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Self-efficacy (SE) is an important determinant for the psychological adjustment of people with spinal cord injury (SCI). However, little is known about the course of SE during inpatient rehabilitation up to 1 year after discharge. The aim of this study was to determine latent trajectory classes of SE, depressive mood, and anxiety in people with SCI, as well as the interrelationships between these trajectories. Longitudinal inception cohort study. Eight specialized SCI rehabilitation centers. The participants (N=268) were mainly men 183 of 268 (68.3%) with a mean age of 55.6 years. Almost half had a traumatic SCI 135 of 268 (50.4%) and tetraplegia (53.7%), and the minority had a motor complete SCI (32.2%). Not applicable. SE was measured using the University of Washington Self-Efficacy Scale. In addition, the Hospital Anxiety and Depression Scale was used to asses distress and perform dual trajectory modeling analyses. Three trajectories of SE, indicating low, middle, and high SE, could be distinguished. Furthermore, a 2-class trajectory solution for depressive mood and a 4-class solution for anxiety were found to be most suitable. All trajectories were stable over time. Developmental connections between SE and depressive mood and between SE and anxiety were revealed. In particular, participants who adjusted well, reporting low scores on depressive mood and anxiety, could be identified by their high SE scores. However, the group of participants with high depressive mood scores and anxiety scores could not always be identified based on their SE trajectory. In accordance with our hypotheses, distinct trajectories of SE, depressive mood, and anxiety were identified and high probabilities that SE trajectories were interrelated to the trajectories from depressive mood and anxiety were confirmed. Concurrent screening for SE and distress might best detect people at risk for adjustment problems. [ABSTRACT FROM AUTHOR]

The article focuses on a study about the Risk Level Based Management System (RLBMS), an occupational risk management (ORM) model related to occupational safety, hygiene, and health (OSHH) resources for hazardous procedures at work. The model categorizes the risk levels (RLs) and characterizes the risks for commonly performed activities. The RLBMS tracks the activities, increases OSHH work time and presents control measures to a RLs for a task.

Evidence of a managerial influence on occupational risk prevention is largely lacking. The incidence of major accidents in high-hazard sectors of industry does not show a downward trend. Also, the decline of fatal occupational accidents in industrialized Western countries may well be attributed to the growing employment in the relatively safe service sectors and to a phenomenon known as export of hazards. Looking more closely at accidents and disasters, we now believe they are not only caused by direct physical events, nor by human errors alone. They have their roots in organizational settings and in the sociotechnical system companies are active in. Whatever their cause, we know that (major) accidents almost always take us by surprise. Despite all our efforts and systems, we seem unable to foresee or predict these events. It seems our management systems are looking at the wrong items. Critics from small- and medium-sized enterprises also point in that direction; management systems are too bureaucratic and lack a focus on hazard and risk identification. Apparently, we fail to incorporate the main ingredients of accident causation in our management systems. This article will discuss current models and presentations. In reference to the title of this article, the possibility to integrate these presentations into management systems will be discussed. This article is based on the presentation given at the 4th International Conference on Occupational Risk Prevention, Sevilla, Spain, May 10–12, 2006. © 2008 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The paper describes the methods used for a study of the safety management system and culture of a cold rolling mill in a steel plant. It uses data from diverse sources which can be validated against each other and combined to produce a rich picture of the current risk control system and its shortcomings. The paper also describes the proposed improvements and what the plant chose to implement. This step also throws light on the culture of the plant. [ABSTRACT FROM AUTHOR]

A Belgian manufacturing company uses pallet movers for internal transport. Despite the company's efforts to improve occupational safety, accidents with pallet movers remain noteworthy. In order to control occupational accidents, it is crucial to have a clear view of the potential accident scenarios that are present in a company. The bow-tie method is a way to capture and visualize these accident processes in an integrative way. Included in the bow-tie are safety barriers (both technical as organizational and human) and management delivery systems that can intervene in these accident processes. Once bow-ties are composed, they are an excellent point of departure to assign indicators to the safety barriers and management delivery systems in order to control (i.e., prevent or mitigate) accident scenarios. Two types of indicators can be distinguished. Firstly, there are general indicators that are assigned to management delivery systems interrupting multiple accident scenarios, which can yield a higher safety gain (as they intervene in multiple accident scenarios). Secondly, there are scenario-specific indicators targeting one specific accident scenario, which can be valuable as they target a specific problem in the company. For the development of the bow-ties, a multi-method design with the inclusion of different data sources was used, leading to a comprehensive overview. This makes the bow-tie analysis of internal transport with pallet movers transferable to other settings where pallet movers are used for internal transport.

Objectives: This paper presents the framework and protocol design for a construction industry risk management toolbox. The construction industry needs a comprehensive, systematic approach to assess and control occupational risks. These risks span several professional health and safety disciplines, emphasized by multiple international occupational research agenda projects including: falls, electrocution, noise, silica, welding fumes, and musculoskeletal disorders. Yet, the International Social Security Association says, "whereas progress has been made in safety and health, the construction industry is still a high risk sector.", Methods: Small- and medium-sized enterprises (SMEs) employ about 80% of the world's construction workers. In recent years a strategy for qualitative occupational risk management, known as Control Banding (CB) has gained international attention as a simplified approach for reducing work-related risks. CB groups hazards into stratified risk 'bands', identifying commensurate controls to reduce the level of risk and promote worker health and safety. We review these qualitative solutions-based approaches and identify strengths and weaknesses toward designing a simplified CB 'toolbox' approach for use by SMEs in construction trades., Results: This toolbox design proposal includes international input on multidisciplinary approaches for performing a qualitative risk assessment determining a risk 'band' for a given project. Risk bands are used to identify the appropriate level of training to oversee construction work, leading to commensurate and appropriate control methods to perform the work safely., Conclusion: The Construction Toolbox presents a review-generated format to harness multiple solutions-based national programs and publications for controlling construction-related risks with simplified approaches across the occupational safety, health and hygiene professions.

The aim of this article was to describe the structure and content of a job-exposure matrix (JEM) for historical asbestos exposure in The Netherlands. The JEM contained 309 occupational job title groups in 70 branches of industry during 10 periods of 5 years during 1945-1994, resulting in 3090 evaluations. Dutch sources on asbestos exposure measurements provided quantitative guidance for 69 evaluations (2.2%) in 25 occupational title groups. In addition, three databases from the UK Health and Safety Executive contributed to 222 evaluations (7.2%) and several other sources aided in another 133 evaluations (4.3%). These evaluations resulted in seven categories of exposure levels for all 3090 combinations of occupational title groups and periods. A verification process with five experts was used to adjust the assignments of exposure categories. The trends in exposure patterns over time were described in relation to production activities, operational control measures and the presence of dust control measures. For the majority of asbestos-related diseases in the past decades, reliable information on their historical exposure patterns was lacking. The limited availability of exposure measurements in the past illustrates the need for a structured assessment of historical asbestos exposure through a JEM.

Objective: To determine whether local environmental exposure to asbestos in the community of Hof van Twente, The Netherlands (which houses a large asbestos cement facility and has a serious environmental asbestos pollution problem), is accompanied by an increased mortality due to pleural mesothelioma among women., Design: A descriptive, ecologic-epidemiological study., Method: Twenty-nine women with a verified diagnosis of pleural mesothelioma were selected from 810 requests for compensation submitted to a specialised lawyers' office in the period 1990-2002. Information on asbestos exposure from occupational, household, environmental or unknown sources was obtained. The place of residence was compared to information on sources of asbestos in the immediate environment derived from the settlement 'Asbestos removal in the environment'. The expected number of cases of pleural mesothelioma among women was estimated on the basis of the observed mortality in The Netherlands in the period 1996-2002. A standardised mortality ratio (SMR) was calculated as the ratio of observed cases divided by the number of expected cases of pleural mesothelioma x 100., Results: In total, 5 cases of pleural mesothelioma were identified among women without occupational or household exposure to asbestos. The age at diagnosis varied from 38 to 81 years. Each case was exposed to asbestos in the direct vicinity of the residence through walking and cycling over local roads metalled with asbestos cement scrap material. The expected number of cases of mortality due to pleural mesothelioma in the town of Hof van Twente for the period 1996-2002 was about 0.46. The SMR was 1090 (95% CI: 465-2551), indicating a 10-fold increase in risk., Conclusion: The increased mortality of pleural mesothelioma was most probably due to environmental exposure to asbestos. This finding agrees with comparable studies in other countries.

In The Netherlands the number of asbestos-related diseases is increasing. An age-cohort model predicts a steep rise in pleural mesothelioma deaths up to 490 cases per year among men, with a total death toll close over 12,000 cases during 2000-2028. In the past decade the number of compensation claims for asbestos-related diseases has more than doubled, with increasingly verdicts in favor of claimants. In addition to the medical information, information about the state of the art of preventive measures in different periods of time plays a decisive role in these claims. The use of asbestos in The Netherlands, the occurrence of asbestos-related diseases, the national asbestos regulations, and the position of the claimants in asbestos lawsuits in The Netherlands are reviewed.

Several attempts have been made to develop strategies for an effective control of workplace hazards. This paper will focus on the results of a European project called Solbase, which is a databank for solutions to occupational hazards and risks. The Safety Science Group of Delft University of Technology in collaboration with TNO Work and Organisation (formerly NIA-TNO) designed Solbase in a series of projects funded by the Dutch Ministry of Social Affairs and Employment and the European Commission. It consists of the design of and software for a databank with an intelligent navigation system allowing users two principal entry points, which correspond to two basic types of solutions. The first entry point is based on the production process, subdivided into the production principle and production function. This entry point provides the dissemination of solutions within and between branches of industry. The second entry point includes the hazard and its emission and transmission as an access point for more conventional occupational hygiene control measures. With the partners of the consortium, from Spain, Italy, Ireland, Germany, the UK and The Netherlands, 535 new and existing solutions throughout Europe and the world were gathered to test the software and the solutions during a field study. Despite the relatively small number of 'test solutions' used, 54% of the search actions in the field study resulted in a useful and suitable solution which the company could actually put into practice. The companies characterized the software as very user friendly. The reproducibility of the coding system for solutions, the classification tree, was satisfactory. Most coders chose the same keywords from the classification tree to describe a corresponding solution. Solbase is a good searching machine for workplace solutions. Especially, the classification of production processes is an inherent guarantee of an exchange of information across the borders of a specific company or branch of industry.

Objective: To describe the occupational background of cases with an asbestos-related disease and to present overall mesothelioma risks across industries with historical exposure to asbestos., Methods: For the period 1990-2000, cases were collected from records held by two law firms. Information on jobs held, previous employers, activities performed and specific products used were obtained from patients themselves or next of kin. Branches of industry and occupations were coded and the likelihood of asbestos exposure was assessed. For each branch of industry, the overall risk of mesothelioma was calculated from the ratio of the observed number of mesothelioma cases and the cumulative population-at-risk in the period 1947-1960. In order to compare mesothelioma risks across different industries, risk ratios were calculated for the primary asbestos industry and asbestos user industries relative to all other branches of industry., Results: In total, 710 mesotheliomas and 86 asbestosis cases were available. The average latency period was approximately 40 yr and the average duration of exposure was 22 yr. Ship building and maintenance contributed the largest number of cases (27%), followed by the construction industry (14%), the insulation industry (12%), and the navy and army, primarily related to ship building and maintenance (5%). In the insulation industry, the overall risk of mesothelioma was 5 out of 100 workers, and in the ship building industry, 1 out of 100 workers. The construction industry had an overall risk comparable with many other asbestos-using industries (7 per 10,000 workers), but due to its size claimed many mesothelioma cases., Conclusion: The majority of cases with asbestos-related diseases had experienced their first asbestos exposure prior to 1960. For cases with first asbestos exposure after 1960, a shift was observed from the primary asbestos industry towards asbestos-using industries, such as construction, petroleum refining, and train building and maintenance. Due to the long latency period, asbestos exposure from 1960 to 1980 will cause a considerable number of mesothelioma cases in the next two decades.

In October 2000, at an international meeting in Pretoria, South Africa, chaired by the World Health Organization (WHO), 45 delegates from Sub-Saharan Africa, Europe, and the United States discussed the results of the Healthy City project in the region and the possibilities for incorporating occupational safety, health, and hygiene items into the project. Working conditions play only a minor role in current Healthy City projects. This is partly the result of a low profile of occupational safety, health, and hygiene on political agendas, and partly a result of a lack of convincing demonstration projects. To tackle these points WHO will start two initiatives. First, a document for decision makers will be issued, to highlight the subject and bring it to the attention of local, national, and international bodies. Second, demonstration projects will be started, making use of the methods developed in the Work Improvement In Small Enterprises (WISE) projects and the experience of the Prevention and Control Exchange (PACE) project.

Compensation schemes for asbestos-related diseases have developed different strategies for attributing a specific disease to occupational exposure to asbestos in the past. In the absence of quantitative exposure information that allows a valid estimate of an individual's historical exposure, general guidelines are required to retrospectively evaluate asbestos exposure. A risk matrix has been developed that contains qualitative information on the proportion of workers exposed and the level of exposure in particular industries over time. Based on this risk matrix, stepwise decision trees were formulated for decisions regarding the decisive role of historical asbestos exposure in case ascertainment of asbestosis and mesothelioma. Application of decision schemes will serve to speed up the process of verifying compensation claims and also contribute to a uniform decision-making process in legal procedures.

Objective: To estimate the future course of mesothelioma mortality as a result of occupational exposure to asbestos in the past., Design: Cohort age model., Setting: Department of Public Health, Erasmus University Rotterdam, the Netherlands., Methods: A cohort age model was developed, based upon age-specific rates of pleural mesothelioma mortality during 1969-1994. This model was linked to the future trend in mortality among Dutch men as projected by the Central Bureau for Statistics in order to predict the future course of mesothelioma mortality in the period 1995-2030., Results: In the next 35 years about 20,000 cases of pleural mesothelioma among men are expected. The projection results in a peak of annual male mesothelioma deaths of approximately 700 in about the year 2018. After 2020 the annual mortality will rapidly decline to about 450 cases in 2030. It is expected that this rapid decline will continue after 2030. In the 1943-1947 birth cohort pleural mesothelioma may account for 0.87% of all deaths. Exposure to asbestos at work largely explains this particular mortality pattern., Conclusion: Exposure to asbestos at work has created an important public health problem among Dutch men.

As part of a study of working conditions chemical exposure was assessed in 10 rubber-manufacturing plants in The Netherlands. Personal exposures to airborne particulates, rubber fumes and solvents, and also dermal contamination, were measured. To identify factors affecting exposure the personal exposure levels and information on tasks performed, ventilation characteristics and production variables were used in multiple linear regression models. The exposure was generally very variable. The specific circumstances in each department of each plant determined the actual levels of exposure to a large extent. The factors affecting exposure turned out to be different for each of the types of exposure considered. The model for exposure to airborne particulates explained 40% of the total variability and incorporating the actual time spent on a task only slightly improved the model (R2 = 0.42). The handling of chemicals in powder form was the main factor affecting exposure, forced ventilation having a negligible effect. The model for exposure to curing fumes (measured as the cyclohexane-soluble fraction of the particulate matter) explained 50% of the variability. Both curing temperature and pressure determined the level of rubber fumes. Local exhaust ventilation showed a significant exposure reducing effect. The effect of curing different elastomers was not statistically significant. Dermal exposure to cyclohexane-soluble matter could only be explained to a limited extent (R2 = 0.22). Tasks with frequent contact with (warm) compound and maintenance tasks in the engineering services departments resulted in high dermal exposure. Tasks in which solvents were directly used explained 56% of the variation in solvent exposures. Exposure data, together with information on tasks, methods of work, ventilation and production throughout a branch of industry, can be used to derive empirical statistical models which occupational hygienists can apply to study factors affecting exposure. These determining factors are of crucial importance, whenever hazard control or epidemiological research is the ultimate goal.

In a survey in the rubber manufacturing industry in The Netherlands both the chemical and physical exposure of operators as well as company policies on working conditions were assessed. Defining the effectiveness of control measures was a part of this study and is the subject of this article. A method of solution-directed workplace analysis was applied to compare and evaluate the control measures within this branch of industry. Elimination of sources appears to be a strategy for prevention which has been adopted on only a limited scale. Control of exposure to particulates is more frequently applied, with local exhaust ventilation as the most important control measure. Both qualitative and quantitative analysis confirmed that local exhaust ventilation has a limited effect. Dust-free forms of chemicals, especially those with health risks, are used on only a moderate scale. In addition to hazard identification and evaluation based on exposure levels, the foreseeable risks associated with the design and requirements of production processes were established. The forthcoming industrial agreement for the rubber manufacturing industry in The Netherlands will, amongst other measures, stimulate use of source related strategies.

In this study the effectiveness of the seat suspension on the transmission of whole-body vibration through the driver's seat has been determined. Eleven types of seat frequently used in lorries, agricultural tractors and fork-lift trucks were selected. The transmissibility coefficient of each seat was measured by the ratio of the acceleration (weighted root-mean-square in the vertical axis) at the interface between the seat surface and the human body to the vibration at the attachment points of the seat on the vehicle floor. Measurements in the laboratory, using standardized representative vehicle vibration spectra and two volunteers of different weights, showed transmissibility coefficients of 0.34-1.28. Attenuation of the vibration input spectrum was obtained in 20 out of 24 (83%) measurements. Measurements in the field, conducted in vehicles under representative working conditions, showed transmissibility coefficients of 0.60-1.45. Attenuation of the vibration spectrum was obtained in 17 out of 24 (71%) vehicle-seat combinations. No significant differences were observed between seats with conventional suspension and those with air suspension. Laboratory measurements of the dynamic response of the seat suspension did not provide an adequate basis for predicting its performance in the field. In most work situations the magnitude and duration of vibration-exceeded the 8 h fatigue-decreased proficiency boundary of 0.32 m s-2 in the vertical axis, which indicates that in many working situations with a daily exposure of 8 h or more suspended seats will not protect professional drivers from harmful exposure to whole-body vibration.