Showing papers in "Journal of Occupational and Environmental Medicine in 2015"

Aerosol transmission of infectious disease.

Abstract: Objective: The concept of aerosol transmission is developed to resolve limitations in conventional definitions of airborne and droplet transmission. Methods: The method was literature review. Results: An infectious aerosol is a collection of pathogen-laden particles in air. Aerosol particles may deposit onto or be inhaled by a susceptible person. Aerosol transmission is biologically plausible when infectious aerosols are generated by or from an infectious person, the pathogen remains viable in the environment for some period of time, and the target tissues in which the pathogen initiates infection are accessible to the aerosol. Biological plausibility of aerosol transmission is evaluated for Severe Acute Respiratory Syndrome coronavirus and norovirus and discussed for Mycobacterium tuberculosis, influenza, and Ebola virus. Conclusions: Aerosol transmission reflects a modern understanding of aerosol science and allows physically appropriate explanation and intervention selection for infectious diseases.

A small randomized pilot study of a workplace mindfulness-based intervention for surgical intensive care unit personnel: effects on salivary α-amylase levels.

Abstract: Objective:To determine whether a workplace stress-reduction intervention decreases reactivity to stress among personnel exposed to a highly stressful occupational environment.Methods:Personnel from a surgical intensive care unit were randomized to a stress-reduction intervention or a waitlist contro

How Do Work Engagement, Workaholism, and the Work-to-Family Interface Affect Each Other? A 7-Year Follow-Up Study.

Abstract: Objective:To investigate the long-term relationships between work engagement, workaholism, work-to-family enrichment, and work-to-family conflict (WFC).Methods:We used structural equation modeling and the three-wave 7-year follow-up data of 1580 Finnish dentists to test our hypotheses.Results:Work e

National survey of US long-haul truck driver health and injury: health behaviors

Abstract: OBJECTIVE: To compare selected health behaviors and body mass index (modifiable risk factors) of US long-haul truck drivers to the US working population by sex. METHODS: The National Survey of US Long-Haul Truck Driver Health and Injury interviewed a nationally representative sample of long-haul truck drivers (n = 1265) at truck stops. Age-adjusted results were compared with national health surveys. RESULTS: Compared with US workers, drivers had significantly higher body mass index, current cigarette use, and pack-years of smoking; lower prevalence of annual influenza vaccination; and generally lower alcohol consumption. Physical activity level was low for most drivers, and 25% had never had their cholesterol levels tested. CONCLUSIONS: Working conditions common to long-haul trucking may create significant barriers to certain healthy behaviors; thus, transportation and health professionals should address the unique work environment when developing interventions for long-haul drivers. Language: en

Recovery Processes During and After Work: Associations With Health, Work Engagement, and Job Performance.

Abstract: Objective:We examined energy management during work, recovery experiences after work and their connections to health, work engagement, and job performance.Methods:An online survey was completed by 1208 Finnish employees. Energy management was assessed through 13 strategies and recovery experiences t

Integrating health and safety in the workplace: how closely aligning health and safety strategies can yield measurable benefits

Abstract: Objective To better understand how integrating health and safety strategies in the workplace has evolved and establish a replicable, scalable framework for advancing the concept with a system of health and safety metrics, modeled after the Dow Jones Sustainability Index. Methods Seven leading national and international programs aimed at creating a culture of health and safety in the workplace were compared and contrasted. Results A list of forty variables was selected, making it clear there is a wide variety of approaches to integration of health and safety in the workplace. Conclusion Depending on how well developed the culture of health and safety is within a company, there are unique routes to operationalize and institutionalize the integration of health and safety strategies to achieve measurable benefits to enhance the overall health and well-being of workers, their families, and the community.

Associations of Ozone and PM2.5 Concentrations With Parkinson's Disease Among Participants in the Agricultural Health Study.

Abstract: Objective:This study describes associations of ozone and fine particulate matter with Parkinson's disease observed among farmers in North Carolina and Iowa.Methods:We used logistic regression to determine the associations of these pollutants with self-reported, doctor-diagnosed Parkinson's disease.

Flourishing in New Zealand workers: Associations with lifestyle behaviors, physical health, psychosocial, and work-related indicators.

Abstract: Objective:To investigate the prevalence and associations of flourishing among a large sample of New Zealand workers.Methods:A categorical diagnosis of flourishing was applied to data from the Sovereign Wellbeing Index, a nationally representative sample of adults in paid employment (n = 5549) contai

Improving Employee Health: Evaluation of a Worksite Lifestyle Change Program to Decrease Risk Factors for Diabetes and Cardiovascular Disease

Abstract: Objective:To determine whether an evidence-based, behavioral lifestyle intervention program delivered at a worksite setting is effective in improving type 2 diabetes and cardiovascular disease risk factors.Methods:A randomized 6-month delayed control design was utilized, with two thirds of the parti

Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program.

Abstract: Objective:To examine the relationships between employees’ trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period.Methods:Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were

Length of Disability and Medical Costs in Low Back Pain: Do State Workers' Compensation Policies Make a Difference?

Abstract: Objective The aim of the study was to examine the impact of state workers' compensation (WC) policies regarding wage replacement and medical benefits on medical costs and length of disability (LOD) in workers with low back pain (LBP). Methods Retrospective cohort analysis of LBP claims from 49 states (n = 59,360) filed between 2002 and 2008, extracted from a large WC administrative database. Results Longer retroactive periods and state WC laws allowing treating provider choice were associated with higher medical costs and longer LOD. Limiting the option to change providers and having a fee schedule were associated with longer LOD, except that allowing a one-time treating provider change was associated with lower medical costs and shorter LOD. Conclusions WC policies about wage replacement and medical treatment appear to be associated with WC LBP outcomes, and might represent opportunities to improve LOD and reduce medical costs in occupational LBP.

Biomonitoring in California Firefighters Metals and Perfluorinated Chemicals

Abstract: Objective: To assess California firefighters’ blood concentrations of selected chemicals and compare with a representative US population. Methods: We report laboratory methods and analytic results for cadmium, lead, mercury, and manganese in whole blood and 12 serum perfluorinated chemicals in a sample of 101 Southern California firefighters. Results: Firefighters’ blood metal concentrations were all similar to or lower than the National Health and Nutrition Examination Survey (NHANES) values, except for six participants whose mercury concentrations (range: 9.79 to 13.42 μg/L) were close to or higher than the NHANES reporting threshold of 10 μg/L. Perfluorodecanoic acid concentrations were elevated compared with NHANES andotherfirefighterstudies.Conclusions:Perfluorodecanoicacidconcentrations were three times higher in this firefighter group than in NHANES adult males. Firefighters may have unidentified sources of occupational exposure to perfluorinated chemicals.

Commercial Driver Medical Examinations: Prevalence of Obesity, Comorbidities, and Certification Outcomes.

Abstract: Commercial motor vehicle (CMV) drivers are the 13th largest employment category in the United States with an estimated 5.7 million CMV drivers in 2012.1 In 2011, there were 3341 fatal large truck crashes and approximately 60,000 crashes with injuries that were reported to the police.1 The average cost per crash with injuries has been estimated at $533,000 ($32 billion total), and the average cost per crash involving a fatality is approximately $11.7 million ($39 billion total).1 Although CMV drivers represent a modest share of the workforce, they are a high impact group because of1 occupational risks from the size and speed of their vehicles,2 frequently poor health status, and3 the large impact of truck crashes on public health and safety.2–5 Research on CMV drivers demonstrates highly prevalent reported obesity (BMI >30.0 kg/m2) and they have considerable health issues, including those commonly attributed to lifestyle and occupational factors (eg, improper diet, inadequate physical activity, poor sleep hygiene, and shift work).6–12 To address public and driver safety, CMV drivers are required to undergo and pass a commercial driver medical examination (CDME) at least once every 2 years to maintain a Commercial Driver's License. The CDME requires the examiner to note the presence and absence of multiple potentially disqualifying conditions. These CDMEs may be challenging as CMV drivers may have multiple conditions. Among the sparsely reported data, CMV drivers have a high risk of chronic diseases, particularly diabetes mellitus, hypertension, and premature heart disease as compared to general population and other occupational cohorts.13,14 There have been some reports evaluating relationships between obesity and factors within CMV driving population.11,15–18 Obese CMV drivers may also be prone to crashes, with a significantly higher crash rate (more than two times) compared with nonobese CMV drivers.19,20 Combinations of medical conditions and/or medication use are believed to increase the risk for crashes.21 Crashes from combinations of risk factors were one of the triggering events behind the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for User legislation in 2004 to revise the process for certifying medical fitness to drive.22 Yet, over the subsequent 10 years that have included 15 Evidence Reports and 10 Medical Expert Panels,21,23 there is no evidence report and only one guideline for qualifying individuals with multiple medical conditions (see Table ​Table11).24 That guideline recommends shortened certification intervals, preclusion of certification after four or more conditions are diagnosed, and higher medical training requirements when there are multiple medical conditions.23,24 Nevertheless, that guideline's impacts have not been systematically studied. TABLE 1. Multiple Conditions Matrix and Data Used From the CDME Form for Each Condition As a first step, the objective of this paper was to present an analysis of relationships between obesity and other chronic conditions to develop a foundation for further research evaluating CMV driver health and potential safety risks. The second objective was to describe the potential impact of the Medical Review Board's multiple conditions matrix.

Isocyanates and human health: multistakeholder information needs and research priorities.

Abstract: On April 3–4th, 2013 an international multidisciplinary conference entitled Isocyanates and Health: Past, Present and Future was held in Potomac, Maryland. Following the conference, representatives of consumer and worker health research and regulatory agencies, academic and industry scientists, labor, and trade associations met to discuss opportunities to advance communication, collaboration, and research funding to better address information gaps and research priorities amongst stakeholders. The purposes of the conference and follow-up meeting were to (i) identify most current knowledge about isocyanates and discuss the important issues concerning potential exposures and worker and consumer health effects of isocyanates, including exposure monitoring, environmental controls, surveillance, and clinical management, and (ii) identify and discuss research gaps to inform future research priorities and information dissemination. This summary reports on the knowledge gaps and research priorities identified across stakeholders, and discusses the potential for greater collaboration across government, academic, industry and worker organizations to improve worker and consumer health.

High Job Demands, Job Strain, and Iso-Strain are Risk Factors for Sick Leave due to Mental Disorders: A Prospective Swedish Twin Study With a 5-Year Follow-Up.

Abstract: Objective:To investigate whether psychosocial work environment and health behaviors are risk factors for sick leave due to mental disorders, and whether familial confounding (genetics and shared environment) explains the associations.Methods:Respondents (n = 11,729), given to complete a questionnair

Heat Illness Among North Carolina Latino Farmworkers

Abstract: Objective:Heat exposure is an important hazard for workers in manual occupations, including farmworkers. This analysis delineates the prevalence of heat illness among farmworkers, and the factors associated with heat illness.Methods:North Carolina Latino male farmworkers completed interviews in Augu

Formaldehyde Exposure and Mortality Risks From Acute Myeloid Leukemia and Other Lymphohematopoietic Malignancies in the US National Cancer Institute Cohort Study of Workers in Formaldehyde Industries

Abstract: Formaldehyde is environmentally and biologically ubiquitous. Major occupational exposure sources include manufacturing of construction materials, plastics, and garments. Cigarette smoking, consumer products including personal care products and some medications, and ambient air pollution are common nonoccupational sources.1,2 Formaldehyde is also produced endogenously and is an essential intermediate in the biosynthesis of purines, thymidine, and various amino acids.3 Thus, formaldehyde is present in small quantities in all body tissues. Exogenous formaldehyde is rapidly metabolized at the site of entry (typically the upper respiratory tract). There is consistent evidence that exogenous formaldehyde cannot reach distant organs including the bone marrow.4–7 Cancer risks associated with formaldehyde exposure have been investigated in occupational cohort and community-based case–control studies. The occupational cohort studies generally provide higher-quality evidence than population-based case–control studies—primarily due to better exposure data and a greater potential for higher and more sustained levels of formaldehyde exposure.8 In 2009, the International Agency for Research on Cancer Working Group concluded that “There is sufficient evidence in humans for the carcinogenicity of formaldehyde. Formaldehyde causes cancer of the nasopharynx and leukaemia.”9(p430) Baan et al summarized the findings of the Working Group meeting and reported that “The Working Group concluded that, overall, there is sufficient evidence for leukaemia, particularly myeloid leukaemia.”10(p1144) Despite the clear language regarding causation, the Volume 100F monograph reported that the consensus was based on the small majority of the working group who held the view that the evidence for leukemia was sufficient while a minority of the working group found the evidence for leukemia to be limited. Subsequently, the National Institute of Environmental Health Sciences National Toxicology Program changed the classification of formaldehyde from “anticipated to be carcinogenic in humans” as listed in the Second Report on Carcinogens (RoC) to “known to be a human carcinogen” in the 12th RoC.11 (Each revision of the RoC is cumulative and includes previous substances as well as newly reviewed substances. The 13th RoC, released in October 2014, contains 243 substance profiles.) The change in classification from anticipated carcinogen to known carcinogen was based on “consistent findings of increased risks of nasopharyngeal cancer, sinonasal cancer, and lymphohematopoietic cancer, specifically myeloid leukemia among individuals with higher measures of exposure to formaldehyde (exposure level or duration), which cannot be explained by chance, bias, or confounding. The evidence for nasopharyngeal cancer is somewhat stronger than that for myeloid leukemia.”11 Findings from one large cohort mortality study of workers from 10 US plants producing or using formaldehyde 12 have been especially influential in the designation by the International Agency for Research on Cancer9 and the National Institute of Environmental Health Sciences National Toxicology Program13 of formaldehyde as leukemogenic. This study was begun by the US National Cancer Institute (NCI) in the 1980s in collaboration with the Formaldehyde Institute, and the first results were published in 1986.14 Sequential analyses of updated mortality for the NCI cohort12,15 reported associations of “peak” exposures with myeloid leukemia (ML) and Hodgkin lymphoma (HL), but not with cumulative, average, or frequency of “peak” exposures. Null or very weak associations were observed with cumulative or “peak” exposures and the other specific lymphohematopoietic malignancies (LHMs) including lymphatic leukemia (LL), non-Hodgkin lymphoma (NHL), and multiple myeloma. Acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) were not reported separately in the NCI analyses but were combined as ML. Although both AML and CML arise in myeloid stem cells, the risk factors associated with AML and CML differ. Most individuals diagnosed with CML have a gene mutation in the leukemia cells called the Philadelphia chromosome, describing the translocation between chromosomes 22 and 9. The translocation leads to the development of the Bcr-Abl oncogene, and this gene instructs the bone marrow to produce Bcr-Abl tyrosine kinase, leading to the development of CML.16,17 In addition, the known risk factors for AML—tobacco smoking, exposure to benzene, chemotherapy, or radiation treatment—are not recognized risk factors for CML.17 High-dose radiation, such as that experienced by survivors of atomic bombs or nuclear reactor accidents, is the only recognized environmental risk factor for CML.17 These recognized differences in histopathology and in the risk factors for AML and CML raise the question of whether the reported association between formaldehyde exposure and combined MLs reflects an underlying association between formaldehyde exposure and the more plausible specific type of leukemia, AML. We obtained the data included in the most recent update of the NCI cohort12 via a Technology Transfer Agreement. Our objectives were to replicate the updated findings reported by Beane Freeman et al12 and to conduct additional analysis of associations of specific LHM, and especially AML, with peak exposure, using an alternative, more standard definition of peak.

Implementation of a Worksite Wellness Program Targeting Small Businesses: The Pinnacol Assurance Health Risk Management Study

Abstract: Objective:To assess small business adoption and need for a worksite wellness program in a longitudinal study of health risks, productivity, workers' compensation rates, and claims costs.Methods:Health risk assessment data from 6507 employees in 260 companies were examined. Employer and employee data

The association between physical activity, sitting time, sleep duration, and sleep quality as correlates of presenteeism.

Abstract: Objective:This study aims to examine the relationship of lifestyle behaviors (physical activity, work and non-work sitting time, sleep quality, and sleep duration) with presenteeism while controlling for sociodemographics, work- and health-related variables.Methods:Data were collected from 710 worke

Health Impact Assessment of PM10 and PM2.5 in 27 Southeast and East Asian Cities.

Abstract: OBJECTIVE We aimed to evaluate the annual health impacts of particulate matter (PM) less than 10 μm diameter (PM10) and less than 2.5-μm diameter (PM2.5) in 27 cities in Southeast and East Asian countries (Japan, the Philippines, the Republic of Korea, Singapore, and Vietnam) for the year 2009 (n = 50,756,699). METHODS We estimated the number of cases attributable to long-term exposure. We used a scenario that reduced the annual mean values for PM10 and PM2.5 to 20 and 10 μg/m, respectively. RESULTS A reduction in long-term exposure to PM10 and PM2.5 would have postponed 8% to 9% of all-cause mortality or about 37,000 deaths. One third of them were associated with cardiopulmonary mortality and one ninth of them were associated with lung cancer mortality. CONCLUSIONS Current air pollution levels in Southeast and East Asian countries have a nonnegligible public health impact.

Absenteeism due to Functional Limitations Caused by Seven Common Chronic Diseases in US Workers

Abstract: Objective The study examined the relationship between functional limitation due to chronic diseases and absenteeism among full-time workers. The studied chronic diseases include arthritis/rheumatism, cancer, diabetes, heart disease, hypertension, lung disease, and stroke. Methods We analyzed data from the 2011 to 2013 National Health Interview Survey. Economic impact was determined by workdays lost and lost income. Results Increase in absenteeism was observed for each studied condition. Employees with multiple conditions also saw increase absenteeism. Employers lose 28.2 million workdays annually ($4.95 billion in lost income) due to functional limitation caused by chronic diseases. Conclusions The results show a burden on society due to functional limitation caused by studied chronic diseases. Employers should look into implementing intervention/prevention programs, such as the Chronic Disease Self-Management Programs, to help reduce the cost associated with absenteeism.

The impact of domestic violence in the workplace: results from a Pan-Canadian survey

Abstract: OBJECTIVE: When workers experience domestic violence (DV) at home, impacts are felt in the workplace; however, little research is available on this topic. METHODS: We conducted an online survey regarding the impacts of DV at work. RESULTS: A total of 8429 people completed the survey. More than a third of respondents reported experiencing DV; among them, more than a third reported that DV affected their ability to get to work, and more than half reported that it continued at or near work. Most reported that DV negatively affected their performance. Almost all respondents, regardless of DV experience, believed that it impacts victims' work lives. CONCLUSIONS: This research identifies the scope and impact of DV on workers and workplaces. The data should assist governments, unions, and employers to enact and evaluate proactive practices to address the impact of DV in the workplace. Language: en

Physical activity levels at work and outside of work among commercial construction workers.

Abstract: Objective:Characterize the number of minutes of moderate and vigorous physical activities at work and outside of work during seven consecutive days, in a sample of 55 commercial construction workers.Methods:Workers wore accelerometers during work and outside-of-work hours for seven consecutive days

The COMPASS pilot study: a total worker Health™ intervention for home care workers.

Abstract: Objective: To develop a team-based Total Worker Health TM (injury prevention + health promotion) intervention for home care workers and estimate intervention effects on workers’ well-being and health and safety behaviors. Methods: Home care workers (n = 16) met monthly in teams for education and social support using a scripted, peer-led approach. Meeting process measures and pre-/postintervention outcome measures were collected. Results: Knowledge gains averaged 18.7% (standard deviation = 0.04), and 62.0% (standard deviation = 0.13) of participants reported making safety or health changes between meetings. Workers’ well-being improved significantly (life satisfaction, d = 0.65, P < 0.05; negative affect, d = 0.64, P < 0.05), and the majority of other safety and health outcomes changed in expected directions. Conclusions: COMPASS is a feasible intervention model for simultaneously preventing injuries and promoting health among home care workers.

Effects of Psychological and Social Factors in Shiftwork on Symptoms of Anxiety and Depression in Nurses: A 1-Year Follow-Up.

Abstract: Objectives:The aim of the current study was to elucidate prospective effects of both shift schedules and work environment on mental distress.Methods:A total of 2059 nurses participated at baseline (38.1%), and 1582 nurses completed wave 2 of the survey (76.8%). Psychosocial work factors were measure

Busy yet socially engaged: volunteering, work-life balance, and health in the working population.

Abstract: Objective: To understand the relationship between volunteering and health in the overlooked yet highly engaged working population, adopting a contextualizing balance approach. We hypothesize that volunteering may function as a psychosocial resource, contributing to work–life balance and, ultimately, health. Methods: A total of 746 Swiss workers participated in an online survey; 35% (N = 264) were additionally volunteers in a nonprofit organization. We assessed volunteering, work–life balance perceptions, paid job demands, and resources and health outcomes. Results: After controlling for job characteristics, volunteering was associated with less work–life conflict, burnout and stress, and better positive mental health. Results further revealed that balance perceptions partly explained the relationship between volunteering and health. Conclusions: Volunteering, albeit energy and time-consuming, may contribute to a greater sense of balance for people in the workforce, which might, in turn, positively influence health.

Development and validity of a scale to measure workplace culture of health.

Abstract: Objective:To describe the development of and test the validity and reliability of the Workplace Culture of Health (COH) scale.Methods:Exploratory factor analysis and confirmatory factor analysis were performed on data from a health care organization (N = 627). To verify the factor structure, confirm

Factors Associated With Truck Crashes in a Large Cross Section of Commercial Motor Vehicle Drivers.

Abstract: OBJECTIVE: This large, cross-sectional study calculated prevalence of disorders and assessed factors associated with self-reported lifetime crashes. METHODS: Truck drivers (n = 797) completed computerized questionnaires reporting crashes, demographics, psychosocial factors, and other elements, as well as had taken measurements (eg, height, weight, serum, and blood pressure). RESULTS: Most drivers were male (n = 685, 85.9%), and the mean body mass index was 32.9 ± 7.5 kg/m with 493 (61.9%) being obese. Many drivers (n = 326, 39.9%) experienced at least one, with 132 (16.6%) having multiple, lifetime, reportable crashes. Many factors were associated with crashes, including increasing age, increasing truck driving experience, male sex, alcohol, low back pain, heart disease, and feeling tense. The most consistent associations with crashes were pulse pressure, cell phone use, and feeling physically exhausted after work. CONCLUSIONS: Modifiable factors associated with self-reported crashes were identified. These suggest targeted interventions may reduce risks of crashes. Language: en

Well-being improvement in a midsize employer: changes in well-being, productivity, health risk, and perceived employer support after implementation of a well-being improvement strategy.

Abstract: Objective:To evaluate employee well-being change and associated change in productivity, health risk including biometrics, and workplace support over 2 years after implementation of a well-being improvement strategy.Methods:This was an employer case study evaluation of well-being, productivity (prese