Showing papers in "Journal of Occupational Health in 2011"

The development of the European framework for psychosocial risk management: PRIMA-EF.

Abstract: Aim: This paper presents the development process of the European framework for psychosocial risk management (PRIMA-EF). It also summarises and discusses key findings of research conducted through this policy-orientated research programme. Objectives: This paper presents an overview of the development process of PRIMA-EF. The background, methods and outcomes are described and discussed. The paper summarises the key findings of PRIMA-EF and concludes by a discussion of the merit of PRIMA-EF in the area of psychosocial risk management and its intended use. PRIMA-EF has been built on a review, critical assessment, reconciliation and harmonisation of existing European approaches for the management of psychosocial risks and the promotion of mental health at the workplace. The framework has been built from a theoretical analysis of the risk management process, identifying its key elements in logic and philosophy, strategy and procedures, areas and types of measurement, and from a subsequent analysis of European risk management approaches. It is meant to accommodate all existing psychosocial risk management approaches across Europe. It also provides a model and key indicators that relate to the psychosocial risk management process both at the enterprise and macro levels. Method: Experts, researchers, social partners, key European and international organisations and networks were involved throughout the development of PRIMA-EF. A number of methods were applied including literature, case study and policy reviews, interviews, surveys, focus groups and workshops. The scientific findings have been used to develop user-friendly tools for use at the enterprise and policy levels such as guidelines, indicators, guidance sheets, inventories and web-based tools. Conclusions: PRIMA-EF is intended as a framework for harmonizing practice and current methods in the area of psychosocial risk management. It can also be used as a guidance tool for the development of further methods both in Europe and internationally as it can provide a benchmark for validation of new methods. A number of priorities have been identified on the basis of PRIMA-EF for the future of psychosocial risk management and the promotion of mental health at workplace in Europe.

Evaluation of acute oxidative stress induced by NiO nanoparticles in vivo and in vitro.

Abstract: Objectives: Nickel oxide (NiO) is an important industrial material, and it is also a harmful agent. The toxicity of NiO is size-related: nanoparticles are more toxic than fine-particles. The toxic mechanism induced by NiO nanoparticles remains unexplained, and the relationship between in vitro and in vivo NiO toxicity results is unclear. In the present study, we focused on the oxidative stress caused by NiO nanoparticles by examining and comparing in vitro and in vivo acute responses induced by NiO nanoparticles. Methods: Cellular responses induced by black NiO nanoparticles with a primary particle size of 20 nm, were examined in human lung carcinoma A549 cells. In vivo responses were examined by instillation of NiO nanoparticles into rat trachea. Bronchoalveolar lavage fluid (BALF) was collected after intratracheal instillation at different time points, and concentrations of lipid peroxide heme oxygenase-1 (HO-1), surfactant protein-D (SP-D) and lactate dehydrogenase (LDH) in BALF were measured. Results: The levels of intracellular reactive oxygen species and lipid peroxidation in A549 cells increased with increasing exposure to NiO nanoparticles, and increases in gene expressions of HO-1 and SP-D were observed in A549 cells. The lipid peroxide level in BALF significantly increased after 24 h instillation but decreased three days later. LDH leakage was also observed three days later. Conclusions: NiO nanoparticles induce oxidative stress-related lung injury. In vivo and in vitro oxidative stress was induced resulting in activation of antioxidant systems. Based on these responses, we conclude that the results of the in vivo and in vitro studies tend to correspond.

Inhalation Carcinogenicity and Chronic Toxicity of Indium-tin Oxide in Rats and Mice

Abstract: Objectives: Carcinogenicity and chronic toxicity of indium-tin oxide (ITO) were examined by inhalation exposure of rats and mice to ITO aerosol. Methods: Fifty mice of both sexes were exposed to ITO at 0 (control), 0.01, 0.03 or 0.1 mg/m3 for 6 h/day, 5 day/wk for 104 wk, and 50 rats of both sexes were exposed to 0, 0.01 or 0.03 mg/m3 ITO for the same time period. The repeated exposure of 50 rats of both sexes to 0.1 mg/m3 ITO was discontinued at the 26th wk, followed by clean air exposure for the remaining 78 wk. Results: In rats, incidences of bronchiolo-alveolar adenomas and carcinomas, bronchiolo-alveolar hyperplasia, alveolar wall fibrosis and thickened pleural wall, alveolar proteinosis and infiltrations of alveolar macrophages and inflammatory cells were significantly increased. Combined incidences of malignant lung tumors in male rats and total lung tumors in male and female rats were significantly increased at exposure to 0.01 mg/m3 ITO. In mice, no carcinogenic response occurred, but thickened pleural wall, alveolar proteinosis and alveolar macrophage infiltration were induced. Mice were less susceptible to ITO than rats. The lung content of indium was the greatest, followed by the spleen, kidney and liver. Blood indium levels increased dose-dependently. Conclusions: There was clear evidence of carcinogenicity of inhaled ITO in male and female rats but not clear evidence in mice, together with occurrence of the chronic pulmonary lesions in both rats and mice.

Occupational stress and its related factors among university teachers in China.

Abstract: Objectives University teachers in China are expected to suffer serious occupational stress due to the expanding enrollment in universities without a proportional increase in teacher resources and the fact that all promotions for university teachers are determined based on not only teaching but also the outcome of scientific research. This study was designed to assess the occupational stress among university teachers in China and clarify its risk factors. Methods A cross-sectional study was performed in Liaoning Province, the centralized area of higher education in Northeast China. Eight universities (2 multidiscipline and 6 specialized) and 10% of academic staff each were randomly sampled. Questionnaires pertaining to occupational stress indicated by the Chinese Version Personal Strain Questionnaire (PSQ) and demographic characteristics, health status, work situations, and personal and social resources were distributed in October 2008. A total of 827 effective respondents (response rate 76.4%) became our participants. Results The average raw score of PSQ was 91.0 among the university teachers. General linear model analysis showed that the factors significantly associated with the PSQ score were, in standardized estimate (β) sequence, mental health, role overload, role insufficiency, social support, monthly income, role limitations due to physical problems, research finance and self-rated disease with adjustment for age and sex. Conclusion We concluded that, in comparison to work-related factors and social support, mental health is a prominent risk factor for occupational stress in university teachers in China. Improvement of mental health and organizational climate should be considered to lessen the occupational stress of university teachers.

Association between Job Stress and Insomnia in Korean Workers

Abstract: Objective: We investigated the association between job stress and insomnia in a large nationwide samples of Korean workers. Methods: In this cross-sectional study, a total of 8,155 workers from a nationwide sample were recruited. We surveyed the subjects' socio-demographic and work-related characteristics and seven subscales of occupational stress using the Korean Occupational Stress Scale Short Form. Each subscales of job stress was dichotomized into higher or lower group by respective median scores. Insomnia was defined as having at least one of the three sleep symptoms. we performed multivariate logistic regression analysis to identify association between job stress and insomnia. Results: We found that individuals with relatively high job stress experienced insomnia significantly more frequently, and the significance was maintained even after adjustment for confounding variables(high job demand: OR: 1.30, 95% CI: 1.14-1.47; insufficient job control: OR: 1.13, 95% CI: 0.99-1.29; inadequate social support: OR: 1.30, 95% CI: 1.14-1.47; job insecurity: OR: 1.25, 95% CI: 1.11-1.44; organizational injustice: OR: 1.27, 95% CI: 1.12-1.44; lack of reward: OR: 1.18, 95% CI: 1.04-1.34; discomfort in occupational climate: OR: 1.38, 95% CI: 1.22-1.57; total job stress: OR: 1.45, 95% CI: 1.28-1.64). Conclusion: This study suggested that job stress is possible risk factor for insomnia and that particularly discomfort in occupational climate and inadequate social support have more strong relation to insomnia in Korea.

Occupational Violence at Lebanese Emergency Departments: Prevalence, Characteristics and Associated Factors

Abstract: Background: Emergency departments (EDs) workers are at higher risk of exposure to occupational violence. The prevalence of occupational violence is potentially higher and consequences are more serious in areas with poor security conditions. Objectives: We investigated the prevalence, characteristics and factors associated with the exposure of ED workers to violence at Lebanese hospitals. Methods: All ED employees at six tertiary hospitals in Lebanon were surveyed using a cross-sectional design. The survey instrument included four sections collecting demographic/professional information and measuring exposure to violence, degree of job satisfaction and degree of professional burnout. The questionnaire was distributed to all ED employees at participating hospitals and was completed by 256 ED workers (70.3% response rate). Multinomial and binary logistic regressions were used to investigate factors significantly associated with verbal and physical violence. Results: Over the past 12 months, four in five ED employees were verbally abused and one in four was physically assaulted. Exposure to verbal abuse was associated with serious outcomes including significantly higher levels of occupational burnout and an increased likelihood to quit current job. Exposure to physical violence was associated with increased likelihood-to-quit, nurse status and "public hospital" employment. Conclusion: Violence largely prevails at Lebanese EDs. Most vulnerable are nurses and employees of public hospitals who are disproportionally exposed to violence. ED stakeholders must work collaboratively to investigate the root causes of violence and devise and implement effective antiviolence policies and measures. Such measures will be necessary to protect the well-being and decrease the turnover of ED workers. Language: en

Effects of fatigue on immune function in nurses performing shift work.

Abstract: Objectives: We investigated the effects of fatigue on NK cell function and lymphocyte subpopulations in nurses performing shift work using a longitudinal design. Methods: Fifty-seven female nurses engaged in shift work at a hospital in Japan were selected for our study cohort. The hospital used a counterclockwise rotating three-shift system. Night shifts followed day shifts after a seven-hour interval. Immune parameters measured at the beginning of the day shift through to the end of the night shift were compared between two groups stratified by their level of fatigue. Statistical differences were evaluated after adjusting for baseline immune values and other demographic features. Results: Subjective feelings of fatigue increased progressively from the beginning of day shifts to the end of night shifts. From the beginning of day shifts to the end of night shifts, NK cell activity and CD16+CD56+ lymphocytes decreased, while CD3+ and CD4+ lymphocytes increased. The group with the greater increase in fatigue showed a larger decrease in NK cell activity and a larger increase in CD4+lymphocytes when compared with the group reporting less fatigue. These findings did not change after adjusting for demographic factors and sleep hours. Conclusion: Our data suggest that shift work has deleterious effects on NK cell function and that the effects depend on the degree of fatigue. Proper management of shift work may lessen fatigue in workers and also ameliorate many health problems experienced by shift workers.

Development of an evidence-based guideline for supervisor training in promoting mental health: literature review.

Abstract: Objective: To review published studies to assess the effects of supervisor training on the mental health of subordinate workers, and thereby develop an evidence-based guideline for supervisor training in promoting workers’ mental health. Method: Seven studies that assessed the effect of supervisor training, whose outcomes included psychological stress responses of (subordinate) employees, were retrieved for assessment from PubMed, the Cochrane Library, MEDLINE, the Web of Science, and Ichushi-Web. An additional five studies were also reviewed for discussion on the content and types of training. Results: Providing supervisors with necessary skills and information on mental health, including relevant occupational stressors, has a favorable effect on workersi mental health, at least in the short term. The subject populations had a background of requiring mental health measures. The effect of the training varied depending on the participation rate of supervisors, suggesting that the overall effect on an organization may be limited without a certain extent of participation by supervisors. There is no evidence of a long-term (over 1 yr) effect of supervisor training, and the effect of education on the supervisorsi knowledge and behavior tends to be lost after 6 mo. Conclusion: The current evidence indicates that the following items should be taken into consideration for the development of a guideline for supervisor training: identification of high-priority populations requiring education, development of a strategy to improve the participation rate in education, inclusion of occupational stressors as well as basic information in workplace mental health teaching materials, and regular repetition of the program.

Two- and 13-week inhalation toxicities of indium-tin oxide and indium oxide in rats.

Abstract: Objectives: Two- and 13-week inhalation toxicities of indium-tin oxide (ITO) and indium oxide (IO) were characterized for risk assessments of workers exposed to ITO. Methods: F344 rats of both sexes were exposed by inhalation to ITO or IO aerosol for 6 h/day, 5 day/wk for 2 wk at 0, 0.1, 1, 10 or 100 mg/m3 or 13 wk at 0, 0.1or 1 mg/m3. An aerosol generator and inhalation exposure system was constructed. Results: Blood and lung contents of indium were elevated in a dose-related manner in the ITO- and IO-exposed rats. ITO and IO particles were deposited in the lung, mediastinal lymph node and nasal-associated lymphoid tissue. Exposures to ITO and IO induced alveolar proteinosis, infiltrations of alveolar macrophages and inflammatory cells and alveolar epithelial hyperplasia in addition to increased lung weight. ITO affected the lung more severely than IO did. Fibrosis of alveolar wall developed and some of these lesions worsened at the end of the 26-week post-exposure period. Conclusions: Persistent pulmonary lesions including alveolar proteinosis and macrophage infiltration occurred after 2- and 13-week inhalation exposures of rats to ITO and IO. Fibrosis of alveolar wall developed later. These lesions occurred after ITO exposure at the same concentration as the current occupational exposure limit in the USA and at blood indium levels below the biological exposure index in Japan for indium.

Pulmonary Toxicity Following an Intratracheal Instillation of Nickel Oxide Nanoparticle Agglomerates

Abstract: Pulmonary Toxicity Following an Intratracheal Instillation of Nickel Oxide Nanoparticle Agglomerates: Yasuo M ori M oto , et al. Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan— Objective: We examined the pulmonary toxicity of nickel oxide nanoparticle agglomerates in the rat lung following an intratracheal instillation. Methods: The weighted average surface primary diameter of nickel oxide nanoparticles was 8.41 nm, and the count median diameter of nickel oxide nanoparticle agglomerates suspended in saline was 1.34 µm. Male Wistar rats were exposed to 1 mg (3.3 mg/kg) of nickel oxide nanoparticles intratracheally. The control group received intratracheal instillation of saline. Rats were dissected 3 days, 1 wk, 1 mo, 3 mo, and 6 mo after the instillation. Cytokine-induced neutrophil chemoattractant (CINC)- 2αβ in the lung tissue was determined by quantitative measurement of protein by ELISA. Results: The total cell count in bronchoalveolar lavage fluid (BALF) was increased persistently from 3 days to 6 mo. The neutrophil counts in BALF were also increased at 3 days, 1 wk, 3 mo, and 6 mo. In the lung tissue, infiltration of mainly neutrophils and alveolar macrophages was observed in alveoli from 3 days to 6 mo. The CINC-2αβ concentration was elevated from 3 days to 6 mo in the lung tissue. Conclusions: These results showed that micron-sized nickel oxide nanoparticle agglomerates also induced a persistent inflammatory response. (J Occup Health 2011; 53: 293-295)

Biomechanical and Psychosocial Work Exposures and Musculoskeletal Symptoms among Vineyard Workers

Abstract: Objectives: This study explored the associations between biomechanical and psychosocial work factors and musculoskeletal symptoms in vineyard workers. Methods: This cross-sectional study was based on a random sample of 2,824 male and 1,123 female vineyard workers in France. Data were collected using a self-administered questionnaire. Neck/shoulder, back and upper and lower extremity symptoms were evaluated using the Nordic questionnaire. Biomechanical exposures included 15 tasks related to vineyard activities. Psychosocial work factors included effort-reward imbalance and overcommitment, measured using the effort-reward imbalance model, and low job control and insufficient material means. Statistical analysis was performed using logistic regression analysis, and the results were adjusted for age, body mass index, educational level, work status and years in vineyard. Results: Pruning-related factors increased the risk of upper extremity pain for both genders, of back pain for men and of neck/shoulder and lower extremity pain for women. Driving increased the risk of neck/shoulder and back pain among men. Psychosocial work factors, which were insufficient material means, overcommitment (both genders), effort-reward imbalance (men) and low job control (women), were associated with musculoskeletal symptoms, back and upper extremity pain for both genders and neck/shoulder and lower extremity pain for men. Conclusions: These results underlined that both biomechanical and psychosocial work factors may play a role in musculoskeletal pain among vineyard workers. Prevention policies focusing on both biomechanical and psychosocial work exposures may be useful to prevent musculoskeletal symptoms.

Perceptions of psychosocial hazards, work-related stress and workplace priority risks in developing countries.

Abstract: Objectives: During the last few decades, major global developments in the world of work include an international trend to shift production to developing countries, with wide variations in working conditions and exposure to traditional and emerging occupational risks, such as psychosocial risks. The latter have rarely been addressed or explored in developing and economically-emerging country contexts while we find an abundant body of research from industrialized countries. The research presented, which is part of a larger study, explored the perception of multi-disciplinary experts from different regions, as defined by the World Health Organization (WHO), of the nature of psychosocial hazards, and work-related stress, as well as their views on workplace priorities that require urgent attention. Methods: Semi-structured interviews were conducted with 29 experts from developing countries which were subjected to thematic analysis. A two-tiered Delphi survey was completed by 74 experts in the first round with 53 of these experts completing the survey in the second round. Results: Psychosocial hazards and work-related stress were mostly seen as interchangeable in terms of source and effect and all participants perceived them as concern to their workforce. Through the interviews and the Delphi surveys they allude to our contemporary understanding of psychosocial risks. Workplace risks of priority differed by region but primarily work-related stress, injury and accident prevention, and substance abuse and risk behaviors were reported to require urgent attention. Conclusions: The current lack of awareness and research in the area of psychosocial risks and work-related stress hampers action in developing countries. International experts should support the exchange of information and the development of interventions in workplaces in developing countries with a view to integrating these emerging risks into comprehensive occupational health and safety policy frameworks to make such approaches more effective. Language: en

A Study on Work Stress, Stress Coping Strategies and Health Promoting Lifestyle among District Hospital Nurses in Taiwan

Abstract: Objectives: To determine work stress, and stress-coping strategies, and to analyze their the relationships in order to improve health-promoting lifestyle of nurses in Taiwan Methods: Three hundred eighty-five nurses who had work experience for more than 6 mo, were selected from four district hospitals in Kaohsiung and Ping Tung We used a stratified cluster random sampling method for the selection The nurses answered a self-report questionnaire, which was categorized into four sections: personal background data, work stress, stress-coping strategies, and health-promoting lifestyle Results: The findings indicate work stress and the health promoting lifestyle of nurses are at a higher level, with stress-coping strategies being at a medium level Work stress and stress-coping strategies were significantly and positively correlated Professional relationships, managerial role, personal responsibility, and recognition of work stress and the responsibilities of a health-promoting lifestyle were negatively correlated Managerial role, personal responsibility, and organizational atmosphere of work stress as well as realization, an item of health-promoting lifestyle, were negatively correlated Recognition of work stress and stress management, items of health-promoting lifestyle, were negatively correlated Health responsibility, and self-actualization, items of health-promoting lifestyle, as well as stress-coping strategies were negatively correlated Nutrition, an item of health-promoting lifestyle, and the support stress-coping strategy was negatively correlated Conclusions: Nurses have greater work pressure and better work stress-coping strategies, but worse health responsibility and realization of a health-promoting lifestyle We suggest hospitals build good relationships and appropriately increase employment of nurses through a good work atmosphere to achieve nurses' realization of a health-promoting lifestyle

Work-related aggression and violence committed by patients and its psychological influence on doctors.

Abstract: Work-related Aggression and Violence Committed by Patients and Its Psychological Influence on Doctors: Keigo S aeki , et al. Department of Community Health and Epidemiology, Nara Medical University School of Medicine—Objectives: To determine the incidence rate of work-related aggression and violence (WRAV) against doctors and investigate risk factors and psychological influences of WRAV doctors. Methods: We sent a self-administered questionnaire on WRAV committed by patients and their associates to 1,148 doctors in Nara Prefecture, Japan. We calculated the incidence rate of WRAV using the number of incidents encountered during the previous 12 mo and the doctor's average weekly working hours. Risk factors for the incidence WRAV were analyzed by Poisson regression, and the influence of WRAV on the symptoms of post-traumatic stress disorder (PTSD) was evaluated by multiple logistic regression analysis. Results: A total of 758 (66.0%) doctors returned the questionnaire. The incidence rate of WRAV was 0.20 (95% CI: 0.17-0.24)×10 -3 per practice hour. Adjusted incidence rate ratios of WRAV were significantly increased among doctors 1) with a shorter career (11.0; 95% CI: 5.0-24.2), 2) working in a region with the lowest average taxable income (1.6; 1.1-2.4), and 3) whose specialties were dermatology (3.8; 2.3-6.3), psychiatry (2.7; 1.3-5.6) and ophthalmology (1.9; 1.2-3.2). Of 289 subjects who had encountered WRAV at least once during their career, 26 doctors (8.2%) had symptoms suggestive of PTSD due to the most severe incident. Conclusions: Doctors encountered WRAV at an incidence rate of 0.20×10 -3 per practice hour, and some of them might develop PTSD. Countermeasures are required to maintain sound health and safe workplaces for doctors. (J Occup Health 2011; 53: 356-364)

Noise and health--sleep disturbance in adults.

Abstract: Factors modifying the effect of environmental noise on sleep include sex, age, susceptibility, personality and the health status, including past and present history of disease. Objective: The effects of noise on sleep and habituation of sleep to noise were summarized. Results and conclusions: 1) The effect of noise on sleep is associated with physical changes, such as changes in heart rate, blood flow volume, breathing and the immune and neurocirculatory systems. During sleep, specific changes in these indicators are noted during different sleep stages. There are individual and sex differences, and it is important to understand the effects of noise on sleep considering several related factors. 2) Habituation to noise is also an important phenomenon that must be addressed while considering the effects of noise on sleep. Habituation is dependent on the type and sound level of the noise. In occupational fields, shift work and job stress should be considered to determine the association between noise and sleep, which is important to retaining a good quality of working life.

Job stress and mental health of permanent and fixed-term workers measured by effort-reward imbalance model, depressive complaints, and clinic utilization.

Abstract: Objectives: The number of workers with precarious employment has increased globally; however, few studies have used validated measures to investigate the relationship of job status to stress and mental health. Thus, we conducted a study to compare differential job stress experienced by permanent and fixed-term workers using an effort-reward imbalance (ERI) model questionnaire, and by evaluating depressive complaints and clinic utilization. Methods: Subjects were permanent or fixed-term male workers at a Japanese research institute (n=756). Baseline data on job stress and depressive complaints were collected in 2007. We followed up with the same population over a 1-year period to assess their utilization of the company clinic for mental health concerns. Results: The ERI ratio was higher among permanent workers than among fixed-term workers. More permanent workers presented with more than two depressive complaints, which is the standard used for the diagnosis of depression. ERI scores indicated that the effort component of permanent work was associated with distress, whereas distress in fixed-term work was related to job promotion and job insecurity. Moreover, over the one-year follow-up period, fixed-term workers visited the on-site clinic for mental concerns 4.04 times more often than permanent workers even after adjusting for age, lifestyle, ERI, and depressive complaints. Conclusions: These contrasting findings reflect the differential workloads and working conditions encountered by permanent and fixed-term workers. The occupational setting where employment status was intermingled, may have contributed to the high numbers of mental health-related issues experienced by workers with different employment status.

Recovery of Chronic Noise Exposure Induced Spatial Learning and Memory Deficits in Young Male Sprague-Dawley Rats

Abstract: Objective: Noise has always been an important environmental public health issue for mankind. Although reports exist on hippocampal-dependent spatial learning and memory (LM) impairment due to noise, there are only a few studies that have examined the effects of recovery from noise stress on LM impairments. Therefore, the present study investigated the effects of recovery from chronic noise exposure on LM deficits. Materials and Methods: In this study, the detrimental effects of noise stress on young male rats in the Morris water maze (MWM) were investigated at 1, 10, 20, 30, and 40 days after the discontinuation of chronic noise exposure of 80 dB or 100 dB for 4 h per day, for 30 days. The levels of monoamine neurotransmitters in the hippocampus were also evaluated by HPLC-EC at the end of each behavioral test. Results: Statistical analysis revealed that rats in the noise-treated groups failed to reach the same level of performance as the controls in the MWM. Further, the levels of dopamine (DA), norepinephrine (NE) and 5-hydroxytryptamine (5-HT) were significantly decreased in the hippocampus after noise exposure. However, the reduction in monoamine levels and impaired water maze performance recovered over time, so that by 30th day after cessation of noise exposure the 80 dB group showed no performance difference from the controls, and by 40th day, the 100 dB group also showed no performance difference from the control. Conclusion: Our findings suggest that noise impaired LM in young male rats and reduced monoamine neurotransmitters in the hippocampus. However, the noise-induced water maze deficits recovered over time, and the concurrent restoration of hippocampal monoamine neurotransmitter levels suggest that they are involved in LM impairments.

Iranian clinical nurses' coping strategies for job stress.

Abstract: Objectives: Since the existence of work-related stressors is inevitable in nurses' workplace, nurses usually use a variety of coping strategies which can be called cognitive, affective, and behavioral techniques. In this study, we aimed to explore the coping strategies employed by the Iranian clinical nurses in depth. Methods: This work was a qualitative study using Straus and Corbin's grounded theory approach focusing on the process of coping with job stress used by Iranian clinical nurses. Results: The results of the present qualitative study indicate that the core category was "on the route to coping" which contained six categories comprising work management, self-control, emotional, spiritual, cognitive, and interactional strategies. Conclusions: We conclude that in nursing it is inevitable that different kinds of strategies are used to cope with the many stressors. The conceptual model emerging from the data indicate that nurses are engaged in a dynamic process of struggling to cope with job stressors. In fact, they are "on the route to coping" with the job stressors. Considering the high level of stress in the nursing profession, the findings of this study have implications for both hospital managers and Iranian clinical nurses.

Pulmonary toxicity in mice by 2- and 13-week inhalation exposures to indium-tin oxide and indium oxide aerosols.

Abstract: Objectives: Inhalation toxicities of indium-tin oxide (ITO) and indium oxide (IO) in mice were characterized in comparison with those previously reported in rats. Methods: B6C3F1 mice of both sexes were exposed by inhalation to ITO or IO aerosol for 6 h/day, 5 day/wk for 2 wk at 0, 0.1, 1, 10 or 100 mg/m3 or 13 wk at 0, 0.1or 1 mg/m3. Results: ITO and IO particles were deposited in the lung, mediastinal lymph node (MLN) and nasal-associated lymphoid tissue. Alveolar proteinosis, infiltrations of alveolar macrophages and inflammatory cells and increased lung weight were induced by 2- and 13-week exposures to ITO and IO, while alveolar epithelial hyperplasia occurred only in the 2-week exposures. Thickened pleural wall, hyperplastic MLN, extramedullary hematopoiesis in the spleen and increased levels of erythrocyte parameters were induced by 13-week exposure to ITO. The ITO- and IO-induced pulmonary lesions were milder in mice than those previously reported in rats, and the fibrotic lesions were different between these two species. Indium levels in the lung and pooled blood were analyzed in the mice exposed to ITO and IO for 13 wk. In the 13-week inhalation exposure of mice to ITO, alveolar proteinosis and significantly increased lung weight were induced at the same exposure concentration as the current threshold limit value for indium and its compounds.

Brief morning exposure to bright light improves subjective symptoms and performance in nurses with rapidly rotating shifts.

Abstract: Objective: To investigate whether or not brief bright light (BL) exposure on workday mornings can improve health, performance and safety in nurses with rapidly rotating shifts. Methods: We conducted a randomized crossover study involving registered nurses at a teaching hospital working a two-shift system including the night shift. Participants were instructed to expose themselves to BL for 10 min on workday mornings. Results: A total of 61 participants were enrolled in the present study. Thirty-one participants received BL exposure in the first month, and the other 30 received it in the second month. Significant improvements were noted in the BL periods compared with the non-BL periods for self-assessed sleepiness at 10:00 on day-shift days evaluated using the Karolinska Sleepiness Scale, self-assessment of night sleep for day-shift days using the Visual Analogue Scale and for fatigue assessed using the Checklist Individual Strength Questionnaire. The estimated mean difference for each scale (95% confidence interval) was -0.55 (-0.91, -0.20), 0.37 (0.04, 0.70) and -2.13 (-3.78, -0.48), respectively. Mean response time evaluated using the psychomotor vigilance task test (PVT) showed significant improvement in the BL periods compared with the non-BL periods. No statistically significant differences were observed for sleepiness at 14:00, depression, number of PVT lapses or frequency of perceived adverse events and near misses. Conclusion: Our findings suggest that brief BL exposure on mornings preceding a day shift is effective in improving sleepiness and performance during day-shift work, subjective nighttime sleep on day-shift days, and perceived fatigue for the preceding two weeks in rapidly rotating shift nurses.

The Effect of Globalization on Employee Psychological Health and Job Satisfaction in Malaysian Workplaces

Abstract: Objective: To examine the impact of globalization on employee psychological health and job satisfaction via job characteristics (i.e., job demands and job resources) in an emerging economy, that of Malaysia. As external factors are regarded as influences on the working environment, we hypothesized that global forces (increased pressure and competition) would have an impact on burnout and job satisfaction via increased demands (role conflict, emotional demands) and reduced resources (supervisor support, coworkers support). Methods: Data were collected using a population based survey among 308 employees in the state of Selangor, Malaysia. Participants were approached at home during the weekend or on days off from work. Only one participant was selected per household. Structural equation modelling was used to analyse the data. Nearly 54% of respondents agreed that they need to work harder, 25% agreed that their job was not secure and 24% thought they had lost power and control on the job due to global trade competition. Results: Consistent with our predictions, demands mediated the globalization to burnout relationship, and resources mediated the globalization to job satisfaction relationship. Conclusions: Together, these results support the idea that external factors influence work conditions and in turn employee health and job satisfaction. We conclude that the jobs demands-resources framework is applicable in an Eastern setting and that globalization is a key antecedent of working environments.

Symptoms of respiratory disease and lung functional impairment associated with occupational inhalation exposure to carbon black dust.

Abstract: Purpose: The aim of this study was to ascertain whether symptoms of respiratory disorders and lung functional impairments are associated with occupational inhalation exposure to carbon black (CB) in a group of rubber workers. Methods: The study population consisted of 72 male workers with a past history of and current exposure to CB and 69, randomly selected, healthy unexposed male office workers that served as the referent group. Subjects were interviewed and given standardized respiratory symptom questionnaires to answer. Furthermore, pulmonary function tests (PFTs) were performed before and after the work shift for exposed subjects and once during the work shift for referent subjects. Furthermore, to assess the extent to which workers were exposed to CB, using standard methods, inhalable and respirable dust fractions of CB were measured in different dusty worksites. Results: The levels of exposure to inhalable and respirable CB dust were estimated to be 6.2 ± 1.7 and 2.3 ± 0.29 mg/m3 respectively (mean ± SD). Respiratory symptom questionnaires revealed that regular cough, phlegm, wheezing and shortness of breath were significantly (p<0.05) more prevalent among exposed workers. Furthermore, significant decreases in some preshift and postshift parameters of pulmonary function of exposed workers with a spirometric pattern consistent with restrictive ventilatory disorder were found. Conclusion: The findings of this study provide circumstantial evidence to support the notion that exposure to CB exceeding its current TLV is associated with a significant increase in the prevalence of respiratory symptoms along with both acute, partially reversible and chronic irreversible significant decreases in some parameters of pulmonary function.

An effective quarantine measure reduced the total incidence of influenza A H1N1 in the workplace: another way to control the H1N1 flu pandemic.

Abstract: Objectives: To evaluate the effectiveness of a non-vaccine quarantine measure against pandemic influenza A H1N1 in workplaces. Methods: Design was quasi-cluster randomized controlled trial in two sibling companies (Cohort 1 n=6,634, Cohort 2 n=8,500). The follow-up period was from July 1st, 2009 to February 19th, 2010 (233 days). Intervention was voluntary waiting at home on full pay if the family became Influenza like Illness (ILI). The incidences of influenza A H1N1 and those of the subgroups whose families got ILI in both cohorts were compared by a Cox regression model and log-rank test. Results: There were 189 and 270 workers who got H1N1 infection during the follow-up period in each cohort. In this period 317 workers in Cohort 1 were asked to wait at home for several days (100% obeyed). The intervention group (Cohort 1) showed a statistically significant lower risk (p for log-rank test=0.033) compared with the control (Cohort 2), and the hazard ratio of the intervention was 0.799 [0.658-0.970] after adjusting for age, sex, BMI and smoking status. The workers who were asked to wait at home showed H1N1 infection more frequently (49 out of 317) compared with the workers whose family got ILI but were not asked to wait and work regularly (77 out of 990, RR=2.17 [1.48-3.18]). Conclusions: The waiting on full pay policy in the workplace reduced the overall risk of influenza A H1N1 by about 20% in one flu season in Japan. This kind of non-vaccine measure will be a promising option in workplaces to control the next flu pandemic.

Changes in Craniocervical and Trunk Flexion Angles and Gluteal Pressure during VDT Work with Continuous Cross-legged Sitting

Abstract: Objectives: This study investigated changes in craniocervical and trunk flexion angles and gluteal pressure on both sides during visual display terminal (VDT) work with continuous cross-legged sitting. Methods: The gluteal pressures of ten VDT workers, who were recruited from laboratories, were measured using a Teckscan system and videotaped using a single video camera to capture the craniocervical and trunk flexion angles during VDT work at 30 s, 10, 20 and 30 min. Results: The craniocervical angle was significantly increased at 10 and 20 min compared with the initial angle (p<0.05). The trunk flexion angle was significantly decreased at 30 s, 10, 20 and 30 min (p<0.05). The gluteal pressure of the crossed-leg side significantly increased at 30 s, 10 and 20 min (p<0.05). The gluteal pressure of the uncrossed-leg side significantly decreased at 30 s (p<0.05). Conclusion: We found that cross-legged sitting during VDT work may exert disadvantageous postural effects resulting from craniocervical and trunk flexion angles and gluteal pressure. Therefore, this posture could not be recommended during long-term VDT work.

Burnout, workplace violence and social support among drivers and conductors in the road passenger transport sector in Maputo City, Mozambique.

Abstract: Objectives: Workplace violence is a work stressor which is presumed to lead to burnout, whereas social support is hypothesized to buffer the impact of such a stressor on health outcomes. In this study the association between burnout and workplace violence was investigated, and the role played by social support in moderating the relationship assessed. The study group consisted of workers in the road passenger transport sector in Maputo City, Mozambique. Methods: A random sample of 504 participants was selected from a register of 2,618 drivers and conductors working with road passenger transport. The study design was cross-sectional. Previously validated measures of burnout, workplace violence and social support were used. Results: The prevalence of severe burnout was 3.6% and of mild burnout 30.1%. Workplace violence was significantly associated with burnout after control for potential confounders. Burnout was more common among workers lacking social support following workplace violence than among peers who had received supported following an incident of violence. Conclusions: The study suggests that burnout is a public health problem among workers in the road passenger transport sector, and may be closely and independently linked to workplace violence. Social support appears to buffer or moderate the effect of workplace violence on burnout. This has implications for policy in the workplace. Strategies and guidelines are needed to support workers following workplace violence, since these may prove vital in reducing burnout and other psychosocial consequences.

Elevated Oxidative Damage in Kitchen Workers in Chinese Restaurants

Abstract: Objectives: To investigate associations between occupational exposure to cooking oil fumes (COFs) and potential oxidative and genotoxic effects in kitchen workers. Methods: Sixty-seven male kitchen workers and 43 male controls from Chinese restaurants in Guangzhou were recruited. For all the participants, the levels of 1-hydroxypyrene (1-OHP) and 8-hydroxy-2-deoxyguanosine (8-oxodG) in urine, binucleated micronucleus (BNMN) frequency, comet tail length and tail DNA% in peripheral blood lymphocytes (PBLs) and malondialdehyde (MDA) and superoxide dismutase (SOD) in serum were measured. The inhalable particulates (PM10) in their workplaces were also monitored. Results: Our results showed that the exposed group had a significantly higher median level of urinary 1-OHP than that of the control group (p<0.01). In addition, the median levels of 8-oxodG, BNMNs, tail length and MDA in the exposed group were markedly higher than those of the controls (p<0.01). These differences, except that of MDA, appeared not to be modified by the potential confounders: age, BMI, smoking and alcohol consumption. A univariate regression analysis showed that greater 1-OHP, 8-oxodG, BNMNs, tail length and MDA were associated with years working in a kitchen and cooking time per day. All these positive associations remained after adjusting for the four confounders in a subsequent multivariate linear regression analysis. Conclusions: Occupational exposure to COFs led to increased oxidative damage in Chinese kitchen workers. The health consequences of these oxidative changes need further investgation. Urinary 1-OHP and 8-oxodG are noninvasive and effective biomarkers for assessment of oxidative damage in restaurants workers.

Association between job stress and newly detected combined dyslipidemia among Chinese workers: findings from the SHISO study.

Abstract: Objectives: Previous studies examining the association between job stress and blood lipids have produced mixed findings. We sought to investigate the association between job stress and blood lipids among Chinese workers. Methods: A total of 544 subjects (367 men and 177 women) without known diseases from the Stress and Health in Shenzhen Workers (SHISO) cross-sectional study were analyzed. Job stress was evaluated by the effort-reward imbalance (ERI) model. The associations between job stress and blood lipids, such as for total cholesterol (TCHO), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were explored by multiple linear regression. The association between job stress and combined dyslipidemia was examined by multiple logistic regression. Results: Compared with their corresponding low level groups, groups with high levels of effort, overcommitment and ERI had a significantly increased risk of combined dyslipidemia with adjusted odd ratios (ORs) of 3.5 (95% CI 1.8-6.7), 4.2 (95% CI 2.3-7.7) and 2.7 (95% CI 1.5-5.1), respectively, whereas high rewards significantly reduced the risk of combined dyslipidemia (adjusted OR 0.3, 95% CI 0.2-0.6) compared with low rewards. Effort, overcommitment and ERI were significantly positively related to TG and LDL-C, while rewards were inversely related to them. No significant associations were observed between job stress and TCHO and HDL-C. The results were similar for men and women. Conclusions: Effort, overcommitment, low reward and ERI increased the risk of dyslipidemia among Chinese workers, and they were significantly associated with TG and LDL-C rather than TCHO or HDL-C. Increasing blood lipids may be the possible link between job stress and coronary heart disease.

A brief cognitive-behavioral stress management program for secondary school teachers.

Abstract: Objective: This study aimed to assess the efficacy of a brief cognitive-behavioral program that was designed to reduce the work-related stress levels of secondary school teachers. Methods: A quasi-experimental design was used to compare the intervention groups with the wait-list control groups. Seventy teachers from the intervention groups and 54 from the control groups completed a set of validated scales at the baseline and 3-4 wk later. The scales included the Depression Anxiety Stress Scale, the Dysfunctional Attitude Scale-Form A, the Health-Promoting Lifestyle Profile II, and the Occupational Stress Inventory Revised Edition. Results: After controlling for the baseline measures, the intervention groups had significantly lower role stress, personal strain and overall work-related stress 3-4 wk after the baseline measurements. The intervention groups also had significantly higher stress management behaviors, and less general stress and dysfunctional thoughts than the control groups (all p≤0.05). The levels of dysfunctional thoughts and stress management behaviors significantly predicted general stress after intervention and personal resource deficits. The level of dysfunctional thoughts also predicted the personal strain of work-related stresses (all p<0.05). Conclusions: The brief program reported in this study was efficacious in reducing the work-related stress of secondary teachers. Teachers experienced less work-related stress after the program, and they reported reduced dysfunctional thoughts and enhanced stress management behaviors. This program may be considered as an initial strategy for teachers to develop skills to cope with their work-related stress in the short term and could be incorporated with other strategies to achieve longer-term effects.

Entrepreneurs' self-reported health, social life, and strategies for maintaining good health.

Abstract: Objectives: This study investigated the association between self-reported good health and self-valued good social life. An additional aim was to examine entrepreneur's strategies for maintaining good health. Methods: The study design included a two-wave questionnaire, with five years between the surveys (2001 and 2006), and qualitative interviews. The study group consisted of 246 entrepreneurs from the central region of Sweden and represented ten different trades. Entrepreneurs reporting good health in both 2001 and 2006 were compared with entrepreneurs reporting poor health on both occasions or with inconsistent answers. Six of the entrepreneurs were strategically chosen for the interview study. Results: Consistent good health was reported by 56% of the entrepreneurs. Good social life in 2001 was associated with an increased odds ratio (OR) for consistent good health when the analyses were adjusted for physical work conditions and job satisfaction (OR 2.12, 95% CI 1.07-4.17). Findings for good leisure time, weekly moderate physical exercise, and a rating of work being less or equally important as other life areas, were similar but not statistically significant when job satisfaction was considered in the analyses. Strategies for maintaining good health included good planning and control over work, flexibility at work, good social contact with family, friends and other entrepreneurs, and regular physical exercise. Conclusion: This study demonstrated an association between self-reported good health and good social life for entrepreneurs in small-scale enterprises. In addition, the entrepreneurs emphasised strategies such as planning and control over work and physical exercise are important for maintaining good health.

Burnout among Judo Coaches in Turkey

Abstract: Objectives: The purpose of this study was to determine the prevalence of professional burnout experienced by Turkish judo coaches and to compare possible differences in the three burnout dimensions based on coaching experience in years and satisfaction status of their sport administrators. Methods: The data were obtained by using a three-section questionnaire including a socio demographic data form and the Turkish version of the Maslach Burnout Inventory from 65 judo coaches working in the Turkish Judo and Kurash Federation. Results: In the analysis of data, descriptive statistics (mean and standard deviation) and one-way ANOVA tests were used. This study showed that judo coaches have medium level burnout experience. The results also showed that there were significant differences in the emotional exhaustion levels of judo coaches based on coaching experience in years and satisfaction status from their sport administrators. Conclusions: Burnout appears to be a problematic issue for judo coaches. When coaches begin to feel emotionally depleted, they distance themselves from athletes, and experience a reduced sense of meaning about their work; it is likely to affect the quality of the athletic experience for both the coach and the athletes. Language: en