Showing papers in "Journal of Occupational and Environmental Medicine in 2002"

Stanford presenteeism scale: health status and employee productivity.

Abstract: Workforce productivity has become a critical factor in the strength and sustainability of a company’s overall business performance. Absenteeism affects productivity; however, even when employees are physically present at their jobs, they may experience decreased productivity and below-normal work qu

Work stress in aging police officers

Abstract: Data are sparse regarding the impact of psychosocial work stress on the health and well-being of aging workers, even for employees working in high-stress occupations, such as law enforcement. To improve our understanding of this issue in older workers, we assessed and characterized work stress, coping strategies, and stress-related health outcomes in a sample of police officers aged 50 years and older (n = 105). The most important risk factors associated with officers' perceived work stress were maladaptive coping behaviors (e.g., excessive drinking or problem gambling) (odds ratio [OR], 4.95; 95% confidence interval [CI], 2.11 to 11.6) and exposure to critical incidents (e.g., shootings) (OR, 3.84; 95% CI, 1.71 to 8.65). In turn, perceived work stress was significantly associated with anxiety (OR, 6.84; 95% CI, 2.81 to 16.65), depression (OR, 9.27; 95% CI, 3.81 to 22.54), somatization (OR, 5.74; 95% CI, 2.47 to 13.33), posttraumatic stress symptoms (OR, 2.89; 95% CI, 1.29 to 6.47), symptoms of "burnout" (OR, 5.93; 95% CI, 2.54 to 13.86), chronic back pain (OR, = 3.55; 95% CI, 1.57 to 8.06), alcohol abuse (OR, 3.24; 95% CI, 1.45 to 7.22), and inappropriately aggressive behavior (OR, 4.00; 95% CI, 1.34 to 11.88). These data suggest that older workers in high-stress jobs may be at increased risk for work stress-related health problems, especially if they rely on risky health behaviors to cope with stress. Given the size of the rapidly aging US workforce and the likelihood that many are employed in high-stress jobs, interventions are urgently needed to address this emerging public health issue.

The business case for quality mental health services: why employers should care about the mental health and well-being of their employees.

Abstract: Employers are very concerned about rising mental health care costs. They want to know whether their health care spending is improving the health of workers, and whether there is a productivity payback from providing good mental health care. This article addresses the subject of employee depression and its impact on business. The literature suggests that depressed individuals exert a significant cost burden for employers. Evidence is mounting that worker depression may have its greatest impact on productivity losses, including increased absenteeism and short-term disability, higher turnover, and suboptimal performance at work. Although there is no conclusive evidence yet that physical health care costs decrease when depression is effectively treated, there is growing evidence that productivity improvements occur as a consequence of effective treatment, and those improvements may offset the cost of the treatment.

Productivity losses related to the common cold.

Abstract: Health-related productivity assessments typically focus on chronic conditions; however, acute conditions, particularly colds, have the potential to cause substantial health-related productivity losses because of their high prevalence in working-age groups. This article presents the findings of a study conducted to estimate productivity loss due to cold by using a telephone-administered survey that measured three sources of loss: absenteeism, on-the-job productivity, and caregiver absenteeism. Each cold experienced by a working adult caused an average of 8.7 lost work hours (2.8 absenteeism hours; 5.9 hours of on-the-job loss), and 1.2 work hours were lost because of attending to children under the age of 13 who were suffering from colds. We conclude that the economic cost of lost productivity due to the common cold approaches $25 billion, of which $16.6 billion is attributed to on-the-job productivity loss, $8 billion is attributed to absenteeism, and $230 million is attributed to caregiver absenteeism.

Prevalence of psychiatric disorders in patients with chronic work-related musculoskeletal pain disability.

Abstract: The cost and prevalence of chronic work-related musculoskeletal pain disability in industrialized countries are extremely high. Although unrecognized psychiatric disorders have been found to interfere with the successful rehabilitation of these disability patients, few data are currently available regarding the psychiatric characteristics of patients claiming work-related injuries that result in chronic disability. To investigate this issue, a consecutive group of patients with work-related chronic musculoskeletal pain disability (n = 1595), who started a prescribed course of tertiary rehabilitation, were evaluated. Psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. Results revealed that overall prevalences of psychiatric disorders were significantly elevated in these patients compared with base rates in the general population. A majority (64%) of patients were diagnosed with at least one current disorder, compared with only 15% of the general population. However, prevalences of psychiatric disorders were elevated in patients only after the work-related disability. Such findings suggest that clinicians treating these patients must be aware of the high prevalence of psychiatric disorders and be prepared to use mental health professionals to assist in identifying and stabilizing these patients. Failure to follow a biopsychosocial approach to treatment will likely contribute to prolonged pain disability in a substantial number of these patients.

Outdoor air pollution and acute respiratory infections among children in developing countries.

Abstract: Acute respiratory infections (ARIs) are the most common cause of illness and death in children in the developing world. This review focuses on outdoor air pollutants associated with pediatric ARI mortality and morbidity. Studies were identified using MEDLINE and other electronic databases. Four studies showed an increase in infant mortality in relation to outdoor air pollution. Short-term follow-up and time-series studies suggest that air pollutants act as risk factors for respiratory infection. Air pollution exposure increases the incidence of upper- and lower-respiratory infections in children. Because complex pollution mixtures are present in the studied urban areas, pollutant levels at which ARI risk would be expected to increase cannot be determined. Children may be at greater risk, given the poor environmental and nutritional conditions prevalent in developing countries.

The long-term impact of Johnson & Johnson's Health & Wellness Program on employee health risks

Abstract: To be viewed as successful, corporate health promotion and disease prevention programs must demonstrate that they can improve the risk profile of employees as a whole, and, in particular, those employees at highest risk. This study reports the effectiveness of Johnson & Johnson's newly configured Health & Wellness Program in reducing the health risks of 4586 employees who participated in two serial health screening programs, with a minimum of 1 year between screenings. The study also examines the impact of participation in a high-risk intervention program called Pathways to Change on health risk factors. McNemar chi-squared and z-test statistics were used to evaluate changes in health risks over time. Results indicate significant risk reduction in 8 of 13 risk categories examined for all employees who participated in two health risk assessments over an average of 2 3/4 years. When comparing Pathways to Change participants with non-participants, participants outperformed their non-participant counterparts in six categories but performed worse in five other categories that were not specifically targeted by the high-risk program. In two categories, no differences were found. The study underscores the ability of large-scale, well-attended, and comprehensive corporate health and productivity management programs to positively impact the health and well-being of workers.

Long-term impact of Johnson & Johnson's Health & Wellness Program on health care utilization and expenditures.

Abstract: The long-term impact of corporate health and wellness programs is largely unknown, because most evaluations focus on impact in just 1 or 2 years after program initiation. This project estimated the longer-term impact of the Johnson & Johnson Health & Wellness Program on medical care utilization and expenditures. Employees were followed for up to 5 years before and 4 years after Program implementation. Fixed-effects regression models were used to control for measurable and unmeasurable factors that may influence utilization and expenditures. Results indicated a large reduction in medical care expenditures (approximately $224.66 per employee per year) over the 4-year Program period. These benefits came from reduced inpatient use, fewer mental health visits, and fewer outpatient visits compared with the baseline period. Most benefits occurred in years 3 and 4 after Program initiation. We conclude that programs designed to better integrate occupational health, disability, wellness, and medical benefits may have substantial health and economic benefits in later years.

Relationship between cardiovascular disease morbidity, risk factors, and stress in a law enforcement cohort.

Abstract: It is unclear to what extent law enforcement officers (LEOs) experience increased prevalence of cardiovascular disease (CVD; defined as coronary heart disease, myocardial infarction, angina, or stroke) and, if so, whether perceived stress affects this relationship. First, self-reported CVD risk factors among currently employed male LEOs from 9 states (n = 2818) were compared to CVD risk factors among similarly-aged males with similar incomes in the same states (n = 8046). Second, CVD prevalence was compared among LEOs (n = 1791) and similarly-aged males with similar incomes (n = 2575) from four of these states. Finally, among the LEOs only, the possible effect of perceived stress on the relationship between CVD prevalence and CVD risk factors was assessed. LEOs reported higher prevalence of hypertension, hypercholesterolemia, tobacco use, and elevated body mass index. CVD prevalence did not differ significantly between the LEO group and the general population (2.3% +/- 15% versus 3.1% +/- 17%; P = 0.095). In the LEO-only group, the best predictors of CVD were: time in the profession (OR = 1.07; 95% CI = 1.03-1.11), perceived stress (OR = 1.05; 95% CI = 1.00-1.10), and hypertension (OR = 0.33; 95% CI = 0.18-0.62). In the LEO-only group, perceived stress was associated with CVD (P = 0.008), and three CVD risk factors were significantly affected by perceived stress: cholesterol, hypertension, and physical activity. Perceived stress was affected by duration of time in the profession (P = 0.004), independent of an age effect (P = 0.353). Among susceptible officers, perceived stress may contribute to CVD directly and through potentiating several CVD risk factors.

Acute traumatic occupational hand injuries: type, location, and severity.

Abstract: The National Electronic Injury Surveillance System reports that the fingers and hand are the most frequent body parts injured at work and treated in hospital emergency departments. In this study, we describe the type, location, and severity of occupational hand injuries among 1166 patients recruited from 23 occupational health clinics in five New England states. Subjects ranged in age from 18 to 77 years, with a mean of 37.2 years (SD, 11.4), and approximately 75% were men. In decreasing order of frequency, subjects were employed in machine trades, service work, structural work, and less frequently, in benchwork, professional, technical managerial and clerical, and sales work. The majority of subjects (83.4%) had a single type of injury: 62.6% were lacerations, 13.1% were crush injuries, 8.0% were avulsions, and 6.1% were punctures. Metal items, such as nails, metal stock, and burrs accounted for 38.4% of the injuries, followed by hand tools with blades and powered machinery (24.4% and 12.3%, respectively). Hand tools with blades were least likely to result in multiple types of injuries, whereas powered machines or nonpowered hand tools were more likely to result in multiple types of injuries than other injury sources. The generalizability of these results should be limited to clinic-based patients employed in similar occupations. The results of this study may suggest possible prevention strategies for acute traumatic hand injuries. (J Occup Environ Med. 2002;44:345–351) A

Physical workload and risk of early retirement: prospective population-based study among middle-aged men.

Abstract: Early retirement produces a heavy economic burden in many western societies. There is a need to identify single risk factors for early retirement and to find methods for preventing it. To estimate the effect of heavy physical work on early retiring, a cohort of 1755 men aged 42 to 65 years from eastern Finland was followed up from 1984 to 2000. Self-estimated physical workload was assessed at baseline. The inclusive pension records were obtained from national pension institutions. Logistic regression modeling was used to estimate the effect of physical workload and single physical risk factors on the risk of disability pension and nonillness-based pension. Risks were estimated for both disease-specific and all disability pensions. The interaction of physical fitness and physical workload and the resulting effects on risk were also estimated. During the follow-up, 861 (49.1%) men retired on a disability pension and 331 men (18.9%) retired on a nonillness-based early pension. Only 273 (15.6%) men reached the age for getting the normal old-age pension without having had any other early pension After adjustment for age, body mass index, alcohol consumption, smoking, maximal oxygen uptake, education and corresponding illness at baseline, heavy physical work was found to be associated with an increased risk of being retired on a disability pension due to musculoskeletal disorders (odds ratio (OR) 2.21, 95% confidence interval 1.36 to 3.61) but not due to cardiovascular or mental diseases. The association was stronger if cardiorespiratory fitness was poor. Lifting, static muscular loading and uncomfortable work positions increased the risk of early retirement especially due to musculoskeletal disorders. Loading of the upper extremity alone or with the neck and shoulder region seems to be an independent risk factor for early retirement. We concluded that physical workload increases the risk of retirement on a disability pension especially due to musculoskeletal disorders. In heavy physical work, the risk is increased especially among men with musculoskeletal or cardiovascular disease and poor cardiorespiratory fitness.

Risk factors for multisymptom illness in US Army Veterans of the Gulf War

Abstract: This research study examined the prevalence of symptoms and identified risk factors for reported symptoms among a group of Army Gulf War (GW) veterans. A survey was mailed to all members of the Ft. Devens cohort in 1997, representing the third assessment of a group that consisted of 2949 US Army soldiers deployed to the Gulf, and was studied initially in 1991. A total of 1290 subjects responded to the mailed survey; aggressive follow-up methods to address non-response bias were employed. Subjects were classified as having multisymptom illness if they reported symptoms from at least two of three symptom categories (fatigue, mood-cognition, musculoskeletal). Sixty percent of the respondents met criteria for multisymptom illness. Female gender, lower levels of education, psychological symptoms, self-reported use of a medical clinic in the Gulf, ingestion of anti-nerve gas pills (pyridostigmine bromide), anthrax vaccination, tent heaters, exposure to oil fire smoke, and chemical odors were significantly related to multisymptom illness in logistic regression analyses. Analyses in which subjects were stratified by level of psychological symptoms revealed different sets of GW-service environmental exposures and suggest that subgroups of GW veterans may have different sets of risk factors.

The economic burden of lost productivity due to migraine headache: a specific worksite analysis.

Abstract: Large, epidemiologic survey studies have established that migraine headaches affect approximately 6% of men and 18% of women in the United States and that the condition peaks during the prime working years (25 to 55 years of age). The consequent economic burden experienced by employers is substantial. The majority of this economic burden is realized by employers in terms of lost productivity, a combination of costs attributable to absenteeism and to lost productivity while on the job ("presenteeism"). Although large survey studies have produced estimates of national prevalence and have suggested substantial national costs, specific employers are rarely able to apply these projections to their specific workforce. Using demographic and payroll data available from a large financial services corporation with over 80,000 employees, this study used established prevalence data to estimate corporate costs stemming from migraine-related absenteeism and reduced on-the-job productivity to total at least $21.5 M and $24.4 M. In addition, a comparison of predicted prevalence and cost impact was conducted using a simpler and less costly health risk appraisal. This assessment proved to be a reliable tool in assessing prevalence of migraineurs in this corporation's workforce. Its use with a sample of 19,853 employees at this corporation produced prevalence rates of 7.7% of men and 23.4% of women, estimates closely comparable to those of national surveys. Suggestions are made regarding a corporate response to the substantial costs of lost productivity associated with migraine headache.

Air pollution and emergency room visits due to chronic lower respiratory diseases in the elderly: an ecological time-series study in São Paulo, Brazil.

Abstract: The objective of this study was to investigate the effect of daily air pollution levels (carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and particulate matter with an aerodynamic profile < or = 10 microns) on morbidity by using the daily number of emergency room visits due to chronic lower respiratory disease (CLRD) in people older than 64 years of age in the city of Sao Paulo, Brazil, from 1996 to 1998. Generalized additive Poisson regression models adjusted for long-time trend and weather (nonparametric functions), weekdays (dummy variable), and daily number of nonrespiratory admissions were adopted. Ozone and sulfur dioxide were the pollutants statistically associated with CLRD visits. Interquartile range increases in the 6-day moving average of sulfur dioxide (11.82 micrograms/m3) and in the 4-day moving average of ozone(35.87 micrograms/m3) increased CLRD emergency room visits in 18% and 14%, respectively. These results reinforce the idea that air pollution may promote adverse health effects in the elderly.

Prevalence of common infections among employees in different work schedules.

Abstract: This study examined the prevalence of common infections among employees in different work schedules. Self-administered questionnaire data from the Maastricht Cohort Study on "Fatigue at Work" (n = 12,140) were used. Job title was used as a matching variable between day and shift workers to control for their different work environment. We used a multilevel analysis of a two-level structure, in which the individual employees (level 1) were nested within job titles (level 2), adjusted for demographics, longstanding disease, health behavior, work-related factors, fatigue and sleep quality. Results from the multilevel analyses showed that, compared to day work, shift work was associated with a higher risk for common infections, with the highest risk in three-shift workers. Compared to day work, shift work was further associated with differences in health, health behavior, sleep, fatigue and perceived job characteristics, factors that may influence the occurrence of infections and should be taken into account in future studies as well.

Audiometric findings in workers exposed to low levels of styrene and noise.

Abstract: Audiometry and exposure measurements were conducted on workers from fiberglass and metal products manufacturing plants and a mail distribution terminal (N = 313). Workers exposed to noise and styrene had significantly worse pure-tone thresholds at 2, 3, 4, and 6 kHz when compared with noise-exposed or nonexposed workers. Age, noise exposure, and urinary mandelic acid (a biologic marker for styrene) were the variables that met the significance level criterion in the multiple logistic regression. The odds ratios for hearing loss were 1.19 for each increment of 1 year of age (95% confidence interval [CI], 1.11-1.28), 1.18 for every decibel >85 dB(A) of noise exposure (95% CI, 1.01-1.34), and 2.44 for each millimole of mandelic acid per gram of creatinine in urine (95% CI, 1.01-5.89). Our findings suggest that exposure to styrene even below recommended values had a toxic effect on the auditory system.

Cancer incidence among triazine herbicide manufacturing workers.

Abstract: This study evaluated cancer incidence and prostate specific antigen (PSA) testing among workers at a plant in Louisiana (LA) that made atrazine and other triazine herbicides. The study covered the time period 1985 through 1997 and included 2045 subjects, of whom 757 worked for the company that owned the plant and 1288 were contract employees. Linkage with a population-based cancer registry and review of death certificates and plant medical records identified cancer cases. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) compared subjects' cancer incidence rates with those of a regional general population. Plant medical records provided data on the proportion receiving PSA tests among male company employees. Subjects had 46 observed and 40 expected cases of all cancers combined (SIR = 114, CI = 83-152) and had 11/6.3 prostate cancers (SIR = 175, CI = 87-312). The prostate cancer excess was greater in actively working company employees (5/1.3, SIR = 394, CI = 128-920) than in contract employees or inactive company employees (6/5.0, SIR = 119, CI = 44-260) and was limited to men under 60 years of age. Of the 11 prostate cancer cases, nine were diagnosed at an early clinical stage. From 1993 to 1999, the proportion of male company employees who had at least one PSA test was 86% for those who reached 40 years of age while actively working and was 98% for those who reached 45 years of age. The observed prostate cancer increase may have been due to the frequent PSA testing of actively working company employees. There is no epidemiologic or other information that clearly supports a causal relation between atrazine and prostate cancer.

Depression-related short-term disability in an employed population.

Abstract: There has been a growing realization that the number of workplace disability claims for mental and nervous disorders is increasing. Yet, little is known about the working population disabled by these disorders. Absence of basic information describing this population makes it virtually impossible to plan effective workplace programs. Using administrative data collected from three major Canadian financial/insurance sector employers, we focus on one group of disorders--depression. In this study, we report the prevalence of short-term disability due to depression and describe the characteristics of workers affected and their disability outcomes. We observed that compared with other nervous and mental disorders, depression-related short-term disability generally affected more employees, lasted longer, and had a higher rate of recurrence. In addition, at the end of their episodes more than three quarters of workers returned to work. These estimates suggest that the potential magnitude of the impact of short-term disability should be a concern for employers. This study helps identify the main characteristics of workers who develop depression-related disability. It also helps clarify what happens to those on short-term disability.

Deep body core temperatures in industrial workers under thermal stress.

Abstract: To date, no field study has continuously monitored the deep body core temperatures of industrial workers. A program to continuously measure deep body core temperatures in 36 industrial workers working lo-, 12-, and 12.5-hour day and nightshifts in a hot, deep, underground mine in the Tropics was conducted. No heat illness occurred in these workers during the study. Miniaturized radio-transponders (‘fills”) taken orally were used to measure temperature during the transit time in the gastrointestinal tract. Commonly recommended limits for industrial hyperthemzia are 38. O’C, or an increase of + 1 “C. The results showed that miners regularly exceeded these limits in terms of maximum deep body core temperature (average, 38.3”C; standard deviation, 0.4”C), maximum temperature rise (1.4”C, 0.4”C), and maximum heat storage (431 kzJ, 163 kJ) without reporting any symptoms of heat illness. A significant component of the observed elevated core temperatures was attributable to the normal circadian rhythm, which was measured at 0.9”C (standard deviation, 0.2”C). Evidence was found that workers “selfpace” when under thermal stress. (J Occup Environ Med. 2002; 44:125-135)

Validity of a self-administered questionnaire for assessing physical work loads in a general population.

Abstract: The aim of the study was to evaluate eight questions concerning physical loads, used in public health questionnaires. Working women and men (203) completed a self-administered questionnaire twice, following a test-retest method. The questions were also validated with a structured interview. Response agreement was calculated with Cohen's kappa statistics with quadratic weights (kappa w). Test-retest agreement varied from 0.74 to 0.92, and inter-method agreement from 0.38 to 0.81. The lowest coefficients were for the questions concerning bent/twisted work postures (kappa w 0.38) and repetitive movements (kappa w 0.39). The results did not indicate any substantial influence of gender, type of work or musculoskeletal complaint. The questions concerning general physical activity and sitting work postures, and physical exercise/sports during leisure times, had good validity. The questions concerning bent/twisted work posture and repetitive movements need to be re-designed.

Parental concentration of dichlorodiphenyl dichloroethene and polychlorinated biphenyls in Michigan fish eaters and sex ratio in offspring.

Abstract: Contamination of fish in the Great Lakes generated three surveys assessing polychlorinated biphenyls (PCB) serum concentration in Michigan anglers: 1973 to 1974, 1979 to 1982, and 1989 to 1991. This cohort provided 1177 individuals with PCB determinations. In 2000, we conducted telephone interviews

Potential association between male infertility and occupational psychological stress.

Abstract: The purpose of this work was to investigate the influence of working conditions, occupational exposures to potential reproductive toxic agents, and psychological stress on male fertility. The study population consisted of 202 consecutive male patients attending a fertility clinic. Of those, 106 patients had attended the clinic because of a male infertility problem (case group), 66 patients had attended the clinic because of a female infertility problem (control group), and 30 patients had a combined infertility problem (male and female). Male infertility was associated with working in industry and construction as compared with other occupations (78.6% vs 58.3%, P = 0.044). Industry and construction workers were of lower educational level than the other workers (mean: 12.1 vs 13.4 years, P = 0.021). These patients also tended to smoke more than the other workers (OR = 2.53, 95% CI = 1.08 to 5.98), more often worked in shifts (OR = 3.12, 95% CI = 1.19 to 8.13), reported physical exertion in work (OR = 3.35, 95% CI = 1.44 to 7.80), and were more exposed to noise and welding (OR = 3.84, 95% CI = 1.63 to 9.14, OR = 4.40, 95% CI = 1.11 to 1.76, respectively). Male infertility (case group) was found to be statistically related to higher marks in all four measures of burnout as compared with the controls. The largest difference was obtained in the measure of cognitive weariness (mean: 2.9 vs 2.1, P < 0.001). In a multiple logistic regression analysis, industry and construction jobs (adjusted OR = 2.2, 95% CI 1.2 to 2.7) and cognitive weariness (adjusted OR = 1.8, 95% CI = 1.03 to 4.6) were found to be independent risk factors for male infertility problems. Male infertility was independently associated with industry and construction jobs as well as job burnout.

Risk factors for sick leave due to low back pain: a prospective study.

Abstract: The objectives of this prospective study were to identify predictive factors for sick leave of 8 days or more due to low back pain (LBSL) and to compare them with predictive factors for low back pain with no or shorter sick leave (LB) in a cohort of French workers. The predictive factors for LBSL were a past history of low back pain (odds ratio [OR], 7.2; 95% confidence interval [CIJ, 4.1 to 13), a low employment grade (OR, 4.3; 95% CI, 1.7 to 11), heavy smoking (OR, 5.5; 95% CI, 2.3 to 13), a pain score different from zero (OR, 4. 9; 95 % CI, 2.5 to 9. 7), required bending backward or forward at work every day repetitively (OR, 7.4; 95% CI, 2.3 to 23), overall social integration (OR, 2.0; 95% CI, 1.3 to 3.3), and low social support at work (OR, 3. 4; 95% CI, 1.6 to 7.3). Low social support at work and bending backward or forward at work were more strongly associated with LBSL than with LB (P = 0.02 and P < 0.01, respectively) The implications of the results of this prospective study are that both the level of biomechanical exposure and the psychosocial work environment, especially social support, represents important dimensions to consider in the reduction of work absenteeism.

Association of Body Mass Index and Health Status in Firefighters

Abstract: This study evaluates the usefulness of body mass index (BMI) as a preventive screening tool for general health and duty fitness status among firefighters. Two major BMI categorization methods were used: (1) "standard" [low ( or = 27 30)]; and (2) WHO [(normal ( or = 25 or = 30 or = 39)]. Using the "standard" categorization, nearly 60% of individuals had medium or high BMI's; using the World Health Organization categorization, 80.7% of individuals were found to be overweight, obese, or morbidly obese. Statistically significant, inverse correlation between BMI and each of the following parameters was noted: systolic and diastolic blood pressure, VO2max, METS, and total cholesterol. Inconsistent or statistically insignificant correlation was found between BMI and HDL, Chol/HDL ratio, triglycerides, FVC% predicted, and FEV1 second% predicted. Findings were similar to previous studies of such correlates. BMI continues to prove useful as a screening tool and may be useful in identifying individual firefighters for health and fitness intervention measures.

Association of comorbidity and outcome in episodes of nonspecific low back pain in occupational populations.

Abstract: We examined the relationship between comorbidity and first return to work after episodes of work-disabling, nonspecific low back pain (NSLBP). An inception cohort of workers with new episodes of NSLBP was identified from administratively maintained occupational health records. We compared 6-month return-to-work rates between workers with one or more comorbid conditions with those without documented comorbidity. Workers with comorbidity were 1.31 times more likely to remain work disabled than those with uncomplicated NSLBP, after adjusting for age, gender, lifting demands, and company membership (adjusted hazards ratio [HR] = 1.31; 95% confidence interval [CI] 1.12 to 1.52). Concurrent injury (i.e., sprains or strains of the neck, upper extremity, and lower extremity; contusions; and lacerations) had the strongest association (adjusted HR = 1.49; 95% CI, 1.21 to 1.83), followed by musculoskeletal disorders (adjusted HR = 1.13; 95% CI, 0.77 to 1.66). Comorbidities should be routinely evaluated at first visit by occupational health professionals to better manage disability associated with LBP.

Respiratory symptoms and lung function among Danish woodworkers.

Abstract: A cross-sectional study including 54 furniture factories and three control factories was conducted to survey lung function and prevalence of respiratory symptoms among woodworkers. Spirometry was performed on 2423 persons. Questionnaires regarding respiratory symptoms and wood dust exposure were com

Occupation and risk of non-Hodgkin's lymphoma and chronic lymphocytic leukemia.

Abstract: To investigate the association between occupation and the risk of non-Hodgkin’s lymphoma (NHL) and chronic lymphocytic leukemia (CLL), and to test whether the associations may vary by histological type of NHL, we analyzed data from two population-based, case-control studies of NHL performed in Kansa

Influence of participation in a worksite health-promotion program on disability days.

Abstract: This study assessed the impact of health-promotion program participation on short-term and long-term disability absence days during a 6-year period in a manufacturing company. Male, hourly, active employees (n = 4189) were analyzed from 1995 to 2000. Disability absences were compared for program participants and nonparticipants from baseline (1995) through 5 years of the program. The percentage of nonparticipants absent on any given day was greater than that of participants. Moreover, the average number of disability absence days incurred by nonparticipants significantly increased from baseline to program year 5 compared with participants. The total amount saved each year in disability absence days for the 2596 program participants was $623,040, which resulted in a savings-to-cost ratio of 2.3 per year. Participation in worksite health-promotion programs may lead to reduced disability days in a manufacturing worksite population.

Lung cancer and indoor exposure to coal and biomass in rural China.

Abstract: Incomplete combustion of coal in homes has been linked with lung cancer in China. We report on a lung cancer case-control study in a rural area of China, where many residents live in underground dwellings and burn coal and unprocessed biomass (crop residues, wood, sticks, and twigs) for heating and cooking. We interviewed 846 patients with lung cancer (626 men, 220 women; aged 30 to 75 years) diagnosed between 1994 and 1998, and 1740 population-based controls. The odds ratio for lung cancer associated with coal use compared with that for biomass in the house of longest residence was 1.29 (95% confidence interval, 1.03 to 1.61), adjusted for smoking and socioeconomic status. The risk for lung cancer increased relative to the percentage of time that coal was used over the past 30 years (P = 0.02). Our findings suggest that coal may contribute to the risk of lung cancer in this rural area of China.

Parental occupation and neural tube defect-affected pregnancies among Mexican Americans.

Abstract: In a case-control study, we examined whether parental occupational exposures were related to neural tube defect (NTD)-affected pregnancies among Mexican Americans living along the Texas-Mexico border. Case women were 184 Mexican-American women with NTD-affected pregnancies; control women were 225 study-area residents who delivered normal babies during the same period as the case women. The women were interviewed in person about maternal and paternal occupations and work exposures during the periconceptional period. Compared with control women, case women were more likely to have had occupational exposures to solvents (odds ratio [OR], infinity; 95% confidence interval [CI], 2.4-infinity) and also were more likely to have worked in cleaning (OR 9.5; 95% CI, 1.1 to 82.2) or health care occupations (OR 3.0; 95% CI, 1.0 to 9.0) than control women. No compelling associations were found between paternal work exposures or occupations and NTDs in offspring in this population.