Showing papers in "AAOHN Journal in 2012"

Associations between Obesity and Stress and Shift Work among Nurses

Abstract: Nurses' work is known to be stressful, and many nurses work shifts. Both stress and shift work are factors that can influence how and what nurses eat and may increase nurses' risk for weight gain and obesity. This literature review summarizes the evidence regarding the prevalence of obesity and overweight among nurses who work shifts and examine associations between stress and the eating behaviors of these nurses. The conclusion provides some implications for occupational health nurses who promote wellness for their employees.

Pesticide exposure and child neurodevelopment: summary and implications.

Abstract: Widely used around the world, pesticides play an important role in protecting health, crops, and property However, pesticides may also have detrimental effects on human health, with young children among the particularly vulnerable Recent research suggests that even low levels of pesticide exposure can affect young children's neurological and behavioral development Evidence shows a link between pesticides and neonatal reflexes, psychomotor and mental development, and attention-deficit hyperactivity disorder Implications include a need for improved risk assessment and health histories by clinicians, greater education at all levels, more common use of integrated pest management, and continued policy and regulatory strategies to mitigate the effects of and the need for pesticides

Prevalence of blood pressure self-monitoring, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with hypertension.

Abstract: Uncontrolled blood pressure remains a major public health issue. Medication adherence is a key factor in blood pressure management; however, adherence behavior is not clearly understood and the most significant factors contributing to poor medication adherence and blood pressure control are unknown. The purpose of this study was to determine the relationship of self-monitoring of blood pressure, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with access to health insurance. Stage of change was a significant independent predictor of self-monitoring of blood pressure, but not blood pressure control. A strong relationship was found between medication adherence and medication adherence self-efficacy (r = .549, p < .05).

The Effect of Work Shift and Sleep Duration on Various Aspects of Police Officers' Health:

Abstract: Police officers are prone to cardiovascular disease, overweight, and obesity. Because night-shift work affects sleep, a modifiable risk factor linked to chronic disease, the researchers explored the relationship among shift work, sleep, and wellness for police officers. Sleep, C-reactive protein (CRP) levels, stress, fatigue, and body mass index were used to compare officers who worked primarily day shifts to those who worked primarily evening or night shifts, and officers who slept less than 6 hours per day to those who slept at least 6 hours per day. A cross-sectional study of 85 male officers, 20 to 63 years old, was completed at three Midwestern police departments. The Pittsburgh Sleep Quality Index was used to assess sleep. A questionnaire was used to collect officer demographics and work hours. Other measurements included serum CRP, height, weight, perceived stress, and vital exhaustion. The relative risk of sleeping less than 6 hours per day for officers who primarily worked non-day shifts, compared to those who worked day shifts, was 14.27 (95% confidence interval [CI], 1.98-102.95, p < .001), and the relative risk of overall poor sleep quality for officers who slept less than 6 hours per day, compared to those who slept more hours, was 2.44 (95% CI, 1.15-5.20, p = .027). CRP was not associated with shift or sleep duration, even when adjusted for officers' ages.

Occupational Injuries for Consecutive and Cumulative Shifts among Hospital Registered Nurses and Patient Care Associates: A Case-Control Study

Abstract: Nontraditional work shifts for hospital registered nurses and patient care associates and associated injuries were examined through a case-control study. Inpatient care requires that many staff work nontraditional shifts, including nights and 12-hour shifts, but some characteristics remain unexplored, especially consecutive shifts. A total of 502 cases (injured workers) were matched to single controls based on their hospital, unit type, job type, gender, and age (± 5 years). Conditional logistic regression was used for the analysis, controlling for weekly hours scheduled. For both, consecutive shifts of 2 or more days and some various cumulative shifts over a week and month period, especially night shifts, were associated with increased odds of injury. More investigations on the phenomenon of consecutive shifts are recommended. Additionally, the assessment of shift policy and subsequent injury outcomes is necessary before implementing intervention strategies.

A Pilot Study of Occupational Injury and Illness Experienced by Classical Musicians

Abstract: Limited attention is paid to the hazards experienced by orchestra musicians in the occupational health and safety literature. Within that literature, the primary focus has been on noise exposure. A focus on this area is warranted because high sound pressure levels are a product of this work environment. However, in addition to being at risk for noise-induced hearing loss, workers are also at risk for musculoskeletal injury and illness related to stressful body postures held for prolonged work periods. The socio-political forces of employment may place workers at risk for mental health disorders (e.g., depression). The researchers distributed an anonymous survey to classical orchestra musicians in the southwestern United States. The survey inventoried several areas related to occupational health risks. Results suggest low health care-seeking behaviors relative to self-reported signs and symptoms of morbidity. Musicians also reported limited formal training and education regarding occupational health risks. Risk information was provided late in their professional development. This is a particular concern because of the young age at which music training is initiated.

Farm Elders Define Health as the Ability to Work

Abstract: Thirty percent of America's 2.2 million farms are operated by individuals older than 65 years. This study examined how older farmers define health and determined whether demographic characteristics, farm work, and physical and mental health status predict health definition. Data were collected via telephone and mailed surveys during the baseline wave of data collection in a longitudinal study of family farmers residing in two southern states (n=1,288). Nearly 42% defined health as the "ability to work" compared to a physical health-related definition. Predictors of defining health as the ability to work included being White, performing more farm tasks in the past week, taking prescription medications daily, and having minimal health-related limitations to farm work. Health behaviors are centered on the individual's perception of health. Understanding the defining attributes of health can support better approaches to health care and health promotion, particularly among rural subcultures such as farmers, whose identity is rooted in their work.

Occupational Injuries, Duty Status, and Factors Associated with Injuries among Firefighters

Abstract: The aim of this study was to assess the type of occupational injuries, duty status, and factors associated with injuries among firefighters. A total of 437 firefighters from three U.S. states participated in an Internet-based survey. Approximately 66% of firefighters experienced occupational injuries and 56% reported multiple injuries. The most commonly reported injuries were muscle strains and sprains (74%), extremity injuries (60%), back injuries (54%), and burns (28%). A significant number of firefighters reported no duty (58%) or modified duty (46%). Firefighters with more than 17 years in fire services were more likely to report injuries (odds ratio [OR] = 2.96; 95% confidence interval [CI] = 1.92-4.58) and multiple injuries (OR = 2.47; 95% CI = 1.49-4.10). Hispanics (OR = 0.34; 95% CI = 0.15-0.76) and those with stronger organizational commitments (OR = 0.54; 95% CI = 0.35-0.84) were less likely to report injuries. Several factors were associated with injuries. These factors should be incorporated into interventions to reduce occupational injuries.

Musculoskeletal symptoms, work ability, and disability among nursing personnel.

Abstract: Nursing personnel are at risk for developing musculoskeletal symptoms, which can result in persistent pain and inability to work. This study was designed to investigate the occurrence of musculoskeletal symptoms and their association with work role as well as to verify the relationship between pain intensity and disability among symptomatic individuals. Three hundred one nursing personnel, of whom 80.7% had musculoskeletal symptoms in at least one body part, participated in the study. The mean work ability score of symptomatic personnel was lower for physical demands. A significant difference between symptomatic and asymptomatic personnel was found for each demand measured by the Work Role Functioning Questionnaire, except social demand. Correlations were moderate but significant between pain intensity and disability. The results suggest that musculoskeletal symptoms interfere with work life.

Does Current Scientific Evidence Support a Link between Light at Night and Breast Cancer among Female Night-Shift Nurses?: Review of Evidence and Implications for Occupational and Environmental Health Nurses

Abstract: Breast cancer is increasingly prevalent in industrialized regions of the world, and exposure to light at night (LAN) has been proposed as a potential risk factor. Epidemiological observations have documented an increased breast cancer risk among female night-shift workers, and strong experimental evidence for this relationship has also been found in rodent models. Indirect support for the LAN hypothesis comes from studies involving blind women, sleep duration, bedroom light levels, and community nighttime light levels. This article reviews the literature, discusses possible mechanisms of action, and provides recommendations for occupational health nursing research, practice, and education. Research is needed to further explore the relationship between exposure to LAN and breast cancer risk and elucidate the mechanisms underlying this relationship before interventions can be designed for prevention and mitigation of breast cancer.

Burnout among workers in a pediatric health care system.

Abstract: Burnout among health care workers is recognized as an organizational risk contributing to absenteeism, presenteeism, excessive turnover, or illness, and may also manifest as decreased patient satisfaction. Pediatric health care may add stressors including worried parents of ill or dying children, child custody issues, child abuse, and workplace violence. The purpose of this study was to measure burnout among workers in a regional pediatric health care system and report whether burnout in a pediatric health care system is different from previously published data on human service workers. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Copenhagen Burnout Inventory (CBI) were used to measure burnout. Pediatric health care workers expressed significantly less burnout as compared to published MBI-HSS scores and client-related CBI scores. Personal burnout CBI scores were not different, but work-related CBI scores were significantly higher than normative scores.

Occupational Trajectories and Immigrant Worker Health

Abstract: During their initial years in the receiving country, many immigrants experience occupational downgrading. Downgrading is a loss of occupational status between one's last job in the home country and first job in the receiving country, often resulting in overeducation or overqualification. Although the extent and determinants of such occupational trajectories have been characterized, the connection to immigrant worker health has not been widely examined. However, an emerging body of knowledge indicates that negative health outcomes are associated with overeducation and overqualification in general worker populations, suggesting similar experiences by immigrant workers. This article provides an overview of the magnitude and conceptualization of occupational downgrading, overeducation, and overqualification and discusses implications for immigrant worker health. Occupational health professionals should spearhead research efforts on occupational downgrading, raise public awareness about the issue, and serve as advocates for immigrant workers' rights.

Building a Health Literate Workplace

Abstract: Approximately 36% of America's adult population cannot perform daily activities that require basic reading, writing, and numeric skills. Individuals who are at risk for low health literacy have demographics and socioeconomic backgrounds similar to those of individuals considered vulnerable by the National Occupational Research Agenda (NORA). Improving health literacy is a public health priority. Occupational health nurses can play a major role in assisting employers to build a health literate organization while improving the health of their employees. This article discusses attributes of a health literate organization, including organizational commitment, infrastructure, policies and practices with a health literacy priority, and effective communication at all levels.

Occupational and environmental health nursing: Ethics and professionalism

Abstract: This article provides an overview of ethical issues related to the practice of occupational and environmental health nursing and possible strategies for resolution. Also, professionalism related to professional growth and advancing the specialty is discussed.

Professional autonomy of occupational health nurses in the United States.

Abstract: Autonomy, the freedom to practice independently and to exercise professional judgment in practice activities, is a central element for professional practice. Numerous articles and studies have reported on professional autonomy in general nursing practice; however, professional autonomy for occupational health nurses has not been explored in depth. This article advances the development of a body of knowledge relative to professional autonomy in the practice of occupational health nursing. This article also provides an overview of professional autonomy in nursing practice; discusses the nature and importance of professional autonomy in the occupational health practice setting; reports findings from a seminal study of occupational health nurse autonomy; and addresses professional autonomy in the context of collaborative practice.

Time Management for Today's Workplace Demands

Abstract: As the work force decreases, the workload remains the same or, in many cases, increases. An effective employee must arrange work time to accomplish what needs to be done in the time available. The best way to manage time is to set a goal, develop a plan, and measure the outcome. To manage time requires determining where time is currently spent, taking time at the end of the day to prepare for the next morning, managing appointments, carefully planning projects, and managing phone, electronic, and paper mail. Organization is another step in effectively managing time. An organizational system decreases wasted time. Keeping the desk clear and creating a system to organize mail improves efficiency. Time management also focuses on balance, an overall purpose, and supporting principles. Personal or professional effectiveness does not depend solely on the effort expended, but whether the effort is in the right direction. The challenge of time management is to manage not only time, but also oneself.

Posttraumatic stress disorder among paramedics: exploring a new solution with occupational health nurses using the Ottawa Charter as a framework.

Abstract: Paramedics have the highest rate of posttraumatic stress disorder (PTSD) among emergency service workers, higher than police or firefighters. This disorder can be detrimental to their personal and family lives, as well as their careers. Current biomedical, behavioral, and socioenvironmental interventions do not address paramedics' work environment, which contributes to the high rate of PTSD. Occupational health nurses can influence the triad of factors contributing to PTSD among paramedics by facilitating social support and emotional expression while advocating for reduced job exposure to traumatic events. This goal can be accomplished by using a component of the Ottawa Charter, creating a supportive work environment, as a framework. Occupational health nurses, together with management and paramedics, can facilitate a sustainable and supportive work environment that initiates change from within the trauma membrane of paramedics' workplaces to prevent PTSD.

Occupational exposure to blood and other body fluids among health care workers at a university hospital in Iran.

Abstract: Occupational exposure to sharp items or body fluid splash is a hazard for health care personnel via transmission of blood-borne viruses through such exposures. To determine the occurrence of needlestick injuries and other high-risk exposures among health care workers at a hospital in Iran, data collected for 2 years were reviewed. During this period, 171 occupational exposures were self-reported. Approximately 20% of all exposed personnel were men and 80% were women. One hundred twenty-six (74%) of the exposed personnel had needlestick injuries, 13 (8%) had sharp instrument injuries, and 32 (19%) had mucosal contact with potentially infectious fluids. Thirty-two percent of injuries occurred during or after sharp instrument disposal and 67% during operative procedures. Appropriate blood tests were performed for 55 (32%) and postexposure prophylaxis was administered to 31 (18%) of the exposed personnel.

Occupational Injuries for Consecutive and Cumulative Shifts among Hospital Registered Nurses and Patient Care Associates

Abstract: Nontraditional work shifts for hospital registered nurses and patient care associates and associated injuries were examined through a case-control study. Inpatient care requires that many staff work nontraditional shifts, including nights and 12-hour shifts, but some characteristics remain unexplored, especially consecutive shifts. A total of 502 cases (injured workers) were matched to single controls based on their hospital, unit type, job type, gender, and age (± 5 years). Conditional logistic regression was used for the analysis, controlling for weekly hours scheduled. For both, consecutive shifts of 2 or more days and some various cumulative shifts over a week and month period, especially night shifts, were associated with increased odds of injury. More investigations on the phenomenon of consecutive shifts are recommended. Additionally, the assessment of shift policy and subsequent injury outcomes is necessary before implementing intervention strategies.

Mortality and cancer incidence in a copper-zinc cohort.

Abstract: Previous studies of copper-zinc workers have primarily observed significant increases in lung and other respiratory cancers. This study concurrently examined cancer incidence and cause-specific mortality for a cohort of workers at a copper-zinc producer in Ontario, Canada, from 1964 to 2005. Significant elevations in lung cancer incidence were observed for males in the overall cohort (standardized incidence ratio [SIR] = 124, 95% confidence interval [CI] = 102-150) and for surface mine (SIR = 272, 95% CI = 124-517), concentrator (SIR = 191, 95% CI = 102-327), and central maintenance (SIR = 214, 95% CI = 125-343) employees. Significant elevations of non-Hodgkin's lymphoma incidence were observed for male underground mine employees (SIR = 232, 95% CI = 111-426). Occupational etiology cannot be ascertained with the current exploratory study design. Future studies could (1) incorporate exposure assessment for subgroups within the existing cohort and (2) determine the efficacy of wellness programs in partnership with the local health unit.

Does training in performing a fit check enhance N95 respirator efficacy

Abstract: Fit testing of respirators has been recommended, legislated, and implemented in many countries. In the United States, the National Institute for Occupational Safety and Health advocates a fit check, or seal check, before donning a respirator for each fit test. The aim of this study was to investigate the relationship between respirator fitness and performance of the fit check upon donning a respirator. Eighty-four first-year undergraduate nursing students were selected for this study; they were divided randomly into four groups. None had performed a fit test or fit check before being recruited for this study. The real-time self-developed fit test method was used to measure the ambient air particle concentration outside and inside the respirator. Results showed significant differences between groups trained to perform the fit check and those untrained. The overall fit factors were higher in the two groups trained to perform the fit check. The overall fit factors were lower in the two groups not trained to do the fit check. N95 respirators are designed to form a tight seal against wearers' faces. Each time workers don respirators, they should evaluate proper fit. Training wearers in how to fit check increases the likelihood that they will adjust respirators to proper fit.

Reducing Health Care's Carbon Footprint—The Power of Nursing:

Abstract: Global warming and environmentalism continue to be national and international issues as their complexities and implications become better understood. One ironic contributor to the degradation of th...

Relationship between handling heavy items during pregnancy and spontaneous abortion: a cross-sectional survey of working women in South Korea.

Abstract: The researchers conducted a cross-sectional survey to determine the relationship between handling heavy items during pregnancy and spontaneous abortion among working women in South Korea. One thousand working women were selected from a database of those eligible for maternity benefits under the National Employment Insurance Plan. Study results showed that handling heavy items during pregnancy was associated with an increased risk of spontaneous abortion after adjusting for general characteristics of the participants and their work environment. A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant.

Workplace hand hygiene and wellness: a survey of knowledge, beliefs, and practices.

Abstract: Community hand hygiene interventions have reduced the spread of infectious disease in elementary schools, daycare centers, and private homes. Despite this success, and the potential for reducing wo...

Reducing the frequency and severity of migraine headaches in the workplace: Implementing evidence-based interventions

Abstract: The impact of migraine headaches on worker productivity and quality of life is significant. A medical center employee health department implemented an evidence-based, multicomponent intervention to...

Occupational health nursing in the United States.

Abstract: This article is a summary of information about occupational health nurses and occupational health nursing in the United States. The article provides demographic, education, credentialing, role, and other data based on secondary analysis of occupational health nurses' responses to the 2008 National Sample Survey of Registered Nurses. Current issues affecting the U.S. work force and businesses are addressed and high-risk business and industrial sectors are noted. Occupational health nurse practice opportunities are highlighted and practice areas where occupational health nursing research is currently focused are discussed. The article also examines the challenges facing the next generation of occupational health nurses.

The nurse education imperative.

Abstract: Robert Wood Johnson Foundation, Princeton, NJ, USA. Nearly 18 months after the release of the Institute of Medicine (IOM) report ‘‘The Future of Nursing: Leading Change, Advancing Health,’’ it makes sense to ask: what changes are occurring? how can we make the most difference? and where can the report’s recommendations take us toward improving patient care? One of the report’s focal points, and a priority for the Robert Wood Johnson Foundation, is ensuring that nurses are educated and trained to excel as 21 century health care delivery becomes more complex and extends beyond acute care settings. The Future of Nursing report emphasizes that if nurses are to maintain their effectiveness in providing highquality patient care, they will need to be better prepared. Specifically, the report recommends creating a system that produces more nurses educated at the bachelor of science (BSN) level and policies that allow nurses to transition seamlessly from an associate’s degree to the BSN or a higher degree. From the perspective of the IOM committee that developed the report, increasing the percentage of the workforce holding a BSN to 80% by 2020 is both an achievable goal and a necessary step to meet workforce competency and capacity requirements. As a physician, I have seen the tremendous capabilities of nurses—capabilities that are essential to meeting patient needs. But to ensure that they maximize their contributions to health and health care, nurses will need advanced skills and expertise in care management, interdisciplinary teamwork, problem solving, and more. This makes higher levels of education imperative. In addition, having a larger pool of highly educated nurses will be necessary to expand the ranks of nurse faculty, addressing the shortfall that now causes nursing schools to turn away

Application of community-based participatory research principles: preventing work-related musculoskeletal disorders among female Korean-Chinese migrant workers in Korea.

Abstract: The primary purpose of this study was to describe the intervention development process using the National Occupational Research Agenda (NORA) research framework. The intervention was then implemented to prevent work-related musculoskeletal disorders among female Korean-Chinese migrant workers living in Korea. The secondary purpose was to determine how community-based participatory research (CBPR) principles could be applied to the intervention development process. A literature review, a focus group of the target population, key informant interviews, and community committee meetings with the researchers were conducted. Several CBPR principles, including developing community resources and promoting an equitable partnership between the researchers and the migrant community, ensured the appropriateness of the stretching intervention program for the ethnic migrant group, promoting program participation. It is suggested that occupational health nurses consider the CBPR approach in program development for underserved migrant workers.

Occupational silica exposure in hydraulic fracturing.

Abstract: Workers may be exposed to dust containing high levels of respirable crystalline silica during hydraulic fracturing.

Changes in eye protection behavior following an occupational eye injury.

Abstract: This study investigated whether workers modify eye protection behavior following an occupational eye injury. Workers treated for work-related eye injuries were questioned regarding the use of prote...