Showing papers in "Journal of Occupational and Environmental Medicine in 2007"
TL;DR: Fatigue frequently co-occurs with other conditions and, when present, is associated with a threefold increase, on average, in the proportion of workers with condition-specific LPT.
Abstract: Objective: The objective of this study was to estimate fatigue prevalence and associated health-related lost productive time (LPT) in U.S. workers. Methods: Fatigue prevalence, LPT due to fatigue, and LPT for any health-related reason (in hours and dollars) were measured in a national cross-sectional telephone survey of U.S. workers. Results: The 2-week period prevalence of fatigue was 37.9%. Of workers with fatigue, 65.7% reported health-related LPT compared with 26.4% of those without fatigue. Workers with fatigue cost employers $136.4 billion annually in health-related LPT, an excess of $101.0 billion compared with workers without fatigue. Fatigue frequently co-occurs with other conditions and, when present, is associated with a threefold increase, on average, in the proportion of workers with condition-specific LPT. Conclusions: Fatigue is prevalent in the U.S. workforce. When occurring with other health conditions, it is associated with significantly more condition-specific LPT. (J Occup Environ Med. 2007;49:1–10)
364 citations
TL;DR: This study demonstrates that Integrated Population Health & Productivity Management should be built on a foundation of Integrated Population health and productivity Measurement.
Abstract: Objective:The objective of this study is to assess the magnitude of health-related lost productivity relative to medical and pharmacy costs for four employers and assess the business implications of a “full-cost” approach to managing health.Methods:A database was developed by integrating medical and
216 citations
TL;DR: Substantial absenteeism costs are associated with obesity and morbid obesity in the United States, and employers should explore workplace interventions and health insurance expansions to reduce these costs.
Abstract: Objective:To document the absenteeism costs associated with obesity and morbid obesity by occupation.Methods:Data from the Medical Expenditure Panel Survey for 2000–2004 are examined. The outcomes are probability of missing any work in the previous year and number of days of work missed in t
189 citations
TL;DR: Both a team-centered and individual-oriented intervention promoted healthy behaviors and the scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.
Abstract: Objective:PHLAME’s (Promoting Healthy Lifestyles: Alternative Models’ Effects) objective was to assess and compare two means to promote healthy lifestyles.Methods:Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (M
186 citations
TL;DR: Increased efforts should be directed at disseminating the experiences of promising practices in HPM, so that additional public and private funding is made available for applied research in “real-life” business settings.
Abstract: Objective:To identify key success factors related to employer-based health and productivity management (HPM) programs.Methods:Data regarding promising practices in HPM were gathered via literature review, discussions with subject matter experts, online inventory, and site visits.Results:Prom
176 citations
TL;DR: Exposure to road traffic noise exposure at home may be associated with hypertension in subjects who are between 45 and 55 years old, and Associations seemed to be stronger at higher noise levels.
Abstract: OBJECTIVE: The purpose of this study was to assess the relationship between road traffic noise exposure at home and the prevalence of hypertension. METHODS: We conducted cross-sectional analyses in a large random sample (N = 40,856) of inhabitants of Groningen City, and in a subsample (the Prevention of Renal and Vascular End-Stage Disease [PREVEND]) study cohort; N = 8592). RESULTS: Before adjustment for confounders, road traffic noise exposure was associated with self-reported use of antihypertensive medication in the city of Groningen sample (odds ratio [OR] = 1.31 per 10-dB increase in Lden). Adjusted odds ratios were significant for the subjects between 45 and 55 years old in the full model when adjusted for PM10 (OR = 1.19) and at higher exposure (Lden >55 dB) only (OR = 1.21; with adjustment for PM10, OR = 1.31). In the PREVEND cohort, the unadjusted odds ratio was 1.35 for hypertension (systolic and diastolic blood pressure >140 and >90 mm Hg, respectively, or use of antihypertensive medication). Again, the adjusted odds ratio was significant for subjects between 45 and 55 years old (OR = 1.27; with adjustment for PM10, OR = 1.39). CONCLUSIONS: Exposure to road traffic noise may be associated with hypertension in subjects who are between 45 and 55 years old. Associations seemed to be stronger at higher noise levels. ©2007The American College of Occupational and Environmental Medicine.
165 citations
TL;DR: The findings indicate a modest positive association of PFOA on some lipid parameters and a need for follow-up studies.
Abstract: Objective:To examine the relationship between serum perfluorooctanoate (PFOA), a biomarker of ammonium perfluorooctanoate (APFO) exposure, and lipids and liver enzymes in a cross-sectional study among workers with potential occupational exposure to APFO.Methods:We conducted a cross-sectional study o
165 citations
TL;DR: It is revealed that modest financial incentives can be effective in motivating overweight employees to lose weight.
Abstract: Objective:To test the ability of two levels of modest financial incentives to encourage weight loss among overweight employeesMethods:This study used a randomized design with measurements at baseline, 3, and 6 months and two levels of financial incentives ($7 and $14 per percentage point of
159 citations
TL;DR: The Environmental Relative Moldiness Index scale may be useful for home mold-burden estimates in epidemiological studies.
Abstract: Objective:The objective of this study was to establish a national relative moldiness index for homes in the United States.Methods:As part of the Housing and Urban Development's American Healthy Homes Survey, dust samples were collected by vacuuming 2 m2 in the bedrooms plus 2 m2 in the livin
158 citations
TL;DR: These medical surveillance data collected on workers for up to 25 years contributes useful information on the effects of ammonium perfluorooctanoate exposure on human liver and lipid chemistry.
Abstract: Objective:To examine the relationship between serum perfluorooctanoate (PFOA), a biomarker of ammonium perfluorooctanoate exposure, and lipids and liver enzymes.Methods:We conducted a longitudinal study on 454 workers and used mixed models to examine the relationship between serum PFOA and lipids an
150 citations
TL;DR: In this article, the authors determined the indirect cost burden associated with migraine using data from Thomson-Medstat's Health and Productivity Management (HPM) database for the 2002 through 2003 calendar years.
Abstract: Objective:The purpose of this study was to determine the indirect cost burden associated with migraine.Methods:Data were obtained from Thomson-Medstat's Health and Productivity Management (HPM) database for the 2002 through 2003 calendar years. The migraine cohort was composed of patients wh
TL;DR: Higher levels of symptom burden, lower levels of health behaviors, and more negative problem solving orientation were characteristic of the brain tumor survivor group, and modifiable factors account for most of the variance in work limitations for both groups.
Abstract: Objective:To determine the association of symptom burden to work limitation among working survivors of malignant brain tumors.Methods:Working adults with malignant brain tumors (n = 95) and a non-cancer comparison (n = 131) group completed a web-based questionnaire. Measures of demographics, tumor t
TL;DR: Until John Snow, the subject of the two books to be reviewed, the miasma (bad air) theory of the etiology of cholera prevailed over the contagionists who believed that the disease was somehow transmitted from person to person (but not by water).
Abstract: Historically, cholera, which had been endemic in India for millennia, was spread by people in caravans, military operations, pilgrimages and sailing ships to cause what are regarded as seven great pandemics. It reached England for the first time during the second pandemic in June 1831 [and America in 1832 (see Pollitzer, R. Cholera. World Health Organization, Geneva. 1959)] and then, again, during the third pandemic in 1853‘54. The causative agent, Vibrio cholerae, was unknown until it was isolated in pure culture by Robert Koch in Egypt in 1883 although it had been described, in 1854, by Italian microscopist Filippo Paccini whose observations were ignored by the scientific community. Until John Snow, the subject of the two books to be reviewed, the miasma (bad air) theory of the etiology of cholera prevailed over the contagionists who believed that the disease was somehow transmitted from person to person (but not by water).
TL;DR: It is suggested that maternal arsenic exposure early in pregnancy negatively affects newborn birth weight and that maternal hair provides the best integrated measure of arsenic exposure.
Abstract: Objective:To characterize the effects of maternal arsenic exposure on birth weight.Methods:Hair, toenail, and drinking water samples were collected from pregnant women (n = 52) at multiple time points during pregnancy and from their newborns after birth. Total arsenic was measured using indu
TL;DR: Non–work-time behaviors play a significant role in mediating maladaptive outcomes from work strain and are more significant in maximizing recovery fromWork strain than is commonly recognized.
Abstract: Objective:In this exploratory study, we investigated the extent to which common leisure time behaviors, which generate positive feelings of fulfillment and personal reward, are significant in alleviating work-induced stress between successive work periods We tested the hypotheses that such activiti
TL;DR: OC is significantly associated with the health and well-being of hospital nurses and OC factors were independently associated with injuries and measures of burnout.
Abstract: Objective: The objective of this study was to determine relationships between organizational climate (OC) factors and occupational health outcomes (lost workdays, musculoskeletal injury, blood and body fluid exposures, injuries, and burnout) among hospital-based nurses. Methods: Measures were obtained through a self-administered, anonymous survey distributed in 13 New York City hospitals. Multivariate models appropriate for clustered data were developed. These analyses controlled for nurse and employment characteristics. Independent effects of OC factors were examined. Results: Surveys from 2047 predominantly registered nurses were obtained (response rate 50%). More than 75% reported lost workdays due to illness in the previous 4-month period and over one third reported experiencing some type of injury. OC factors were independently associated with injuries and measures of burnout (P ≤ 0.05). Conclusions: OC is significantly associated with the health and well-being of hospital nurses.
TL;DR: Developing effective smoking prevention strategies specifically targeting blue-collar groups is warranted after there were significant annual reductions in smoking rates for all adult US workers in both survey periods.
Abstract: Objective:It is unknown if the gap in smoking rates observed between United States blue- and white-collar workers over the past four decades has continued into the new millennium.Methods:The National Health Interview Survey is a nationally representative survey of the US civilian population. Smoking
TL;DR: Job strain conditions may be associated with the co-occurrence of adverse health behaviors that contribute to preventable chronic diseases and reducing work stress by increasing job control and decreasing psychologic demands might help efforts to promote healthy lifestyles.
Abstract: Objective The objective of this study was to explore the association between job strain and the co-occurrence of adverse health behaviors; smoking, heavy drinking, obesity, and physical inactivity. Methods The authors studied cross-sectional data of 34,058 female and 8154 male public sector employees. Results Multinomial logistic regression models adjusted for sex, age, basic education, marital status, and type of job contract showed that high job strain and passive jobs were associated with 1.3 to 1.4 times higher odds of having > or =3 (vs 0) adverse health behaviors. Among men, low job control was associated with a 1.3-fold likelihood and among women active jobs were associated with a 1.2-fold likelihood of having > or =3 (vs 0) adverse behaviors. High demands were associated with a higher likelihood of co-occurrence of one to two (vs 0) adverse behaviors among women. Conclusions Job strain conditions may be associated with the co-occurrence of adverse health behaviors that contribute to preventable chronic diseases. Clinical significance Adverse job conditions may increase the likelihood of co-occurring health risk behaviors. Reducing work stress by increasing job control and decreasing psychologic demands might help efforts to promote healthy lifestyles.
TL;DR: The range of quit rates suggests that Internet cessation programs can be effective in promoting cessation and preventing relapse in a worksite setting.
Abstract: Objective:To evaluate effectiveness of an Internet-based smoking cessation program as part of a comprehensive health risk reduction initiative in a large, geographically dispersed employee population.Methods:A financial incentive for participation was offered during 2003 health benefits enro
TL;DR: Workers who have diabetes with neuropathic symptoms lose the equivalent of $3.65 billion/yr in health-related LPT, higher in the symptom and non-symptom groups versus for those without diabetes.
Abstract: Objective:Estimate the impact of diabetes and neuropathic pain on the US workforce.Methods:Data on lost productive time (LPT) was collected by telephone interview in a random sample of the US population (N = 36,634). Of 19,075 occupation-eligible working adults included in the analysis, 1003 reporte
TL;DR: PM10 exposure during pregnancy may result in adverse birth outcomes with different critical periods, as stillbirths, premature birth, and low-birth-weight births were affected by the PM10 level during entire trimesters of pregnancy.
Abstract: Objective:The aim of this study was to evaluate the effects of PM10 on birth outcomes using a prospective cohort of pregnant women.Methods:The multicenter prospective study was conducted in Korea from 2001 to 2004. To estimate the effects of PM10 exposure on birth outcomes, the logistic and linear r
TL;DR: A relationship between physical loads and musculoskeletal disorders was indicated by the results, which will enable creating a database for tracking reports of MSDs in the US working population.
Abstract: OBJECTIVE: Assessments of potential risk factors for musculoskeletal disorders (MSDs) from large, national study populations using personal interviews are critical to our understanding of exposure-response relationships. To address this need, we analyzed two outcome measures--self-reported back pain and upper extremity pain--from the quality of work life (QWL) module of the General Social Survey (GSS). We investigated several individual, psychosocial, and physical factors for their relationship to these outcome measures. METHODS: The study population included US adults, noninstitutionalized, English-speaking, aged 18 years or older, and employed at least part time (>or=20 hr/wk). Final sample size was 1484 workers. RESULTS: Variables of physical exposure significantly increased the risk of both low back pain and upper extremity pain. Multiple injuries and some psychosocial factors were associated with MSDs, and there was an additive effect on risk of MSDs with exposure to both physical exposure and work stress. CONCLUSIONS: A relationship between physical loads and musculoskeletal disorders was indicated by the results, which will enable creating a database for tracking reports of MSDs in the US working population. Language: en
TL;DR: Sleep and self-appraised lifestyle were significantly related to changes in perceived flexibility over time and may play an important role in effective worksite health promotion programs.
Abstract: Objective:To examine the cross-sectional and longitudinal associations between workplace flexibility and health behaviors, and estimate the potential importance of flexibility for effective worksite health promotion programs.Method:Cross-sectional and longitudinal health risk appraisal data
TL;DR: The social context of the home-work environment challenges the implementation of preventive interventions to reduce occupational hazards in HHC, and risk factors for bloodborne pathogen exposures are focused on.
Abstract: Objective: Home health care (HHC) is one of the fastest growing US industries. Its working conditions have been challenging to evaluate, because the work environments are highly variable and geographically dispersed. This study aims to characterize qualitatively the work experience and hazards of HHC clinicians, with a focus on risk factors for bloodborne pathogen exposures. Methods: The researchers conducted five focus group discussions with HHC clinicians and ten in-depth interviews with HHC agency managers and trade union representatives in Massachusetts. Results: HHC clinicians face serious occupational hazards, including violence in neighborhoods and homes, lack of workstations, heavy patient lifting, improper disposal of dressings or sharp medical devices, and high productivity demands. Conclusions: The social context of the home-work environment challenges the implementation of preventive interventions to reduce occupational hazards in HHC.
TL;DR: Elevated PM10 may contribute to oxidative stress and impaired cardiovascular function in patients with diabetes mellitus and mixed-effects models were tested.
Abstract: Objective: We investigated whether personal exposure to particulate matter 10 m in diameter (PM10) contributes to impaired cardiovascular function and increased systemic
inflammation and oxidative stress in diabetic patients Methods: We monitored 25 patients’ personal exposure to PM10 for 24 hours and then measured their heart rate, blood pressure, brachial arterial diameter, flow-mediated vasodilation (FMD), plasma cytokines, and thiobarbituric acid reactive substances (TBARS), which is an oxidative stress marker We repeated this procedure for 7 weeks on each subject We tested the associations using mixed-effects models Results: PM10 was significantly positively associated with FMD and TBARS but inversely associated with end-systolic basal brachial arterial diameter (P 005) Moreover, in subjects
not taking vasoactive medications, PM10 was significantly positively associated with blood
pressure but inversely associated with artery flow Conclusion: Elevated PM10 may contribute to oxidative stress and impaired cardiovascular function in patients with diabetes mellitus
TL;DR: Veterans of military operations in Southwest Asia have deployment-related health and exposure concerns that will need to be addressed by their ambulatory care physicians.
Abstract: Objective:We report the clinical concerns of US veterans of Operations Iraqi Freedom and Enduring Freedom evaluated at the New Jersey War-Related Illness and Injury Study Center (NJ WRIISC) between June 2004 and January 2006.Methods:We conducted a retrospective chart review of veterans' heal
TL;DR: High job strain was an important independent risk factor for higher ambulatory blood pressure at work, at home, and during sleep in a group of men and women.
Abstract: OBJECTIVE: The aim of this study was to assess whether job strain is associated with 24-hour ambulatory blood pressure measurements within a subsample of the Belgian Job Stress Project (BELSTRESS) population. METHODS: A group of 89 middle-aged male and female workers perceiving high job strain and an equally large group of workers perceiving no high job strain wore an ambulatory blood pressure monitor for 24 hours on a regular working day. RESULTS: Mean ambulatory blood pressure at work, at home, and while asleep was significantly higher in workers with job strain as compared with others. The associations between job strain and ambulatory blood pressure were independent from the covariates. CONCLUSIONS: Within this study, high job strain was an important independent risk factor for higher ambulatory blood pressure at work, at home, and during sleep in a group of men and women.
TL;DR: Work accommodation offer and acceptance and advice from health care provider to the workplace on re-injury prevention were significant predictors of shorter work absence duration indexed by both self-report and administrative data.
Abstract: OBJECTIVES: To examine, using administrative and self-reported data, the relationship between early return-to-work (RTW) strategies and work absence duration. METHODS: Using a cohort of 632 claimants with work-related musculoskeletal injuries, Cox proportional hazard analyses were performed with RTW strategies measured 1 month after injury as predictors. Outcomes were 6-month self-reported work absence duration and time receiving wage replacement benefits from an administrative database. RESULTS: Work accommodation offer and acceptance and advice from health care provider (HCP) to the workplace on re-injury prevention were significant predictors of shorter work absence duration indexed by both self-report and administrative data. Receiving an ergonomic visit was a significant predictor of shorter duration receiving benefits only. CONCLUSIONS: Analyses using administrative and self-reported indices of work absence generally converged. Work accommodation and targeted HCP communication with the workplace are critical for effective early RTW interventions. Language: en
TL;DR: No association was observed between working in a PFOS-exposed job and the risk of any of the surveyed conditions, including cancers, common health conditions, and birth weight.
Abstract: Objective:To evaluate whether some cancers, other conditions, and pregnancy outcomes were related to occupational perfluorooctane sulfonate (PFOS) exposure.Methods:We surveyed current and former employees of a perfluorooctanesulfonyl fluoride production facility, using a self-administered qu
TL;DR: Effectiveness of encouraging workplace adherence to the American Conference of Governmental Industrial Hygienists recommendations deserves investigation as a possible key to wide-scale prevention of carpal tunnel syndrome.
Abstract: Objective: To assess risks associated with work-related biomechanical overloads in onset/course of carpal tunnel syndrome Methods: Workgroups with job tasks spanning different biomechanical exposures were evaluated at baseline in terms of American Conference of Governmental Industrial Hygienists hand-activity/peak force action limit and threshold limit values (TLV) Exposures of interest were “unacceptable” (hand-activity above TLV) and “borderline” (between action limit and TLV) overloads Clinical/individual data were collected at baseline and 12 months Results: One-year incidence of “classic/possible” carpal tunnel syndrome symptoms as defined by consensus criteria was 73% (153 of 2092) “Unacceptable” overload was associated with a 3-fold increased risk of onset with respect to “acceptable” load At ordered logistic regression analysis of symptom-status variations, increased risks were recorded for “unacceptable” and “borderline” overloads Conclusions: Effectiveness of encouraging workplace adherence to the American Conference of Governmental Industrial Hygienists recommendations deserves investigation as a possible key to wide-scale prevention