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PubMed2005

A proportionate mortality study of bricklayers and allied craftworkers.

BACKGROUND: Mortality among members of the International Union of Bricklayers and Allied Craftworkers (IUBAC) is examined. Bricklayers and allied craft workers may be exposed to cobalt, epoxy resins, pitch, lime, and to lung carcinogens such as asbestos, silica, and nickel. METHODS: Proportionate mortality ratios (PMRs) were computed using US age-, gender-, and race-specific mortality rates for members who died during 1986-1991. RESULTS: Statistically significant PMRs among white men were found for cancers of the esophagus (PMR=134), stomach (PMR=131), respiratory system, trachea, bronchus, and lung (PMR=144), other parts of the respiratory system (PMR=216), other and unspecified sites (PMR=125). Elevated PMRs were also found for other diseases of the blood and blood forming organs (PMR=201), emphysema (PMR=133) and for asbestosis (PMR=554), and other respiratory diseases (PMR=119). CONCLUSIONS: Results are consistent with those found in previous studies, and suggest the need for intervention activities directed at the prevention of these cancers, and other respiratory diseases.

Adult↗
PubMedDate not supplied

1997 survey of salaries & responsibilities for hospital biomedical clinical engineering & technology personnel.

The Journal of Clinical Engineering conducted its twelfth annual survey of the salaries paid to biomedical/clinical engineering and technology personnel in U.S. hospitals. This paper reports the salary and work responsibility data obtained from 276 professionals in relationship to: region of the U.S.; teaching versus nonteaching facilities; years of experience; education; certification; union membership; and gender. Data are included on wage increases and job responsibilities as of 12/31/96, and are compared with data as of 12/31/95. The average BMET I has 2.9 years of experience and earns $26,126 +/- $5,800 (nationwide mean +/- standard deviation). The average BMET II has 8.29 years of experience and ears $34,687 +/- $6,300. The average BMET III has 12.7 years of experience and earns $40,960 +/- $6,900. The average BMET Specialist has 16.7 years of experience and earns $46,131 +/- $9,100. The average BMET Supervisor has 15.0 years of experience and ears $44,248 +/- 47,700. The average Clinical Engineer has 13.6 years of experience and earns $44,839 +/- $10,000. CE Supervisors have an average of 21.6 years of experience and an average salary of $59,789 +/- $13,100. The overall group or department Director or Manager has 17.5 years of experience and earns $55,325 +/- $16,200 on average.

Age Factors↗
PubMed2004

Construction workers' perceptions of management safety practices: a qualitative investigation.

BACKGROUND AND GOALS: The purpose of this study was to identify perceptions of management safety practices from the viewpoint of union and nonunion construction workers. A complementary investigation was conducted with construction managers. METHODS: A semi-structured interview guide was used to elicit information from 64 workers (95% male) in ten focus groups. Questions were designed to elicit information about management practices that facilitate or discourage safe working conditions, including communication style, attitude, expectations, and unspoken messages. Data were analyzed using thematic content analysis. RESULTS: Workers identified management commitment to safety, concern for workers, congruence between spoken messages and practice, professionalism, and communication skills as key qualities in successful managers. Workers provided vivid examples of excellent and poor management strategies. CONCLUSIONS: Construction managers play a pivotal role in the definition and implementation of safety practices in the workplace and workers look to them for guidance and modeling. Given the high rates of injury in construction, deeply imbedded protective policies that rely on input from a broad range of stakeholders, including construction workers, should be developed.

Administrative Personnel↗
PubMed1990

Asbestos-related pulmonary disease in boilermakers.

Boilermakers are skilled building tradesmen who construct, repair, and dismantle boilers. The present study reports on the evaluation of members of a Michigan boilermaker's union for the presence of signs and symptoms of chronic pulmonary disease. Study variables included standardized evaluations of chest x-ray findings, pulmonary function testing, physical examination, and respiratory symptoms. An overall participation rate of 69% was achieved. A non-participant survey identified no significant differences between participants and non-participants in dyspnea, cough, age, or smoking history. Among participants with greater than 20 years experience in the trade, the mean FVC was 91% of predicted; the FEV1 was 86% of predicted; 25% showed at least a 1/0 profusion of interstitial markings on chest x-ray; 30% had bilateral pleural abnormalities; and 52% had audible inspiratory rales on physical examination. Forced vital capacity and forced expiratory volume at one second both decreased with years in the trade. Chest x-ray findings of interstitial fibrosis and pleural plaques were related to ten or more years in the trade, as were respiratory symptoms of pulmonary rales, wheeze, and dyspnea.

Age Factors↗
PubMed1996

[Physicians' strikes and health services: an ethical perspective].

For the public opinion, medical strikes are a controversial issue; physician's ethical judgments are also different. The present article analyses the requisites to consider legitimate a strike and, based on these, the ethical duties of physicians; the features of medical unionism; the ethical duties of authority; the manipulation of ill people by the strike and the social factors that may cause these conflicts. In a medical strike, universal ethical values based on the Hyppocratic oath and promoted by the profession, are endangered. This article concludes that a medical strike may be explainable due to different reasons, but it is not ethically justifiable beyond any doubt. The health profession that is not prepared to give up strikes as gremial pressure tool, should not choose a profession that takes care of the ill. The best way to avoid medical strike is to prevent them: the society and the authority have the ethical obligation to create work conditions that elude conflicts. To settle disputes between physicians and health institutions, the creation of a permanent arbitral instance agreed by physicians and the authority, i.e. a high level committee integrated by respected individuals and physicians, could be necessary. This committee should send forth veredicts that would be obeyed by the contending parties.

Attitude to Health↗
PubMed1996

A strategic response to the occupational health establishment.

The experiences of occupational health and safety "activists" in Canada reveal the limits of achieving reform in working conditions by technical efforts in combination with rank-and-file activation. The author argues that the way union "activists" approach occupational health and safety limits workers in dealing with their actual experiences and understanding about workplace hazards and risks, then discusses the condition for the awakening of their critical consciousness as a basis of acting on hazardous working conditions. The first movement in the way the worker apprehends the work environment is a movement of negation and is the prior condition to a critical and disclosive discourse about workplace hazards. It is the positive side of "No!" and the taking seriously of workers' rights. It is this negation of the negative that holds out the greatest hope for solidarity and a liberatory community in workplaces, since legislated workers' rights as the basis of protection have become a facade. Workers can respond with the power of saying "No!" in solidarity with suffering workers, and then work through appropriate principles, ends, or strategies avoiding entrapment by a "telos" in the first instance. By laying out these "ends" or a strategic paradigm, one introduces a "conversation stopper" for workers and atrophies their activation.

Canada↗
PubMed1980

Three-year-incidence of disability pensions among male members of the Danish semi-skilled workers' union.

The aim of this study is to evaluate the age- and diagnosis-specific incidence of disability pensions awarded within a large group of working men. The study population is the 228,612 male members, aged 20-64, of Denmark's largest trade union, the Semi-skilled Workers' Union (SID), of which two thirds of the so-called unskilled male workers are members. In all 4838 awarded disability pensions were registered in the period April 1, 1973--March 31, 1976 against 3787 expected, i.e. an excess of 31.7%. The incidence rates increases more rapidly with age for the SID-men than for all men in Denmark. The Standard Disability Ratio(SDR) is found to be over 100 for all major diagnoses. The highest SDRs are found for major diagnoses of the respiratory system (183.9) and of the musculoskeletal system (169.2). For these diagnoses a "wear syndrom" is suggested, where small handicaps combined with demands for strenuous work cause a considerable reduction in capacity to work. Regional differens in the 3-year incidence of disability pensions are found. In all 15 counties, except one, significantly more disability pensions are found to have been awarded to SID-men than expected. The highest SDRs can be found within the large branches in the Copenhagen area.

Adult↗
PubMed1975

Cost-financed mental health facility. III. Economic issues and implications for future patterns of health care.

Data are presened concerning the economics of a cost-financed mental health facility and a lobor union insurance program. The total cost per insured enrolle for all mental health services did not exceed $5.41 per year. The cost per treated patient per year remained under $490. These data strongly support the feasibility of including mental health benefits in national health insurance. Costs are then compared between fee-for-service insurance and cost financing. Average costs per treated patient in the cost-financed facility were $302 over a 4-year period. Similar computations under fee-for services financing showed costs of $824. The difference reflects much greater use of hospitalizations in the fee-for-service system. These data and the data from the preceding two papers on the clinical and utilization partterns of cost-financed facilites suggest that these facilities are practical clinical forms. Implications for national health insurance, HMO legislation, and community mental health centers are explored.

Community Mental Health Services↗
PubMed1997

Second surgical opinion programs: dead or alive?

BACKGROUND: In the 1970s, second surgical opinion programs were established in an effort to improve medical care and to control health care costs. The cost-effectiveness of these programs has been questioned recently. STUDY DESIGN: A retrospective review was conducted of elective second-opinion surgical consultations for members of Local 32B-J of the International Service Employees Union for the years 1993-1994. Nonconfirmed consultations were reviewed against claims history data for the subsequent 2 years. Data were analyzed for rates of nonconfirmation by diagnosis and surgical specialty and for cost-effectiveness benefit. RESULTS: Of the 5,601 second surgical consultations performed, 490 procedures were not confirmed as medically necessary (9%). Claims history survey for these 490 patients for the 2 years following the consultation revealed that no operation was performed in 62%. The highest nonconfirmation rate (41%) was in plastic and reconstructive surgery, followed by gynecology (22%). The cost-benefit ratio for the program was calculated to be 1.34. CONCLUSIONS: A second surgical opinion program confers both cognitive and psychologic beneficial effects on Joint Trust Fund members and their dependents who are advised to undergo elective operations. Our current second surgical opinion nonconfirmation rate is 9%, with hysterectomy, prostatectomy, and bunionectomy among the procedures most frequently nonconfirmed. The cost-benefit ratio was estimated at 1.34.

Cost-Benefit Analysis↗
PubMed2003

Health care utilization of carpenters with substance abuse-related diagnoses.

BACKGROUND: Persons in the construction trades in the US have high rates of alcohol and substance abuse. We had the unique opportunity to evaluate health care utilization through private insurance and workers' compensation for a group of carpenters at high risk of injury and substance abuse. METHODS: We identified a cohort of union carpenters. Their claims for medical care through union insurance and workers' compensation, and appropriate measures of time at risk were documented. Using methods of indirect standardization, we compared utilization and costs between carpenters with and without alcohol and substance-abuse related diagnoses (ASRD). RESULTS: Through private insurance, those with ASRD had 10% higher outpatient utilization and 2.1 times higher rates of hospitalizations for injury care; 2.6 times higher rates of outpatient care; and 2.9 times higher inpatient admissions for non-injury care. Individuals with ASRD had only modestly increased rates (10%) of outpatient utilization through workers' compensation. CONCLUSIONS: These findings support the need for alcohol and drug abuse prevention and treatment services for this workforce. Operationalizing this among highly mobile workforces, such as the construction trades, is a challenge. While not intending to minimize the problems of alcohol or substance abuse on the job among carpenters, the focus of prevention should not necessarily be in the workplace.

Adolescent↗
PubMed1979

A study of the BMA-TUC Joint Committee on Medical Questions, 1935-1939.

The BMA (British Medical Association)-TUC (Trades Union Congress) Joint Committee on Medical Questions, established in 1936, was an experiment in consensus. It was the first attempt to cross the barriers in medical politics. In the 1930s the strategy of 'administration rather than advocacy' prompted the co-operation of the TUC with the BMA on medical questions of mutual interest. The operation of the partnership is explored here in the formulation of a scheme for a national maternity service acceptable to both parties. However, the reality of co-operation at the level of specific proposals was an insistence by the BMA on its own point of view. The TUC had to decide whether a joint scheme was worth the price. Although a scheme was eventually produced, as an experiment in consensus the committee had failed. To some extent the war obscured this failure, but the consensus itself was wrecked by the intransigence of the BMA and the hostility of the Labour movement, which was angry at the extent of the concessions which the TUC had made for a national maternity scheme.

Conflict, Psychological↗
PubMed1992

The Critikon ProtectIV catheter issue.

Most healthcare professionals have already read about the union grievance over the Critikon ProtectIV catheter filed at San Francisco General Hospital. The union's position was that the catheter which is designed to prevent needlesticks during insertion and removal, should be used in all applications at the hospital, rather than only in those that seemed to present greater risk of injury or infection. HHMM believes that engineering controls--specifically safety needles--should be fundamental to a good exposure control plan for bloodborne pathogens. If the primary pathway of exposure is the needlestick and the point of the control plan is to reduce needlesticks, then it is hard to refute the logic that safety devices are the best approach. The following material consists of the statement made by Dr. Peter Lurie to the grievance committee at San Francisco++ General and a letter from Dr. Janine Jagger presenting initial data on the effectiveness of the ProtectIV catheter in reducing injuries. Both are reprinted with permission. HHMM offers these documents for the information they contain, as well as for the guidance they offer in how to begin evaluating safety needle devices.

Acquired Immunodeficiency Syndrome↗
PubMed2001

A multi-sectorial committee in directing HIV/AIDS-specific interventions in the occupational setting: an example from South Africa.

We present a descriptive analysis of a mechanism to coordinate and implement human immunodeficiency virus (HIV) prevention and care in the occupational setting. The mechanism we describe is a multidisciplinary committee composed of stakeholders in the occupational health environment including unions, management, medical researchers, and medical personnel. The site chosen for the analysis was a South African sugar mill in rural KwaZulu-Natal. The factory is situated in an area of high HIV seroprevalence and has a workforce of 400 employees. The committee was initiated to coordinate a combined prevention-care initiative. The issues that were important in the formation of the committee included confidentiality, trust, and the traditional roles of the stakeholder relationships. When these points were addressed through the focus on a common goal, the committee was able to function in its role as a coordinating body. Central to this success was the inclusion of all stakeholders in the process, including those with traditionally opposing interests and legitimacy conferred by the stakeholders. This committee was functionally effective and demonstrated the benefit of a freestanding committee dedicated to addressing HIV/acquired immune deficiency syndrome (AIDS) issues. We describe the implementation and feasibility of a multisectoral committee in directing HIV/AIDS initiatives in the occupational setting in rural South Africa.

Feasibility Studies↗
PubMed1998

Management of health and safety in the organization of worktime at the local level.

OBJECTIVES: This study examined the consideration of health and safety issues in the local process of organizing worktime within the framework of regulations. METHODS: The study encompassed all 7 hospitals in one region of Denmark. Twenty-three semi-structured interviews were carried out with 2 representatives from the different parties involved (management, cooperation committees, health and safety committees from each hospital, and 2 local unions). Furthermore, a questionnaire was sent to all 114 wards with day and night duty. The response rate was 84%. Data were collected on alterations in worktime schedules, responsibilities, reasons for the present design of schedules, and use of inspection reports. RESULTS: The organization of worktime takes place in single wards without external interference and without guidelines other than the minimum standards set in regulations. At the ward level, management and employees were united in a mutual desire for flexibility, despite the fact that regulations were not always followed. No interaction was found in the management of health and safety factors between the parties concerned at different levels. CONCLUSIONS: The demands for flexibility in combination with the absence of guidelines and the missing dynamics between the parties involved imply that the handling of health and safety issues in the organization of worktime may be accidental and unsystematic. In order to consider the health and safety of night and shift workers within the framework of regulations, a clarification of responsibilities, operational levels, and cooperation is required between the parties concerned.

Accidents, Occupational↗
PubMed1986

A proportionate mortality study of granite cutters.

Several recent studies (animal and human) have suggested an association between lung cancer and silica exposure. To test the hypothesis, we have studied death benefit records of 1,905 members of the Granite Cutters Union. A proportionate mortality analysis (PMR) was conducted, using U.S. deaths as a comparison population. Statistically (PMR) was conducted, using U.S. deaths as a comparison population. Statistically significant excesses were observed for death from nonmalignant respiratory significant excesses were observed for death from nonmalignant respiratory disease (largely silicosis) (183 obs, 43.7 exp) and for tuberculosis (largely silicotuberculosis) (262 obs, 19.3 exp). Other significant excesses were observed for bone cancer (6 obs, 1.9 exp) and arthritis (5 obs, 1.5 exp). A significant decrease was observed for leukemia (5 obs, 13.0 exp). For lung cancer a slight but nonsignificant excess was observed (97 obs, 81.1 exp, PMR = 1.19, 95% CI 0.97-1.46). A proportionate cancer mortality analysis (PCMR) showed similar results for lung cancer (PCMR = 1.09, 95% CI 0.89-1.33). Lung cancer mortality also failed to show any trend with either calendar time or duration of exposure. Although no significant excess of lung cancer was observed for the entire silica-exposed cohort, there was an indication that those who were silicotic had an excess risk of lung cancer, based on a review of contributing causes on the death certificate.

Construction Materials↗
PubMed1986

Overcoming resistance to power sharing.

Power is a fundamental necessity for human development. Not only do people have a right to seek power, they have the duty to do so, if some force prevents them from pursuing their full development or promoting the development of persons dependent on them. Pope John Paul II, in his encyclical On Human Work, defends workers' right to seek power by forming unions to defend their vital interests and by striking if necessary. The bishops, through their pastoral letter on Catholic Social Teaching and the U.S. Economy, and the National Council of Churches in the United States also affirm this right. A refusal to share power usually means that the power holder perceives the purpose of power as "getting things done" rather than "helping people to grow." Resistance to power sharing can be attributed to three possible attitudes: Management's view that the sharing of power is a "gift" that can be withdrawn at any time; The perception of board members who come from the capitalist system that power sharing does not work; Adherence by management personnel in government to the theory that power holders' authority derives from the will of the people. Human service workers unquestionably can benefit from power sharing. The persons most in need of their services, however, also are powerless and must be considered in any discussion of a potential strike. Withholding services from these groups--the poor, minorities, children, the elderly, and the disabled--can result in a tragic tension, pitting the powerless against the powerless.

Catholicism↗
PubMedDate not supplied

Reduction of cardiovascular disease events by worksite hypertension treatment.

A retrospective cohort study of hypertensive employees to evaluate the impact of worksite antihypertensive treatment (WST) on cardiovascular disease (CVD) over 8 1/2 years is reported. In a union-sponsored screening from August 1973 to February 1974, 604 hypertensives (greater than or equal to 160 and/or 95 mm Hg, or on medication) were identified. Of these, standardized criteria were met by 344, of whom 150 chose WST and 194 referred care (RC). The study groups were similar in age and sex composition. Union hospitalization and death records through 1982 revealed that CVD rates were fewer in WST than RC (3.0 vs 5.4/100 person-years; p less than 0.01). By contrast, nonCVD rates were similar (8.1 vs 9.6). All-cause mortality rate in WST (0.89) was significantly (p less than 0.05) lower than that in RC (1.81), as was the standard mortality ratio (55.1), based on U.S. mortality in 1978. CVD mortality was also lower (0.48 vs 1.10; NS). Persons with an initial blood pressure (BP) less than 160/95 mm Hg had CVD event rates that were low and similar in WST and RC (3.6 vs 3.5). However, among those with elevated BP at entry, WST subjects fared significantly better than RC (2.8 vs 6.1; p less than 0.001). Furthermore, in WST, previously treated patients with elevated BP at screening experienced one-third the CVD morbidity of their counterparts in RC (3.1 vs 10.8; p less than 0.01). These results extend previous evidence that WST is an effective method to achieve BP control and demonstrate that this approach to the management of hypertension alters health outcomes favorably and significantly.

Age Factors↗
PubMed2003

Exposure to secondhand smoke at work: a survey of members of the Australian Liquor, Hospitality and Miscellaneous Workers Union.

OBJECTIVE: To measure workers' attitudes towards and experiences of exposure to secondhand smoke (SHS) in the workplace. METHOD: A stratified random sample of members from the Victorian Branch of the Australian Liquor, Hospitality and Miscellaneous Workers Union (LHMU) was interviewed by telephone in September 2001. Of the 1,078 respondents surveyed (77% response rate), hospitality workers comprised 49% of the sample, while the remainder comprised community services, property services and manufacturing workers. RESULTS: Overall, 54% of union members were employed in workplaces that did not completely ban smoking and 34% reported being exposed to SHS during their typical working day. Workplaces with total smoking bans had a high level of compliance with these restrictions, with no workers in these settings indicating exposure to SHS at work. Compared with other workers, hospitality workers reported working in environments that had more permissive smoking policies. Consistent with this, 56% of hospitality workers said they were exposed to SHS during a typical day at work compared with 11% of other workers. Overall, 79% of workers expressed concern about exposure to SHS, including 66% of smokers. Compared with other workers, hospitality workers reported a higher level of concern about exposure to SHS at work. CONCLUSION: These findings provide evidence that many workers, and especially those employed in the hospitality sector, are exposed to SHS during their working day and are concerned about the effects of such exposure on their health. IMPLICATIONS: These findings indicate that workplace smoke-free policies are effective in reducing worker exposure to SHS and demonstrate support for the extension of smoke-free policies to hospitality workplaces.

Adult↗