Search

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

In response to the COVID-19 pandemic, many countries have adopted a broad spectrum of containment measures, from recommendations to stay at home to quarantines of large geographic regions. As part of this response, corporations and governments alike have strongly encouraged workers to telecommute where possible. More than 3.4 billion people in 84 countries have been confined to their homes, as estimated in late March 2020, which potentially translates to many millions of workers temporarily exposed to telecommuting. Since 2000, the emergence of digital and broadband internet has facilitated the development of home telework. Despite limited research interest on its impact on occupational health, several health benefits and risks of telework have been identified in academic or grey literature (table 1) (for a review see Ref. 1). …

The latest technological innovations have considerably increased the field of application for infrasound, and the possible risks that infrasound may present to those exposed to it must be taken into account. The main task of this article is to organize and summarize recent studies on the most common artificial emitting sources and the effects that these non-audible frequencies have on health when absorbed by the body, as well as presenting the existing regulations, a discussion and a series of conclusions that clarify aspects of infrasound. The intention of the authors of this article is that what is exposed in this review can be used to address and determine future lines of research and promote architects to take the spaces of installations within a building very seriously as well as carry out competent administration considering a minimum distance from the road to where habitable buildings are planned.

Introduction Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women’s expenditure on healthcare. Conclusions The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women’s health.

Zusammenfassung. Hintergrund: Fortbildungen für Pflegende auf der Intensivstation sind obligat, es fehlt jedoch oft an Kurzfortbildungen von bis zu 15 Minuten innerhalb der Arbeitszeit. Derzeit gibt es keine vergleichende Datenlage zur zeitlichen Verortung von Kurzfortbildungen. Fragestellungen: Welche Auswirkungen haben zeitlich unterschiedlich verortete Kurzfortbildungsveranstaltungen zu Beginn des Spätdienstes gegenüber zum Ende des Frühdienstes auf die Wissensaufnahme von Pflegenden auf der Intensivstation? Ergänzend sollten weitere Rahmenbedingungen und eine abschließende Empfehlung für die Veranstaltungen ermittelt werden. Methode: In einer Beobachtungsstudie mit Pflegenden, die Kurzfortbildungsveranstaltungen vor dem Spätdienst (VS) oder nach dem Frühdienst (VF) besuchten, kam ein Fragebogen zum Einsatz. Als primärer Outcome-Effekt wurde die Odds Ratio (OR) anhand von drei Quizfragen errechnet. Sekundäre Outcome-Parameter, zu denen u.a. eine pünktliche Teilnahme der Pflegenden sowie das Empfehlungsverhalten zählten, wurden mit Methoden deskriptiver Statistik ermittelt. Ergebnisse: Bei einem Rücklauf von 98,59% (n = 420) betrug die OR 1,22 (95%-KI: 0,90; 1,64) zugunsten der Gruppe VS im Vergleich zu VF. Pflegende aus VS konnten zu 96,73% (n = 237) und aus VF zu 80,13% (n = 121) die Veranstaltungen pünktlich besuchen. Weiterhin empfahlen Teilnehmende die Kurzfortbildungen auf einer Skala von 1 (unbedingt hingehen) bis 6 (lass lieber bleiben) in VS im Mittelwert mit 2,27 (SD 1,15) und in VF mit 2,21 (SD 1,07). Schlussfolgerung: Kurzfortbildungen sollten zu Beginn des Spätdienstes angeboten werden.

ObjectivesPrevious studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between psychosocial work factors and blood pressure in a large general working population in the Netherlands.MethodsWe included 63 800 employees from the Netherlands, aged 18–65 years, with blood pressure measurements and a reliable job code at baseline. Psychosocial work factors (job strain, effort–reward imbalance (ERI) and emotional demands) in the current job were estimated with three recently developed psychosocial job exposure matrices. To examine the associations, regression analyses adjusted for covariates (age, sex, body mass index, education, monthly income, pack-years, smoking, alcohol consumption and antihypertensive medication (not included for hypertension)) were performed.ResultsHigher job strain was associated with higher systolic blood pressure (SBP) (B (regression coefficients) (95% CI) 2.14 (1.23 to 3.06)) and diastolic blood pressure (DBP) (B (95% CI) 1.26 (0.65 to 1.86)) and with higher odds of hypertension (OR (95% CI) 1.43 (1.17 to 1.74)). Higher ERI was associated with higher DBP (B (95% CI) 4.37 (3.05 to 5.68)), but not with SBP or hypertension. Higher emotional demands were associated with lower SBP (B (95% CI) −0.90 (−1.14 to −0.66)) and lower odds of hypertension ((OR) (95% CI) 0.91 (0.87 to 0.96)).ConclusionsIn the general working population, employees in jobs with high job strain and ERI have higher blood pressure compared with employees with low job strain and ERI. Emotional demands at work are inversely associated with blood pressure.

BACKGROUND: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available. OBJECTIVE: The objective of this study was to provide such an overview and to interpret the results for clinical practice. METHODS: A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE). RESULTS: Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness. CONCLUSIONS: Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.

Purpose The purpose is to report on the mental health response to the Grenfell incident within the London Fire Brigade (LFB). Design/methodology/approach The LFB implemented screening for the symptoms of posttraumatic stress disorder (PTSD) at 28 days, 3 months and 6 months for all personnel directly involved in the incident. Findings The prevalence of PTSD within frontline personnel was 13.4% at 28 days, falling to 7.6% at 6 months. The LFB's internal Counselling and Wellbeing Service offered treatment to those scoring above the cut-off for PTSD along with accepting self-referral and referrals from line managers and occupational health. There were 139 referrals within the 12-month period following the incident. Research limitations/implications The outcomes for those who engaged in treatment are broadly in line with other studies evaluating post-disaster interventions. Issues for consideration within national guidelines are discussed. Practical implications The screen and treat approach adopted by LFB was shown to be a feasible approach to use within such a scenario. Originality/value The current study reports on a screen and treat approach to one of the largest single incidents in the UK in recent years.

Objectives The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. Material and methods The study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. Results Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. Conclusions This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population.

Men extend their employment beyond pensionable age more often than women, but the factors that contribute to this sex difference are unknown. This study aimed to examine sex differences in extending employment and the contribution of sociodemographic, work- and health-related factors to these differences. Participants of this prospective cohort study were 4,263 public sector employees from Finland who reached their individual pensionable date between 2014 and 2019 and responded to a survey on work- and non-work-related issues before that date. Extended employment was defined as continuing working for over six months beyond the individual pensionable date. We used mediation analysis to examine the contribution of explanatory factors to the association between sex and extended employment. Of the participants, 29% extended employment beyond the pensionable date. Men had a 1.29-fold (95% confidence interval 1.11-1.49) higher probability of extending employment compared with women. Men had a higher prevalence of factors that increase the likelihood of extended employment than women (such as spouse working full-time, no part-time retirement, low job strain, high work time control, and lack of pain) and this mediated the association of sex with extended employment by up to 83%. In conclusion, men were more likely to extend their employment beyond pensionable age than women. This difference was largely explained by men being more likely to have a full-time working spouse, low job strain, high work time control, no pain, and not being on part-time retirement.The online version contains supplementary material available at 10.1007/s10433-021-00663-1.

Background To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. Methods Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. Results Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. Limitations Information on working conditions was based on self-reported recollections. Conclusions Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

The effectiveness of vibration-reducing (VR) gloves is conventionally assessed based on the vibration transmissibility of the gloves. This study proposed a method for analyzing and assessing the effectiveness of VR gloves based on how gloves affect the vibration power absorption (VPA) of the hand&ndash, arm system and its distribution. A model of the entire tool&ndash, handle&ndash, glove&ndash, hand&ndash, arm system was used to predict the VPA distributed in the glove and across the substructures of the hand&ndash, arm system. The ratio of the gloved-VPA and ungloved-VPA in each group of system substructures was calculated and used to quantify VR glove effectiveness, which was termed the VPA-based glove vibration transmissibility in this study. The VPA-based transmissibility values were compared with those determined using to-the-hand and on-the-hand methods. Three types of gloves (ordinary work glove, gel VR glove, and air bubble VR glove) were considered in the modeling analyses. This study made the following findings: the total VPA-based transmissibility spectrum exhibits some similarities with those determined using the other two methods, the VPA-based transmissibility for the wrist&ndash, forearm&ndash, elbow substructures is identical to that for the upper&ndash, arm&ndash, shoulder substructures in the model used in this study, each of them is equal to the square of the glove vibration transmissibility determined using the on-the-wrist method or on-the-upper-arm method, the other substructure-specific VPA-based transmissibility spectra exhibit some unique features, the effectiveness of a glove for reducing the overall VPA in the hand&ndash, arm system depends on the glove effectiveness for absorbing the vibration energy, which seems to be associated primarily with the glove cushioning materials, the glove may also help protect the fingers or hand by redistributing the VPA across the hand substructures, this redistribution seems to be primarily associated with the glove structural properties, especially the tightness of fit for the glove.

Background The prevailing global work scenario and deteriorating health facilities in economies indulge the risk perspective in the labor market model. This is the reason that the risk factor is cautiously attributed to wages and labor market efficiencies specifically in developing and emerging economies. In this respect, Occupational Injuries of Workers (OIW) is considered essential to demonstrate the risk and Occupational Health and Safety (OHS) setups given the constraints of the labor. Intuitively, the prime objective of this study is to make an assessment of the labor market considering the OIW through the indicators of industry division, employment status, occupational distribution, adopted treatment, gender and regionality. Methods The assessment strategy of the study has been categorized into trend analysis and Index Value Calculation (IVC) segments employing the data from 2001 to 2018. Results The pattern of the selected indicators of the OIW has been observed in the available data while the IVC estimations are considered through time and reference categories. The findings of both exercises revealed absolute and relative heterogeneities at both industry and occupational levels. Conclusion The consistency for gender and regional distribution of both assessments points out the need for effective policy initiatives. The study suggests separate analyses of industry and occupations for a better understanding of the OHS setups and up-gradation in Pakistan.

Objectives: Our aim was to validate the “Wulira App” a mHealth application against gold standard audiometry as a pragmatic audiometry solution for under-served and vulnerable groups of patients at risk of hearing loss. The specific objectives were as follows: To compare hearing thresholds determined using the Wulira app to standard pure tone audiometry among patients on MDR-TB treatment. To determine the correlation between the measured hearing loss with the Wulira app and standard audiometry with patient reported hearing loss. To determine the proportion of patients on MDR-TB treatment that experience hearing loss? Materials and Methods: We consecutively recruited patients ≥18 years old and receiving kanamycin in their treatment regimen between February and June 2019 for this study. Clinical and demographic data were obtained from each participant and documented in a secure database. Participants had hearing assessment performed once at enrolment with paired standard audiometry and the Wulira mobile phone app in a soundproof room. Results: A total of 120 MDR-TB patients with a mean age of 34.0 (±9.6) years were recruited for this study and 69 (57.5%) were male. When compared to pure tone audiometry, the Wulira app was able to correctly detect 91.4% hearing loss in right ear and 88.4% in the left ear. The specificity of the Wulira app was equally high, reaching 93.2% in the right ear and 91.5% in the left ear. Conclusion: The Wulira app may be a useful alternative home-based tool for hearing assessment in MDR-TB patients, essentially for early detection of hearing loss following commencement of second-line injectable drugs.

Objective To identify latent components from among 13 work and non-work stressors and to examine whether the accumulation of stress factors within these components was associated with sleep problems. Methods A cohort of older employees (n = 2771 individuals, n = 3921 person-observations) responded to at least two surveys. Principal Component Analysis (PCA) was used to identify latent components. Analysis of variance was used to examine their associations with sleep. Results The components were: 'Physical workload and shift work', 'Psychosocial workload', 'Social and environmental non-work adversity' and 'Life event- and health-related non-work adversity'. They were consistently associated with sleep problems, except for 'Physical workload and shift work'. 'Social and environmental non-work adversity' was associated with sleep problems at follow-up. Conclusions Clusters of work- and non-work-related stressors were identified, and their accumulation was associated with sleep problems among older employees.

Objectives Previous studies on the effect of low social support at work on blood pressure showed mixed results. Few previous studies have used ambulatory blood pressure and examined whether the effect of low social support at work vary among men and women. The aim of this study was to examine the association between low social support at work, ambulatory blood pressure means and hypertension prevalence, in a sample of white-collar workers men and women. Methods A repeated cross-sectional design was used. Data were collected three times during a 5-year period, among 3919 white-collar women and men. At each time, coworker and supervisor social support at work were measured using validated scales. Ambulatory blood pressure was measured every 15 min during a working day. General estimating equations were used. Results In adjusted models, women exposed to low coworker (+0.6 mmHg) and low supervisor social support at work (+0.7 mmHg) had slightly higher diastolic blood pressure means when compared to unexposed women. In men, those with low coworker social support at work had higher diastolic (+0.7 mmHg) blood pressure while those with low supervisor social support had a higher prevalence of hypertension (prevalence ratio = 1.14, 95% CI: 1.04–1.24). Conclusions Men with low supervisor social support at work had a higher prevalence of hypertension. Low social support at work was associated with modest increases in diastolic blood pressure among men and women. Workplace prevention strategies aiming to increase social support at work could lead to beneficial effects on worker’s cardiovascular health.

BACKGROUND: Environmental hazards in healthcare institutions affect the quality of patient care as well as personnel and patient safety. OBJECTIVE: The aim of this study was to develop and apply a semi-quantitative risk assessment method to calculate occupational health risk levels with regard to the sensitivities of healthcare institutions. METHODS: The present research was conducted in three phases. In phases 1 and 2, the model was developed using a review of different risk assessment methods, extracting expert opinions (N = 10) through semi-structured interviews, and using the fuzzy analytical hierarchy process (FAHP). In phase 3, in order to validate the proposed method, one of the five public hospitals was randomly selected and a case study comprising 6 sections was performed. RESULTS: A total of 43 health risks were identified and evaluated using the present method, 41.86% of which were at very high levels, 16.27% at high levels, 30.23% at substantial ones, 9.3% at medium and 2.32% at low levels. The highest health risks were found in paraclinical and operating room wards. CONCLUSION: To overcome the shortcomings of the proposed health risk assessment methods, a semi-quantitative method was used in the present study to more accurately calculate the risk levels in the healthcare institutions and also calculate the risk level of each hospital unit. The proposed semi-quantitative method can be used as a tool for assessing occupational health risks as a key element of risk management. In addition, by focusing on an appropriate framework for occupational health risk assessment, specialists in the organization will be able to take significant and effective steps to implement an efficient risk management system.

Workers who experience language barriers are more likely to get injured or sick because of their work and have poorer claim and return-to-work outcomes compared to other workers. To better understand the systemic factors that shape access to compensation in contexts of language barriers, we compared language accommodation policies and practices in the Quebec and Ontario workers’ compensation systems. We uncovered gaps limiting access to professional interpreters in both provinces, although gaps were more pronounced in Quebec where workers were responsible for the cost of interpreters. We argue that simply improving the linguistic competence of workers’ compensation systems is not sufficient to tackle access barriers and must be accompanied by efforts to address the root causes of social and economic inequities for workers who experience language barriers.

Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians’ risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1–3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68–3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61–4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44–3.21) and a higher number of short (

ZusammenfassungZiel der Studie „Real world“-Daten aus der ambulanten Gesundheitsversorgung sind in Deutschland nur schwer systematisch und longitudinal zu erlangen. Unsere Vision ist eine permanente Datenablage mit repräsentativen, de-identifizierten Patienten- und Versorgungsdaten, längsschnittlich, fortwährend aktualisiert und von verschiedenen Versorgern, mit der Möglichkeit zur Verknüpfung mit weiteren Daten, etwa aus Patientenbefragungen oder biologischer Forschung, zugänglich für andere Forscher. Wir berichten methodische Vorgehensweisen und Ergebnisse aus dem RADAR Projekt.Methodik Untersuchung des Rechtsrahmens, Entwicklung prototypischer technischer Abläufe und Lösungen, mit Machbarkeitsstudie zur Evaluation von technischer und inhaltlicher Funktionalität sowie Eignung für Fragestellungen der Versorgungsforschung.Ergebnisse Ab 2016 entwickelte ein interdisziplinäres Wissenschaftlerteam ein Datenschutzkonzept für Exporte von Versorgungsdaten aus elektronischen Praxisverwaltungssystemen. Eine technische und organisatorische Forschungsinfrastruktur im ambulanten Sektor wurden entwickelt und im Anwendungsfall „Orale Antikoagulation“ (OAK) umgesetzt. In 7 niedersächsischen Hausarztpraxen wurden 100 Patienten gewonnen und nach informierter Einwilligung ihre ausgewählten Behandlungsdaten, reduziert auf 40 relevante Datenfelder, über die Behandlungsdatentransfer-Schnittstelle extrahiert, unmittelbar vor Ort in identifizierende bzw. medizinische Daten getrennt und verschlüsselt zur Treuhandstelle (THS) bzw. an den Datenhalter übertragen. 75 Patienten, die die Einschlusskriterien erfüllten (mind. 1 Jahr Behandlung mit OAK), erhielten einen Lebensqualitäts-Fragebogen über die THS per Post. Von 66 Rücksendungen wurden 63 Fragebogenergebnisse mit den Behandlungsdaten in der Datenablage verknüpft.Schlussfolgerung Die rechtskonforme Machbarkeit der Gewinnung von pseudonymisierten hausärztlichen Routinedaten mit expliziter informierter Patienteneinwilligung und deren wissenschaftliche Nutzung einschließlich Re-Kontaktierung und Einbindung von Fragebogendaten konnte nachgewiesen werden. Die Schutzkonzepte Privacy by design und Datenminimierung (Artikel 25 mit Erwägungsgrund 78 DSGVO) wurden systematisch in das RADAR Projekt integriert und begründen wesentlich, dass der Machbarkeitsnachweis rechtskonformer Primärdatengewinnung und sekundärer Nutzung für Forschungszwecke gelang. Eine Nutzung hinreichend anonymisierter, aber noch sinnvoller hausärztlicher Gesundheitsdaten ohne individuelle Einwilligung ist im bestehenden Rechtsrahmen in Deutschland schwerlich umsetzbar.

Resume Introduction L'objectif de cette etude consiste a comparer l'hypothese de vulnerabilite et l'hypothese d'expression pour expliquer la plus grande detresse psychologique des femmes en emploi. Ces deux hypotheses sont contrastees en integrant les stresseurs du travail, de la famille, le conflit travail-famille et les ressources psychosociales. Methode Les modeles conceptuels ont ete testes par des analyses de chemins en multiniveaux aupres de 2026 employes quebecois (Canada) repartis dans 63 etablissements. Resultats Les resultats soutiennent partiellement les deux hypotheses. Dans le cas de l'hypothese de vulnerabilite, la monoparentalite, les problemes avec les enfants et l'estime de soi sont indirectement impliques dans la variation du niveau de la detresse psychologique parmi les femmes par l'intermediaire de l'interference famille-travail. Dans le cas de l'hypothese d'expression, bien que l'interference famille-travail soit associee a plus de detresse psychologique parmi les femmes, ce stresseur est associe a davantage de consommation d'alcool a risque parmi les hommes. Les tensions avec le conjoint et le sentiment de controle participent egalement au mecanisme d'expression a travers l'interference famille-travail. Conclusion Ces resultats soulignent l'importance de considerer les multiples mecanismes par lesquels le genre contribue aux inegalites de sante mentale. Ils invitent egalement a distinguer les deux directions du conflit travail-famille comme mediateurs genres.

Introduction Current Brazilian legislation requires that all workers exposed to noise are to be given an audiogram upon hiring, after 6 months of employment (first periodic test), and annually after the first periodic test. In other countries, the regulations of hearing conservation programs do not include the requirement for audiometric testing at 6 months of employment, but only annually. There is no evidence that the periodicity adopted by Brazilian legislation is the most appropriate. Objective The present study aimed to evaluate the first 3 occupational audiometric tests of workers exposed to noise. Methods Historical cohort study with cross-sectional analysis. Participants were all male metallurgy workers aged up to 40 years. The first 3 audiograms of each worker were analyzed: pre-employment audiometric test, periodic audiometric test 1, and periodic audiometric test 2. For each worker, mean frequency thresholds were calculated at 3, 4, and 6 kHz in the left and right ears for each test. Statistical analysis was performed using the nonparametric Wilcoxon test. Results A total of 988 workers were included. There was a significant difference in auditory thresholds between the pre-employment test and the 2 subsequent periodic tests for the right and left ears. There was no significant difference between Test1 and Test2 in either ear. Conclusion Given the lack of difference between the first 2 periodic tests, we believe that they could be merged into a single test, i.e., first periodic audiometric testing could be performed at 12 months of employment without compromising workers’ health.

The importance of remaining in, or re-entering, the labour market is emphasised by governments internationally. While this may bring benefits, progressive disabilities such as dementia affect an individual’s employability. Although employers have legal obligations to support employees with disabilities, research suggests that employers are not providing this support to employees living with dementia and are undermining their capabilities. Drawing on interview data from 38 key informants collected over two studies, we explore the potential for supporting and promoting the employability of people living with dementia. A model of sustainable employability based on the Capability Approach is used as a lens to explore this issue. The findings demonstrate the implications of progressive disabilities for employability when the worker and their family are faced with dealing with a disability in a period of uncertainty with a lack of public and workplace understanding.

The extent to which long-term individual-oriented flexibility in working hours is associated with working beyond retirement age is not known. The aims of the present study were to identify trajectories of worktime control (WTC) and to examine whether the membership of WTC trajectories was associated with working beyond individual’s pensionable age. A total of 1,953 older employees participated in the study and had data up to 16 years before pensionable age. Group-based latent trajectory modeling was used to identify WTC trajectories and Cox proportional hazard regression models were used to examine the associations of WTC trajectories with duration of employment. Seven trajectories described WTC: “Stable very low” (7%), “Stable low” (21%), “Declined” (12%), “Stable mid-low” (28%), “Improved” (10%), “Stable high” (16%), and “Stable very high” (5%). When compared with the lowest WTC trajectory groups, trajectories of “Stable high/very high” (hazard ratio [HR] 1.34, 95% confidence interval [CI] 1.17–1.54) and “Improved” WTC (HR 1.49, 95% CI 1.25–1.78) were associated with longer duration of employment. Although the memberships of the “Stable high/very high” and “Improved” WTC trajectories correlated with gender, marital status, occupational position, and self-rated health, the association between WTC and duration of employment was not fully confounded or mediated by these factors. These findings support the hypothesis that having improved or constantly high control over working times from midlife to retirement age may prolong working lives at retirement age.

Objectives. Human factors have been identified as the most common causes of catastrophic accidents in the oil and gas industry. Therefore, this study aims to analyze human causal factors of accidents in the oil and gas industry using the human factors analysis and classification system for the oil and gas industry (HFACS-OGI) framework. Methods. This study involved quantitative data collection for 184 accident cases in the oil and gas industry that occurred from 2013 to 2017 from the International Association of Oil and Gas Producers (IOGP) database. The causal factors of these accidents were coded using the HFACS-OGI framework. Accident data were analyzed using descriptive statistics and the χ2 test. Results. Study findings reveal that 23% of all accidents were recorded in 2013. Thirty-two percent of accidents occurred in Asia, while 69% of accidents were recorded in onshore locations. Contractors were involved in 86% of accidents, while 28% of accidents occurred during drilling, workover and well services. The contractor’s work environment was the main human factor in 90% of accident cases. Conclusion. The HFACS-OGI framework proves to be a vital tool for robust accident analysis of human factors in the oil and gas industry.

IntroductionThe risk of asbestosis, malignant mesothelioma and lung cancer among motor vehicle mechanics is of concern because of potential exposure to chrysotile asbestos during brake, clutch and gasket repair and maintenance. Asbestos has also been used in insulation and exhaust systems.MethodsWe examined the long-term risk of incident mesothelioma, lung cancer, asbestosis and other lung diseases and mortality due to mesothelioma, lung cancer, asbestosis and other lung diseases in a nationwide cohort of all men registered as motor vehicle mechanics since 1970 in Denmark. This was compared with the corresponding risk in a cohort of male workers matched 10:1 by age and calendar year, with similar socioeconomic status (instrument makers, dairymen, upholsterers, glaziers, butchers, bakers, drivers, farmers and workers in the food industry, trade or public services).ResultsOur study included 138 559 motor vehicle mechanics (median age 24 years; median follow-up 20 years (maximum 45 years)) and 1 385 590 comparison workers (median age 25 years; median follow-up 19 years (maximum 45 years)). Compared with other workers, vehicle mechanics had a lower risk of morbidity due to mesothelioma/pleural cancer (n=47 cases) (age-adjusted and calendar-year-adjusted HR=0.74 (95% CI 0.55 to 0.99)), a slightly increased risk of lung cancer (HR=1.09 (95% CI 1.03 to 1.14)), increased risk of asbestosis (HR=1.50 (95% CI 1.10 to 2.03)) and a chronic obstructive pulmonary disease risk close to unity (HR=1.02 (95% CI 0.99 to 1.05)). Corresponding HRs for mortality were 0.86 (95% CI 0.64 to 1.15) for mesothelioma/pleural cancer, 1.06 (95% CI 1.01 to 1.12) for lung cancer, 1.79 (95% CI 1.10 to 2.92) for asbestosis, 1.06 (95% CI 0.86 to 1.30) for other lung diseases caused by external agents and 1.00 (95% CI 0.98 to 1.01) for death due to all causes.ConclusionsWe found that the risk of asbestosis was increased among vehicle mechanics. The risk of malignant mesothelioma/pleural cancers was not increased among vehicle mechanics.

Die Mundgesundheit spielt im Themenspektrum der Gesundheitsberichterstattung eher eine nachrangige Rolle. Dies hat zum einen mit einer eingeschrankten Datenverfugbarkeit zu tun, zum anderen mit der historisch gewachsenen Fokussierung der Gesundheitsberichterstattung auf die grosen Risikofaktoren und die Volkskrankheiten. Angesichts der Bedeutung der Mundgesundheit fur die Pravention sowie fur die Versorgung ware eine starkere Berucksichtigung des Themas in der Gesundheitsberichterstattung wunschenswert. Der vorliegende Artikel versucht auf der Basis einer Internetrecherche eine Bestandsaufnahme, in welchem Umfang die Mundgesundheit in Deutschland bereits in der Gesundheitsberichterstattung aufgegriffen wird, welche fachlichen Standards es gibt und welche Datenquellen dazu zur Verfugung stehen. Es wird angeregt, die Gesundheitsberichterstattung auf dieser Basis weiterzuentwickeln.

Access “The Action Level”® Questions online at: http://www.acgih.org/products/joeh/alquestions.htmAccess “The Action Level”® Answers online at: http://www.acgih.org/products/joeh/alanswers.htmAcces...

PurposeSchool principals are generally seen as key facilitators for the delivery and long-term implementation of activities on school health promotion, including health literacy. However, there is little evidence on the health literacy and health status of this occupational group. The purpose of this paper is to investigate the health literacy of school principals and its association with mental health indicators.Design/methodology/approachA cross-sectional online survey with German school principals and members of the management board (vice principals) was conducted (n = 680, 68.3% female). Demographic (gender, age) and work characteristics (type of school, professional role) as well as health literacy served as independent variables. Mental health as a dependent variable included well-being, emotional exhaustion and psychosomatic complaints. Next to uni- and bivariate analysis, a series of binary logistic regression models was performed.FindingsOf the respondents, 29.2% showed a limited health literacy with significant differences to the disadvantage of male principals. With regard to mental health, respondents aged over 60 years and those from schools for children with special educational needs were less often affected by low well-being as well as frequent emotional exhaustion and psychosomatic complaints. Taking into account demographic and work characteristics, regression models revealed significant associations between a low level of health literacy and poor mental health across all indicators.Research limitations/implicationsThe cross-sectional nature of this study does not allow to draw conclusions about the causal pathways between health literacy and mental health. Although the sample has been weighted, the results cannot be generalized to the whole population of school principals. There is a need for evidence-based interventions aiming at promoting health literacy and mental health tailored to the needs of school principals.Originality/valueThis is the first study to investigate health literacy and its association with health indicators among school principals.

Workplace cyberbullying and online harassment are ongoing problems requiring organizational intervention. This chapter utilizes cultural-historical activity theory as a lens to examine organizational activities. Organizational activities establish the productive norms of the workplace which produce and reproduce objects that serve the needs of an organization. By examining the framework of the workplace, organizational leaders and policymakers can more effectively create prevention policies. Activities are broken down into six interrelated parts: tools, subjects, objects, rules, communities of practice, and divisions of labor. The author argues the motivations of individual actors and the motivations of the organization as key pressure points requiring further analysis in order to foster proactive, preventative workplace bullying policy and the development of positive organizational communicative norms.

Artisanal small-scale mining is associated with disease, injury, environmental and social risks. These risks negatively impact human health and the environment. This study assesses miners' awareness and perceptions of the risks associated with their activity in three main districts in Ghana. Using the convenience sampling approach, 148 miners participated in the study in addition to key informant interviews and focus group discussions. The study revealed that the miners were generally not aware of the risks associated with their work. There were no statistically significant differences between the miners' socio-economic characteristics and disease, environmental and social risks. However, the study showed significant differences between the miners' level of education and awareness of injury risk. A common perception among 41% of the miners was that death in artisanal small-scale mining was normal. It is recommended that relevant state institutions empower miners through training and education to enhance their knowledge of risks.

In this contribution we intend to shed light on the social dimension of sustainability. Thereby, we follow adhere to the goals for sustainable development as issued by the United Nations. The majority of the goals concerns social topics in the national societies. We intend to research in what way resilience lead to social progress and, through that, to sustainability. The attainment of the goals is hindered by the phenomenon of negative spillover effects between countries. In addition, we assume the presence of intra-national spillover effects which means that advancements in some areas are accompanied by deteriorations in other parts of the country. The negative effects concentrate and accumulate disadvantages into distinct neighborhoods. Inhabitants who try to overcome the disadvantages can be fostered in their resilience by beneficial interventions and conditions. However, they will be faced with impeding interventions and conditions as well. A case in the Netherlands shows that by resilience inspired policy reforms rather inflict additional problems on disadvantaged inhabitants. A set of interviews with key persons sheds light on the question of how resilience in the neighborhoods could be fostered instead. It requires support of individuals who take the initiative to improve the living conditions of themselves and others. The processes need some guidance by professional workers who do relate to everyday live in the neighborhoods, and who build relationship op the basis of trust. In their situational work, they need to be enabled and backed by their superiors.

Procode is a free of charge web-tool that allows automatic coding of occupational data (free-texts) by implementing Complement Naïve Bayes (CNB) as a machine-learning technique. The paper describes the algorithm, performance evaluation, and future goals regarding the tool’s development. Almost 30 000 free-texts with manually assigned classification codes of French classification of occupations (PCS) and French classification of activities (NAF) were used to train CNB. A 5-fold cross-validation found that Procode predicts correct classification codes in 57–81 and 63–83% cases for PCS and NAF, respectively. Procode also integrates recoding between two classifications. In the first version of Procode, this operation, however, is only a simple search function of recoding links in existing crosswalks. Future focus of the project will be collection of the data to support automatic coding to other classification and to establish a more advanced method for recoding.

International audience; In France, laws require each company to draw up an inventory of the risks that may threaten employees’ health in order to prioritize the preventive actions to be implemented. Focusing on chemical risk, databases on hazards or exposures are widely available but they lack information regarding chemical risks resulting from combining the hazards of chemicals with their conditions of use, thus generating exposures. Our objective is to build a matrix of French work situations associated with their chemical risk. Eighty-eight work situations were collected from reports written by professionals from the French public health insurance service. Each work situation is defined by descriptive parameters of the task, the exposure and the hazard. According to an expert elicitation method (Delphi, n = 21 experts), each work situation was assessed and a chemical risk score defined, taking into account all the descriptive exposure and hazard parameters. Chemical risk scores were expressed as a range of values from 0-100, with the size of the range chosen by the experts themselves according to their uncertainty. The experts’ assessments were merged to assign one risk score for each work situation, variability and confidence. The results showed that 50% of the work situations had a risk risk score between 40 and 60. The average variability and confidence were around 15% and 82%, respectively. This work situation matrix constructed from French data can be used by occupational safety and health managers that have similar work situations in their company (Western European industrial sector). In this context, it may be useful to easily determine the level of risks for similar tasks and prioritize those that are most risky. Moreover, it could be used to compare and define the differences between a risk assessment performed by "expertise" and another defined by a software.

Development of musculoskeletal disorders caused by awkward postures are present in tasks performed in small companies. Consequently, this chapter evaluates the postural risk level associated to the task of changing brake pads of a forklift, and proposes the design and the implementation of an ergonomic bench that helps to reduce this level of postural risk. As methods, postural risk level corresponding to the task was determined using REBA, whereas anthropometric analysis was developed, and axiomatic design and TRIZ methodologies were used to develop the proposed design. Results showed a REBA score of 8 (high-risk level). The final design is done of nylamid, and it contains some TRIZ principle, such as copying, extraction, and dynamicity. Respect axiomatic design, the bench meets some functional requirements, such as support the user's weight, avoid unsafety conditions, and be adjustable. With the TRIZ principles and functional requirements, this bench will help diminish postural risk level.

Background Given current discussions about extending working lives, more knowledge is needed on working conditions associated with labour market status in older age. Objective To explore associations between combinations of job demands and job control among workers aged 55–64 years and their labour market status 11 years later. Methods A population-based prospective cohort study using nationwide register data. The 616,818 individuals in Sweden aged 55–64 who in 2001 were in paid work were categorised using a job exposure matrix based on tertiles (reference = medium control/medium demands). Participants were followed up in 2012 regarding their main labour market status (paid work, old-age pension, no income/social assistance, sickness absence/disability pension, emigrated, dead; reference = old-age pension) using multinomial logistic regression for odds ratios (OR) and 95% confidence intervals (CI). The fully adjusted analyses included adjustment for sociodemographic factors and unemployment or sickness absence/disability pension for more than half the year in 2001. Results Those in occupations with low job control at baseline were less likely to be in paid work at follow-up (OR low demands/low control 0.74, CI 0.71–0.78; high demands/low control 0.81, CI 0.75–0.87). Those in occupations with baseline high demands were less likely to have no income/social assistance at follow-up (OR high demands/low control 0.71, CI 0.52–0.96; high demands/high control 0.59, CI 0.47–0.75). Conclusion Job demands and control when aged 55–64 were associated with labour market status 11 years later: high control was associated with greater chance of being in paid work, and high demands were associated with lower risk of no income/social assistance.

Companies are in constant search of greater productivity and better use of resources; however, they have neglected the human being. In this regard, it is important to analyze the presence of the psychosocial factors to which workers are exposed at all levels. These factors exert both a positive and a negative influence and indeed turn into a risk when they are not in balance with worker capabilities. This literature review aims to provide a comprehensive understanding of the psychosocial factors present in the manufacturing industries. The methodology consisted of conducting a search in two databases in addition to government pages. A combination of keywords was used for the search, and each publication was classified according to the factors analyzed, the type of evaluation, and the area of application. Out of all 2,468 publications found, eight were selected. Finally, work-related psychosocial factors were found to be the most analyzed.

Zusammenfassung Hintergrund Gerade im höheren Lebensalter kann regelmäßige körperliche Aktivität einen wertvollen Beitrag zur Gesundheitsvorsorge und zum Erhalt eines selbständigen Lebens leisten. Das hausärztliche Setting gilt als gut geeignet, um ältere Patienten kompetent zu beraten, sie auf geeignete Bewegungsformate hinzuweisen und zu einer längerfristigen Wahrnehmung selbiger zu motivieren. Ziel der Arbeit Die Studie soll einen Beitrag leisten, den Status quo des Themas Bewegungsförderung für ältere Menschen im hausärztlichen Setting zu explorieren. Material und Methoden Zwischen März und September 2020 wurden 38 qualitative Einzelinterviews mit Hausärzt*innen in Rheinland-Pfalz und Hessen geführt. Ergebnisse Die Interviewten zeigen ein ausgeprägtes Maß an Bewusstsein und Sensitivität in Bezug auf die Gesundheits- und Bewegungsförderung im höheren Lebensalter. Viele Ärzte sind engagiert, wenn es darum geht, geeignete Aktivitäten für ältere Patienten zu identifizieren und diese nachhaltig zu einer Teilnahme zu bewegen. Einige Ärzte arbeiten eng mit Gesundheits- und Sportakteuren vor Ort zusammen. Die Interviewten benennen Herausforderungen, insbesondere ein Fehlen adäquater Strukturen zur Bewegungsförderung. Einem Teil der Hausärzte mangelt es an einem Überblick, welche Bewegungsangebote in der Umgebung angeboten werden; Kooperationen mit Gesundheitsanbietern sind nicht immer gegeben. Schlussfolgerung Hausärzt*innen sollten in einer aktiven Rolle im Bereich der Bewegungs- und Gesundheitsförderung bestärkt werden. Damit sie effektiv auf Angebote verweisen bzw. Patienten dorthin vermitteln können, kommt es darauf an, das hausärztliche Setting in ein kommunales Netzwerk der Prävention und Gesundheitsförderung einzubinden. Gezielte Schulungen können das hausärztliche Team darin unterstützen, Praxisbesuche älterer Patienten systematisch zu nutzen, um auf den Wert körperlicher Aktivität hinzuweisen.

This chapter presents a knowledge management and Ergonomics implementation in manufacturing systems, through the development and validation of a critical success factors questionnaire. The instrument developed measures the frequency of inclusion of critical success factors for the implementation of Ergonomics and its benefits, validated in the manufacturing industry. The frequency is based on a five-point Likert scale. So far, no instrument able to measure such factors has been found in the literature. The questionnaire comprises 73 questions presented in four main stages: planning, process startup stage, work improvement cycle and long-term development. In addition, it contains a section of benefits regarding health and safety, operational and quality of life at work. The instrument was validated through a pilot test involving 140 participants from seven companies in the manufacturing sector of Ciudad Juárez, Chihuahua, México, through the use of an intentional selective method.

Europe’s population is ageing. Statutory retirement ages are commonly raised to account for continuous increases in life expectancy. In order to estimate the potential to increase statutory and consequently effective retirement ages further, in this study, we investigate the relationship between partial working life expectancy (WLE) and three health expectancies that represent health aspects important for work ability and employability between ages 50 and 59 as well as 60 and 69 for women and men in Europe. We also explore the association between these four indicators and the highest level of educational attainment. We apply Sullivan’s method to estimate WLE and three selected measures that capture general, physical, and cognitive health status of older adults for 26 European countries since 2004. Over time, WLEs increased significantly in the younger age group for women and in the older age group for both sexes. The expected number of years in good physical health have continuously been higher than any of the other three indicators, while the expected number of years in good cognitive health have shown a noticeable increase over time. The investigation of the relationship between education and each life expectancy confirms the well-established positive correlation between education and economic activity as well as good health. Our results indicate potential to extend working lives beyond current levels. However, significant differences in the expected number of years in good health between persons with different levels of education require policies that account for this heterogeneity.

Maritime transportation is indispensable for world trade. Marine casualties have serious consequences. The majority of the accidents in the maritime industry are caused by human error. If necessary precautions are taken, human error can be prevented to a great extent. Safety culture is of tremendous importance in taking precautions and preventing accidents. The concept of safety culture emerged after the Chernobyl accident. Today, the importance of safety culture in preventing accidents is accepted by all international organizations. There are many elements affecting safety culture. In this study, the situation of the safety culture of 221 deck officers against many variables was examined. According to the analysis of variance test, it has been observed that the vessel type has a significant effect on safety culture even among the officers who graduated from the same college.

U.S. dairy workers suffer occupational injuries and illnesses at rates higher than the national average. Occupational health and safety management systems (OHSMS) have been proposed as a way to reduce injuries and illnesses for businesses of all types and sizes. The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing an OHSMS to U.S. businesses. As part of this service, the consultants determine the level of OHSMS programming using the Safety and Health Program Assessment Worksheet (Revised OSHA Form 33). A total of 167 dairy industry records were obtained from OSHA. Forty-five of those records had both injury rate and OHSMS data. Using these records, a Spearman Rank-Order correlation was used to determine the strength and significance of the associations between prior injury rates and OSHA measured OHSMS programming level for dairy operations. Additional analyses were conducted to examine potential relationships between workforce size, injury rates, and OHSMS programming levels. There was a negative correlation between OHSMS programming level and injury rates, both for the overall OHSMS and by OHSMS component. Management Leadership was the OHSMS component most strongly associated with lower injury and illness rates. OHSMS interventions, as part of a comprehensive risk management approach for the U.S. dairy industry, may be warranted to help reduce the unacceptable number of injury and illnesses in the U.S. dairy industry. Further research is needed to determine if similar relationships between OHSMS programming and injury rates occur in other industries.

Objectives The use of a job-exposure matrix (JEM) to assess exposure to potential health hazards in occupational epidemiological studies requires coding each participant’s job history to a standard occupation and/or industry classification system recognized by the JEM. The objectives of this study were to assess the impact of inter-coder variability in job coding on reliability in exposure estimates derived from linking the job codes to the Canadian job-exposure matrix (CANJEM) and to identify influent parameters. Method Two trained coders independently coded 1000 jobs sampled from a population-based case–control study to the ISCO-1968 occupation classification at the five-digit resolution level, of which 859 could be linked to CANJEM using both assigned codes. Each of the two sets of codes was separately linked to CANJEM and thereby generated, for each of the 258 occupational agents available in CANJEM, two exposure estimates: exposure status (yes/no) and intensity of exposure (low, medium, and high) for exposed jobs only. Then, inter-rater reliability (IRR) was computed (i) after stratifying agents in 4 classes depending, for each, on the proportion of occupation codes in CANJEM defined as ‘exposed’ and (ii) for two additional scenarios restricted to jobs coded differently: the first one using experts’ codes, the other one using codes randomly selected. IRR was computed using Cohen’s kappa, PABAK and Gwet’s AC1 index for exposure status, and weighted kappa and Gwet’s AC2 for exposure intensity. Results Across all agents and based on all jobs, median (Q1, Q3; Nagents) values were 0.68 (0.59, 0.75; 220) for kappa, 0.99 (0.95, 1.00; 258) for PABAK, and 0.99 (0.97, 1.00; 258) for AC1. For the additional scenarios, median kappa was 0.28 (0.00, 0.45; 209) and −0.01 (−0.02, 00; 233) restricted to jobs coded differently using experts’ and random codes, respectively. A similar decreasing pattern was observed for PABAK and AC1 albeit with higher absolute values. Median kappa remained stable across exposure prevalence classes but was more variable for low prevalent agents. PABAK and AC1 decreased with increasing prevalence. Considering exposure intensity and all exposed jobs, median values were 0.79 (0.68, 0.91; 96) for weighted kappa, and 0.95 (0.89, 0.99; 102) for AC2. For the additional scenarios, median kappa was, respectively, 0.28 (−0.04, 0.42) and −0.05 (−0.18, 0.09) restricted to jobs coded differently using experts’ and random codes, with a similar though attenuated pattern for AC2. Conclusion Despite reassuring overall reliability results, our study clearly demonstrated the loss of information associated with jobs coded differently. Especially, in cases of low exposure prevalence, efforts should be made to reliably code potentially exposed jobs.

La reciente promulgación de la ley que prohíbe el amianto en Colombia plantea un importante número de retos. Las mayores fábricas que históricamente han procesado asbesto incluyen cinco instalaciones de asbesto cemento localizadas en las ciudades de Sibaté (Cundinamarca), Cali (Valle del Cauca) y Barranquilla (Atlántico), y Manizales (Caldas), que tiene dos, así como una instalación de productos de fricción en Bogotá D.C. Una mina de asbesto crisotilo también ha operado en Colombia desde 1980 en Campamento (Antioquia). En el marco del desarrollo del Perfil Nacional de Asbesto para Colombia, en este estudio se estimó la población que reside en las cercanías de las plantas de procesamiento de asbesto o de la mina y, por lo tanto, potencialmente en riesgo de contraer la enfermedad. Utilizando un sistema de información geográfica, se procesaron los datos demográficos obtenidos de los dos últimos censos generales de población para determinar el número de personas que viven dentro de los círculos concéntricos que rodean las instalaciones de asbesto y la mina. En estudios anteriores realizados en diferentes países del mundo, se ha informado de un mayor riesgo de enfermedades relacionadas con el amianto para las personas que viven a diferentes bandas de distancia de las instalaciones de procesamiento de amianto. Con base en estos estudios, se combinaron círculos de radios de 500, 1000, 2000, 5000 y 10,000 m, centrados en las instalaciones de procesamiento de asbesto y la mina que operaban en Colombia, con los datos del censo para estimar el número de personas que vivían dentro de estos radios. Se identificó un gran número de personas. Se estima que en 2005, a nivel del país, 10.489 personas vivían a menos de 500 m de una instalación de procesamiento de amianto o de una mina. En 2018, y en un radio de 10.000 m, el número de personas era de 6.724.677. Esta información puede ayudar a las estrategias de vigilancia de la salud pública. The recent enactment of the law banning asbestos in Colombia raises a significant number of challenges. The largest factories that have historically processed asbestos include five asbestos-cement facilities located in the cities of Sibaté (Cundinamarca), Cali (Valle del Cauca), and Barranquilla (Atlántico), and Manizales (Caldas), which has two, as well as a friction products facility in Bogotá D.C. An asbestos chrysotile mine has also operated in Colombia since 1980 in Campamento (Antioquia). In the framework of developing the National Asbestos Profile for Colombia, in this study, we estimated the population residing in the vicinity of asbestos processing plants or the mine and, therefore, potentially at risk of disease. Using a geographic information system, demographic data obtained from the last two general population censuses were processed to determine the number of people living within the concentric circles surrounding the asbestos facilities and the mine. In previous studies conducted in different countries of the world, an increased risk of asbestos-related diseases has been reported for people living at different distance bands from asbestos processing facilities. Based on these studies, circles of 500, 1000, 2000, 5000, and 10,000 m radii, centered on the asbestos processing facilities and the mine that operated in Colombia, were combined with the census data to estimate the number of people living within these radii. Large numbers of people were identified. It is estimated that in 2005, at the country level, 10,489 people lived within 500 m of an asbestos processing facility or mine. In 2018, and within a distance of 10,000 m, the number of people was 6,724,677. This information can aid public health surveillance strategies.

Today, ships navigating all around the world are not allowed to emit SOx more than 0.5%. Same regulation for nitrogen has already come into force. More and more nations are becoming aware and concerned about the negative effects of climate change, whereas many countries are already feeling the effects of harmful greenhouse gas emissions. Therefore, the world’s fleet needs a new fuel types, which are alternative to conventional petroleum-based ship fuels. Benefits such as low sulphur standards accompany all alternative fuel options. As will be discussed further in Section 2, there are challenges and limitations associated with CO2 emissions along with benefits. The review of the literature and field shows that the impact of these current choices on the management and environments is still not bright enough, although each alternative has consisted entirely different effects in their body and each alternative pose specific risks to the environment, crew, management and port states. This chapter gives a review on the impact of each alternative fuels on the environment. In addition, the chapter touches upon handling of risks associated with alternative fuels and technologies.

ObjectivesThe Abilitator is a patient-reported outcome measure (PROM) of work ability and functioning of those in a weak labour market position. It covers items for work ability and self-rated health, for example, and summary scales for social, psychological, cognitive and physical functioning, as well as everyday skills. The aim of this study was to evaluate the intrarater test–retest reliability, internal consistency and basic psychometric properties of the Finnish version of the Abilitator.Design, setting and outcomeThe test–retest study was conducted in European Social Fund projects in 2018–2019. The participants completed two Abilitator questionnaires over 7–14 days. The internal consistency analysis was based on data collected in 2017–2019 in services for the long-term unemployed. The reliability was assessed using correlations (r, rs, intraclass correlation coefficient (ICC)), agreement with Bland-Altman analysis and internal consistency with Cronbach’s alpha.ParticipantsThe test–retest study had 67 participants (52% men, mean age 43.9 years) and the internal consistency study 10 923 (48% men, mean age 38.58 years), respectively. Of all the participants, 80% had been unemployed for over a year.ResultsThe test–retest r or rs ranged from 0.71 to 0.93 and ICC from 0.74 to 0.93 for the items and summary scales. An exception was the life satisfaction item, with an rs of 0.60 and ICC of 0.45. A statistically significant difference was observed in the summary scale for social functioning (t=−2.01, p=0.049). Agreement was observed for all variables except social functioning. Alphas for summary scales ranged from 0.74 to 0.91.ConclusionsThe Finnish version of the Abilitator is a reliable PROM for the target group and has acceptable to excellent intrarater test–retest reliability and internal consistency, apart from the life satisfaction item. Further testing is needed for the social functioning summary scale.

Highlights • AGRICOH analyzed cancer incidence in >248,000 agricultural workers from 6 countries. • Cancer overall occurred less in agricultural workers than in the general population. • An excess was found for multiple myeloma, melanoma of the skin, and prostate cancer. • Direction of risk was largely consistent across cohorts with a few deviations. • A large deficit of larynx and lung cancers was observed in nearly all cohorts., Background Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations. Methods The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis. Results During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01–1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04–1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01–1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77–0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men. Conclusion The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.

Background: This cross-sectional study aimed to assess the level of perceived stress and occupational burnout in groups of Polish maritime navigators and air traffic controllers. The study was part of research into occupational groups regarded as equally emotionally burdened. We tested the usability of a model linking occupational burnout, perceived stress, and seniority. Methods: The set of questionnaires, including the link burnout questionnaire, perceived stress scale&mdash, 10, and generalized self-efficacy scale were distributed to 54 maritime navigators and 88 air traffic controllers (rate of return: 18&ndash, 56%). Spearman&rsquo, s rho, &chi, 2 test, the Mann&ndash, Whitney U test, Cohen&rsquo, s d and Hedge&rsquo, s g coefficients, linear regression, and F statistic were used. Results: The assumption that persons employed in occupations with the special professional requirements as air traffic controllers and maritime navigator with a risk of strong, chronic emotional overload evaluate their life situation as less stressful than other employees was confirmed. A higher level of occupational burnout was observed in groups of controllers and navigators compared to an equally emotionally burdening occupational group of Polish firefighters, but not Polish psychiatrists. The research groups differed regarding the source of stress: fear of helplessness in the air traffic controller group and inefficacy in overcoming adversities in the maritime navigators. Maritime navigators reported a higher level of occupational burnout, deterioration of relations with coworkers, and disappointment with their work compared to the air traffic controllers. Conclusions: The results showed differences in factors linked to workplace demands and the personal predispositions of employees, and the role these may play in mutual relations between occupational burnout, life situation evaluation, and personal resources. We postulate that the level of perceived stress should be taken into account in the studies of occupational burnout syndrome.

Background Both the presence of psychological problems and the absence of an employment contract are related to long-term sickness absence, prolonged work disability and unemployment. Studies researching the effectiveness of return-to-work interventions on these non-permanent workers, including unemployed and temporary agency workers and workers with an expired fixed-term contract, are lagging behind. Therefore, a return-to-work intervention called “Brainwork” was developed. The aim of this study was to assess the effectiveness of the ‘Brainwork Intervention’ in reducing the duration of sick leave compared to usual care over a 12-month follow-up. Methods In a multicenter controlled clinical trial, using a quasi-randomization procedure, we compared the Brainwork Intervention (n = 164) to usual care (n = 156). The primary outcome was the duration of sick leave. Secondary outcomes were the duration of sick leave starting from Social Security Agency transfer; the proportion of workers returned to work; the number of hours of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. Protocol adherence (Brainwork Intervention) was considered sufficient when at least three of the five protocol steps were followed. Cox regressions, linear and ordinal regression, and Mixed Model analyses were performed. Results All 320 participants were analyzed. The Brainwork Intervention resulted in a non-significant reduction of the duration of sick leave compared to usual care (269 days versus 296 days; HR = 1.29; 95% CI 0.94–1.76; p = 0.11). For those working (46%) during the 12-month follow-up, the mean number of hours of paid employment was non-significantly higher in the usual care group (682 h versus 493 h; p = 0.053). No significant differences were found for other secondary outcomes. Protocol adherence was 10%. Conclusions The Brainwork Intervention as performed with a low protocol adherence did not result in a significant reduction of the duration of sick leave compared to usual care. It remains unclear what the results would have been if the Brainwork Intervention had been executed according to protocol. Trial registration The Netherlands Trial Register (NTR); NTR3976 (old registration number NTR4190). Registered September 27th 2013.

Purpose: To investigate the effect of Individual Placement and Support (IPS) according to diagnoses of schizophrenia, bipolar disorder, major depression, substance use disorders, or forensic psychiatric conditions. Methods: A systematic search of the literature was conducted in June 2017 and repeated in December 2020. The systematic review included 13 studies. Analyses of pooled original data were based on the six studies providing data (n = 1594). No studies on forensic psychiatric conditions were eligible. Hours and weeks worked were analyzed using linear regression. Employment, and time to employment was analyzed using logistic regression, and cox-regression, respectively. Results: The effects on hours and weeks in employment after 18 months were comparable for participants with schizophrenia, and bipolar disorder but only statistically significant for participants with schizophrenia compared to services as usual (SAU) (EMD 109.1 h (95% CI 60.5–157.7), 6.1 weeks (95% CI 3.9–8.4)). The effect was also significant for participants with any drug use disorder (121.2 h (95% CI 23.6–218.7), 6.8 weeks (95% CI 1.8–11.8)). Participants with schizophrenia, bipolar disorder, and any drug use disorder had higher odds of being competitively employed (OR 2.1 (95% CI 1.6–2.7); 2.4 (95% CI 1.3–4.4); 3.0 (95% CI 1.5–5.8)) and returned to work faster than SAU (HR 2.1 (95% CI 1.6–2.6); 1.8 (95% CI 1.1–3.1); 3.0 (95% CI 1.6–5.7)). No statistically significant effects were found regarding depression. Conclusions: IPS was effective regarding schizophrenia, bipolar disorder, and substance use disorder; however, the effect on hours, and weeks worked was not statistically significant regarding bipolar disorder. For people with depression the impact of IPS remains inconclusive. Non-significant results may be due to lack of power. Trial Registration: PROSPERO protocol nr. CRD42017060524.