and the Short Form 36 general health assessment. The patients were divided into 2 groups on the basis of whether care of the shoulder problem was covered by injured workers' compensation insurance. The results indicate that patients whose shoulder condition is covered by workers' compensation have significantly lower self-assessed shoulder function and health status than do those patients whose shoulder conditions are not related to on-the-job injuries. The differences between the workers' compensation and non-workers' compensation groups could not be attributed to differences in age, sex, or diagnosis.

Adult↗
PubMedDate not supplied

Green tobacco sickness: occupational nicotine poisoning in tobacco workers.

In this study the authors describe the investigation of a 1992 outbreak of green tobacco sickness, a form of nicotine poisoning from dermal exposure, among 47 tobacco workers in a five-county region of central and south-central Kentucky. Cases were identified through medical record searches at participating hospitals, as well as from reports submitted to the Occupational Health Nurses in Agricultural Communities program. A case-control study was undertaken to assess risk factors for green tobacco sickness. In a 20-min telephone interview, 40 cases and 83 controls responded to questions contained in a questionnaire. In 1992, 47 persons (3 were under age 16 y) in the study region sought medical treatment for green tobacco sickness. Twelve persons were hospitalized and 2 required intensive-care treatment. The crude incidence in 1992 was 10.0/1,000 tobacco workers. In 1993, 66 cases (7 were under age 16 y) of green tobacco sickness were identified in the study region (i.e., annual incidence of 14.0/1,000). A case-control study demonstrated that ill workers were younger, and were more likely to have worked in wet conditions, compared with workers who were not ill. Green tobacco sickness is a common problem among tobacco workers that may be prevented by avoiding work in wet tobacco or by use of protective clothing. Children younger than 16 y of age represented 9% of the green tobacco sickness cases in 1992 and 1993. Current occupational safety and health laws do not address protection of tobacco workers with respect to green tobacco sickness.

Adolescent↗
PubMed1985

Monitoring study of urinary metabolites and selected symptomatology among Florida citrus workers.

A cross-sectional monitoring study was made of citrus fieldworkers employed during an entire citrus growing season in Florida. A survey questionnaire was administered to 1811 fieldworkers employed as applicators, mixers, loaders, tractor drivers, general combination workers, and pickers on 436 citrus groves throughout Florida. The study was designed to evaluate exposure to organophosphorus pesticides by analyzing the urine of citrus fieldworkers for dimethyl phosphate (DMP), dimethyl thiophosphate (DMTP), dimethyl dithiophosphate (DMDTP), diethyl phosphate (DEP), diethyl thiophosphate (DEPT), and diethyl dithiophosphate (DEDTP), and to relate the findings to the reported occurrence of selected health symptoms associated with pesticide intoxication. Urine samples were collected for analysis from 332 spray-season workers and 265 harvest-season workers. Measurable DEP residue values were found in 68% of the spray season workers and 43% of the harvesters. However, with the exception of DEP and DETP values in the urine of spray-season workers, metabolite residues were low, often at, or just above, detection limits (which were usually 0.02 ppm but occasionally rose higher, with a few at 0.03 ppm and a very few at 0.04 ppm). Although there was clearly exposure to organophosphates among the citrus fieldworkers, there was no apparent association between the reported health symptoms and the relatively low levels of organophosphate metabolites found in the urine of the workers.

Agricultural Workers' Diseases↗
PubMed2006

Physical fitness, absenteeism and workers' compensation in smoking and non-smoking police officers.

BACKGROUND: Employers seek to minimize business costs by creating conditions of employment. Relying on the presumably negative effects of smoking on variables such as workers' compensation claims, absenteeism and physical fitness scores, they seek a rational basis for requirements that employees refrain from smoking. No research has been found on police officer smoking rates relating to physical fitness, and the resulting economic variables of workers' compensation claims and absenteeism rates. AIMS: To compare police officer non-smoker and smoker physical fitness, absenteeism rates and workers' compensation claims. METHODS: The sample included 514 officers of a metropolitan police department. A physical fitness test was administered. Smoking status, yearly absenteeism rates and workers' compensation claims were collected. RESULTS: Male smokers were significantly older than non-smokers. An analysis of covariance controlling for sex and age indicated that smokers had significantly (P < or = 0.05) lower fitness scores in sit and reach flexibility, sit-ups endurance, bench press strength and bicycle ergometer cardiovascular endurance. When neither age nor sex was controlled in males, a similar trend continued. However, in females only the sit and reach and sit-up tests demonstrated statistically significant differences. Fat percentage, step-test scores, absenteeism rates and workers' compensation claims were not statistically different. CONCLUSION: These data do not provide a rational basis for the requirement that officers refrain from smoking when considering body fat and the economic savings of lower absenteeism rates and workers' compensation. To some extent, smoking policies can be justified by officers' physical fitness but there are age, gender and test protocol considerations.

Absenteeism↗
PubMed1988

Components and modifiers of the healthy worker effect: evidence from three occupational cohorts and implications for industrial compensation.

The authors examined the components and modifiers of the healthy worker effect using mortality data from three occupational cohorts: the employees of Atomic Energy of Canada Limited followed between 1950 and 1981, a 10% sample of the Canadian labor force followed between 1965 and 1979, and workers at the Eldorado Resources Limited Beaverlodge uranium mine followed between 1950 and 1980. Two important components of the healthy worker effect have been identified in these cohorts, namely, initial selection of and continuing employment of healthy individuals. There is less evidence for a contribution from the existence of differential risk factors among employed individuals as compared with the general population. The healthy worker effect is, however, substantially modified by time since employment, sex, age, specific cause of death, and specific occupation. Because of this variation, it is inappropriate to account for the healthy worker effect by a single parameter, and all of the above factors must be taken into account in any appropriate analysis. When the only available comparison group for an occupational cohort is the general population, the healthy worker effect is unlikely to have any substantial influence on the process of assessing causality for any observed association or attributing cause in an individual case. This would be particularly true for cancer, and even more so for lung cancer, a disease often associated with industrial compensation cases.

Adolescent↗
PubMed2005

Field testing of the ACCESS materials: a portfolio of materials to assist health workers to identify children with disabilities and offer simple advice to mothers.

Children in less-developed countries with mild to moderate disabilities often remain unidentified until school age. Delayed identification leads to less successful interventions for most children and risks secondary disabilities. The disability group at the Centre for International Child Health was funded to address this issue by developing a screening portfolio. The field testing of this portfolio is reported here. The results collected through quantitative analysis of the children brought for screening, and the fact that the field workers identified disabilities in children over the age of 2 years with over 82% accuracy when compared with professionals, suggests that health workers can be taught to use the portfolio effectively. Among younger children the accuracy is poorer. Field workers can additionally be trained to give advice to mothers and/or refer where appropriate. Equally important, results from focus group discussions with both health workers and parents, and questionnaires to health workers, demonstrate that both groups found the process clear and useful. Parents liked the process and found the advice materials helpful. Several health workers made comments about how the portfolio's use helped to develop positive attitudes towards disability and improved their own self-confidence.

Child, Preschool↗
PubMed2000

Epidemiology of work-related burn injuries: experience of a state-managed workers' compensation system.

BACKGROUND: Population-based incidence rates of work-related burn injuries and associated risk factors specific to anatomic sites and degree of burn are not known. METHODS: Using a state-managed workers' compensation database, we estimated incidence rates of work-related burn injuries and identified high-risk occupations and associated exposures. RESULTS: The annual incidence rate of occupational burn was 26.4 per 10,000 workers, with the highest rate observed in the manufacturing sector for males and in the service sector for females. Welders, cooks, laborers, food service workers, and mechanics had higher incidence rates of burn injury compared with other occupations. Wrist and hand burns accounted for a majority of burn injuries, with females experiencing greater incidence of these distal upper extremity burns (8.9 in females and 6.7 in males per 10,000 workers, respectively). Third-degree burns (incidence rate, 1.3 per 10,000 workers) were also most frequently observed in the upper extremities compared with other anatomic sites. The majority of wrist and hand burns were caused by hot liquids/ objects, whereas the majority of eye burns were associated with chemical exposures. Younger cooks and food service workers were at greater risk of burn than older coworkers. CONCLUSION: Specific occupations are associated with degree of burn, anatomic site, and exposures. This information will be useful for targeted intervention among high-risk occupations and work groups.

Adolescent↗
PubMed1999

Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project II: medical and disability costs.

OBJECTIVES: This study examined the effect of managed care on medical and disability costs as part of an evaluation of the Washington State Workers' Compensation Managed Care Pilot (MCP). METHODS: One hundred twenty firms (7,041 employees) agreed to have their injured workers treated in managed care plans. Managed care introduced two changes from the fee-for-service (FFS) delivery system currently used by injured workers in Washington State: experience- rated capitation and a primary occupational medicine delivery network. The FFS control group included injured workers employed at 392 firms (12,000 employees). Medical and disability costs were compared for 1,058 injuries in the managed care group and 1,159 injuries in the FFS group occurring between April 1995 and June 1996. Univariate and multivariate statistical methods were used to analyze the effects of managed care on medical and disability costs. RESULTS: The mean unadjusted medical cost per injury ($587) for the managed care group was 21.5% lower (P = 0.06) than for the FFS group ($748). Adjustment for differences in worker and firm-level characteristics through multivariate analysis had little effect on the unadjusted results, except that the difference in costs between managed care and FFS groups became statistically significant (P<0.01). The major cost differences were for outpatient surgery (cost per surgery) and ancillary services (pharmacy, x-ray, physical therapy, and all other costs). In addition, disability costs, particularly percent on time loss and time-loss cost per injury, were significantly lower (P<0.01) in the managed care group. CONCLUSIONS: The results from the MCP suggest that substantial savings in workers' compensation medical and disability costs may be realized using the type of managed care intervention designed for this study. Delivering occupational health services through managed care arrangements whose design is based on an integrated, occupational health-centered delivery model may offer a viable approach for improving delivery systems, reducing costs and encouraging greater attention to disability prevention.

Adult↗
PubMed1984

Assessment of workers' compensation claims for back strains/sprains.

Workers' compensation claim data for 1979 obtained from the Bureau of Labor Statistics' Supplementary Data System (SDS) were utilized to examine the demographic and occupational incidence of back strains/sprains among U.S. industrial employees covered by state compensation systems. These data were combined with estimated employment figures to provide incidence ratios, which allowed better approximations of industry- and occupation-specific risk. Industries found to have the largest incidence ratios were construction (1.6 claims/100 workers) and mining (1.5 claims/100 workers). Occupations with the largest ratios were miscellaneous laborers (12.3 claims/100 workers) and garbage collectors (11.1 claims/100 workers). The 285,468 compensation claims due to back strains/sprains filed in the 26 SDS states in 1979 suggest that back injuries continue to be a large and costly problem for U.S. workers and their employers.

Adolescent↗
PubMed1986

Biological monitoring of agricultural workers exposed to pesticides: I. Cholinesterase activity determinations.

An estimated 4 to 5 million persons work in agriculture; within this sector, mixers, loaders, applicators, and other workers who directly handle agricultural chemicals are at highest risk for pesticide-related illnesses. Among field workers, seasonal workers engaged in certain cultivation and harvesting operations are also at risk of exposure to pesticide residues. Biological screening for agricultural workers is limited at present to pesticide mixers, loaders, and applicators, and consists almost exclusively of measurements of cholinesterase activity to estimate inhibition by organophosphate and carbamate compounds. We review here the measurement and interpretation of cholinesterase activity in occupationally exposed populations and the correlation between cholinesterase activity and symptoms of acute and chronic illness among agricultural workers. The only state to mandate medical surveillance for agricultural workers is California: criteria for surveillance, baseline cholinesterase determination, periodicity of testing, and criteria for removal from and return to work are described, and alternative approaches for screening and clinical evaluations are discussed.

Adult↗
PubMed2001

Modified work: prevalence and characteristics in a sample of workers with soft-tissue injuries.

Modified-work programs are designed to facilitate the return to work for employees with a work-related injury. Although extensive published literature exists that describes and evaluates "ideal" programs, to date there is a paucity of data describing practice. To address this pertinent issue, we administered a survey to a large sample of 1833 workers with soft-tissue injuries in Ontario, Canada, and asked them detailed questions about modified work and employer contact. Our results reveal that most workers (66%) were contacted by someone from their workplace to check on how they were doing. However, only a minority (36%) were offered arrangements by their employer to help them return to work after developing a work-related soft-tissue injury. Most arrangements that were offered to injured workers consisted of such temporary modifications as reduced hours (24%), flexible work hours (25%), or a lighter job (57%) rather than more permanent changes to the way that work is conducted, such as changes to the work layout or equipment (8%). Merely being contacted by the workplace to check on how the worker was doing was not associated with reduced compensation benefit duration. Workplace offers of arrangements to help the worker return to work were associated with reduced compensation benefit duration but were not statistically associated with workers' pain grade.

Disability Evaluation↗
PubMedDate not supplied

An analysis of occupational burn injuries in Rhode Island: workers' compensation claims, 1998 to 2002.

Occupational burns have been determined to be a serious public health concern. The analysis of workplace risks and risk factors associated with burns are critical to developing effective interventions in the future. In this study, we examined accepted Rhode Island workers' compensation claims (n = 5619) from 1998 to 2002 to assess the rates and risks of occupational burns. We used employment data from the Department of Labor's Current Population Survey (CPS) to estimate claim rates and shift analyses. The overall burn rate was estimated to be 24.3 per 10,000 workers. The claim rate for workers younger than 25 years of age was almost double that for all other age groups. The average per-claim disability duration for claims requiring indemnity was 167.9 days, and average annual total cost of claims was dollar 1,010,166. The highest claim rate identified was for workers in food service occupations and an increased risk was found for chemical burns among evening and night-shift workers. Increased interventions are needed to reduce occupational burns in work settings. Particular diligence should be should address occupational burn hazards in restaurant establishments, and preventative should be measures aimed at young employees and late-shift workers.

Accidents, Occupational↗
PubMed2003

Comparison of the Roland-Morris Disability Questionnaire and generic health status measures: a population-based study of workers' compensation back injury claimants.

STUDY DESIGN: Workers' compensation back injury claimants completed baseline and follow-up telephone interviews in a prospective population-based cohort study. OBJECTIVE: To compare the Roland-Morris Disability Questionnaire (RDQ) to widely used generic health status measures in a sample of workers with recent work-related back injuries in terms of validity, reliability, responsiveness to change, and floor and ceiling effects. SUMMARY OF BACKGROUND DATA: Little research has directly compared the validity and responsiveness of the RDQ to that of the Short-Form 12 or Short-Form 36 health status measures among individuals with back pain. Furthermore, there is little information concerning the validity, reliability, and responsiveness of the RDQ as a measure of functional outcomes for workers with back injuries. METHODS: Approximately 8 weeks (median) after filing low back injury claims, 309 workers completed the RDQ, Short-Form 12, and Short-Form 36 scales and gave information about their work status in computer-assisted telephone interviews. An average of 5 months later, 284 workers (91.9%) completed the measures again. RESULTS: The RDQ demonstrated excellent internal consistency and validity through correlations with other measures of physical functioning, ability to discriminate between those working and those not working, and much more responsiveness to change than the Short-Form 12 and Short-Form 36 scales. However, 15% of the sample did not answer one or more RDQ items. CONCLUSIONS: The RDQ is a valid measure of physical disability among workers with back injuries. Its greater responsiveness to change suggests its superiority to the Short-Form 12 and Short-Form 36 as an outcome measure in this population.

Adolescent↗
PubMed2003

Prostate cancer risk in California farm workers.

Previous studies have evaluated prostate cancer in farm-working populations and most, although not all, have found an elevated risk of this cancer in farmers and farm workers. Specific occupational risk factors have not been identified. A nested case-control study of prostate cancer was conducted within a large cohort of a predominantly Hispanic labor union in California, the United Farm Workers of America. By conducting an electronic record linkage between a roster of the union members and the California Cancer Registry for the years 1988 through 1999, newly diagnosed cases of prostate cancer were identified within the union. Age-matched controls were randomly selected from the remainder of the cancer-free cohort. Risk for prostate cancer was examined by examining the type of crops and commodities cultivated by the farm workers as well as by the date of first union activity and duration of union affiliation. In addition, the risk of prostate cancer was evaluated in association with use of several pesticides recorded by the California Department of Pesticide Regulation. Between 1988 and 1999, 222 newly diagnosed prostate cancer cases were identified for analysis and 1110 age-matched controls were selected. The risk of prostate cancer was not associated with patterns of employment in any crop/commodity. Increasing duration of union affiliation was associated with decreasing prostate cancer risk. Although risk was not associated with total pounds of pesticides applied in the years and counties where farm workers were employed, risk was increased with specific chemicals, including simazine, lindane, and heptachlor, and suggestive increases were observed with dichlorvos and methyl bromide. We concluded that Hispanic farm workers with relatively high levels of exposure to organochlorine pesticides (lindane and hepatachlor), organophosphate pesticides (dichlorvos), fumigants (methyl bromide), or triazine herbicides (simazine) experienced elevated risk of prostate cancer compared to workers with lower levels of exposure.

Aged↗
PubMed1990

Respiratory and immunological reactions among Shiitake (Lentinus edodes) mushroom workers.

Four workers, the total work force employed at a Shiitake farm, developed cough and sputum production following a variable period of exposure to Shiitake mushrooms. All four had abnormal diffusing capacity and three had abnormal spirometry values. Chest roentgenograms demonstrated an interstitial pattern in one worker. Pulmonary function tests performed before and during several days of work demonstrated a significant decrease (greater than 20%) in forced vital capacity (FVC) and/or maximal mid-expiratory flow (MMEF) in three workers. Although specific antibodies to an extract of Shiitake spores were detected in sera from three workers none were IgE. High levels of Shiitake spores were detected in growing rooms (greater than 10(6)/m3) as well as other locations at the farm. Shiitake spore airborne antigen, detected by an immunochemical assay, was present in dust collected with a volumetric sampler from different locations at the farm. Antigenic determinants of Shiitake spore antigens, in common with antigens from other cultivated mushrooms (Agaricus and Pleurotus) were demonstrated by ELISA inhibition assay. This study demonstrates that workers exposed to high levels of Shiitake spores develop symptoms and laboratory findings suggestive of hypersensitivity pneumonitis (HP). Strict environmental control and the wearing of a face mask is probably needed to reduce the high risk of sensitization and possible development of immunological lung disease. Shiitake spores must be considered as an aetiological agent of mushroom workers' lung.

Agricultural Workers' Diseases↗
PubMed2004

Use of mechanical patient lifts decreased musculoskeletal symptoms and injuries among health care workers.

OBJECTIVE: To evaluate the effectiveness of mechanical patient lifts in reducing musculoskeletal symptoms, injuries, lost workday injuries, and workers' compensation costs in workers at a community hospital. DESIGN: Pre-post intervention study. SETTING: Three nursing units of a small community hospital. Patients or SUBJECTS: Nursing personnel. INTERVENTIONS: Mechanical patient lifts were made available and nursing staff trained in their use between August 2000 and January 2001. MAIN OUTCOME MEASURES: Workers completed symptom surveys at baseline and six months after lift training. Pre-intervention and post-intervention rates of injuries and lost workday injuries using Occupational Safety and Health Administration logs of the three study units, from the period July 1999 through March 2003 were analyzed. Injuries potentially related to lifting patients were included in the analyses. Using workers' compensation data from the same time period, the compensation paid ($ per full time equivalent [FTE]) due to injuries during the pre-intervention and post-intervention period was calculated. RESULTS: Sixty one staff members were surveyed pre-intervention; 36 (59%) completed follow up surveys. Statistically significant improvements in musculoskeletal comfort (p<0.05) were reported for all body parts, including shoulders, lower back, and knees. Injury rates decreased post-intervention, with a relative risk (RR) of 0.37 (95% confidence interval (CI) 0.16 to 0.88); decreased injury rates persisted after adjustment for temporal trends in injury rates on non-intervention units of the study hospital (RR = 0.50, 95% CI 0.20 to 1.26). Adjusted lost day injury rates also decreased (RR = 0.35, 95% CI 0.10 to 1.16). Annual workers' compensation costs averaged $484 per FTE pre-intervention and $151 per FTE post-intervention. CONCLUSION: Reductions were observed in injury rates, lost workday injury rates, workers' compensation costs, and musculoskeletal symptoms after deployment of mechanical patient lifts. Strengths of this study include the community hospital setting and the inclusion of a variety of different outcomes. Limitations include the pre-post study design and the small sample size.

Hospitals, Community↗
PubMed1993

High mortality in lower salaried Norwegian men: the healthy worker effect?

STUDY OBJECTIVE: This study aimed to examine whether the high mortality in lower salaried men in Norway was related to an inflow into this group of unskilled workers with high mortality. DESIGN: Individual information on occupation was derived from the 1970 and the 1980 censuses and linked to mortality data for the period 1980-5 by the official, individual identification numbers. PARTICIPANTS: The study population included Norwegian men aged 20-64 years in 1980. All men enumerated in the 1980 census (and who were registered in the 1970 census) within the two occupational groups, unskilled workers and lower salaried employees, were included. MEASUREMENTS AND MAIN RESULTS: The subjects were allocated to the two occupational groups according to the official Norwegian classification of socioeconomic status. Mortality was measured by standardised mortality ratios (SMR). The findings suggest that a fairly large number of unskilled workers with high mortality move into the lower salaried employee group. This transition produces a higher SMR in lower salaried employees and, simultaneously, an artificially but modestly lower SMR in unskilled workers. The difference in SMR between the two groups is thereby exaggerated by 44%. The difference among the elderly was smaller. CONCLUSION: Occupational mobility consistent with "the healthy worker effect" increases the SMR of lower salaried men and, at the same time, reduces slightly the SMR of unskilled workers.

Adult↗
PubMed1988

Forestry workers exposed to vibration: a neurological study.

Neurological findings were examined in 186 forestry workers with a mean exposure to chain saw vibration of 16.6 hours. The prevalence of active vibration induced white fingers was 5%, parethaesias of the hands 53%, and muscle weakness 13%. Clinical polyneuropathy was observed in 16 forestry workers in the hands (7.5%) which did not correlate with alcohol consumption. Seventy nine forestry workers of the total population were selected for electromyographic examination. Generalised EMG based polyneuropathy in the hands was observed in only two of the 79 forestry workers (2.5%). The carpal tunnel syndrome was found in 20 of the 79 forestry workers (26%). Headache and vertigo were not linked with exposure to vibration in forestry and a significant part of the numbness reported may be due to the carpal tunnel syndrome. Sensorimotor polyneuropathy is rare among forestry workers. The rise in the vibration detection thresholds was linked to the carpal tunnel syndrome.

Adult↗