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Preview: Occupational Medicine - current issue

Occupational Medicine Current Issue





Published: Mon, 29 May 2017 00:00:00 GMT

Last Build Date: Mon, 29 May 2017 11:49:17 GMT

 



mHealth Innovation: Best Practices From the Mobile Frontier

2017-05-29

Edited by KrohnRick and MetcalfDavid. Published by Healthcare Information Management Systems Society (HIMSS), Chicago, Illinois, 2014. ISBN: 978 1 938904 61 5. Price: $72 (online) e-books also available. 388 pp.



Occupational cancer: recent developments in research and legislation

2017-05-29

In recent years, it has been become increasingly popular to carry out estimation of the burden of disease with the aim of identifying major risk factors contributing to important morbidity burdens as an aid to prioritizing risk reduction strategies. The area of occupational disease and in particular occupationally related cancer is no exception. As outlined in an earlier Editorial [1], the British occupational burden of cancer project provided one of the most detailed evaluations of the relationship between >40 workplace carcinogens and >20 cancer sites highlighting industries of particular concern and demonstrating the usefulness of different burden measures such as proportion affected and numbers of new cancers versus deaths [2].



Charles Turner Thackrah, 1795–1833, ‘The Father of Occupational Medicine’

2017-05-29

‘I hold in my hand a treatise by a medical gentleman of great intelligence, Mr Thackrah of Leeds.’






Reply

2017-05-29

Dear Sir,






Reply

2017-05-29

Dear Sir,



In This Issue of Occupational Medicine

2017-05-29

This issue showcases the unique preventive role of occupational medicine. Heralding the Society of Occupational Medicine Annual Scientific Meeting in Leeds in June, Mathie [1] applauds the legacy of Charles Turner Thackrah, anatomist, experimental physiologist, clinician, teacher, founder of the Leeds Medical School, preventive medicine pioneer and humanitarian. Thackrah packed so much into his short life before dying of pulmonary tuberculosis the day after his 38th birthday in 1833. He was a shrewd observer, an assiduous recorder, who married benevolence with imagination and vision. He published his famous tract in 1831 with a larger and definitive edition following in 1832, ‘The effects of the arts, trades, and professions, and of civic states and habits of living, on health and longevity: with suggestions for the removal of many of the agents which produce disease, and shorten the duration of life’. The book covered over 100 trades in Leeds at the time and made important recommendations for prevention, opining that ‘Thoughtlessness or apathy is the only obstacle to success.’ The discipline of occupational medicine resulted and it influenced the Factory Act 1833 which prohibited the employment of children under 9 years old in the textile mills. Sir John Simon, the first chief medical officer in 1855, ranked Thackrah’s contribution to preventive medicine as important as Jenner’s work on smallpox.



George Stubbs Haymakers 1785

2017-05-29

Nine farm workers (four men, three women and two horses) are stylishly posed against the backdrop of a pale blue summer sky full of wispy white clouds and framed by a majestic oak. The open fields and distant hills fade away to the hazy lower right [1], drawing the eye past a graceful rustic tableau. The characters are carefully positioned in three groups, their unexpected elegance gentrifying the humble bucolic scene. On the left two implausibly but impeccably dressed women, all frills and finery, caress newly mown hay with long-handled wooden rakes, poised in delicate hands and projecting diagonally towards the waiting cart, where a bare-headed man gathers in from his colleague’s pitchfork. The central group of three is organized vertically. The workers’ upright stance, farm implements and extended limbs accentuate the provocative, hand-on-hip pose of an elegant young woman, who affects the iconic pretensions of a Roman goddess or a mediaeval martyr [2]. The final group, horizontally displayed on the right, consists of one and a bit horses or in racing parlance ‘one length and a neck’. The lead horse is beautifully portrayed, its features captured by an artist intimately familiar with equine anatomy—coat gleaming, ears pricked, eyes blinkered, heroic patience worthy of a study in itself. The location is not known. It may be England’s South Midlands or the countryside around London [3]. The painting is likely based on drawings made ‘on site’ then worked up in the studio [4]. Stubbs sets his ‘heroic’ workers centre stage like civic dignitaries creating a ‘feel-good vision of the countryside, made to order for the gentry’ [5], a ‘proletariat conversation piece’ [1]. It is signed ‘Geo: Stubbs pinxit 1785’.






Well-being apps

2017-05-29




Occupational Medicine Calendar

2017-05-29

2017DateEventContact AddressVenueAugust 28–31EPICOH 2017 Conference - Eliminating Occupational Risk: Translating Research into Actionhttps://epicoh2017.orgEdinburghAugust 29– September 16th International Congress of the ICOH Scientific Committee on Work Organization and Psychosocial Factorshttp://condor.zaragoza.unam.mx/wops/Mexico City, MexicoSeptember 3–6XXI World Congress on Safety and Health at Work 2017http://www.safety2017singapore.com/SingaporeSeptember 13–1545th International MEDICHEM Congress 2017http://medichem2017.euVienna, AustriaSeptember 20How to Manage Back Pain at Work – a New Approach, organised by The At Work Partnership Ltdinfo@atworkpartnership.co.ukLondon, UK September 27–29 (part 1) and November 14–15 (part 2)Certificate in OH Law, organised by The At Work Partnership Ltdinfo@atworkpartnership.co.ukLondon, UKOctober 1–410th International Symposium on Biological Monitoring in Occupational and Environmental healthhttp://www.centercongressi.com/isbm10Naples. ItalyOctober 3–6WOS 9th International Conference on the prevention of accidents at workhttp://www.wos2017.net/Prague, Czech RepublicOctober 10–11Workplace Health 2017, organised by The At Work Partnership Ltdinfo@atworkpartnership.co.ukWarwickshire, UKNovember 1–410th European Public Health Conference 2017. Sustaining resilient and healthy communitieshttp://www.ephconferences.euStockholm, SwedenDecember 28–3010th International Joint Conference on Occupational Health for Healthcare Workers: Health & wellbeing in the health care sector; addressing current threats to workerswww.ohhcw2017.orgKhon Kaen, Thailand



Low back pain among taxi drivers: a cross-sectional study

2017-05-11

Abstract
Background
Low back pain (LBP) is a common occupational problem for drivers all over the world. However, few epidemiological studies have investigated LBP among taxi drivers.
Aims
To investigate the prevalence of LBP and associated work-related factors among Chinese taxi drivers.
Methods
A cross-sectional survey was administered to all participants. Using cluster sampling, questionnaires were collected from taxi drivers of three major taxi companies in Jinan, China. Univariate and multivariate logistic regressions were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) among participants.
Results
A total of 800 taxi drivers were invited to take part, with a participation rate of 90%. The 1-year period prevalence of LBP was 54%. Multivariate logistic regression analysis revealed that longer daily driving duration (OR 3.3, 95% CI 1.9–5.9), night shifts (OR 1.9, 95% CI 1.2–3.1) and increasing work years as a taxi driver (OR 1.7, 95% CI 1.2–2.5) were associated with increased risk of reporting LBP; while increased rest days per month (OR 0.8, 95% CI 0.7–0.9), longer sleep duration (OR 0.7, 95% CI 0.5–0.9) and more physical activity (OR 0.5, 95% CI 0.3–0.8) were significantly associated with decreased risk of reporting LBP.
Conclusions
The prevalence of LBP among professional taxi drivers in China was associated with a number of occupational features.



Corrigendum

2017-05-10

Public Health: A Very Short Introduction



Occupational asthma caused by acrylic compounds from SHIELD surveillance (1989–2014)

2017-04-20

Abstract
Background
Acrylic monomers (acrylates), methacrylates and cyanoacrylates all cause asthma by respiratory sensitization. Occupational inhalation exposures occur across a variety of industries including health care and dental work, beauty, laboratory science, assembly and plastic moulding.
Aims
To examine notifications of occupational asthma caused by acrylic compounds from a UK-based regional surveillance scheme, in order to highlight prevalent exposures and trends in presentation.
Methods
Retrospective review of all cases reported to the SHIELD surveillance scheme for occupational asthma, West Midlands, UK between 1989 and 2014. Patient data were gathered on demographics, employment, asthma symptoms and diagnostic investigations including serum immunological testing, serial peak flow analysis and specific inhalation challenge tests. Descriptive statistics were used to illustrate worker characteristics and evidence for sensitization to acrylic compounds.
Results
There were 20 affected patients out of 1790 total cases of occupational asthma (1%); all cases were confirmed by OASYS (Occupational Asthma SYStem) analysis of serial peak flow measurements, with three additional positive specific inhalation challenge tests. Three out of 20 (15%) patients were current smokers and 11/20 (55%) were atopic. A variety of exposures and industries were implicated including: manufacturing, health care, beauty and printing and a novel presentation seen in teachers exposed to floor adhesives.
Conclusions
This is the largest reported series of occupational asthma caused by acrylic compounds, which remain an important aetiological factor in this disease. Exposure occurs in a variety of industries, particularly in manufacturing and is seen with other, perhaps better recognized sensitizing agents such as isocyanates and epoxy resins.



Work organization, sleep and metabolic syndrome among long-haul truck drivers

2017-04-17

Abstract
Background
The work organization of long-haul truck drivers in the USA contains factors that have been shown to degrade sleep. In combination, these factors generate elevated cardiometabolic risk by inducing components of the metabolic syndrome (MetS). However, the prevalence and severity of MetS and the degree to which such factors differentially influence MetS among these drivers are unknown.
Aims
To determine the prevalence and severity of MetS among US long-haul truck drivers and to determine the predictive value of demographic, work organization and sleep variables in MetS diagnosis and severity.
Methods
A non-experimental, descriptive, cross-sectional study, designed to collect survey, anthropometric and biometric data from US long-haul truck drivers. Descriptive analyses were performed for demographic, work organization, sleep and MetS measures. Logistic and linear regression analyses examined potential predictive relationships between demographic, work organization and sleep variables and MetS diagnosis and severity.
Results
The study population was 262. Nearly 60% of drivers met MetS diagnosis criteria. Over 80% had a waist circumference >102 cm, 50% had triglyceride levels of ≥150 mg/dl, 66% had an high-density lipoprotein of <40 mg/dl, 28% had a blood pressure of ≥135/80 mm Hg and 17% had a fasting glucose of ≥110 mg/dl. Driving experience and work day sleep quality were associated with MetS prevalence and severity.
Conclusions
The prevalence and severity of MetS among this sample of US long-haul truck drivers were high. Preventive efforts should focus on experienced drivers and work day sleep quality.



Biopsy-proven hypersensitivity pneumonitis caused by a fluorocarbon waterproofing spray

2017-04-08

Abstract
Background
We present the case of a 35-year-old male who developed a chronic hypersensitivity pneumonitis (HP) following inhalational exposure to a fluorocarbon waterproofing aerosol spray, caused by his work for an upholstery and soft furnishings retailer. This is the first case report from inhalational fluorocarbon exposure with histological evidence of chronic HP. This is then discussed in the context of previous reports of interstitial lung disease and lung injury, caused by similar occupational and non-occupational exposures.



Mixed contact methods to improve response to a postal questionnaire

2017-03-24

Abstract
Background
Postal questionnaires remain an important method of collecting data in trials. However, a high non-response rate can lead to biases, which may undermine the validity of the study.
Aims
To assess a simple method of trying to improve response rates in an occupational health trial evaluating an intervention to prevent hand dermatitis in nurses.
Methods
The trial employed questionnaires at t = 0, t = 1 month and t = 12 months. The t = 1 month questionnaire was posted to study participants (student and intensive care nurses) together with a free postage reply envelope. After 2 weeks, an e-mail was sent to non-responders reinforcing the need for completed questionnaires to be returned. Two weeks later, non-responders were sent another hard copy of the questionnaire, along with an accompanying letter. Six weeks after posting the initial questionnaires, non-responders were sent an SMS text message or were telephoned to remind them to return the questionnaire.
Results
The response rates for the 744 student nurses were 8% (no reminder), 27% (after first reminder), 22% (after second reminder) and 27% (after the third reminder), resulting in a response rate of 63%. The response rates for the 959 intensive care nurses were 9% (no reminder), 24% (after first reminder), 24% (after second reminder) and 31% (after third reminder), resulting in a final response rate of 63%.
Conclusions
We found that a series of regular reminders including a third, personalized reminder by SMS text or telephone had a positive impact on non-responders.



Cardiac health and fitness of Colorado male/female firefighters

2017-03-16

Abstract
Background
Cardiovascular disease (CVD) is documented as the leading cause of mortality in on-duty firefighters.
Aims
To examine the prevalence of metabolic syndrome (MetS) components, cardiorespiratory fitness levels and the association between them in firefighters in Colorado, USA.
Methods
This study included male and female Colorado firefighters. MetS was identified where three or more metabolic abnormalities were present, using Cholesterol Education Program/Adult Treatment Panel III guidelines. Cardiorespiratory fitness (indicated by VO2 max) was evaluated with the Bruce protocol. Poisson regression was conducted to examine the association between MetS components and VO2 max.
Results
Among the 947 male and 76 female study subjects, MetS was present in 9% of all firefighters, in 5% of females and 10% of males. The mean age was 37 ± 10 years. MetS prevalence increased with age (from 3% at age <30 to 17% at 50 and older, data not shown). In addition, 35% had one and 19% had two abnormal MetS components and 49% of participants did not meet the minimum recommended VO2 max of 42.0 ml/kg/min. VO2 max was negatively associated with abnormal MetS components (incident rate ratios = 0.95, 95% confidence interval 0.94–0.96, P < 0.001).
Conclusions
About one in 10 of these Colorado firefighters had MetS and nearly half had insufficient cardiorespiratory fitness. Comprehensive CVD risk management and cardiorespiratory fitness improvement are essential for firefighter health and safety.



Factors associated with sickness absence among employees with chronic conditions

2017-03-08

Abstract
Background
The growing prevalence of chronic conditions in the ageing workforce has been shown to have a negative impact in terms of optimal work performance and quality of life. It is therefore important to understand the factors associated with sickness absence due to health problems.
Aims
To examine the socio-demographics, health status indicators, barriers to self-care and social support associated with working adults missing work because of chronic conditions.
Methods
We analysed data from working adults in the USA with one or more chronic conditions who completed the National Council on Aging (NCOA) Chronic Care Survey. Analyses were performed using SPSS version 22; independent sample t-tests and chi-squared tests were used to compare sample characteristics and logistic regression was used to assess factors associated with missed work as a dichotomous outcome variable.
Results
Among the 250 study subjects, employees who reported poorer general health status [odd ratio (OR) = 1.62, P < 0.05], more physician visits (OR = 1.45, P < 0.01), not having enough money for their health (OR = 3.69, P < 0.01) and a higher reliance on their co-workers (OR = 1.71, P < 0.05) were significantly more likely to report sickness absence due to their chronic conditions.
Conclusions
To reduce absences among employees with chronic conditions, employers need to understand the importance of factors such as employee income, resources and knowledge of disease self-care. US employers should explore opportunities for employees to offset health care costs, apply appropriate time-flexible work policies and encourage employees’ participation in health knowledge enhancing interventions.



Protective factors for work ability in preschool teachers

2017-03-08

Abstract
Background
Work ability (WA) describes the physical and intellectual resources on which individuals can rely to respond to work demands. While several studies have investigated the protective role of work-related psychosocial factors on WA, only a few have examined differences across age cohorts. Moreover, few studies have investigated WA in the educational context and most of those did not consider preschool teachers.
Aims
To examine the role of psychosocial factors (support from colleagues, support from supervisors, work meaning, reward, skill discretion and autonomy) in sustaining WA among preschool teachers in different age cohorts.
Methods
A cross-sectional study of preschool teachers employed in the municipal educational services of a city in northwest Italy. Study subjects completed a self-reported questionnaire.
Results
Among the 706 study subjects, in the 35–44 age cohort, support from colleagues was positively associated with WA. In the 45–54 age cohort, WA was found to be associated with reward and skill discretion while in the 55–63 age cohort, work meaning was significantly associated with WA.
Conclusions
Our findings indicate that potential protective factors for WA may differ between age cohorts. They also suggest that in order to sustain WA effectively, interventions in working populations should be tailored to employees’ ages.



Perceived office environments and occupational physical activity in office-based workers

2017-03-01

Abstract
Background
Individuals in office-based occupations have low levels of physical activity but there is little research into the socio-ecological correlates of workplace activity.
Aims
To identify factors contributing to office-based workers’ perceptions of the office environment and explore cross-sectional relationships between these factors and occupational physical activity.
Methods
Participants in the Active Buildings study reported perceptions of their office environment using the Movement at Work Survey. A principal component analysis (PCA) was conducted on survey items. A sub-sample wore the ActivPAL3TM accelerometer for ≥3 workdays to measure occupational step count, standing, sitting and sit-to-stand transitions. Linear regression analyses assessed relationships between environmental perceptions and activity.
Results
There were 433 participants, with accelerometer data available for 115 participants across 11 organ izations. The PCA revealed four factors: (i) perceived distance to office destinations, (ii) perceived office aesthetics and comfort, (iii) perceived office social environment and (iv) perceived management discouragement of unscheduled breaks. Younger participants perceived office destinations as being closer to their desk. Younger and female participants perceived more positive office social environments; there were no other socio-demographic differences. Within the sub-sample with accelerometer data, perceived discouragement of breaks by management was related to occupational step count/hour (B = −64.5; 95% CI −109.7 to −19.2). No other environmental perceptions were related to activity or sitting.
Conclusions
Perceived managerial discouragement of breaks could be related to meaningful decreases in occupational step count. Future research should aim to elucidate the role of the workplace socio-cultural environment in occupational walking, with a focus on the role of management.



Unabated occupational risk in a patient with rheumatoid pulmonary fibrosis

2017-02-23

Abstract
Background
This case highlights the importance of considering hypersensitivity pneumonitis (HP) in the differential diagnosis of interstitial lung disease (ILD) and of obtaining an occupational history so that remediable risk factors may be identified and managed.
Aims
To report a case of a chicken sexer with severe rheumatoid arthritis (RA) who developed progressively worsening dyspnoea and restrictive lung disease associated with pulmonary fibrosis.
Methods
Clinical investigation included physical examination, occupational history, pulmonary function tests (PFTs), chest imaging and bronchoalveolar lavage (BAL), as well as serological tests including standard IgE bird feather mixture and local IgG precipitin preparation to chicken excrement. Lung histopathology was examined post-mortem.
Results
The patient had worked as a chicken sexer for 29 years with limited control of exposure to chicken bioaerosols. PFTs initially showed mild restriction with a moderate gas transfer defect and computerized tomography of the chest exhibited extensive interstitial infiltrates throughout with severe honeycombing at the bases. Cytology from a BAL revealed multinucleated giant cells (MNGs). Specific serologic tests for bird antigens were negative. Histopathology demonstrated diffuse interstitial fibrosis with honeycombing, poorly formed granulomas and MNGs.
Conclusions
Findings were consistent with a diagnosis of HP with RA-associated ILD. The patient’s history of severe RA biased the diagnosis to one of RA-associated ILD and her occupational risk had been less emphatically addressed. Obtaining a thorough occupational history can uncover exposures to workplace respiratory hazards and may create opportunities for intervention to limit morbidity from chronic lung disease.



Awareness of occupational skin disease in the service sector

2016-07-11

Abstract
Background
Occupational skin disease (OSD) is a common occupational disease. Although primary prevention strategies are known, OSDs remain prevalent in a variety of work environments including the service sector (restaurant/food services, retail/wholesale, tourism/hospitality and vehicle sales and service).
Aims
To obtain information about awareness and prevention of OSD in the service sector.
Methods
Focus groups and a survey were conducted with two groups. The first consisted of staff of the provincial health and safety association for the service sector and the second group comprised representatives from sector employers. Focus groups highlighted key issues to inform the survey that obtained information about perceptions of awareness and prevention of OSD and barriers to awareness and prevention.
Results
Both provincial health and safety association staff and sector employer representatives highlighted low awareness and a low level of knowledge of OSD in the sector. Barriers to awareness and prevention included a low reported incidence of OSD, low priority, lack of training materials, lack of time and cost of training, lack of management support and workplace culture.
Conclusions
A starting point for improving prevention of OSD in the service sector is increased awareness. Identification of the barriers to awareness and prevention will help to shape an awareness campaign and prevention strategies. Building on existing experience in Europe will be important.