Showing papers in "Journal of Occupational and Environmental Medicine in 2009"
TL;DR: Self-reported health care utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods.
Abstract: Objective
To determine the accuracy of self-reported healthcare utilization and absence reported on health risk assessments (HRAs) against administrative claims and human resource records.
326 citations
TL;DR: A strong link exists between health and productivity and Integrating productivity data with health data can help employers develop effective workplace health human capital investment strategies, according to this study.
Abstract: Objective:To explore methodological refinements in measuring health-related lost productivity and to assess the business implications of a full-cost approach to managing health.Methods:Health-related lost productivity was measured among 10 employers with a total of 51,648 employee respondents using
321 citations
TL;DR: SP may be an important phenomenon to consider when evaluating measures aimed at decreasing sickness absenteeism because more SP may lead to future sickness absence.
Abstract: OBJECTIVE: To prospectively investigate whether sickness presenteeism (SP), ie, going to work despite illness, has an impact on future sickness absenteeism. METHODS: Two study populations were used ...
307 citations
TL;DR: For public health planning, it is critical to identify populations that may experience synergistic effects of multiple risk factors for health problems, both related to climate change and to other temporal trends, with specific geographic factors that convey climate-related risks.
Abstract: Climate change can be expected to have differential effects on different subpopulations. Biological sensitivity, socioeconomic factors, and geography may each contribute to heightened risk for climate-sensitive health outcomes, which include heat stress, air pollution health effects, extreme weather event health effects, water-, food-, and vector-borne illnesses. Particularly vulnerable subpopulations include children, pregnant women, older adults, impoverished populations, people with chronic conditions and mobility and cognitive constraints, outdoor workers, and those in coastal and low-lying riverine zones. For public health planning, it is critical to identify populations that may experience synergistic effects of multiple risk factors for health problems, both related to climate change and to other temporal trends, with specific geographic factors that convey climate-related risks.
288 citations
TL;DR: In this paper, the authors evaluated temperature-related morbidity and mortality for the 2007 U.S. national assessment on impacts of climate change and variability on human health, and evaluated literature published since the 2000 national assessment, evaluating epidemiologic studies, surveys, and studies pr
Abstract: Objective:We evaluated temperature-related morbidity and mortality for the 2007 U.S. national assessment on impacts of climate change and variability on human health.Methods:We assessed literature published since the 2000 national assessment, evaluating epidemiologic studies, surveys, and studies pr
283 citations
TL;DR: Clinical and cost-effectiveness research in the worksite/corporate environment continues to evolve although there was only one randomized clinical trial conducted during the most recent interval.
Abstract: This critical review focuses on the 12 new studies focused on the clinical and cost outcomes research focused on worksites and published between 2000 and 2004. Although these new studies indicate further evidence of positive clinical and cost outcomes, the quantity and quality of such research continue to decline. When corporations and health plans are demanding more evidence-based outcomes, this decline in rigorous research marks a serious challenge to the field of health promotion and disease management.
233 citations
TL;DR: No clinical evidence of any specific trouble or disease has been recorded over the 30 years, and all the biochemical parameters turned out to be within the reference ranges, but a significant association of total cholesterol and uric acid with and PFOA serum level was evidenced.
Abstract: Objective:To report health outcomes of 30 years (1978–2007) of medical surveillance of workers engaged in a perfluooctanoic acid (PFOA) production plant.Methods:Fifty-three males workers (20 to 63 years) were submitted every year to medical examination and blood chemical chemistry tests, and serum P
201 citations
TL;DR: It is suggested that the participatory intervention for workplace improvement is effective against deterioration in mental health and for improving job performance.
Abstract: Objective:To explore the effect of participatory intervention for workplace improvement on mental health and job performance.Methods:Eleven assembly lines were randomly allocated to six intervention and five control lines (47 and 50 workers, respectively). The primary outcome was defined as
146 citations
TL;DR: Fourteen years after deployment, 1991 Gulf War veterans continue to report a higher prevalence of many adverse health outcomes, compared with Gulf Era veterans.
Abstract: Objective: To assess periodically the health status of a cohort of 1991 Gulf War veterans by comparing various health outcomes with those of their military peers who were not deployed to the Gulf. Methods: We conducted a follow-up health survey to collect health information among population-based samples of 30,000 veterans (15,000 Gulf War veterans and 15,000 Gulf Era veterans) using a structured questionnaire. Results: Gulf veterans reported significantly higher rates of unexplained multi-symptom illness, chronic fatigue syndrome-like illness, posttraumatic stress disorder, functional impairment, health care utilization, a majority of selected physical conditions and all mental disorders queried during the survey than did Gulf Era veteran controls. Conclusions: Fourteen years after deployment, 1991 Gulf War veterans continue to report a higher prevalence of many adverse health outcomes, compared with Gulf Era veterans. (J Occup Environ Med. 2009;51: 000–000) I
140 citations
TL;DR: Daily exposure to particulate pollution, likely traffic-related, may result in adverse effects on cardiovascular function and blood mediators that modulate vascular system in seniors.
Abstract: Objective : To investigate the associations between exposure to particulate
air pollution and changes in cardiovascular function and plasma
mediators in seniors. Methods : We monitored daily indoor and outdoor
black carbon and particulate matter 2.5 m (PM2.5) and personal
PM2.5 repeatedly for 28 nonsmoking seniors. We then measured their
blood pressure, heart rate, and brachial artery function, and determined
plasma mediators of inflammation, vascular function, and oxidative
stress. We tested associations using mixed-effects models. Results : Increases in black carbon and PM2.5 were associated with increases in
blood pressure, heart rate, endothelin-1, vascular endothelial growth
factor, and oxidative stress marker thiobarbituric acid reactive substances,
and a decrease in brachial artery diameter (P 0.05). Conclusion : Daily exposure to particulate pollution, likely trafficrelated,
may result in adverse effects on cardiovascular function and
blood mediators that modulate vascular system in seniors.
117 citations
TL;DR: A significant and consistent association among three factors (high biometric laboratory values, cigarette and alcohol use, and poor emotional health) and increased presenteeism for both men and women and increased absenteeism for women is found.
Abstract: Objective:To quantify the impact of health risks on medical care and productivity costs in an employed population.Methods:Health risk, medical care, and productivity data were obtained for 5875 Novartis employees in 2005-2006. Factor analysis was performed to identify relationships among health risk
TL;DR: Worksite intervention with both SRT as well as APE is recommended, since these activities compared with REF resulted in clinically relevant reductions of cardiovascular and metabolic syndrome-related risk factors as wellAs musculoskeletal pain symptoms, in combination with minor increases in physical capacity.
Abstract: sObjective:To investigate the effect of two contrasting physical activity worksite interventions versus a reference intervention (REF) on various health outcomes.Methods:A 1-year randomized controlled trial was conducted with specific resistance training (SRT), all-round physical exercise (A
TL;DR: Environmental interventions at the workplace can support weight management and risk reduction after 2 years of implementation and, at higher intensity sites, improvements were more pronounced.
Abstract: Objective:To examine first-year results from a workplace environmental obesity prevention program at The Dow Chemical Company.Methods:A quasi-experimental cohort study was conducted among employees at nine treatment worksites (n = 8013) who received environmental weight management interventi
TL;DR: Results indicate that asthma control is associated with better health outcomes, and management with therapies optimizing asthma control may reduce direct and indirect costs of treatment.
Abstract: Objective:To determine the association between asthma control and health outcomes.Methods:Cross-sectional data on asthmatic patients were from the 2006 U.S. National Health and Wellness Survey. Asthma control was determined by the Asthma Control Test. Outcomes assessed included work productivity los
TL;DR: Drivers identified by the consensus criteria have a high likelihood of OSA and their poor compliance with polysomnography referrals and OSA treatment support federally mandated screening of commercial drivers.
Abstract: Objective:To evaluate consensus criteria for screening commercial drivers for obstructive sleep apnea (OSA).Methods:Consecutive drivers underwent OSA screening using Joint Task Force consensus criteria at commercial driver medical examinations. Outcomes included: clinical yield of screening; and dri
TL;DR: Consideration of issues pertaining to particle heterogeneity, temporal factors, exposure characterization, disease endpoints, and identification of the study population provides the foundation for initiating epidemiologic research on workers exposed to engineered nanoparticles.
Abstract: Objective:Capitalizing on phenomena at the nanoscale may present great benefits to society. Nevertheless, until the hazards and risks of engineered nanoparticles are determined, the technological products and advances of nanotechnology may be impeded by the societal concerns. Although animal
TL;DR: While the economic evaluation of interventions in this literature warrants further expansion, it is found that ergonomic and other musculoskeletal injury prevention interventions in manufacturing and warehousing are worth undertaking in terms of their financial merits.
Abstract: OBJECTIVE:: We reviewed the occupational health and safety intervention literature to synthesize evidence on financial merits of such interventions. METHODS:: A literature search included journal databases, existing systematic reviews, and studies identified by content experts. Studies meeting inclusion criteria were assessed for quality. Evidence was synthesized within industry-intervention type clusters. RESULTS:: We found strong evidence that ergonomic and other musculoskeletal injury prevention interventions in manufacturing and warehousing are worth undertaking in terms of their financial merits. We also found strong evidence that multisector disability management interventions are worth undertaking. CONCLUSIONS:: While the economic evaluation of interventions in this literature warrants further expansion, we found a sufficient number of studies to identify strong, moderate, and limited evidence in certain industry-intervention clusters. The review also provided insights into how the methodological quality of economic evaluations in this literature could be improved. Language: en
TL;DR: GBC did not differ in RTW compared with UC, but may be beneficial for the majority of workers with minor stress-related disorders, and subgroup analysis showed a small effect in favor of GBC for workers with administrative functions and/or “minor” stress- related symptoms.
Abstract: Objective:To evaluate the effectiveness of guideline-based care (GBC) of workers with mental health problems, which promotes counseling by the occupational physician (OP) facilitating return to work (RTW).Methods:In a randomized controlled trial with police workers on sick leave due to mental health
TL;DR: Prospective cohort data have identified subgroups of military populations at higher risk or more resilient to decrements in mental and physical health, which will answer long-term health questions related to military service.
Abstract: Objective:To describe current and future career-span health research in the US Department of Defense Millennium Cohort Study.Methods:Collaborating with all military service branches and the Department of Veterans Affairs, the Millennium Cohort Study launched in 2001, before September 11 and the star
TL;DR: SLE, particularly with nephritis, is associated with substantial costs and Therapies that can better manage SLE may provide opportunities for savings to employers.
Abstract: Objectives:To estimate the medical- and productivity-related cost burden of systemic lupus erythematosus (SLE) and SLE with nephritis in an employee population.Methods:Using administrative data, annual costs were calculated for SLE patients, a subset with nephritis, and a matched control group of pa
TL;DR: Fibromyalgia places a significant cost, absence, and productivity burden on employers, as measured by the burden of illness from the employer perspective.
Abstract: Objectives: To calculate the fibromyalgia (FM) burden of illness (BOI) from the employer perspective and to compare annual prevalence, work output, absence, and health benefit costs of employees with FM versus osteoarthritis (OA) Methods: Retrospective regression model analysis comparing objective work output, total health benefit (health care, prescription drug, sick leave, disability, workers' compensation) costs, and absence days for FM, versus OA and NoFM cohorts, while controlling for differences in patient characteristics Results: FM prevalence was 0 73 %; OA 0 90 % Total health benefit costs for FM were $8452 versus $11,253 (P < 0 0001 ) for OA and $4013 (P < 0 0001 ) for NoFM, with BOI = $4439 Total absence days were 168 versus 198 (P < 0 0001 ) and 6 4 (P < 0 0001 ), respectively FM had significantly lower annual work output than NoFM (195 %, P = 0 003) but comparable with OA Conclusion: FM places a significant cost, absence, and productivity burden on employers
TL;DR: Results suggest that the new intervention model is substantially more engaging and effective with truck drivers than previous education-based tactics.
Abstract: Objective: This study was designed to evaluate the effectiveness of a new health promotion model for lone workers Methods: A single group pre- or posttest design was used to evaluate intervention effectiveness for reducing body weight and increasing healthful and safe behaviors Truck drivers (n 29) from four companies participated in a 6-month intervention involving a weight loss and safe driving competition, computer-based training, and motivational interviewing Results: Objectively measured body weight reduced by 78 lbs (SD 115, d 068, P 0005), and survey measures showed significant reductions in dietary fat and sugar consumption An objective measure of safe driving also showed significant improvement, and increases in exercise motivational stage and walking fitness approached significance Conclusions: Results suggest that the new intervention model is substantially more engaging and effective with truck drivers than previous educationbased tactics (J Occup Environ Med 2009;51:1233–1246)
TL;DR: Residents and local workers as well as those with work-associated exposure to WTC dust have new and persistent respiratory symptoms with lung function abnormalities 5 or more years after the WTC destruction.
Abstract: Objective: To describe physical symptoms in those local residents, local workers, and cleanup workers who were enrolled in a treatment program and had reported symptoms and exposure to the dust, gas, and fumes released with the destruction of the World Trade Center (WTC) on September 11, 2001. Methods: Symptomatic individuals underwent standardized evaluation and subsequent treatment. Results: One thousand eight hundred ninety-eight individuals participated in the WTC Environmental Health Center between September 2005 and May 2008. Upper and lower respiratory symptoms that began after September 11, 2001 and persisted at the time of examination were common in each exposure population. Many (31%) had spirometry measurements below the lower limit of normal. Conclusions: Residents and local workers as well as those with work-associated exposure to WTC dust have new and persistent respiratory symptoms with lung function abnormalities 5 or more years after the WTC destruction.
TL;DR: These data support an important role for occupational exposures in COPD and support a physician’s diagnosis of COPD, emphysema, or chronic bronchitis.
Abstract: A growing body of evidence supports the link between occupational exposures and COPD. Historically, key evidence to support this association has been industry specific, in particular analyses of dust-years of exposure in coal or gold mining in relation to airflow obstruction.1,2 In more recent years, however, a growing number of investigations has addressed the risk of COPD from work-related exposures across multiple industries and occupations. This approach, frequently defining risk as survey-based reports of exposure to vapors, gas, dust, or fumes (VGDF), has allowed the estimation of risk from a population-based perspective, quantified as the population attributable fraction (PAF). Two systematic reviews of the epidemiological literature have found the PAF for the occupational exposure contribution to the population burden of COPD is approximately 15%.3,4 A recent international ecological analysis of this question indicated that the association between occupational exposure and COPD prevalence is a global phenomenon with an impact on women and men in countries with both more-developed and less-developed economies.5
Risk estimates of occupational exposure have taken into account the concomitant effect of cigarette smoking on population health, which is by far the dominant risk factor for COPD, with an estimated PAF of 80-90%. At the same time, evidence is emerging that the combined effects of occupational exposures and smoking are may be more than additive. In two previous analyses in separate cohorts, we found combined occupational exposure and smoking markedly increased the odds ratios (OR's) for COPD to 18-fold risk compared to non-exposed non-smokers, a modestly supra-additive effect.6,7 Using a recently recruited, community-based cohort of adults with COPD, we re-assessed the relationship between occupational exposure and COPD, including potential combined effects with smoking. We wished to see whether our findings would be consistent with other recent estimates of occupational risk for COPD risk, further supporting a causal interpretation of this association.
TL;DR: By improving psychosocial factors at work, it is possible to promote employee health as well as prevent employee ill-health.
Abstract: Objective:The aim was to identify psychosocial factors at work that promote positive changes in employee health and factors that prevent negative changes in employee health.Method:This study is part of a large longitudinal study and includes 1212 employees. Data for psychosocial work factors and sel
TL;DR: Police officers have increased levels of atherosclerosis compared with a general population sample, which was not fully explained by elevated CVD risk factors; thereby potentially implicating other mechanisms whereby law enforcement work may increase CVDrisk.
Abstract: Objective Employment as an urban police officer was hypothesized to be associated with increased structural subclinical cardiovascular disease (CVD), measured by carotid artery intima-media thickness (IMT). Methods The sample of men and women consisted of police officers (n = 312) and the general population (n = 318), free of clinical CVD. Results Officers had elevated levels of age-adjusted CVD risk factors (blood pressure, total cholesterol, smoking prevalence) compared with the population sample. In age-, gender-, and traditional risk factor-adjusted models, police officers exhibited increased mean common carotid IMT (police = 0.67 mm, population = 0.64 mm; P = 0.03) and mean maximum carotid IMT (police = 0.99 mm, population = 0.95 mm; P = 0.13). Conclusions Police officers have increased levels of atherosclerosis compared with a general population sample, which was not fully explained by elevated CVD risk factors; thereby potentially implicating other mechanisms whereby law enforcement work may increase CVD risk.
TL;DR: By identifying components of coal before mining activities, the risk of developing CWP may be reduced and the active agent within coal appears to be iron, not quartz.
Abstract: The objective was to evaluate the component of coal responsible for coal workers' pneumoconiosis (CWP). A literature search of PubMED was conducted to address studies that have evaluated the risk of CWP based on the components of coal. The risk of CWP (CWP) depends on the concentration and duration of exposure to coal dust. Epidemiology studies have shown inverse links between CWP and quartz content. Coal from the USA and Germany has demonstrated links between iron content and CWP; these same studies indicate virtually no role for quartz. In vitro studies indicate strong mechanistic links between iron content in coal and reactive oxygen species, which play a major role in the inflammatory response associated with CWP. The active agent within coal appears to be iron, not quartz. By identifying components of coal-before mining activities, the risk of developing CWP may be reduced.
TL;DR: Negative beliefs about LBP are associated with both work absence and reduced work-productivity and should be examined as a target for educational interventions when considering initiatives to reduce the socioeconomic costs of LBP.
Abstract: OBJECTIVE:: To examine the influence of beliefs about low back pain (LBP) on reduced productivity at work ("presenteeism") caused by LBP. METHODS:: Two thousand five hundred seven individuals completed the Back Beliefs Questionnaire, the Fear Avoidance Beliefs questionnaire (FABQ), and questions about LBP-related work-absence, reduced work-productivity, pain, comorbidity, and demographics. RESULTS:: Six hundred seventy (25%) individuals were of working age, employed and reported current LBP. Univariate models showed beliefs were more "negative" in individuals with work-absence and reduced productivity (P = 0.0001). In multivariable analysis, controlling for confounders, "FABQwork" was a unique predictor of both absenteeism and presenteeism (each, P = 0.0001), though with small effect sizes. CONCLUSIONS:: Negative beliefs about LBP are associated with both work absence and reduced work-productivity. Further investigations should examine their potential as a target for educational interventions when considering initiatives to reduce the socioeconomic costs of LBP. Language: en
TL;DR: In this case series, an unusual number of MM cases in WTC responders under 45 years is observed, highlighting the importance of maintaining surveillance for cancer and other emerging diseases in this highly exposed population.
Abstract: Objectives:We report on cases of multiple myeloma (MM) observed in World Trade Center (WTC) responders registered in the WTC Medical Program.Methods:Possible cases of MM diagnosed between September 11, 2001, and September 10, 2007, in responders were confirmed if they met the World Health Organizati
TL;DR: The results provide support for the IEISI being a reliable, valid, and fast tool for the study of specific symptom prevalence in IEI and encourage further study of subgroups.
Abstract: Objective: To develop, evaluate, and apply a questionnaire-based instrument for investigation of specific symptoms in idiopathic environmental intolerance (IEI), called the Idiopathic Environmental ...