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Preview: Occupational Medicine - current issue

Occupational Medicine Current Issue





Published: Sat, 02 Dec 2017 00:00:00 GMT

Last Build Date: Fri, 08 Dec 2017 15:01:05 GMT

 



ABC of Clinical Leadership

Sat, 02 Dec 2017 00:00:00 GMT

Edited by SwanwickTim and McKimmJudy. Published by John Wiley & Sons, West Sussex, 2017. ISBN: 978-1-119-13431-2. Price: £24.99 (paperback). 89 pp.



Essential Travel Medicine

Sat, 02 Dec 2017 00:00:00 GMT

Edited by ZuckermanJane N., BrunetteGary, LeggatPeter. Published by Wiley Blackwell, Chichester, UK, July 2015, 1st edition, ISBN: 978-1-118-5. Price: £64.99 (Paperback), £58.99 (E-book), 360 pp.



Challenging Pain SyndromesPhysical Medicine and Rehabilitation Clinics of North America

Sat, 02 Dec 2017 00:00:00 GMT

Edited by SchreiberAdam L.. Consulting Editor: Gregory T. Carter. Published by Elsevier, May 2014. ISBN: 978-0-323-29723-3. Price: £62.99. 270 pp.



Occupational health and safety in the Southern African Development Community

Sat, 02 Dec 2017 00:00:00 GMT

Occupational health and safety (OHS) practice in the Southern African Development Community (SADC) has been greatly constrained by inadequate integration with the political, economic and social environment of many SADC member states. SADC is a regional economic community comprising 15 member states: Angola, Botswana, Democratic Republic of Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe [1]. Even in the presence of global OHS instruments by the International Labour Organization (ILO) that guide all countries in the promotion of workplace health and safety and in managing OHS programmes, including No. 81 (Labour inspection), No. 155 (Occupational safety and health), No. 161 (Occupational health services), No. 170 (Chemical safety) and No. 174 (Prevention of major industrial accidents), many SADC member states lack a comprehensive OHS policy and the resources to implement it [2,3].



Why work is so problematic for people with disabilities and long-term health problems

Sat, 02 Dec 2017 00:00:00 GMT

Occupational health researchers and practitioners are well aware of the stubborn gap in employment rates between disabled and non-disabled people in countries within the Organisation for Economic Co-operation and Development (OECD) [1]. They may be less aware that many of the causes of this gap can be found in the workplace. The example of employers’ attitudes towards sickness absence shows how some of these causes might be traced back to the behaviour of employers. UK employers are particularly likely to be exercised by levels of sickness absence [2]. Even though UK rates of sickness absence are modest by European standards, and levels of sick pay are among the lowest in Europe, a higher proportion of sick pay is paid by employers in the UK than in other European countries [3–5]. This gives UK employers a particular incentive to reduce sickness absence. In 2004, disabled people in the UK were twice as likely as non-disabled people to require sickness absence and a decade later this gap persisted even as overall rates of sickness absence fell. In 2016, the rate of sickness absence was 4.4% for employees with long-term [7] health conditions as against 1.2% for those without [6,7]. Any attempts by employers to bear down on the costs of sickness absence may well have a disproportionate effect on disabled employees and contribute to the disability employment gap by causing them to leave their jobs [8].



Bringing together occupational and environmental medicine specialistsDevelopment of the International Occupational Medicine Society Collaborative (IOMSC)

Sat, 02 Dec 2017 00:00:00 GMT

Occupational and environmental medicine (OEM) is a unique preventive medicine specialty that positively impacts the health and productivity of workforces and therefore, the health of national economies. OEM specialists work to ensure that the highest standards of health and safety can be achieved and maintained in the workplace. OEM involves a variety of disciplines—however, its primary focus is preventive medicine and the management of illness and injuries related to the workplace [1,2]. The traditional role of OEM physicians has been identifying hazards, assessing exposures, protecting the workforce and educating workers regarding workplace hazards through integrated health and safety policies, procedures and programmes. Today, the role of the OEM physician has expanded to include a broader emphasis on productivity and wellness in the workplace [3]. The sphere of influence of OEM impacts millions of workers worldwide, with one OEM physician capable of impacting tens of thousands of employees and their families annually. As organizations become more global in nature, many OEM physicians impact not only workers, but also the communities in which these workers operate—by participating in research and advice on international health issues, such as communicable diseases and chronic diseases.



In this issue of Occupational Medicine

Sat, 02 Dec 2017 00:00:00 GMT

Sleep has dominated the health news recently [1]; most notably, a recent randomized controlled trial showed that sleep disruption might have a contributory causal role in the occurrence of psychotic experiences and a wide range of other mental health problems [2]. In this issue, McDowell et al. [3] evaluated the impact of shift work on sleep quality. In their cross-sectional study of 888 nurses, the authors found that the prevalence of self-reported poor sleep quality was high in both nurses that worked shifts and those that did not. However, the authors found that undertaking shift work was the only significant association with poor sleep quality, when controlling for confounders. The authors concluded that in view of their findings, workplace interventions related to sleep should include organizational considerations and not be restricted to individually focused interventions.






Anti-smoking legislation

Sat, 02 Dec 2017 00:00:00 GMT

Tobacco was introduced to Europe in 1493 when Columbus returned from his first voyage to the New World. Tobacco leaves and instruction in their use had been given to some of his crew by Tainos Indians on Hispaniola. Smoking and the use of tobacco gradually took hold although it was initially the preserve of the rich. Pipe-smoking was introduced to the UK in 1572 by Sir Francis Drake. By 1590, tobacco use was such a problem in mainland Europe that Pope Urban VII threatened to excommunicate anyone who ‘took tobacco in the porchway of, or inside, a church, whether by chewing it, smoking it with a pipe, or sniffing it in powdered form through the nose’. Ten years later, Samuel Rowlands wrote in Epigram 18 of ‘The Letting of Humours in the Head-Vaine’:



Revalidation, appraisal and continuing professional development

Sat, 02 Dec 2017 00:00:00 GMT

One of the key requirements for continuing practise is that occupational physicians undertake appropriate continuing professional development (CPD). Occupational physicians, and occupational health professionals (OHPs), face challenges both in terms of time and cost in meeting the requirements of annual appraisals and revalidation [1]. There are many ways in which such learning needs could be met but many are resource intensive in both time and cost. So, where can an OHP go for free education to supplement existing occupational health targeted conferences and meetings?



Occupational Medicine Calendar

Sat, 02 Dec 2017 00:00:00 GMT

2018DateEventContact AddressVenueMarch 12–13ICOHS 2018: 20th International Conference on Occupational Health and Safetyhttps://www.waset.org/conference/2018/03/miami/ICOHSMiami, FloridaApril 16–19BOHS Annual Occupational Hygiene Conferencehttp://www.oh-2018.com/Stratford-upon-Avon, UKApril 29 – May 2Annual American Occupational Health Conference (103rd AOHC)http://www.acoem.org/educational_conferences.aspxNew Orleans, LAApril 29 – May 432nd International Congress on Occupational Health. ICOHhttp://www.icoh2018.orgDublin, IrelandMay 6–10American Aerospace Medical Association Annual Meetinghttps://www.asma.org/scientific-meetings/asma-annual-scientific-meeting/future-annual-meetingsDallas, TexasSeptember 23–25OEMAC 36th Annual Scientific Conferencehttp://oemac.org/annual-conference/2018-calgary/Calgary, Alberta2019April 28 – May 1Annual American Occupational Health Conference (104th AOHC)http://www.acoem.org/educational_conferences.aspxAnaheim, CAMay 5–9American Aerospace Medical Association Annual Meetinghttps://www.asma.org/scientific-meetings/asma-annual-scientific-meeting/future-annual-meetingsLas Vegas, Navada



Systematic Review: Occupational illness in the waste and recycling sector

Mon, 20 Nov 2017 00:00:00 GMT

Abstract
Background
The waste and recycling sector is a growing part of industry. Whether health surveillance is indicated and how it should be undertaken is unclear.
Aims
To undertake a review of the literature to identify hazards to health, biological effects and occupational illnesses for workers in the sector.
Methods
A systematic review of the published literature and two UK databases.
Results
Rates of fatal, non-fatal injuries and self-reported work-related illness were found to be higher in the waste and recycling sector than in UK industry as a whole. There was an increased prevalence of respiratory, gastro-intestinal and skin complaints in workers exposed to compost relative to controls. They may also be at increased risk of extrinsic allergic alveolitis, allergic bronchopulmonary aspergillosis, occupational asthma and abnormalities of lung function. Workers involved with the recycling of batteries and cables may be at risk of lead poisoning and exposure to other heavy metals. There were case reports of mercury poisoning from the recycling of fluorescent lights. Cases of occupational asthma have been reported in association with wood and paper recycling. The recycling of e-waste may cause exposure to heavy metals and organic pollutants, such as polybrominated diphenyl ethers, dioxins and polyaromatic hydrocarbons, which have been associated with damage to DNA and adverse neonatal outcomes.
Conclusions
Ill-health and adverse biological effects have been described in waste and recycling workers, but their true prevalence has probably not been captured. Targeted health surveillance may be required to assess exposure and to identify occupational illness.



The impact of shift work on sleep quality among nurses

Tue, 10 Oct 2017 00:00:00 GMT

Abstract
Background
Shift work is common among nurses, and it is known to be a workplace hazard as it may cause poor sleep quality, which can impact adversely on the health and safety of nurses and their patients.
Aims
To explore factors that contribute to poor sleep quality in shift working nurses (SWNs) compared with non-shift working nurses (NSWNs) and to assess the awareness of support from occupational health.
Methods
Cross-sectional study of nurses at a National Health Service (NHS) foundation trust, February to March 2016. Data were collected via an online questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index.
Results
Eight hundred and eighty-eight nurses participated; the response rate was 34%. The prevalence of poor sleep quality was 78% (95% confidence interval [CI] 0.748–0.813) in the SWNs, compared with 59% (95% CI 0.503–0.678) in the NSWNs. There was a mean sleep quality score difference of 1.58 between the SWNs and the NSWNs, which was statistically significant, P < 0.001 (95% CI 0.913–2.246). Undertaking shift work was the only significant association with poor sleep quality when controlling for the other variables of age, gender and number of years worked, odds ratio 0.410, P < 0.001 (95% CI 0.265–0.634).
Conclusions
There was a high prevalence of poor sleep quality in both SWNs and NSWNs. This was persistent despite few nurses working in rotating shifts or shifts with short recovery time.



Rhizarthrosis in banknote processing workers: a retrospective cohort study

Wed, 27 Sep 2017 00:00:00 GMT

Abstract
Background
Rhizarthrosis, or osteoarthritis of the base of the thumb, is a common condition affecting 10–30% of the population over the age of 60. Whether it is an occupational disease has been the subject of debate as epidemiological studies on the correlation between physical stress and the presence of rhizarthrosis have shown conflicting results.
Aims
To study the correlation between the prevalence of rhizarthrosis and the time spent by employees manually processing banknotes at the National Bank of Belgium (NBB).
Methods
We followed NBB employees currently or previously holding job titles involving the manual or automated processing of banknotes. Each participant’s job history was carefully reconstructed and the number of months holding certain job titles determined. Each participant was clinically and radiologically examined for the presence of rhizarthrosis in both hands. Its presence was scored by a combination of clinical and radiological criteria.
Results
There were 195 participants. The prevalence of rhizarthrosis was 27% in women (mean age: 52.3 ± 4.4 years) and 17% in men (mean age: 53.2). The odds ratio (OR) for rhizarthrosis after 10 years’ full-time overall exposure was significantly higher [OR 10 years: 1.53 (1.03–2.28)]. However, one particular job, ‘manual counting’, described by participants as highly straining and severely taxing on the thumbs, did not show a significantly higher prevalence of rhizarthrosis.
Conclusions
Our study confirmed the correlation between the presence of rhizarthrosis and age, gender and general manual labour, in particular banknote processing, but found no link with one specific job—manual counting.



Developing a tool for identifying high-risk employers for inspection

Mon, 18 Sep 2017 00:00:00 GMT

Abstract
Background
Workers’ Compensation Board (WCB) data and other information are sometimes used to calculate an ‘Occupational Health and Safety (OHS) index’ as a way of identifying businesses considered ‘high risk’ to be inspected as part of enforcement work. However, no evidence on the validity of this index exists.
Aims
To evaluate the performance of the Alberta OHS index, a ‘score’ based largely on WCB claims data, and to see if an index calculated using different information could perform better.
Methods
Data from the Alberta Compliance Management Information System database, 2011–2015, and WCB claim database, 2007–2014, were retrieved. Issuing ‘stop work’ or ‘stop use’ orders in inspections was defined as a proxy of high-risk outcome. The performance of the current and a modified OHS index were assessed using receiver operating characteristics (ROC) and regression analyses.
Results
In large employers, neither the current nor the modified OHS index was particularly effective in identifying ‘high risk’ employers with the area under the ROC curve (AROC) of 0.55 (95% confidence interval [CI] 0.52–0.57; P < 0.001) and 0.59 (95% CI 0.57–0.62; P < 0.001), respectively. In small employers, neither index seemed very effective with an AROC of 0.54 (95% CI 0.53–0.56; P < 0.001) and 0.55 (95% CI 0.53–0.56; P < 0.001), respectively. These results were consistent in subgroup analyses of assignments without specific initiatives, both in large and small employers.
Conclusions
Neither the current nor a modified OHS index seemed to effectively identify high-risk employers. Heterogeneous results in large and small employers suggest that approaches to different-sized employers are appropriate.



Work-sharing and male employees’ mental health during an economic recession

Thu, 14 Sep 2017 00:00:00 GMT

Abstract
Background
One approach to reducing occupational stress during an economic recession is to share work amongst employees. This may include reducing employees’ working hours to avoid redundancies.
Aims
To examine whether work-sharing influenced the psychosocial work environment and depressive symptoms encountered by Japanese employees, and to determine which psychosocial factors predict employees’ mental health during an economic recession.
Methods
A survey was performed in a Japanese manufacturing company at the beginning (T1) and end (T2) of a 6-month period during the 2008 economic recession using the validated Job Content Questionnaire (JCQ) and Self-Rating Depression Scale (SDS).
Results
Three hundred and thirty-six male employees completed the questionnaire. Twenty-four per cent of participants showed depressive symptoms at T1. Despite reductions in employees’ working hours and job strain (P < 0.001), SDS scores showed no change after 6 months. Logistic regression analyses showed that low social support between the two surveys was associated with depressive symptoms at T2 after adjusting for demographic, lifestyle, workplace factors, scheduled working hours and depressive symptoms at T1.
Conclusions
Reductions in job strain did not affect employees’ depressive symptoms. Employees with low social support during the study had a significantly higher risk of having depressive symptoms. These findings indicate that social and emotional support within the workplace is important during the work-sharing period.



Case-specific colleague guidance for general practitioners’ management of sickness absence

Thu, 24 Aug 2017 00:00:00 GMT

Abstract
Background
General practitioners (GPs) report sickness absence certification as challenging. They express need for support with functional assessment beyond guidelines and reforms. Case-specific collegial one-to-one guidance for other clinical topics has proved popular with GPs and may be an acceptable and effective way to improve GPs skills and competence in sickness absence certification.
Aims
To present a new model of case-specific colleague guidance focusing on the management of long-term sickness absence and to describe its feasibility in terms of application and reception among GPs, and also GPs’ self-reports of effects on their practice.
Methods
Randomly selected GPs received case-specific collegial guidance over a 12-month period, in two Norwegian trials, delivered by former GPs employed by the social security administration. We measured reception and perceived effects by GPs’ self-report and registered participation and withdrawal rates.
Results
The participation rate (n = 165) was 94%, and no GPs withdrew during training. Among the 116 GPs responding to the survey (70%), 112 (97%; 95% CI 92–99) stated they would recommend it to their colleagues. Considerable benefit from the guidance was reported by 68 (59%; 95% CI 50–68). The GPs self-reported other effects on their sickness absence certification, specifically an increased use of part-time sickness absence (Fit-Note equivalent).
Conclusions
This model of case-specific colleague guidance to aid GPs’ management of long-term sickness absence is feasible and was popular. This type of guidance was perceived by GPs to be somewhat beneficial and to alter their sickness absence certification behaviour, though the true impact requires further testing in controlled trials.



Case report of asthma associated with 3D printing

Wed, 23 Aug 2017 00:00:00 GMT

Abstract
Background
Three-dimensional (3D) printing is being increasingly used in manufacturing and by small business entrepreneurs and home hobbyists. Exposure to airborne emissions during 3D printing raises the issue of whether there may be adverse health effects associated with these emissions.
Aims
We present a case of a worker who developed asthma while using 3D printers, which illustrates that respiratory problems may be associated with 3D printer emissions.
Case report
The patient was a 28-year-old self-employed businessman with a past history of asthma in childhood, which had resolved completely by the age of eight. He started using 10 fused deposition modelling 3D printers with acrylonitrile-butadiene-styrene filaments in a small work area of approximately 3000 cubic feet. Ten days later, he began to experience recurrent chest tightness, shortness of breath and coughing at work. After 3 months, his work environment was modified by reducing the number of printers, changing to polylactic acid filaments and using an air purifier with an high-efficiency particulate air filter and organic cartridge. His symptoms improved gradually, although he still needed periodic treatment with a salbutamol inhaler. While still symptomatic, a methacholine challenge indicated a provocation concentration causing a 20% fall in FEV1 (PC20) of 4 mg/ml, consistent with mild asthma. Eventually, his symptoms resolved completely and a second methacholine challenge after symptom resolution was normal (PC20 > 16 mg/ml).
Conclusions
This case indicates that workers may develop respiratory problems, including asthma when using 3D printers. Further investigation of the specific airborne emissions and health problems from 3D printing is warranted.



Work-related stress assessed by a text message single-item stress question

Fri, 18 Aug 2017 00:00:00 GMT

Abstract
Background
Given the prevalence of work stress-related ill-health in the Western world, it is important to find cost-effective, easy-to-use and valid measures which can be used both in research and in practice.
Aims
To examine the validity and reliability of the single-item stress question (SISQ), distributed weekly by short message service (SMS) and used for measurement of work-related stress.
Methods
The convergent validity was assessed through associations between the SISQ and subscales of the Job Demand–Control–Support model, the Effort–Reward Imbalance model and scales measuring depression, exhaustion and sleep. The predictive validity was assessed using SISQ data collected through SMS. The reliability was analysed by the test–retest procedure.
Results
Correlations between the SISQ and all the subscales except for job strain and esteem reward were significant, ranging from −0.186 to 0.627. The SISQ could also predict sick leave, depression and exhaustion at 12-month follow-up. The analysis on reliability revealed a satisfactory stability with a weighted kappa between 0.804 and 0.868.
Conclusions
The SISQ, administered through SMS, can be used for the screening of stress levels in a working population.



Screening for latent tuberculosis in UK health care workers

Wed, 09 Aug 2017 00:00:00 GMT

Abstract
Background
Active tuberculosis (TB) infection was diagnosed in two health care workers (HCWs) originally from high-incidence countries at a National Health Service (NHS) hospital trust in Northern England. In response, the trust screened current clinical employees from countries with a high TB prevalence for active and latent TB infection (LTBI).
Aims
To identify the number of HCWs, within the organization, who are at risk of TB infection.
Methods
Clinical employees from countries with a high TB prevalence (those described by the World Health Organization as having an incidence of >40 cases per 100000 populations) were reviewed. Employees were identified via human resource systems and occupational health records, from which nationality or country of birth was identified. A letter was sent to identified employees advising of the rationale for a reviewed screening process and inviting them to attend for an interferon-gamma release assay (IGRA) blood test.
Results
A total of 587 clinical staff were identified as fitting the criteria of clinical HCWs from high-incidence countries. Of 469 HCWs screened, 27% screened positive using IGRA. This represented 4% of the total clinical workforce for the organization.
Conclusions
A considerable proportion of the workforce at this NHS hospital trust had previously undiagnosed LTBI, carrying a risk of conversion to active disease. Further action, such as treatment of LTBI or increased workforce awareness of symptoms of active disease, could help to reduce the risk of transmission of TB to patients and the need for associated ‘look-back’ exercises.



Effects of work–family conflict and job insecurity on psychological distress

Tue, 23 May 2017 00:00:00 GMT

Abstract
Background
Work–family conflict (WFC) and job insecurity are important determinants of workers’ mental health.
Aims
To examine the relationship between WFC and psychological distress, and the co-occurring effects of WFC and job insecurity on distress in US working adults.
Methods
This study used cross-sectional data from the 2010 National Health Interview Survey (NHIS) for adults aged 18–64 years. The 2010 NHIS included occupational data from the National Institute for Occupational Safety and Health (NIOSH) sponsored Occupational Health Supplement. Logistic regression models were used to examine the independent and co-occurring effects of WFC and job insecurity on distress.
Results
The study group consisted of 12059 participants. In the model fully adjusted for relevant occupational, behavioural, sociodemographic and health covariates, WFC and job insecurity were independently significantly associated with increased odds of psychological distress. Relative to participants reporting WFC only, participants reporting no WFC and no job insecurity had lower odds of moderate and severe distress. Co-occurring WFC and job insecurity was associated with significantly higher odds of both moderate [odds ratio (OR) = 1.55; 95% confidence interval (CI) 1.25–1.9] and severe (OR = 3.57; 95% CI 2.66–4.79) distress.
Conclusions
Rates of WFC and job insecurity were influenced by differing factors in working adults; however, both significantly increased risk of adverse mental health outcomes, particularly when experienced jointly. Future studies should explore the temporal association between co-occurring WFC and job insecurity and psychological distress.