Showing papers in "Occupational Medicine in 1997"
TL;DR: The results revealed moderate levels of knowledge of the routes of absorption of pesticides and of potential symptoms following exposure, and the use of personal protective equipment (PPE) was minimal due primarily to financial constraints.
Abstract: The use of pesticides in Ghanaian agriculture, though beneficial in reducing crop loss both before and after harvest, has been associated with threats to human health often due to the misapplication of the chemicals. This study was an initial attempt to explore the knowledge, attitudes and practices of 123 farm workers on three irrigation project areas in the Accra Plains, Ghana, regarding the safe handling and use of pesticides, to assess the prevalence of symptoms associated with organophosphorus pesticides (OPs) and carbamates and to determine the prevalence of pesticide-related symptoms, and blood cholinesterase. The study design was cross-sectional in type. Methods used were interviews and observation, and biological monitoring. The results revealed moderate levels of knowledge of the routes of absorption of pesticides and of potential symptoms following exposure. Knowledge of personal protective measures was poor to moderate. High risk practices included frequent handling of the chemicals, home storage of pesticides and short re-entry intervals. Despite knowledge of some health risks associated with pesticides, the use of personal protective equipment (PPE) was minimal due primarily to financial constraints. The prevalence of symptoms was higher and cholinesterase levels lower than in a control group of teachers. It is suggested that there is a need for more epidemiologic studies to investigate the problems associated with pesticide induced ill health as well as research into appropriate and affordable PPE. PPE needs to be subsidized. Training of agriculture and health workers in safety precautions, recognition, and management of pesticide-related ill health is a matter of urgency.
176 citations
TL;DR: Effect studies of occupational stress programmes published between 1987 and 1994 are reviewed to give a practical overview of the variety in occupational stress programs, their scope, applicability and the evidence of their effectiveness.
Abstract: There are many occupational stress management programmes available which are designed to prevent and cure the negative aspects of job-stress. The focus of the programmes can be directed towards the individual worker, the working group, the organization of the work or the organization as a whole. Moreover, programmes show a considerable variation with respect to the type of interventions they promote and their underlying assumptions, as well as their duration and costs. In this paper, effect studies of occupational stress programmes published between 1987 and 1994 are reviewed. The aim is to give a practical overview of the variety in occupational stress programmes, their scope, applicability and the evidence of their effectiveness. The paper updates the review by DeFrank and Cooper published in 1989.
173 citations
TL;DR: In the present Japanese population, three-shift workers had higher risks of CHD than day workers, which was characterized by higher levels of serum total cholesterol and tendency to central obesity.
Abstract: This study was conducted to determine if there is an association between shift work and risk factors for coronary heart disease (CHD) in Japanese male blue-collar shift workers. Health check-up data on serum lipid concentration and anthropometric indices of 33 three-shift workers and 27 two-shift workers were compared with those of day workers. The average years in age of the shift workers and day workers were 34.5 (SD = 7.1) and 32.7 (SD = 7.6), respectively. Serum total cholesterol levels of three-shift, two-shift and day workers were 5.70 (SD = 1.19) mmol/l, 4.81 (SD = 1.01) mmol/l, 4.98 (SD = 0.95) mmol/l, respectively, and the cholesterol levels of three-shift workers were significantly higher than the other workers (p < 0.05). In addition, the abdominal to hip circumference ratios were 0.905 (SD = 0.060) for three-shift workers and 0.877 (SD = 0.054) for day workers, with a significant difference (p < 0.05). In the present Japanese population, three-shift workers had higher risks of CHD than day workers, which was characterized by higher levels of serum total cholesterol and tendency to central obesity. These findings held when lifestyle factors were taken into account.
135 citations
TL;DR: It is revealed that only nine per cent of doctors and 46% of midwives had reported the contamination incidents they had received, and doctors' main reason for non-reporting was 'too time consuming' and midwives' was 'did not consider anything could be done'.
Abstract: A 6-month retrospective self-administered questionnaire study of 482 doctors and 380 midwives in two NHS Trusts was undertaken. The response rate was 384 (80%) and 293 (77%) respectively. The study revealed that only nine per cent of doctors and 46% of midwives had reported the contamination incidents they had received. The doctors' main reason for non-reporting was 'too time consuming' and midwives' was 'did not consider anything could be done', although their awareness of the active management of contamination incidents by occupational health departments was good. Seventy-seven per cent of doctors and 69% of midwives underestimated the risk of contracting hepatitis B virus from a needlestick injury, whilst 52% of doctors and 36% of midwives underestimated the risks of acquiring infection with HIV (human immunodeficiency virus) infection following such an injury. Strategies for improving the knowledge of the potential risks of contamination incidents and methods for facilitating ease of reporting are discussed.
60 citations
TL;DR: Assessment of employees' hearing helps to assess the problem and whether preventative measures are effective and to minimize cost and time off work.
Abstract: Occupational noise-induced hearing loss is, at least in theory, preventable. One way to assess the problem and whether preventative measures are effective is to assess employees' hearing. In order to minimize cost and time off work this can be carried out effectively in the workplace as long as certain conditions are met.
57 citations
TL;DR: In a mixed-mode survey of all 1970-80 female graduates of all US veterinary colleges, information was obtained regarding several health, personal and occupational factors including data on occupational needlestick events, comparable to reported rates among health care workers such as nurses, laboratory technicians and hospital housekeeping staff.
Abstract: In a mixed-mode survey of all 1970-80 female graduates of all US veterinary colleges, information was obtained regarding several health, personal and occupational factors including data on occupational needlestick events. Among the 2,532 survey respondents, 1,620 reported one or more needlesticks after graduation from veterinary college (64.0% of all respondents). A total of 2,663 stick events were reported, although the descriptions of each puncture event varied in quality/completeness, probably due in large part to their retrospective nature. Substances most often injected include vaccines, antibiotics, anaesthetics and animal blood. Of the 438 sticks resulting in at least one side-effect (16.4% of all sticks), 337 were classified as mild and localized at the site of injection (12.4% of all sticks, approximately 77% of sticks producing a side-effect), with 18 characterized as severe and systemic (0.7% of all sticks, approximately 4% of sticks producing a side-effect). One accidental self-injection of a prostaglandin compound resulted in a spontaneous abortion, heightening awareness that occupational needlesticks may also represent a serious human reproductive health hazard. The estimated overall needlestick injury rate for this group of health care professionals was 9.3 sticks per 100 person-years (PYs) of practice, comparable to reported rates among health care workers such as nurses, laboratory technicians and hospital housekeeping staff. Accounting for underreporting of the stick events, the actual injury rate is likely to be at least 20 sticks per 100 PYs. When stick rates were estimated by clinical practice type (small animal, large animal and mixed practice), all-small-animal and mixed-practice veterinarians demonstrated the highest rates, with all-large-animal practitioners demonstrating a rate lower by about 40%.
55 citations
TL;DR: It is proposed that ergonomic interventions alone may be sub-optimal in controlling musculoskeletal problems among nurses and the additional provision of psychosocial information to challenge misconceptions and encourage self-management is proposed.
Abstract: This study retrospectively surveyed 1,216 nurses at hospitals in Belgium and The Netherlands. Data concerning workloads, musculoskeletal symptoms, work loss and psychosocial factors were collected by questionnaire. Lifetime prevalence rates for musculoskeletal problems and low back trouble were significantly lower in the Dutch hospitals than the Belgian hospitals, but a significantly higher proportion of Dutch nurses had 'heavy' workloads. Overall, symptoms and work loss in the previous 12 months were not related to workload, nor was the perception that work was causative; a change of duties because of symptoms was rare (< 3%). The Dutch nurses differed strikingly from Belgian nurses on the psychosocial variables; they were less depressed and significantly more positive about pain, work and activity. It is proposed that ergonomic interventions alone may be sub-optimal in controlling musculoskeletal problems among nurses. The additional provision of psychosocial information to challenge misconceptions and encourage self-management is proposed.
52 citations
TL;DR: Significantly different rates of fall in FEV1 and FVC with time were found by geographical location and by smoking habit, but there were no consistent trends with enzyme exposure.
Abstract: This study was undertaken to examine the long term relationship between lung function, smoking and exposure to enzymes in the detergent industry. A total of 731 male workers from five locations in the United Kingdom were subject to respiratory health surveillance including lung function testing over a period of 4-20 years. Exposure groups were defined by job history. Significantly different rates of fall in FEV1 and FVC with time were found by geographical location and by smoking habit, but there were no consistent trends with enzyme exposure.
49 citations
TL;DR: In this article, a questionnaire was issued to 362 flour-exposed workers in a large bakery and all positive respondents to respiratory symptom questions were interviewed by an occupational nurse, and workers with occupationally related symptoms at this interview were referred to the chest clinic.
Abstract: The use of a respiratory screening questionnaire is recommended annually to screen bakery workers in the UK. We compared questionnaire screening with other methods of detecting workers with asthmatic symptoms and then assessed the significance of these symptoms with careful investigation and follow-up. Reasons for questionnaire failures were then explored. A questionnaire was issued to 362 flour-exposed workers in a large bakery. All positive respondents to respiratory symptom questions were interviewed by an occupational nurse. Workers with occupationally related symptoms at this interview were referred to the chest clinic. In addition, workers with negative questionnaires were screened using attendance records, sick notes and direct workplace observations. Workers with frequent absence from work or sick notes with respiratory diagnoses were interviewed in the same manner as those answering the questionnaire positively and then referred to clinic. At clinic, a diagnosis was made for each worker on the basis of clinical assessment, spirometry, serial peak expiratory flow rate (PEFR) analysis and radioallergosorbent testing (RAST) testing for specific IgE. Using the clinic diagnoses, the referral routes were audited to assess the rates of case detection of asthma and occupational asthma. The respiratory screening questionnaire identified 68 workers with respiratory symptoms. Of these, 21 proceeded to full assessment. A diagnosis of asthma was made in five cases, one of which was bakers' asthma. In addition, 11 workers not reporting any symptoms by questionnaire were referred to clinic and five were diagnosed as having asthma. Screening questionnaires may lead to an underestimate of the prevalence of asthmatic symptoms and as such should not be used alone in workplace screening.
45 citations
TL;DR: The findings suggest that symptomatic allergy to bread-baking ingredients is uncommon and where sensitisation to ingredients arises, fungal amylase present in bread improvers is the principal allergen.
Abstract: The purpose of this study was to describe the prevalence of respiratory symptoms and skin prick test findings in a group of 383 employees in a plant bakery population who had the greatest regular exposure to ingredient dusts. The prevalence of positive skin prick tests to fungal amylase was 16%, in contrast to 6% to wheat flour, suggesting that the principal sensitiser is fungal amylase and not flour. Furthermore, the findings suggest that symptomatic allergy to bread-baking ingredients is uncommon (3.1%). In comparison, occasional short-lived symptoms which do not appear to have an allergic aetiology are relatively prevalent (17.2%). Where sensitisation to ingredients arises, fungal amylase present in bread improvers is the principal allergen.
40 citations
TL;DR: The potential for ill-health in greenhouse workers is examined with particular reference to Great Britain and the principal potential effects expected include irritancy, asthma, allergic aleveolitis and dermatitis.
Abstract: Greenhouses are essentially microcosms aimed at providing physical environments suitable for the survival and growth of plants. Crops grown intensively in greenhouses in Great Britain include cut flowers, pot plants and edible crops such as tomato, lettuce cucumber and celery. The enclosed conditions mean that greenhouse workers are more likely to be exposed to higher levels of plant material, plant pests and plant protection products than general horticulture workers. The potential for ill-health in greenhouse workers is examined with particular reference to Great Britain. The principal potential effects expected include irritancy, asthma, allergic aleveolitis and dermatitis. Although biological control agents are widely used, there were no reports of their having caused ill-health in greenhouse workers. About two people per year are found to have suffered ill-health as a consequence of greenhouse exposure to chemical pesticides in reported pesticides incidents in Great Britain.
TL;DR: Despite continuing controversy about the status, aetiology and optimum management of CFS, it is argued that much can be done to improve the outcome for patients with this condition.
Abstract: Chronic fatigue syndrome (CFS) is a controversial condition that many occupational physicians find difficult to advise on. In this article we review the nature and definition of CFS, the principal aetiologic hypotheses and the evidence concerning prognosis. We also outline a practical approach to patient assessment, diagnosis and management. The conclusions of this review are then applied to the disability discrimination field. The implications of the new UK occupational health legislation are also examined. Despite continuing controversy about the status, aetiology and optimum management of CFS, we argue that much can be done to improve the outcome for patients with this condition. The most urgent needs are for improved education and rehabilitation, especially in regard to employment. Occupational physicians are well placed to play an important and unique role in meeting these needs.
TL;DR: The SWORD surveillance scheme as discussed by the authors has been used to report some 3,300 new cases of work-related respiratory disease in 1996, the highest level recorded prior to a low in 1995.
Abstract: Chest and occupational physicians who report to the SWORD surveillance scheme are estimated to have seen some 3,300 new cases of work-related respiratory disease in 1996. This total has regained the level recorded prior to a low in 1995, probably because of improved chest physician participation and the introduction of a sampling system for occupational physicians. Trends in disease incidence have remained fairly constant with some changes only in pneumoconiosis and inhalation accidents. It is of concern that there has been no evidence of a decrease in frequency of occupational asthma or in any of the incriminated agents since the scheme began in 1989. Comparison with other sources of data shows that, for asthma, SWORD records a relatively high frequency in women, a substantial proportion of whom do not appear to receive compensation. For mesothelioma, rates based on death certificates continue for understandable reasons to run at about twice the level reported to SWORD or as reflected by successful claims to the DSS for industrial injuries benefit. The SWORD programme is now one of six clinically-based reporting schemes which, by the end of 1997, are planned to cover all types of occupational disease in the UK.
TL;DR: Starch particles were not found in the air in rooms where latex gloves were not used, and were highest in rooms with a high glove usage but no ventilation, and use of powder-free gloves should be considered especially in unventilated areas in healthcare premises.
Abstract: As latex proteins, which cause latex hypersensitivity, can be found on starch particles and inhalation may be a route for sensitization, the presence of starch particles in hospital air was examined. The starch particles were demonstrated by immobilization onto cellulose acetate filters and staining with iodine. Rooms in which powdered latex gloves were used gave counts of up to > 3,667 particles per cubic meter of air. Starch particles were not found in the air in rooms where latex gloves were not used, and were highest in rooms with a high glove usage but no ventilation. A change to powder-free gloves significantly reduced the count of starch particles in the unventilated Accident/Emergency Department air. Use of powder-free gloves should be considered especially in unventilated areas in healthcare premises.
TL;DR: The study revealed a higher frequency of adverse reproductive outcomes among the women exposed to inorganic mercury levels at or substantially lower than 0.6 mg/m3; no significant differences in the stillbirth or miscarriage rates were noted between the two groups of women.
Abstract: The effect of exposure to inorganic mercury on the pregnant woman and her foetus has received little attention. Transport of elemental inorganic mercury into foetal tissues has been reported, and prior studies indicate a higher incidence of adverse pregnancy outcome. The effects of occupational exposure to inorganic mercury on pregnancy were investigated among 46 exposed women workers; controls were 19 women working in non-production areas of the same factory. There were 104 recorded total pregnancies during the period 1948-77. The study revealed a higher frequency of adverse reproductive outcomes, especially congenital anomalies, among the women exposed to inorganic mercury levels at or substantially lower than 0.6 mg/m3; no significant differences in the stillbirth or miscarriage rates were noted between the two groups of women. The overall foetal death rate in this study was similar to New York state (USA) and national levels for the same period.
TL;DR: OHS may have an important role to play in both prevention and management of long-term absence by early assessment and intervention such as expediting treatment or arranging rehabilitation programmes, however in order to be effective, a clear policy to encourage early and consistent referral is required.
Abstract: This study was carried out to investigate the incidence and causes of long-term sickness absence in an NHS teaching hospital and to explore the role of the Occupational Health Service (OHS) in the management of long-term absence. Examination of attendance records of non-medical staff revealed an annual loss of 20,772 days due to spells of absence lasting 30 calendar days or more, (incidence 0.0528/WTE employees/year, prevalence 5.53 days long-term absence/WTE employee/year). A self-administered questionnaire was sent to 190 staff who had taken long-term absence during the previous 12 months. The response rate was 75%. Musculoskeletal problems and back pain in particular were the main reasons for absence, accounting for 30% of total days lost. Work-related illness made an important contribution with a third of those with musculoskeletal and a quarter of those with mental illness attributing the reason for their absence to work. Many staff reported non-medical factors such as delays in waiting for treatment and anxiety about return to work which prevented them from returning to work sooner. Only a minority of staff had attended OHS and referral was often delayed. OHS may have an important role to play in both prevention and management of long-term absence by early assessment and intervention such as expediting treatment or arranging rehabilitation programmes. However in order to be effective, a clear policy to encourage early and consistent referral is required.
TL;DR: interpretation of the trace element profile analysis overall when an elevation occurs generally requires close attention to the pattern of elevation, clinical context, absolute and relative magnitude of the elevation and knowledge of the exposure history.
Abstract: Trace element profile analysis detects and quantifies the presence of several metals simultaneously at low concentrations in the body. In occupational medicine, it may be used to monitor exposure or to evaluate suspected toxicity. Clinical interpretation is often difficult because, with the exception of lead and possibly cadmium, there is little firm information on toxicity thresholds. For these tests, the reference ranges typically reflect low levels of exposure in the general population and it is expected that workers handling metals in occupations such as welding and industries such as steelmaking will have higher levels. Interpretation requires some knowledge of the toxicokinetics of the metal of interest and the preferred medium for analysis for each: serum, whole blood or urine (preferably 24-hour collection). Trends are often more informative than concentrations at one time. Trace element values are reported together with a reference range which must be distinguished from the normal range of other clinical tests. As a practical matter, the greatest interpretation problems tend to be found with manganese because serum levels have a poor correlation with both recent exposure and neurological symptoms. Molybdenum and vanadium are often found to be elevated among workers exposed to metals who show no evidence of clinical illness. Interpretation of the trace element profile analysis overall when an elevation occurs generally requires close attention to the pattern of elevation, clinical context, absolute and relative magnitude of the elevation and knowledge of the exposure history.
TL;DR: The amputees with ICEROSS suspension performed better and had improved mobility in Group A and at the workplace, dynamic activities were less than the static activities (p < 0.001) and there were overall improvements in comfort and performance of amputee with ICerOSS.
Abstract: A clinical trial was conducted to evaluate the efficiency of ICEROSS on randomly selected 46 male transtibial amputees. After rejection, only 27 (58.69%) amputees volunteered for various stages of the ICEROSS trial. All 27 were categorized into Group A - persons in employment (n = 16) and Group B - persons out of employment or economically inactive (n = 11). The study was conducted on the basis of questionnaire information, clinical examination and objective tests. The pre- and post-ICEROSS status were compared between the groups. Group A was younger and did better. Trauma was the main cause of amputation. There were certain changes of the stump before and after ICEROSS. The amputees with ICEROSS suspension performed better and had improved mobility in Group A. At the workplace, dynamic activities were less than the static activities (p < 0.001) and there were overall improvements in comfort and performance of amputees with ICEROSS.
TL;DR: The importance of communication between occupational health physician and other doctors in the occupational health process is confirmed and the likelihood of a communication was strongly influenced by reason for referral.
Abstract: Four hundred and seventy-two consecutive referral episodes relating to 386 patients attending the Occupational Health Department of a general teaching hospital were analyzed to evaluate the frequency, content and effect on management of communications between the occupational physician and other doctors. In all, 250 episodes (53%) were associated with such a communication. The likelihood of a communication was strongly influenced by reason for referral, particularly in respect of long or short term sickness absence; univariate odds ratios (OR) = 10.58, 95% CI = 8.13-27.08) and 2.65, 95% CI = 1.55-4.60) respectively; a medical diagnosis of psychiatric illness (OR = 3.17, 95% CI = 1.69-5.97)); and by number of consultations. Communication was also more likely when the occupational outcome was ill health retirement, rehabilitation in work or modified work. Ninety-eight per cent of specific requests for information or an opinion elicited a reply. Information received from other doctors influenced the occupational health physician's management in 52 referral episodes (20%). Specific action by GPs as a result of communication was documented in 54 and by specialists in 37 episodes. The importance of communication between occupational health physician and other doctors in the occupational health process is confirmed.
TL;DR: The poorly controlled used of pesticides in the farms appeared to have caused sub-clinical intoxication in the farm workers and indicated the need for training and implementation of hygiene practices.
Abstract: In this study we have examined 532 migrant farm workers engaged mainly in thecultivation of vegetable crops, in both greenhouses and openfarms, and an equalnumber of controls. Erythrocyte acetylcholinesterase activity (AChE) was measuredto determine the degree of toxicity due to exposure to organophosphate andcarbamate pesticides in the farm workers employed either as foremen (41.5%) orfarmers (58.5%). The mean ages of the farm workers and controls were 35.2 ±7.4(mean ± SD) years and 34 6 ± 7.1 years. AChE activity of the farm workers andcontrols was 3.89 ±0.64 Ul/ml (mean±SD) and 4.15 ±0 29 Ul/ml. The haemoglobinadjusted erythrocyte cholinesterase activity (HAChE) was 29.96 ± 4.14(mean ± SD) forfarm workers and 32 10 ±2 26 for controls. AChE activity was very highly significantlylower for the foremen (3 76 ± 0 69) compared to farmers (3 98 ± 0.59) (Student's f-test= 4.13, p = 0.0001). HAChE was also very highly significantly lower for foremen (29.24±4.37) compared to farmers (30.46 ±3.88) (Student's f-test = 3 64, p = 0.0001). Thepoorly controlled use of pesticides in the farms appeared to have caused sub-clinicalintoxication in the farm workers and indicated the need for training and implementationof hygiene practices.Key words: Agricultural workers; carbamates; erythrocyte acetylcholinesterase; farm workers;greenhouses; haemoglobin, haemoglobin adjusted erythrocyte cholinesterase, openfarms,organophosphates; pesticides
TL;DR: The use of multiple objective tests, the collection of routine data, a proposed scoring system for the sensorineural component and the role of cold provocation testing in the diagnosis of the vascular component are discussed.
Abstract: The Health and Safety Executive has recommended health surveillance for all workers in jobs identified as giving rise to significant risk of the hand-arm vibration syndrome. Objective tests are not routinely recommended for workplace surveillance but may have a role in the assessment of accurate staging or if decisions on an individual's continuing exposure is in question. This paper covers the use of multiple objective tests, the collection of routine data, a proposed scoring system for the sensorineural component and discusses the role of cold provocation testing in the diagnosis of the vascular component.
TL;DR: This is the first case of occupational asthma and rhinitis caused by inhalation of 1,2-benzisothiazolin-3-one, an additive used as a microbicidal in detergent production in a 26-year-old man employed in a chemical factory producing detergents.
Abstract: We report a case of occupational asthma and rhinitis caused by inhalation of 1,2-benzisothiazolin-3-one, an additive used as a microbicidal in detergent production, in a 26-year-old man employed in a chemical factory producing detergents. The subject's task consisted of pouring raw materials into the recipient of a machine which mixed the substances. Two months after the beginning of this job the patient complained of rhinitis and asthma at the workplace. The specific challenge test with 1,2-benzisothiazolin-3-one, one of the raw materials to which the subject was exposed, provoked an immediate prolonged asthmatic response and nasal symptoms, whereas exposure to other agents (e.g., alpha-amylase, alcalase or bezalkonium chloride) to which the patient was also exposed at work did not. To our knowledge this is the first case of occupational asthma and rhinitis caused by this compound.
TL;DR: Although the seminal work in what was to become the specialty of occupational medicine appeared in 1700 as written by Bernardino Ramazzini, it was through the English translation by Wilmer Cave Wright in 1940 and and the subsequent scholarship of Dr Pericle Di Pietro of Modena, Italy, that this monograph became widely known.
Abstract: Although the seminal work in what was to become the specialty of occupational medicine appeared in 1700 as written by the Italian physician, Bernardino Ramazzini and titled De Morbis Artificum Diatriba, it was through the English translation by Wilmer Cave Wright in 1940 and and the subsequent scholarship of Dr Pericle Di Pietro of Modena, Italy, that this monograph became widely known. Ramazzini has been cited by innumerable medical authors and his volume has undergone many translations from the mid-18th century to the present day. References to this early observations of persons and work and their subsequent disease patterns repeatedly infuse today's description of work-related illness. That his pioneering efforts continue to receive adulation is seen in the organizations bearing his name, many eponymous awards, the striking Ramazzini Hall in Japan, and the continuing appearance of new reprintings of Diseases of Workers world-wide. The name Ramazzini marks the beginning of society's concern with the well-being and physical and emotional health of its workers from the shops of the crafts to the offices of the executives.
TL;DR: The purpose of the work was to identify the most dangerous chemicals normally used, which means sources of chemical risk for safety workers and their environment; thus, symptoms of exposure, prevention measures and protection tools are also described.
Abstract: This study addresses the chemical and toxicological questions due to the wide use of chemical treatment programmes for industrial cooling water. First, natural problems encountered in cooling tower systems were presented and grouped into three categories: (i) scaling; (ii) corrosion and (iii) biofouling. Chemical solutions adopted in industrial plants were outlined for each one in order to minimize damage and categorized as shut-down, production loss, heat transfer reduction, upsets, etc. Above all, the purpose of the work was to identify the most dangerous chemicals normally used, which means sources of chemical risk for safety workers and their environment; thus, symptoms of exposure, prevention measures and protection tools are also described. Language: en
TL;DR: The evaluation of a skin care education programme conducted on a fine chemicals manufacturing site where over 1,000 employees are located demonstrates the importance of worker education as a tool for primary prevention of disease.
Abstract: This paper reports the evaluation of a skin care education programme conducted on a fine chemicals manufacturing site where over 1,000 employees are located. Approximately 60% are involved in chemical manufacture. Over a 12 month period production staff received training in prevention of occupational dermatoses linked to a site-wide poster initiative. The incidence of new cases of occupational dermatoses fell from 0.055 (70 cases in 1,277 employees) to 0.021 (27 cases in 1,277 employees) before and after the intervention respectively (p < 0.0001). After other factors such as chemicals handled, observer bias and changes in reporting related to socioeconomic climate were taken into account it is concluded that this study demonstrates the importance of worker education as a tool for primary prevention of disease. Training materials such as video and poster presentations may be effectively used in the chemical manufacturing industry as an adjunct to prevention and control of exposure to substances hazardous to the skin. Such methods may also be used in other industries where there are significant risks of dermatoses.
TL;DR: It is shown that tanker drivers with long exposure to gasoline during the work week developed significantly higher changes in fatigue scores than drivers with short exposure and exposure to MTBE can be reason for acute symptoms among the tanker drivers in this study.
Abstract: The purpose of this study was to investigate changes in the neuropsychological symptoms and moods among tanker drivers during a work week and the associations of the changes with exposure to gasoline (including 10% methyl-tert-butyl ether). The target group for the study consisted of 101 road tanker drivers from three Finnish oil companies in various parts of Finland. The control group consisted of 100 milk delivery drivers from two milk companies from the same localities. Interviews were conducted before the work week and at the end of the same work week. Standardized symptom questionnaires were used to elicit responses to questions about symptoms and moods. In the questionnaires tanker drivers scored significantly higher in the fatigue scale at the end of the work week than before the work week. Our findings show that tanker drivers with long exposure to gasoline during the work week developed significantly higher changes in fatigue scores than drivers with short exposure. During the exposure situations, 20% of tanker drivers reported acute symptoms (headache, dizziness, nausea, dyspnoea, irritation of saliva excretion) at the end of work week voluntarily. These symptoms have been connected, with MTBE (methyl-tert-butyl ether) exposure, among others. Exposure to MTBE during the work week can be reason for acute symptoms among the tanker drivers in this study.
TL;DR: It appears that conventional survey techniques may be successfully employed in health studies of health professionals, particularly if issues of great concern to the target population are addressed.
Abstract: In a recent study of female veterinarians, a subgroup of health professionals growing rapidly in number, the authors employed a mixed-mode survey design in targeting the cohort of women graduating from all US veterinary colleges during the 11-year period 1970-80 (n = 2,997). The questionnaire elicited information on a variety of health and occupational factors and required 35 minutes on average to complete. In the first stage, a modified version of Dillman's Total Design Method for mailed, self-administered questionnaires was employed, yielding a response rate of 82.9%. In the second stage, a telephone interview of all mail non-respondents was attempted, yielding a response rate here of only 30.1%, but iricreasing the overall response rate among those contacted to 90.2%. Non-respondents differed little from mail (early) or telephone (late) respondents with respect to year of graduation and geographic region of veterinary college attendance. Gentle probing of telephone non-respondents suggested the personal nature of some questions and the amount of time required to answer all questions were the main reasons they chose not to participate. It therefore appears that conventional survey techniques may be successfully employed in health studies of health professionals, particularly if issues of great concern to the target population are addressed.
TL;DR: Advice provided at the SHC was perceived to be the most effective method by occupational nurses and safety and health supervisors, and recommendations from OPs stipulated by the Industrial Safety and Health Law to be most effective.
Abstract: This study was conducted to find effective methods to persuade higher management to invest in workplace health promotion (WHP) programmes. The study included 639 occupational health professionals selected from the directory of the Japan Society for Occupational Health. A questionnaire survey was mailed to health professionals throughout Japan in 1992, and all respondents were asked to identify themselves. We received 242 replies, which constituted a response rate of 38%. Eighty-one per cent of the respondents had attempted to persuade higher management to implement a WHP programme. Health professionals frequently presented their case to higher management through a safety and health committee (SHC), and advice provided at the SHC was perceived to be the most effective method by occupational nurses (ONs) and safety and health supervisors (SHSs). This method was rated second by occupational physicians (OPs), who thought recommendations from OPs stipulated by the Industrial Safety and Health Law to be most effective. Statistics on medical examinations constituted the data most frequently used to persuade higher management, followed by reports on worksite inspections and health care plans. Nearly 90% of OPs and 80% of ONs and SHSs felt that the above methods were fairly successful.
TL;DR: It is concluded that chronic tea dust exposure causes increased prevalence of respiratory symptoms and a significant degree of small airways obstruction in workers exposed to tea dust for at least five years during the sifting process of tea manufacture.
Abstract: A cross-sectional study was conducted in order to determine the prevalence of respiratory symptoms and the effect on ventilatory capacity in workers exposed to tea dust for at least five years during the sifting process of tea manufacture compared to a control group of field workers who were not exposed to tea dust previously. Fifty-three subjects each in the study and control groups were matched for age, sex, ethnic group and height. Prevalence of chronic respiratory symptoms was obtained by questionnaire Spirometric measurements included forced vital capacity (FVC), forced expiratory volume in the first second (FEV, J and forced mid-expiratory flow rate (FEF^^*). The study group had a chest radiograph. The odds ratio for any chronic respiratory symptom was 11.6 (95% confidence interval [Cl] = 3.7-39.4) in the study group. Mean values for the spirometric tests were lower in the study group; the differences in FEV10 and FEF25_75% were significant. Tuberculosis was not found in the study group, while one subject (2.4%) had radiological evidence of bronchiectasis. It may therefore be concluded that chronic tea dust exposure causes increased prevalence of respiratory symptoms and a significant degree of small airways obstruction.
TL;DR: Guidelines for occupational rehabilitation of workers with low-back pain were developed as part of a larger study as mentioned in this paper and formulated criteria for good practice of occupational rehabilitation on the basis of these guidelines.
Abstract: Guidelines for occupational rehabilitation of workers with low-back pain were developed as part of a larger study. We have formulated criteria for good practice of occupational rehabilitation on the basis of these guidelines. To assess the quality of occupational rehabilitation in the Netherlands, these criteria were subsequently used in an audit of medical records. The number of patients who received care consistent with the guidelines was compared to the number of patients eligible to receive that kind of care (performance rate). Six performance rates were calculated from the medical files of 40 workers with 48 new episodes of low-back pain. Two performance rates proved to be below 25% and two almost 50%. The highest performance rate, that for curative policy, was 90%. These results are discussed in the light of the reliability of the original data. We recommend construction of guidelines as well as reliable registration of the occupational rehabilitation process to increase the possibilities of auditing and to raise the quality of occupational health care.