Showing papers in "Journal of Occupational and Environmental Medicine in 1999"
TL;DR: A measure of the actual decrease in the productivity of employees while they are on the job is included, in addition to measures of absenteeism and disability, to produce a Worker Productivity Index.
Abstract: The costs attributed to employee health problems are usually measured by employers in terms of direct health care costs, such as medical plan claims. Although it has been understood that employee health problems also produce indirect costs for employers, their measurement has been far less frequent. At best, studies have recorded one component of indirect health costs: the time lost to employee absenteeism and disability. The study presented here includes a measure of the actual decrease in the productivity of employees while they are on the job, in addition to measures of absenteeism and disability. These three measurements were combined to produce a Worker Productivity Index (WPI). The WPIs of 564 telephone customer-service agents were correlated with the employees' number and type of health risks, as measured by a Health Risk Appraisal. Additionally, the WPI was also examined across different disease states in the same population of employees. As the number of health risks increased, an employee's productivity decreased. The nature of the health risk may also differentially affect the pattern of the decrease. Finally, disease states were also associated with different patterns of productivity reduction.
407 citations
TL;DR: The authors' analyses suggest that among these production employees, there were no substantial changes in serum hepatic enzymes, cholesterol, or lipoproteins associated with PFOS levels less than 6 ppm, and these results may be due to the lower levels of serum PFOS measured among theseproduction employees, compared to those suspected to cause effects in laboratory animals.
Abstract: The 3M Company manufactures fluorochemicals, which have as a precursor perfluorooctane sulfonyl fluoride (C8F17SO2F). These compounds may be expected to transform metabolically, to an undetermined degree, to perfluorooctane sulfonate (PFOS, C8F17SO3-) as an end-stage metabolite. Subchronic studies in rats and primates indicate a potential for cumulative toxicity with PFOS with the primary effect related to metabolic wasting with hypolipidemia as a consistent finding. Biennial medical surveillance has been offered to the company's fluorochemical production workers located in Decatur, Alabama, and Antwerp, Belgium. In 1995, the mean serum PFOS level, as measured by high-performance liquid chromatography mass spectrometry, for 178 male employees was 2.19 parts per million (ppm; range, 0.00 to 12.83 ppm), and in 1997, for 149 male employees, it was 1.75 ppm (0.10 to 9.93 ppm). Our analyses suggest that among these production employees, there were no substantial changes in serum hepatic enzymes, cholesterol, or lipoproteins associated with PFOS levels less than 6 ppm. It was not possible to derive inferences from the few employees who had serum PFOS levels > or = 6 ppm. These results may be due to the lower levels of serum PFOS measured among these production employees, compared to those suspected to cause effects in laboratory animals.
228 citations
TL;DR: Exposure of the mother to or the handling of antineoplastic agents during the pregnancy was associated with a significantly increased risk of spontaneous abortion and any loss, and the patterns of increased risk were similar to those seen for women, although the odds ratios were not statistically significant.
Abstract: Insult to the germ cells of an ovum or sperm prior to pregnancy as well as exposures to a fetus during pregnancy can affect the outcome of a pregnancy Antineoplastic agents are mutagenic and teratogenic, so the potential effects of exposure on reproduction are of concern to the workers who handle them This study investigates pregnancy loss associated with occupational exposures to antineoplastic drugs by comparing rates of spontaneous abortion and stillbirths for pregnancies without antineoplastic exposure and exposed pregnancies in which the pregnant woman or the father handled antineoplastic agents either before or during the pregnancy A total of 7094 pregnancies of 2976 pharmacy and nursing staff were examined After age during pregnancy, prior gravidity, maternal smoking during the pregnancy, and occurrence of a spontaneous abortion or stillbirth in a prior pregnancy were controlled for, exposure of the mother to or the handling of antineoplastic agents during the pregnancy was associated with a significantly increased risk of spontaneous abortion (odds ratio = 15; 95% confidence interval, 12 to 18) and combined risk of spontaneous abortion and stillbirth (odds ratio = 14; 95% confidence interval, 12 to 17) but not stillbirth alone Among the wives of exposed men, too few stillbirths occurred to allow analysis However, for spontaneous abortion and any loss, the patterns of increased risk were similar to those seen for women, although the odds ratios were not statistically significant
180 citations
TL;DR: The results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time, and suggest that further investigation of multiple risk factor worksitehealth promotion is warranted.
Abstract: Worksites are a key channel for delivery of interventions designed to reduce chronic disease among adult populations. Although some evaluations of worksite physical-activity interventions have been conducted, to date very few randomized trials of worksite health promotion have included the goal of increasing physical-activity levels as part of a comprehensive multiple risk factor approach to worksite health promotion. This article presents the results regarding behavior change found among the cohort of 2055 individuals who completed three health-behavior assessments as part of their worksites' participation in The Working Healthy Project (WHP), a multiple risk factor intervention implemented in 26 manufacturing worksites. In this study, a randomized matched-pair design was used. Fifty-one percent (n = 2,761) of the employees who completed the baseline assessment also completed the interim survey. Eighty-three percent of those who completed the interim assessment also completed the final survey. The WHP intervention targeted smoking, nutrition, and physical activity. At baseline, 38% of the sample reported engaging in regular exercise, and subjects reported consuming an average of 2.7 servings of fruits and vegetables per day, 7.9 grams of fiber per 1000 kilocalories, and 35.4% calories from fat per day; 28% of the sample were smokers. By the time of both the interim (intervention midpoint) and final (end of intervention) assessments, participants in the intervention condition had significantly increased their exercise behavior, compared with the control condition. There was also increased consumption of fruits and vegetables and fiber in the intervention condition by the time of the final assessment, compared with the control condition. No differences by condition were found with regard to percentage of calories from fat consumed or smoking cessation. These results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time. These data suggest that further investigation of multiple risk factor worksite health promotion is warranted, particularly with a focus on ways to increase participation in these programs and to diffuse intervention effects throughout the entire workforce.
161 citations
TL;DR: The observed effect of treatment with antihistamines suggests substantial indirect economic costs, which up to now have been largely overlooked because work productivity has proved difficult to measure objectively.
Abstract: We examined the effects on work productivity of treatment with antihistamines in a retrospective study using linked health claims data and daily work output records for a sample of nearly 6000 claims processors at a large insurance company, between 1993 and 1995. We explained the variation in work o
156 citations
TL;DR: Cancers that have been associated with estrogen disrupters were found in male, but not female, pesticide applicators and the lack of soft tissue sarcoma is at odds with prior literature associated with the use of phenoxy herbicides.
Abstract: This study is a standardized incidence ratio (SIR) analysis of cancer incidence of licensed pesticide applicators in Florida, compared with that of Florida's general population Through extensive data linkages, 33,658 applicators were assembled who had 1266 incident cancers and 279,397 person-years from January 1, 1975, to December 31, 1993 Disease risk from ethanol and tobacco use were significantly decreased Among males, prostate cancer (SIR = 191; 95% confidence interval [CI], 172-213) and testicular cancer (SIR = 248; 95% CI, 157-372) were significantly elevated No confirmed cases of soft tissue sarcoma (STS) were found, and the incidence of non-Hodgkin's lymphoma was not increased There were few female applicators; nevertheless, cervical cancer incidence (SIR = 369; 95% CI, 184-661) was significantly increased, while the incidence of breast cancer was significantly decreased Cancers that have been associated with estrogen disrupters were found in male, but not female, pesticide applicators The lack of soft tissue sarcoma is at odds with prior literature associated with the use of phenoxy herbicides
139 citations
TL;DR: The absence of evidence of an effect on thyroid function or blood cells from occupational airborne perchlorate exposure at a mean absorption of 34 mg/day demonstrates a no-observed-adverse-effect-level (NOAEL) that can assist in the evaluation of human health risks from environmental per chlorate contamination.
Abstract: Since pharmaceutical exposures to perchlorate are known to suppress thyroid function in patients with hyperthyroidism, a study of employees at a perchlorate manufacturing plant was conducted to assess whether occupational exposure to perchlorate suppresses thyroid function. Exposure to perchlorate w
126 citations
TL;DR: This article found that compliance with work practices designed to minimize exposure to blood and body fluids was positively associated with perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress.
Abstract: There were three main objectives of this cross-sectional study of Maryland State correctional health care workers. The first was to evaluate compliance with work practices designed to minimize exposure to blood and body fluids; the second, to identify correlates of compliance with universal precautions (UPs); and the third was to determine the relationship, if any, between compliance and exposures. Of 216 responding health care workers, 34% reported overall compliance across all 15 items on a compliance scale. Rates for specific items were particularly low for use of certain types of personal protective equipment, such as protective eyewear (53.5%), face mask (47.2%) and protective clothing (33.9%). Compliance rates were highest for glove use (93.2%) waste disposal (89.8%), and sharps disposal (80.8%). Compliance rates were generally not associated with demographic factors, except for age; younger workers were more likely to be compliant with safe work practices than were older workers (P < 0.05). Compliance was positively associated with several work-related variables, including perceived safety climate (i.e., management's commitment to infection control and the overall safety program) and job satisfaction, and was found to be inversely associated with security-related work constraints, job/task factors, adverse working conditions, workplace discrimination, and perceived work stress. Bloodborne exposures were not uncommon; 13.8% of all respondents had at least one bloodborne exposure within the previous 6 months, and compliance was inversely related to blood and body fluid exposures. This study identified several potentially modifiable correlates of compliance, including factors unique to the correctional setting. Infection-control interventional strategies specifically tailored to these health care workers may therefore be most effective in reducing the risk of bloodborne exposures.
103 citations
TL;DR: Use of keyboard A for 12 weeks led to a reduction in hand pain and an improved physical examination finding when compared with keyboard B, and there was no corresponding improvement in hand function or median nerve latency.
Abstract: This randomized clinical trial evaluated the effects of keyboard keyswitch design on computer users with hand paresthesias. Twenty computer users were matched and randomly assigned to keyboard A (n = 10) or B (n = 10). The keyboards were of conventional layout and differed in keyswitch design. Various outcome measures were assessed during the 12 weeks of use. Subjects assigned keyboard A experienced a decrease in hand pain between weeks 6 and 12 when compared with keyboard B subjects (P = 0.05) and demonstrated an improvement in the Phalen test time (right hand, P = 0.006; left hand, P = 0.06). Keyboard assignment had no significant effect on change in hand function or median nerve latency. We conclude that use of keyboard A for 12 weeks led to a reduction in hand pain and an improved physical examination finding when compared with keyboard B. There was no corresponding improvement in hand function or median nerve latency.
99 citations
TL;DR: The role of ergonomic factors in the pathogenesis of both NBP and HWD in sonographers is supported, withDiscomfort for transducer design was the best predictor of HWD, whereas a comfortable chair and correct position of the body protected from the onset of NBP.
Abstract: The prevalence of musculoskeletal complaints of the hand and wrist, and the neck and back, in physicians who operate sonography equipment was evaluated, and associations between these complaints and various work-related and personal variables were studied. A questionnaire survey was distributed among physician sonographers (sonologists) in Italy. The relationship between work habits and musculoskeletal complaints was analyzed by logistic regression models adjusted for gender, age, and duration of work with ultrasound. A total of 2041 physician sonographers completed the questionnaire. It was found that a large proportion of the subjects regularly had work-related complaints, such as neck and back pain (NBP) (18.5%) or hand and wrist cumulative trauma disorder (HWD) (5.3%). Roughly 80% of the sonographers were currently affected, or had been affected in the past, by one or more work-related symptoms. Various work-related factors appeared to be related to musculoskeletal syndromes. The average time spent for each examination was related both to NBP and HWD. Discomfort for transducer design was the best predictor of HWD, whereas a comfortable chair and correct position of the body protected from the onset of NBP. These results support the role of ergonomic factors in the pathogenesis of both NBP and HWD in sonographers.
98 citations
TL;DR: The data suggest that alternative treatments for depression may have differential impact on indirect costs, but further research is warranted.
Abstract: Depression-related costs include a relatively large share of indirect costs. We describe the impact of antidepressant treatment on absenteeism among workers diagnosed and treated for depression. Monthly absenteeism counts from employers were summed in the 6 months before and after the initiation of antidepressant therapy in 630 workers treated for depression with a tricyclic antidepressant or a selective serotonin reuptake inhibitor (fluoxetine, sertraline, paroxetine). Monthly mean absenteeism was compared using pairwise t tests. Absenteeism increased before antidepressant initiation and decreased after the treatment began for all antidepressant cohorts. Absenteeism in the selective serotonin reuptake inhibitor cohorts decreased at similar rates for 4 months but was higher in the paroxetine cohort in months five and six after the treatment initiation. Our data suggest that alternative treatments for depression may have differential impact on indirect costs, but further research is warranted.
TL;DR: It is indicated that having little influence on one's own work situation is a predictor of neck pain.
Abstract: Data from a community-based 4-year prospective study were used to investigate job characteristics as predictors of neck pain. Of 1791 working responders who completed a questionnaire in 1990, 1429 (79.8%) returned a second questionnaire 4 years later (1994). In responders without neck pain during th
TL;DR: The results demonstrated adverse associations between increasing BMI and resting blood pressures, forced vital capacity, alanine aminotransferase, aspartate aminotinase, serum cholesterol, and overall morbidity scores.
Abstract: We analyzed results from the medical examinations of 340 hazardous materials (HAZMAT) firefighters and observed the relationships between selected parameters and body mass index (BMI). Heights and weights were available for 98% of the subjects (333 of 340). The mean BMI was 28.9 +/- 4.1 kg/m2. Eighty-seven percent (290 of 333) of subjects were overweight (BMI > or = 25) and 34% (113 of 333) were obese (BMI > or = 30). Two percent (7 of 333) were morbidly obese (BMI > or = 39). For comparison purposes, we divided subjects into low (BMI or = 30) BMI groups. The results demonstrated adverse associations between increasing BMI and resting blood pressures, forced vital capacity, alanine aminotransferase, aspartate aminotransferase, serum cholesterol, and overall morbidity scores. The high prevalence of overweight and obesity and the associated adverse health effects support the development and implementation of fitness-promotion programs for firefighters.
TL;DR: The results highlight the importance of considering age, status level in the organization, frequency of aerobic exercise, occupational stress, general worries, and social support for the early detection of soldiers at increased risk for back-related disability.
Abstract: Over the past decade, studies have identified a combination of demographic, physical/medical, ergonomic, and psychosocial factors in the development of work disability related to occupational low back pain. Using such data on disability risk factors, investigators have begun to develop risk identification and disability prevention programs. As part of an ongoing effort to develop a secondary prevention program, the present case-control study identified the relative contribution of demographic, physical demand, physical fitness, as well as occupational and individual psychosocial variables to back-related work disability in the US Army. Soldiers (n = 174) diagnosed with a lumbosacral strain and medically discharged from the Army were compared with non-disabled controls (n = 173). Dependent measures were obtained from the US Army Health Risk Appraisal (HRA). For cases, these data pre-dated disability determination by 1 to 3 years. For controls, the HRA was completed during the same time period. Significant predictors of low back disability were: age (odds ratio [OR] = 1.13 per year), lower rank (E2/E3) (OR = 4.08/OR = 3.02), infrequent aerobic exercise (OR = 2.2), higher work stress (OR = 2.71), worries (OR = 2.17), and lower social support (OR = 5.07). The model correctly classified 73.13% of all subjects. These results highlight the importance of considering age, status level in the organization, frequency of aerobic exercise, occupational stress, general worries, and social support for the early detection of soldiers at increased risk for back-related disability. Additionally, the findings support past research indicating the multivariate nature of work disability and emphasize the importance of considering such factors in future secondary prevention efforts.
TL;DR: The study presented here utilized a special data-call and data-reduction strategy to identify the leading ASOII BP-NOI combinations for DAW cases by frequency, incidence rate, and severity (median DAW) for 1994.
Abstract: The United States Bureau of Labor Statistics' (BLS) annual survey of occupational injuries and illnesses (ASOII) is one of the most frequently utilized sources of data on national occupational morbidity. In 1992 the BLS introduced a new and expanded survey method that collects more detailed data on cases with days-away-from-work (DAW). However, to date, the BLS has not released any official publication that contains a comprehensive set of crosstabulated part-of-body (BP) and nature-of-injury (NOI) data. To improve the understanding of national DAW case morbidity estimates, the study presented here utilized a special data-call and data-reduction strategy to identify the leading ASOII BP-NOI combinations for DAW cases by frequency, incidence rate, and severity (median DAW) for 1994. The results indicated the significance of disability associated with discrete trauma (ie, resulting from instantaneous or sudden events) in the US workplace. While morbidity associated with back pain clearly continued as the most frequent type of disabling case, fractures at critical anatomical sites (eg, pelvic region, leg, shoulder) were responsible for the most lengthy disability absences from work in 1994. In some instances these findings were contrary to conclusions typically inferred from BLS publications.
TL;DR: Salivary IgA, but not lysozyme, correlated inversely with self-reported levels of stress, and may be a potential biomarker in future studies on stress.
Abstract: Salivary immunoglobulin A (IgA) and lysozyme have been studied as possible biomarkers of stress. This study examined the stress levels among female nurses in various units and the relationship between these stress levels and salivary IgA and lysozyme secretion. One hundred ninety-five (43%) of 457 e
TL;DR: The lack of any significant elevations in the site-specific cancer mortality of the production workers adds important information about human health effects of PCBs.
Abstract: A mortality study was conducted in workers with at least 90 days' exposure to polychlorinated biphenyls (PCBs) between 1946 and 1977. Vital status was established for 98.7% of the 7075 workers studied. In hourly male workers, the mortality from all cancers was significantly below expected (standardized mortality ratio [SMR] = 81; 95% confidence interval [CI], = 68 to 97) and comparable to expected (SMR = 110; 95% CI, 93 to 129) in hourly female workers. No significant elevations in mortality for any site-specific cause were found in the hourly cohort. All-cancer mortality was significantly below expected in salaried males (SMR = 69; 95% CI, 52 to 90) and comparable to expected in salaried females (SMR = 75; 95% CI, 45 to 118). No significant elevations were seen in the most highly exposed workers, nor did SMRs increase with length of cumulative employment and latency. None of the previously reported specific excesses in cancer mortality were seen. This is the largest cohort of male and female workers exposed to PCBs. The lack of any significant elevations in the site-specific cancer mortality of the production workers adds important information about human health effects of PCBs.
TL;DR: The data from the neonatal screening programs of the state health departments in California and Nevada were analyzed for any increased incidence of congenital hypothyroidism in those counties and did not indicate an increase in the incidence with the reported perchlorate levels.
Abstract: Perchlorate, known to inhibit the human thyroid at doses above 200 mg/day, was detected in the drinking-water supplies of seven counties in California and Nevada at levels of 4 to 16 micrograms/L in 1997. The data from the neonatal screening programs of the state health departments in these two states were analyzed for any increased incidence of congenital hypothyroidism in those counties. County-specific, ethnicity-specific data for Nevada and California were obtained for 1996 and 1997. Within these seven counties, nearly 700,000 newborns had been screened. In all, 249 cases were identified, where 243 were expected, for an overall risk ratio of 1.0 (95% confidence interval, 0.9 to 1.2). The risk ratios for the individual counties ranged between 0.6 and 1.1. These data in this ecological analysis do not indicate an increase in the incidence of congenital hypothyroidism with the reported perchlorate levels.
TL;DR: The results found that most employees had multiple negative consequences from experiencing a bank robbery while at work, and more threatening incidents were associated with more severe consequences.
Abstract: This study explored how experiencing a traumatic event in the workplace affects employee physical health, mental health, personal functioning, and work performance. Post-event use of health care services and the effectiveness of critical incident stress debriefing sessions and other coping interventions were also examined. A retrospective self-report methodology and mailed survey were used with 141 employees of 42 different bank branches that had recently been robbed. The results found that most employees had multiple negative consequences from experiencing a bank robbery while at work. Psychological, physical, work, and personal areas were all affected by the robbery. Furthermore, more threatening incidents were associated with more severe consequences. Critical incident stress debriefing interventions delivered after robbery were rated as helpful by 78% of employees who attended. The implications for health care providers and organizations are discussed.
TL;DR: Flight attendants who worked during early pregnancy had a slightly elevated risk of spontaneous abortion, as compared with attendants who were pregnant outside a time span of active flying.
Abstract: We conducted a retrospective cohort study to investigate whether work as a cabin attendant is related to an increased risk for spontaneous abortion. Data on female cabin crew members were linked to medical records on pregnancies. There were 1751 eligible pregnancies for the final analysis. Flight attendants who worked during early pregnancy had a slightly elevated risk of spontaneous abortion, as compared with attendants who were pregnant outside a time span of active flying (odds ratio [OR] = 1.3; 95% confidence interval [CI], 0.9 to 1.8). During the earliest years of the study period (1973 through 1977), the risk seemed to be decreased (OR = 0.4; 95% CI, 0.2 to 1.1), whereas during the later years (1978 through 1994) the risk was increased (OR = 1.6; 95% CI, 1.1 to 2.4). The results are in agreement with earlier studies, showing suggestive evidence of a slightly increased risk of spontaneous abortion among female cabin crew members.
TL;DR: There was an apparent overuse of diagnostic and treatment modalities and overutilization of either diagnostic or treatment procedures increases the likelihood of iatrogenic complications, is not cost-effective, and may adversely impact clinical and occupational outcomes.
Abstract: Recent consensus guidelines delineate what appears to be the most successful and cost-effective management of low back pain (LBP), and some recent studies have suggested that better outcomes occur with the least aggressive forms of medical intervention The purpose of this study was to describe how practitioners manage new-onset, uncomplicated low back workers' compensation (WC) disability cases A sample of cases was randomly selected from a large insurance carrier's national data source An effort was made to select only uncomplicated cases, which would be expected to have relatively minimal need for medical intervention There was an apparent overuse of diagnostic and treatment modalities Diagnostic imaging was overutilized, not only in terms of the number of studies done (65% had plain films, 22% had magnetic resonance imaging scans) but also in the time frame in which they were performed (38% had plain films on the first clinic visit) Ninety percent received at least one medication, and 38% received more than one prescription for opioid analgesics Expensive non-steroidal anti-inflammatory drugs were prescribed more often than acetaminophen (61% versus 6%, respectively) Sixty-two percent received physical therapy that often included modalities with as yet unproven efficacy Overutilization of either diagnostic or treatment procedures increases the likelihood of iatrogenic complications, is not cost-effective, and may adversely impact clinical and occupational outcomes
TL;DR: Results of the evaluation showed that cancer mortality remains significantly increased, compared with the general population and the control group, by approximately 35%.
Abstract: For the historical follow-up study among arc welders exposed to chromium and nickel, which was started in 1980 in Germany, a third follow-up extending the observation period to the years 1989 through 1995 has been carried out. By 1995, of the 1213 welders and 1688 turners (control group) who were or
TL;DR: In this paper, a group of 500 underground mining workers in the copper-mining industry of the former German Democratic Republic, with high exposures to explosives containing technical dinitrotoluene, were interviewed for their working history and grouped into four exposure categories.
Abstract: Between 1984 and 1997, six cases of urothelial cancer and 14 cases of renal cell cancer occurred in a group of 500 underground mining workers in the copper-mining industry of the former German Democratic Republic, with high exposures to explosives containing technical dinitrotoluene. Exposure durations ranged from 7 to 37 years, and latency periods ranged from 21 to 46 years. The incidences of both urothelial and renal cell tumors in this group were much higher than anticipated on the basis of the cancer registers of the German Democratic Republic by factors of 4.5 and 14.3, respectively. The cancer cases and a representative group of 183 formerly dinitrotoluene-exposed miners of this local industry were interviewed for their working history and grouped into four exposure categories. This categorization of the 14 renal cell tumor cases revealed no dose-dependency concerning explosives in any of the four exposure categories and was similar to that of the representative group of employees, whereas the urothelial tumor cases were predominantly confined to the high-exposure categories. Furthermore, all identified tumor patients were genotyped by polymerase chain reaction, using lymphocyte DNA, regarding their genetic status of the polymorphic xenobiotic metabolizing enzymes, including the N-acetyltransferase 2 and the glutathione-S-transferases M1 and T1. This genotyping revealed remarkable distributions only for the urothelial tumor cases, who were exclusively identified as "slow acetylators." This points to the possibility of human carcinogenicity of dinitrotoluene, with regard to the urothelium as the target tissue.
TL;DR: This study addressed numerous limitations of the previous literature by prospectively collecting extensive data on a large sample of diverse convenience stores and directly addressing the current theory on the robbers' selection of a target store through a matched case-control design.
Abstract: Convenience store clerks have been shown to be at high risk for assault and homicide, mostly owing to robbery or robbery attempts. Although the literature consistently indicates that at least some environmental designs are effective deterrents of robbery, the significance of individual interventions and policies has differed across past studies. To address these issues, a matched case-control study of 400 convenience store robberies in three metropolitan areas of Virginia was conducted. Conditional logistic regression was implemented to evaluate the significance of various environmental designs and other factors possibly related to convenience store robbery. Findings indicate that numerous characteristics of the surrounding environment and population were significantly associated with convenience store robbery. Results also showed that, on a univariate level, most crime prevention factors were significantly associated with a lower risk for robbery. Using a forward selection process, a multivariate model, which included cash handling policy, bullet-resistant shielding, and numerous characteristics of the surrounding area and population, was identified. This study addressed numerous limitations of the previous literature by prospectively collecting extensive data on a large sample of diverse convenience stores and directly addressing the current theory on the robbers' selection of a target store through a matched case-control design.
TL;DR: Although more study is needed, consideration should be made for targeting high-PMR occupations, with improvement in work organization to reduce occupational stress and promotion of healthy lifestyles through cardiovascular disease prevention programs.
Abstract: Cardiovascular disease is the leading cause of death, and the role of occupation continues to generate interest. Using the National Occupational Mortality Surveillance system, proportionate mortality ratio (PMR) analyses were used to examine the association between occupation and ischemic heart disease among 16- to 60-year-old males. We used data from 1982-1992 from 27 states. Separate analyses were conducted for blue-collar and white-collar occupations. Among the blue-collar occupations with the highest PMRs for ischemic heart disease mortality were sheriffs, correctional institution officers, policemen, firefighters, and machine operators. Physicians (blacks only) and clergy (both races) were among the white-collar occupations with the highest PMRs for ischemic heart disease. Although more study is needed, consideration should be made for targeting high-PMR occupations, with improvement in work organization to reduce occupational stress and promotion of healthy lifestyles through cardiovascular disease prevention programs.
TL;DR: The results suggest that workers who were exposed to trichloroethylene experienced an increase in mortality from cancers of the liver.
Abstract: Data provided by the Comprehensive Epidemiology Data Resource allowed us to study patterns of cancer mortality as experienced by 3814 uranium-processing workers employed at the Fernald Feed Materials Production Center in Fernald, Ohio. Using risk-set analyses for cohorts, we estimated the effects of
TL;DR: It is suggested that a coordinated program of medical care, ergonomic assessment, and intervention can be efficacious in the primary, secondary, and tertiary prevention of UEWMSD.
Abstract: In 1992, the johns Hopkins Hospital and University initiated a program aimed at the early diagnosis and treatment of potential upper extremity work related musculoskeletal disorders (UEWMSDs), ergonomic assessment and abatement of work areas where individuals with UEWMSDs are employed, as well as the identification and correction of areas throughout the hospital and university where UEWMSDs could possibly occur. The program resulted in an initial increase in the number and cost for the treatment of UEWMSDs. Subsequently, there was a significant decrease in the number of UEWMSDs reported and virtual elimination of the need to use surgical procedures to correct these conditions. This article suggests that a coordinated program of medical care, ergonomic assessment, and intervention can be efficacious in the primary, secondary, and tertiary prevention of UEWMSD.
TL;DR: It is concluded that among Gulf War veterans seeking evaluation for Gulf War-related health concerns, psychological conditions are common and are associated with important occupational morbidity.
Abstract: The Comprehensive Clinical Evaluation Program is a US military program that provides a voluntary, clinically oriented evaluation for Gulf War health concerns This article presents administrative data on psychological conditions (as coded using the International Classification of Diseases, 9th Revision) from the first year of the program The most commonly diagnosed psychological conditions were medically unexplained physical-symptom syndromes; depression and anxiety, including post-traumatic stress disorder; and alcohol abuse or dependence Psychological conditions were significantly related to a higher number of workdays lost, and the 19% of veterans with a primary diagnosis of a psychological condition reported 28% of the lost workdays among veteran who participated Stressful Gulf War experiences were weakly but significantly related to psychological conditions We conclude that among Gulf War veterans seeking evaluation for Gulf War-related health concerns, psychological conditions are common and are associated with important occupational morbidity
TL;DR: The findings show the impact that design changes have on energy demands and exercise duration in firefighters, with faster rates in modern compared with modified modern or traditional uniforms.
Abstract: Fire departments have replaced traditional uniforms with modern, more thermal protective gear. Although the new uniforms afford superior burn protection, they may reduce work time. Our purpose was to determine if exercise time was (1) reduced by wearing the modern versus traditional uniform, and (2)
TL;DR: To eliminate the burden of disease and death that is caused worldwide by exposure to asbestos, the Collegium Ramazzini calls for an immediate ban on all mining and use of asbestos.
Abstract: To eliminate the burden of disease and death that is caused worldwide by exposure to asbestos, the Collegium Ramazzini calls for an immediate ban on all mining and use of asbestos. To be effective, the ban must be international in scope and must be enforced in every country in the world.