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PubMed1999

Health reasons for leaving the profession as determined among Finnish hairdressers in 1980-1995.

BACKGROUND: Selection into and out of a profession is a known phenomenon in jobs such as hairdressing, in which the workers are exposed to agents and conditions capable of causing work-related symptoms and diseases. OBJECTIVE: To assess the risk for departure from the profession due to health and other reasons among hairdressers as compared with women engaged in commercial work. METHODS: We used a self-administered questionnaire to provide data on 3484 female hairdressers and 3357 referents with regard to their reasons for leaving the profession during the 15-year follow-up period of 1980 1995, for which the relative risks (RR) and 95% confidence intervals (CI) were calculated. The data were collected in August 1995. RESULTS: Of the reasons studied, only the concern for health increased the risk of leaving the profession (RR 1.33; 95% CI 1.16-1.52) among hairdressers. The risk of hairdressers having to leave the profession (1) because of asthma or hand eczema was 3.5 times as great as that found among the control group, (2) because of a strain injury of the wrist or elbow was 2.7 times as great, and (3) because of diseases of the neck or shoulders was 1.7 times as great. The risk of leaving the profession was approximately 20% higher for hairdressers who had suffered at some point in their lives from an atopic disease. CONCLUSIONS: Hairdressers suffering from atopic diseases, hand eczema, and strain injuries of the elbow and wrist are at higher risk of leaving the profession. Active modes of intervention are needed to maintain their working ability. The tools available in the occupational health service are: information on hazards, optimization of working conditions, personal protection, and timely medical care and rehabilitation.

Adult↗
PubMed1998

Allergic responses to pollen of ornamental plants: high incidence in the general atopic population and especially among flower growers.

BACKGROUND: The incidence of allergy to pollen of ornamental plants has not been deeply investigated, and its extent has remained obscure. Most of such studies have concentrated only on pollen of ornamental plants from the Asteraceae family (Compositae). In this study an attempt was made to clarify whether various other ornamental plants may also cause skin responses and allergic symptoms among allergic urban dwellers and among rural flower growers. METHODS: Two hundred ninety-two patients were referred for allergic evaluation by their primary physicians; 75 flower growers and 44 university students were evaluated. For all participants, a detailed health record was obtained, and skin prick tests (SPTs) were performed. Extracts for SPTs included commercial common airborne allergens and autochthonous pollen extracts of 11 species of plants belonging to the Asteraceae, Ranunculaceae, Liliaceae, Scrophulariaceae, and Genetianaceae families. RESULTS: Fifty-one of the 292 patients (17%) referred for allergic evaluation had positive SPT responses to pollen of various ornamental plants. A similar incidence was found among the students (23%). However, the incidence among flower growers was significantly higher, reaching 52%. Higher incidence (83%) of positive SPT responses to ornamental plants was found among flower growers also sensitive to the common allergens. All the tested plants, not only those belonging to the Asteraceae family, provoked positive SPT responses in all 3 groups of participants. None of the participants from the general population or the group of students reported exacerbation of allergic symptoms on exposure to the tested plants. In contrast, almost half of the flower growers (45%) described nasal, ocular, or respiratory symptoms associated with occupational exposure to the tested plants. Some 15% of the growers were eventually compelled to change their profession. CONCLUSIONS: The incidence of positive SPT responses to ornamental plants was 17% to 23% among the general public but 52% among flower growers. Thus the effects of ornamental plant pollen on atopic patients should be seriously contemplated.

Adolescent↗
PubMed2002

Outcome after chronic sciatica as the only reason for lumbar microdiscectomy.

There are only a few long-term studies on microsurgical disc operations, and none concentrated on long-term follow-up of therapy-resistant sciatica. A total of 258 patients whose only neurologic symptoms were sciatica were included in this study. Patients were operated on between 1990 and 1997. All outcome results have been performed by an independent reviewer. The mean follow-up period was 7.3 years (range 4-11 years). At follow-up 25% of the patients were free of pain, 66% demonstrated marked improvement, and 9% had either no improvement or worsening of pain. At follow-up 65% of the patients reported returning to their original occupation or being able to go into retirement without hindrance. A total of 15% required changing of profession following discectomy (75% of these patients applying for early retirement were rejected), 6% were incapacitated and unable to work, and 14% were forced into early retirement. Patients with a history of sciatica longer than 3 months acquired failed back surgery syndrome considerably more often than those <3 months (p = 0.005).

Adult↗
PubMed1981

The reduction of occupational stress among elderly lawyers: the creation of a functional niche.

The question of how older lawyers function in the context of what is generally a high stress occupation is examined from data drawn from a random stratified sample of 130 members of the legal profession. It is shown that elderly lawyers are able to reduce work stress (largely deriving from volume, responsibility, clients, and trials) by control over the quantity and focus of their work, as well as through client selection. Elderly lawyers are able to create a relatively stress free work role, which is in fact a functional niche for them within the profession. The result is high job satisfaction and low rates of retirement among elderly practitioners. Two factors: work role compensation and work role autonomy, are isolated from the legal data and proposed as important variables in a general theory of retirement behavior.

Adaptation, Psychological↗
PubMed1984

Nontherapeutic opiate addiction in health professionals: a new form of impairment.

Case studies describe a new type of addicted health professional whose opiate abuse originated recreationally . Historically, health professionals have had high rates of opiate addiction, usually viewed as an occupational hazard stemming from access and from self-treatment for pain or stresses of the medical profession. Partly because addiction in health professionals was almost always therapeutic (iatrogenic) or quasi-therapeutic (stress-related), it affected them less severely than it affected heroin addicts, whose drug abuse usually began recreationally . Now, however, because recreational drug abuse has become commonplace at American colleges since the mid-1960s, a majority of young health professionals have histories of abusing drugs and some are becoming non-therapeutically addicted. Six case studies describe this new addict type, showing how the subjects went from heavy soft drug use to opiate addiction, experienced severe longterm effects, were treated by society, and responded to treatment.

Adult↗
PubMed1991

Ethics and the scientist.

Ethical issues are receiving considerable attention in the scientific community just as in other areas of society. Scientists who have in the past been accorded a select position in society are no longer guaranteed that status just by virtue of their occupation. Science, and scientists, may not yet be subject to the same intense scrutiny as some other professions, but the trend is evident. Scientists do have special obligations due to the nature of their profession, yet incidences of indiscretion are documented. Expectations of scientists in specific areas such as consulting, animal rights, and advocacy are discussed, and some thoughts on the scientist as an administrator are presented. A short summary of actions being taken in the field of ethics is included.

Administrative Personnel↗
PubMed1982

A report on the AANA Manpower Study--Part I.

Future reports to be released by the Center for Cybernetic Studies will present the occupational structure of the nurse anesthetist and will combine demographic data with a task analysis of the profession. This report has selected some variables of interest and analyzed them. Most important, however, is the intended flexibility that this data based information system should offer. For example, human resource modeling will forecast the number of nurse anesthetists who remain in or leave a given region. This modeling capability could aid schools of anesthesia in their curriculum planning by showing which tasks are predominant in a given location. It could also aid members by providing pertinent employment information. Future reports will present a scenario to exemplify how a data based information system can derive a series of human resource models. The purpose of such an exercise is to develop for the AANA the planning methods some of the larger corporations are already utilizing. The difference, of course, is that these planning methods could be used by the professional association of nurse anesthetists for the advantage of its members. This article has presented a short review of the Manpower Study. We welcome your ideas and suggestions to aid us in making future analyses of this information.

Anesthesiology↗
PubMed1997

[Spinal diseases in the nursing profession--a cross-sectional study].

A cross-sectional study on the profession-specific prevalence rates of back pain symptoms was conducted including N = 3332 nurses as the exposed group and N = 1720 office clerks as a control group. Only participants who had never changed from an exposed to an unexposed profession or vice versa, were included for the results presented here. Severity of symptoms was assessed, dividing into low back pain on the one hand, and lumbago-sciatica/sciatica on the other; frequency of pain episodes was measured using lifetime- and point-prevalence, in all these four combinations of severity and frequency the prevalence rates among nurses were clearly and significantly higher. Multivariate analyses revealed that profession is the most important risk factor among many others that were tested. Estimation of the prevalence rate for the heaviest symptom, the point-prevalence of lumbago-sciatica/sciatica, showed that about 4 out of 5 cases among nursing staff can be attributed to their profession. On the background of this high attributable risk the acceptance rate for LBP diseases of suspected occupational origin among nursing staff by statutory occupational health insurance bodies appears much too low.

Adult↗
PubMed1976

Unaccepted applicants to medical school as a health resource.

The career decisions of national samples of male and female unaccepted applicants to the 1971-72 entering U.S. medical school class are studied in order to determine whether the increasing number of unaccepted applicants is a potential manpower pool for alternative health occupations. The dominant response to rejection among respondents is reapplication to medical school in subsequent years, and the principal determinant of reapplication is receiving postrejection support (usually from family or friends) of the original career intentions. Most of the respondents who do not gain admittance to medical school on reapplications still aspire to doctoral-level degrees, but only half remain in the health area. Those respondents who had formulated contingency career plans in the professions and who had high science aptitude but low math aptitude tended to remain in the health area. A service orientation toward occupations is not associated with remaining in the health area.

Career Choice↗
PubMed1991

[Risk factors of ischemic heart disease in various occupational groups. II. Complex analysis of risk factors].

Four hundred four men aged 30 to 59 years, belonging to one of 4 occupational groups were investigated in a standard clinical conditions. Two from those groups were characteristic for steel mill professions: 121 blast furnace workers; exerting strenuous physical effort and working in hot microclimate. 131 operators (the second group) performed work in comfort microclimate conditions not demanding much effort. The third group comprised 73 executives of industry. The fourth group consisted of 79 monks. For all subjects of investigations 8 selected risk factors of ischemic heart disease were evaluated. They included: age, sex, family history, habit of smoking, systolic blood pressure, fasting blood cholesterol level, obesity index and professional physical activity. The level of each risk factor had numerical value in a span from "0" to "8". The sum of all points was decisive to which of 3 groups of risk given man should be accounted. Those 3 groups were arbitrary divided into "low, intermediate and high risk". The highest risk was found for the executives group, and the lowest for blast furnace workers. From the risk factors under investigation highest overall influence on incidence of ischemic heart disease had habit of smoking and obesity. Described here point classification system seems to be very simple and useful for estimation of risk of ischemic heart disease in a given population.

Adult↗
PubMed1986

Compensation for occupational disease with multiple causes: the case of coal miners' respiratory diseases.

Many diseases associated with occupational exposures are clinically indistinguishable from diseases with non-occupational causes. Given this, how are fair decisions made about eligibility for compensation? This problem is discussed in relation to the federal black lung program. Conflicting definitions of terms--coal workers' pneumoconiosis as defined by the medical profession, pneumoconiosis as defined by the United States Congress, and the popular term, black lung--are important considerations in this discussion. Each is embedded in different logical interpretations of the causes of occupational disease and of disability. Alternative views are presented and critically discussed.

Bronchitis↗
PubMedDate not supplied

Randomized controlled trials to investigate occupational therapy research questions.

The randomized controlled trial (RCT) has become the most widely accepted research design for testing the efficacy of health care interventions. The purposes of this paper are to (a) introduce the essential elements of RCTs, and (b) discuss some of the special problems faced by occupational therapists in conducting and interpreting RCTs. The CONSORT (Consolidated Standards of Reporting Trials) statement is recommended as an introduction to the components of RCT quality. Problems pertinent to the study of the efficacy of occupational therapy and related interventions include the importance of: theory, background, and rationale; treatment fidelity; theory-based outcomes; management of non-masked (non-blinded) interventionists and participants; and multiplicity of statistical analyses. This paper can help practitioners judge the quality of an RCT, and it can help the profession work toward the development of a cadre of qualified researchers who can adapt the well-established methods of RCTs to the study of occupation-based interventions.

Evidence-Based Medicine↗
PubMed1992

Cross-cultural occupational therapy: a critical reflection.

In the Netherlands, Dutch health care professionals, including occupational therapists, are confronted with a growing number of patients whose cultural backgrounds differ from theirs. Acknowledging this influx, the Dutch government allocated a grant for educating occupational therapy students on cross-cultural care. This paper summarizes the information we collected from a survey of Dutch occupational therapists on treatment of immigrants and briefly describes the eight educational tools we developed for the two occupational therapy curricula. Two of these tools are described fully--first, a critical essay on the white middle-class values and norms that underlie occupational therapy theory and practice, and second, the guidelines for developmental policies to use in the treatment of immigrant patients. Case studies illustrate how the values of our profession create obstacles to cross-cultural care.

Clinical Protocols↗
PubMed2005

Henry Smyth Jr. award lecture--occupational exposure limits: do we need them? Who is responsible? How do we get them?

The Henry F. Smyth Jr. Award is presented to an individual who has recognized the needs of the industrial hygiene profession and has made major contributions to fulfill those needs, thereby contributing to the improvement of the public welfare. The American Academy of Industrial Hygiene (now the Academy of Industrial Hygiene) established the Henry F. Smyth Jr. Award in 1981. Henry F. Smyth Jr. was a dedicated teacher and a productive researcher whose projects enhanced the profession. This year's Award was presented to Harry Ettinger, CIH, PE, at the 2004 Professional Conference on Industrial Hygiene (PCIH) in Montreal, Canada.

Awards and Prizes↗
PubMed1998

Occupational social work for the 21st century.

Economic restructuring and radical changes in welfare policy are causing increasingly severe employment dislocation and disadvantage among many urban residents, particularly women, members of racial and ethnic minority groups, and youths. Despite the profession's historic commitment to poor people, little advanced social work practice is reported in work-enhancement programs. This article outlines employment-related needs among poor people in the context of economic and policy change. A brief discussion of successful work programs and traditional occupational practice frames the reformulation suggested in the article. Role definitions, settings, and skills needed for expanded occupational social work practice are followed by implications for social work.

Employment↗
PubMedDate not supplied

COTA to OTR: factors influencing professional development.

OBJECTIVE: This pilot study examined factors that influenced the pursuit of a professional educational degree by certified occupational therapy assistants (COTAs) seeking to become registered occupational therapists (OTRs). METHOD: Questionnaires were distributed to 92 COTAs attending a weekend professional occupational therapy education program. RESULTS: Although the stressors on these students were many, the depth and breadth of motivators, resources, and supports and the availability of weekend classes enabled this group of COTAs to pursue their professional development goal. Enabling the pursuit of professional degrees while working was viewed by the participants as essential to their professional development and career mobility. RECOMMENDATIONS: Strategies for meeting the diverse needs of COTAs and other nontraditional adult students seeking a professional degree in occupational therapy are identified and need to be supported by educators and practitioners. An increased appreciation of the challenges faced by these students and the development of innovative programming to meet their educational needs will strengthen the profession's ability to recruit and retain diverse, competent practitioners.

Adult↗
PubMed1995

A national survey of admissions criteria and processes in selected allied health professions.

A national survey of admissions criteria and procedures was conducted for allied health programs in diagnostic medical imaging, health information management, nurse-midwifery, occupational therapy, physical therapy, and physician assistant education. From a sample of 462, 63.2% responded. The survey canvassed general program information, prerequisites, admissions procedures, and demographic trends. Respondents were primarily from public institutions with faculty actively involved in admissions. The most common prerequisites were anatomy/physiology, physics, biology, chemistry, and psychology; and the most frequently required admissions criteria were GPA, references, interviews, science GPA, and writing sample. Standardized tests were rarely utilized. The following were the major prerequisite characteristics and skills considered: academic skills, communication skills, problem-solving abilities, maturity/confidence, motivation, and work/study habits. Changing demographics were reported, including an increase in second-career, older, and ethnically diverse applicants. Also discussed were nontraditional and minority applicant admissions issues. Future research suggestions include use of noncognitive variables, and academic and clinical outcome studies. The utility of this information for validation/revision of admissions criteria are presented.

Allied Health Personnel↗
PubMed2005

Occupational risk of affective and stress-related disorders in the Danish workforce.

OBJECTIVES: A population-based, nested, case-control study was carried out to quantify the risk of affective and stress-related disorders according to occupation in the entire Danish workforce. METHODS: All incident hospital patients and out-patients aged 18-65 years who received a first-time-ever diagnosis of an affective disorder (ICD-10, F 30-39) or stress-related condition (ICD-10, F 40-48) in Denmark from 1 January 1995 through 31 December 1998 were identified in the Danish Psychiatric Central Research Register (N=28 971). For each case, five randomly selected referents of the same age and gender were drawn from a 5% sample of the Danish population (N= 144 855). The occupation held 1 year before a person became a case was obtained from Denmark's Integrated Database for Labour Market Research. Occupation was classified according to the Danish version of the International Standard Classification of Occupations (ICD). Relative risks (RR) and 95% confidence intervals (95% CI) for 25 occupational categories with clerical staff as the reference were calculated using a conditional logistic regression adjusted for sociodemographic covariates. RESULTS: Eight occupations were associated with significantly elevated risks (RR range 1.20-1.58) among the women, while eight occupations were associated with a significantly reduced risk (RR range 0.50-0.76) among the men. The risks were highest for the teaching (RR 1.58) and health (RR 1.53) professions. Only social workers and professionals caring for mentally and physically disabled persons faced an elevated risk irrespective of gender (women RR 1.72, 95% CI 1.38-2.16; men RR 2.09, 95% CI 1.38-3-15). CONCLUSIONS: Major depression and stress-related psychiatric disorders are related to occupation. Risk profiles vary strongly according to gender.

Adolescent↗