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PubMed1996

Measuring health in injured workers: a cross-sectional comparison of five generic health status instruments in workers with musculoskeletal injuries.

The purpose of this study was to compare the measurement properties of five generic health status measures in a cross-sectional study of injured workers. One hundred twenty-seven injured workers participated in the study. Forty-seven percent had disorders of the upper limb, 12% neck and upper back, and 27% lower back (14% unspecified). All participants completed a package containing: SF-36 (Acute), Nottingham Health Profile (NHP). Duke Health Profile (Duke). Health status section of the Ontario Health Survey (OHS), and the Sickness Impact Profile (SIP). Frequency distributions were examined, correlations carried out, and the ability to discriminate between part of body and overall health state evaluated using analysis of variance. The results showed a ceiling (healthy) effect in the OHS, NHP, and SIP. Correlations were moderate to good. Upper limb subjects appeared "healthier" than low back pain subjects. The instruments were able to discriminate between health states (p < 0.05) except the OHS-Physical function (p = 0.51). Different questionnaires give a different impression of health. Clinicians and researchers should be thoughtful in their selection of outcome measures as different instruments may alter the description, intervention, and priorization of a particular disorder.

Analysis of Variance↗
PubMed2002

How many injured workers do not file claims for workers' compensation benefits?

BACKGROUND: Anecdotal evidence suggests that there are injured workers who do not file for workers' compensation (WC). Several recent studies support this, and we aim to quantify the extent of under-reporting. METHODS: A Canadian survey asked about work injuries in the previous year, and several questions established eligibility for WC and whether a claim had been filed. The proportion of eligible injuries with a claim was estimated. Logistic regression identified predictors of claim submission. RESULTS: Of 2,500 respondents, 143 had incurred an eligible injury, of whom 57 (40%, 95% CI 32-48%) had not filed a WC claim. Severity of injury was the strongest predictor of not claiming. CONCLUSIONS: Survey respondents reported a substantial degree of under-claiming of WC benefits, contrasting with public attention on fraudulent over-claiming. Policy makers should ensure that all relevant parties are aware of their obligations to report work injuries. This will create a more accurate picture of work safety.

Accidents, Occupational↗
PubMed2001

Multiple state hazard models and workers' compensation claims: an examination of workers compensation data from Ontario.

The recurrent nature of some workplace injuries has led some researchers to conclude that the first absence from work does not provide an accurate picture of an individual's claim, or employment history, after a workplace injury. In this paper I estimate a multiple state hazard which estimates the transitions between spells where the individual receives workers' compensation benefits and spells where the individual does not receive any workers' compensation benefits. I apply this model to a sample of claims from Ontario's Workplace Safety and Insurance Board.

Accidents, Occupational↗
PubMed1998

Comparison of workers' compensation costs for two cohorts of injured workers before and after the introduction of managed care.

A comprehensive safety and managed care initiative was instituted in 1991 at a large self-insured medical center in an effort to reduce workers' compensation costs. It features an on-site case management team, a preferred provider organization, and safety engineering efforts and ergonomic controls used proactively to aggressively identify and abate workplace hazards. Two worker populations were followed up longitudinally for three years before and after the initiative. Costs incurred by each cohort were compared. A 50% reduction in total expenditures was seen in the managed care cohort. The hospital component of the system saw a decrease in compensation of 62% for temporary total disability and 38% for permanent partial disability. Medical expenditures decreased 50%. Dramatic reductions in costs are achievable, without compromising quality of care, when managed care principles and safety efforts are emphasized.

Accidents, Occupational↗
PubMed1990

Setting norms in the United Nations system: the draft convention on the protection of the rights of all migrant workers and their families in relation to ILO in standards on migrant workers.

The author reviews the U.N.'s draft proposal concerning the rights of migrant workers and their families. "This article examines the nature and scope of obligations under the United Nations Convention and contrasts them with existing international standards. In the light of the elaboration of the U.N. Convention, the conditions of future normative activities to limit negative consequences of a proliferation of instruments and supervisory mechanisms are outlined." Consideration is given to human and trade union rights, employment, social security, living and working conditions, workers' families, expulsion, and conditions of international migration. (SUMMARY IN FRE AND SPA)

Demography↗
PubMed1992

Responding to the workers' compensation crisis. A proposal on the structure and management of workers' compensation programs.

In 1990 job-related injuries are estimated to have cost American employers over $60 billion in direct workers' compensation expenses, a figure which has doubled in the past four years and which may do so again by 1995. The medical costs of treating work-related injuries and illnesses are estimated to have consumed 41 percent of workers' compensation payouts for 1990, the remainder by indemnity claims costs. Taken together with a 17.1 percent increase in group health care costs in 1990, there is concern for the maintenance of a reasonable business atmosphere under which businesses may remain competitive and prosperous, and employment will be available.

Humans↗
PubMed1988

Railroad workers with pleural plaques: I. Spirometric and nitrogen washout investigation on smoking and nonsmoking asbestos-exposed workers.

Eighty-seven workers exposed to asbestos in a railroad car repair shop, with characteristic asbestos-induced pleural plaques, underwent extensive lung-function examination. Vital capacity (VC) showed the greatest reduction among the static lung volumes, with an asymmetrical distribution of one-fourth of the subjects below 80% of the predicted value. Logistic regression demonstrated VC to be sufficient for optimal discrimination of asbestos-exposed subjects from a group of matched controls. No further discriminatory power was gained by additional spirometric measures, lung mechanics, blood gas analysis, or diffusing capacity. Smoking had an influence on dynamic but not on static lung volumes. In conclusion, reduced static lung volumes among smoking asbestos-exposed workers with pleural plaques should, in the absence of other lung diseases, be mainly attributed to the asbestos exposure.

Adult↗
PubMed1980

Occupational health studies on airport transport workers. II. Muscle strength of airport transport workers.

Airport transport workers do manual work in loading and unloading the cargo space of passenger airplanes. In several types of airplanes the work has to be carried out in narrow spaces and in cramped positions. The present study describes the isometric strength of some muscle groups in 70 airport transport workers. Trunk extensors, trunk flexors, muscles involved in bimanual vertical lifting, elbow extensors, and elbow flexors were measured. A method with fixed positions and strictly isometric contractions was used. The strengths of the different muscle groups correlated with each other and with body weight; those of lifting, trunk flexors and biceps also with stature. The absolute strength of the muscle groups declined with advancing age at rates from 0.3% to 1.5% per year, the relative strength (N/kg body weight) by 0.9%-2.0% per year.

Adult↗
PubMed1995

Bronchial responsiveness decreases in relocated aluminum potroom workers compared with workers who continue their potroom exposure.

We have compared the bronchial responsiveness (BR) of 12 aluminum potroom workers (index group) who were relocated due to work-related asthmatic symptoms (WASTH) and 26 subjects (reference group) with WASTH who continued to work in potrooms. The subjects were examined at regular intervals during a 2-year follow-up period. BR was expressed as the log-transformed dose-response slope [Ln(DRS 5)]. The monthly change in BR (delta BR) in the index group was -4.87 x 10(-2) compared with -1.58 x 10(-2) in the reference group. After adjustment for potential confounders, the difference between the index group and the reference group was -2.39 x 10(-2) (95% CI: -4.07 x 10(-2) to -0.71 x 10(-2)), i.e. 49% of the decrease in BR in the index group could be explained by the removal from exposure. No improvement in lung function was found in the index group compared with the reference group. The results indicate that the removal of potroom workers from exposure causes a decrease in BR.

Adult↗
PubMed1994

Antimicrobial antibodies in Danish slaughterhouse workers and greenhouse workers.

As a consequence of contact with animals and animal products slaughterhouse workers might be at risk of infection with pathogenic microorganisms. This hypothesis has been supported by some earlier studies. In this study 217 slaughtermen and a control group of 113 greenhouse workers were investigated for the prevalence of serum antibodies to Toxoplasma gondii, Campylobacter jejuni (IgA and IgG), Yersinia enterocolitica types 3 and 9, Yersinia pseudotuberculosis types I, II, III, IV, and V, Salmonella typhi, Salmonella paratyphi, Salmonella enteritidis, Salmonella typhimurium, and Borrelia burgdorferi. No significant differences were found concerning either frequency of positive tests or magnitude of titers. The prevalence of toxoplasma antibodies was remarkably high in both groups.

Abattoirs↗
PubMed2001

Are queen Bombus terrestris giant workers or are workers dwarf queens? Solving the 'chicken and egg' problem in a bumblebee species.

In the social bee, Bombus terrestris, the two castes differ in size and physiology, but not in any other morphological and anatomical aspects. The size differences between the castes are the result of longer instar duration in prospective queen larvae. It appears that queen larvae are programmed to have a higher molting weight at the end of the 2nd, 3rd and 4th instars. Calculation of the growth ratio, the ratio between the logarithm of molting weight at two successive instars, revealed that queen larvae have a linear growth ratio over the entire larval development as predicted by Dyar's rule. In the worker larvae, in contrast, linearity of the growth ratio breaks after the second instar, resulting in larval molting at lower weights than expected by Dyar's rule. We therefore suggest that workers' development is abnormally shortened, either by parental manipulation or by adopting a different growth plan in response to the queen's signal.

Animals↗
PubMed1995

Occupational PAH exposure: urinary 1-hydroxypyrene levels of coke oven workers, aluminium smelter pot-room workers, road pavers, and occupationally non-exposed persons in Sweden.

Polycyclic aromatic hydrocarbon (PAH) levels in air, and worker urinary 1-hydroxypyrene levels were studied in a coke oven, a Söderberg aluminium smelter pot-room, and during road-paving. Increased PAH exposure was shown to cause increased 1-hydroxypyrene excretion. Road-paving gave low PAH exposure, but resulted in a detectable elevated urinary 1-hydroxypyrene level. Background urinary 1-hydroxypyrene levels in office workers were determined, and a statistically significant difference between smokers and non-smokers was observed. It is suggested that urinary 1-hydroxypyrene can be used as biological exposure index for PAH exposure.

Air Pollutants, Occupational↗
PubMed1977

Chromosome aberrations and sister-chromatid exchange in workers in chemical laboratories and a rotoprinting factory and in children of women laboratory workers.

Cultured lymphocytes from 73 workers in chemical laboratories and the printing industry were found to have a significantly increased frequency of chromatid and isochromatid breaks, in comparison with 49 control subjects (42 adults and 7 children). An increase of the same magnitude was also found in 14 children, aged 4 days--11 yr, of 11 women laboratory workers who had worked during pregnancy. A significant correlation between age and frequency of chromosome aberrations was noted for both the exposed and control children but not for the adults. The frequency of sister-chromomatid exchange was significantly increased in 12 technicians working in laboratories performing hormone analysis. 4 children of 2 female technicians working during pregnancy also had a significnatly increased frequency of sister-chromatid exchange. The cause and biological significance of these findings are not yet known.

Adolescent↗
PubMed2006

Fear-avoidance beliefs, disability, and participation in workers and non-workers with acute low back pain.

OBJECTIVES: Fear-avoidance beliefs have been shown to be associated with disability and work status in patients with low back pain. Especially in acute low back pain, much research is needed to increase the knowledge concerning the role of fear-avoidance beliefs and its associated avoidance behavior in the influence on disability and the participation in daily and social life activities. The Fear-Avoidance Beliefs Questionnaire is developed to measure such beliefs and has become increasingly popular for use in primary care practice. The aim of the current study was: 1) to investigate the factor structure of the Fear-Avoidance Beliefs Questionnaire in a population of patients with acute low back pain by means of confirmatory factor analysis; 2) to examine the relationship between fear-avoidance beliefs and perceived disability, as well as participation in daily and social life; and 3) to investigate whether perceived disability mediates the association between pain and participation and between fear-avoidance beliefs and participation. METHODS: The study has a cross-sectional design and was performed on a sample of 615 patients with acute low back pain in primary care settings in The Netherlands. Patients completed a visual analogue scale for pain, the Roland Disability Questionnaire, the Fear-Avoidance Beliefs Questionnaire, a sociodemographic questionnaire, and 5 participation items. RESULTS: Confirmatory factor analysis corroborated the 2-factor structure of the Fear-Avoidance Beliefs Questionnaire as found by Waddell et al. Investigation of the association between fear-avoidance beliefs and perceived disability or participation was performed for workers and non-workers separately. The 2 subscales of the Fear-Avoidance Beliefs Questionnaire were significantly associated with perceived disability and participation, although there were differences between the samples. Perceived disability was significantly predicted by pain intensity and fear-avoidance beliefs. Perceived disability significantly predicted participation, and finally, the mediational role of perceived disability was supported. DISCUSSION: In the early stage of low back pain, the reduction of pain and fear-avoidance beliefs might increase the level of activity, which might foster increased participation in daily and social life activities.

Activities of Daily Living↗
PubMed1995

A comparison of substance use rates among female nurses, clerical workers and blue-collar workers.

The issue of impairment of practising professional nurses by alcohol and other drugs has become a critical concern since the 1980s. The literature abounds with conjectures about the large numbers of nurses who are impaired, often without valid data to support the claims that the problem in nursing is greater than it is in the general population. This study reflects an effort to compare the reported substance use of employed female nurses with that of two other groups of working females. Survey data from 920 nurses, 405 clerical workers and 200 females employed in non-traditional trades jobs in two large eastern states in the US revealed that there was little evidence of 'abuse' of any of 15 substances; nurses did not report higher rates of substance use than the other two groups; and most reported substance use occurred in the younger age groups, reflecting the national trend. The need for continuing research efforts and confirmation of valid data, and primary prevention efforts with young female workers, including at-risk student nurses, is made evident.

Adult↗
PubMed2005

Serum markers of collagen metabolism: construction workers compared to sedentary workers.

BACKGROUND: Evaluation of causal relations between physical load and musculoskeletal disorders is hampered by the lack of knowledge as to the biological relevance of different loading parameters and the large variability between individuals. As indicators of molecular changes in the extracellular matrices of structures of the musculoskeletal system, biomarkers of collagen metabolism may provide important information on biological effects of physical load. The carboxyterminal propeptide of type I collagen (PICP) is a serum marker of synthesis and the carboxyterminal telopeptide region of type I collagen (CTx) reflects degradation of type I collagen. AIMS: To explore the feasibility of biomarkers of type I collagen metabolism as measures of the effects of physical load at tissue level. METHODS: Serum concentrations of PICP and CTx were assessed in a group of male construction workers involved in heavy manual materials handling (n = 47) and in a group of male sedentary workers (n = 49). RESULTS: Serum concentrations of both PICP and CTx seemed to be related to heavy physical work. The ratio PICP/CTx, illustrative of the effective metabolic changes, did not differ between the two groups. CONCLUSIONS: The higher turnover rate but similar effective synthesis may be indicative of an increased type I collagen content in the connective tissues as a result of adaptive remodelling in response to years of exposure to physical load. Further validation of these biomarkers is required with respect to dose-response relations and temporal associations between exposure to back load and biomarker concentrations.

Adult↗
PubMed2005

Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney, Australia.

BACKGROUND: This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU) who report engaging in sex work for money or drugs and regular injecting drug users who do not. METHODS: Cross sectional data collected from regular IDU interviewed as part of the New South Wales (NSW) Illicit Drug Reporting System (IDRS) in 2003 were analysed. RESULTS: IDU who reported engaging in sex work were more likely to be female, and identify as being of Aboriginal and/or Torres Strait Islander descent. They initiated injecting drug use at a significantly younger age and were more likely to report injection related problems than IDU who had not engaged in sex work. There were no differences in the drug classes used, but findings suggested that the sex workers tended to be more frequent users of crystalline methamphetamine (ice) and benzodiazepines. CONCLUSION: The similarities between these groups were more striking than the differences. Further research, examining a larger sample is needed to clarify whether injecting drug users who are sex workers have heavier use patterns.

Journal Article↗