The Unique Developmental Considerations of Youth-Related Work Injuries

Abstract

Adolescents and young adults experience higher risks of occupational injuries and fatalities compared to adult workers. Consequently, understanding the risk and protective factors for young workers through a developmental lens is all the more compelling. This study describes the developmental processes of adolescence using a bioecological framework. It describes how factors such as neuromaturation, pubertal development, physical growth, and social contexts may place youth at greater risk of injury and other negative outcomes in the work environment. While the emphasis of the paper is on the developmental processes specific to adolescence, this is discussed in the larger contexts of macro forces such as policies, schools, and families. Implications of developmental factors on work-based practices and policies are also discussed.     

Use of Imaging in the Follow-up of Workers Exposed to Lung Carcinogens: Practices in Occupational Medicine and its Determinants

Abstract

We studied occupational physicians' (OPs) practices of referrals for imaging of workers occupationally exposed to lung/pleural carcinogens and the factors associated with them. This cross-sectional telephone survey of 379 OPs practicing in Southeastern France showed that 81% of them referred exposed patients for chest radiographs, 33.5% for computed tomography (CT), and 16.1% for neither. Making no referral was positively associated with believing cancer risks are lower in one's own geographic sector than elsewhere and negatively associated with keeping employee risk records up-to-date. Referrals for CT were positively associated with work at in-house occupational health services (OHS), and completing employee exposure histories often/always. Both the OHS type and factors that may shape OPs' awareness of cancer risks in their sector appear to influence imaging referral practices. Occupational physicians would benefit from guidelines clarifying benefits and risks associated with imaging in such patients. An effort to harmonize regulatory provisions and guidelines also appears necessary.     

Hospital Work and Pregnancy Outcomes: A Study in the Danish National Birth Cohort

Abstract

In hospitals, women of reproductive age do a range of work tasks, some of which are known to carry potential risks. Tasks such as working with radiation, chemicals, and infectious agents, as well as performing heavy lifting or tasks requiring erratic sleep patterns have been reported to increase the risk of reproductive failures. Our aim was to study pregnancy outcomes in female hospital workers in Denmark. We performed a cohort study of 5976 female hospital workers and used as a reference group 60,890 women employed outside of hospitals. The reproductive health of hospital workers working during pregnancy is comparable to those of non-hospital workers for the majority of reproductive failures studied. However, an increased prevalence of congenital abnormalities was noted in some subgroups of hospital workers, which may indicate that some hospital work still entails fetotoxic hazards.     

Occupational health and safety in hospitals accreditation system: the case of Lebanon

Introduction: Hospital accreditation can be an incentive to improve occupational health and safety (OHS) performance.

Objective: This study assesses the relationship between status of accreditation among private Lebanese hospitals and compliance with OHS accreditation standards.

Methods: A survey was administered to 68 private Lebanese hospitals to assess accreditation status and specific indicators related to each of the 9 OHS codes in the Lebanese accreditation manual. Chi-square, Fisher’s exact test, and independent sample t-tests compared the OHS standards between accredited and non-accredited hospitals.

Results: Fifty-six percent of participating private hospitals were accredited. Accredited hospitals reported statistically better OHS performance than non-accredited hospitals based on the standards outlined in the accreditation manual. However, there was inconsistent performance on numerous OHS indicators among participating hospitals.

Conclusion: The gaps in OHS performance suggest the need for strengthened OHS guidelines in the national accreditation process to safeguard workers’ health. Strategies to fortify OHS performance include tying service reimbursement to OHS compliance and linking OHS standards with national labor legislation.     

Implementation of Virtual Patients in the Training for Occupational Health in Latin America

Abstract

Health professionals trained in occupational health are essential to reduce the burden of occupational accidents and diseases. However, training resources are limited globally. We aimed to promote occupational health and safety (OHS) using virtual patients (VPs) in Brazil, Chile, and Germany. Virtual patients were created in three Latin-American health centers. So-called “partner VPs” comparing the distinct health care systems were designed. Translation, adaptation to different medical and legal systems, expert review, implementation into under- and postgraduate teaching, and user evaluation were performed. Twelve VPs covering traditional and contemporary OHS issues are available in Spanish, Portuguese, and English. Overall, 2371 students used the VPs. The number of Latin American users who evaluated VP content and relevance for their professional career was statistically significantly higher than the number of German students. VPs are a feasible learning method for OHS in middle-income countries. Partner VPs seem to be useful for teaching global aspects.     

Workplace Health Understandings and Processes in Small Businesses: A Systematic Review of the Qualitative Literature

Introduction Small businesses (SBs) play an important role in global economies, employ half of all workers, and pose distinct workplace health problems. This systematic review of qualitative peer-reviewed literature was carried out to identify and synthesize research findings about how SB workplace parties understand and enact processes related to occupational health and safety (OHS). Methods The review was conducted as part of a larger mixed-method review and in consultation with stakeholders. A comprehensive literature search identified 5067 studies. After screening for relevance, 20 qualitative articles were identified. Quality assessment led to 14 articles of sufficient quality to be included in the meta-ethnographic findings synthesis. Results This review finds that SBs have distinctive social relations of work, apprehensions of workplace risk, and legislative requirements. Eight themes were identified that consolidate knowledge on how SB workplace parties understand OHS hazards, how they manage risk and health problems, and how broader structures, policies and systems shape the practice of workplace health in SBs. The themes contribute to ‘layers of evidence’ that address SB work and health phenomena at the micro (e.g. employer or worker behavior), meso (e.g. organizational dynamics) and macro (e.g. state policy) levels. Conclusions This synthesis details the unique qualities and conditions of SBs that merit particular attention from planners and occupational health policy makers. In particular, the informal workplace social relations can limit workers’ and employers’ apprehension of risk, and policy and complex contractual conditions in which SBs are often engaged (such as chains of subcontracting) can complicate occupational health responsibilities. This review questions the utility of SB exemptions from OHS regulations and suggests a legislative focus on the particular needs of SBs. It considers ways that workers might activate their own workplace health concerns, and suggests that more qualitative research on OHS solutions is needed. It suggests that answers to the SB OHS problems identified in this review might lie in third party interventions and improved worker representation.     

SALTRA: A Regional Program for Workers' Health and Sustainable Development in Central America

Abstract

In 2003, the university-based Program on Work and Health in Central America, SALTRA, was launched to build national and regional capacities in occupational safety and health with the goal of preventing and reducing poverty in Central America. SALTRA has implemented 20 projects including action projects in priority sectors (e.g., construction, sugarcane, hospitals, migrant coffee workers); strengthening of surveillance (occupational health profiles, carcinogenic exposures, fatal injuries and pesticides); a participatory model for training and risk monitoring by workers; building occupational health capacity for professionals, employers, and workers, with collaborating networks between the countries; strengthening of universities in work, environment, and health; studies of serious occupational and environmental situations; communication channels; and continued efforts to raise political awareness. SALTRA has placed issues of workers' health on political, business, and academic agendas throughout the region and has laid the foundations for achieving substantial future improvements in health conditions of all workers in the region. External evaluators envisioned SALTRA as an innovative development model.     

Hospital support services and the impacts of outsourcing on occupational health and safety

Background: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.

Objectives: This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.

Methods: Worker’s compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups.

Results: Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries.

Conclusions: This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.     

Fordism in the fast food industry: pervasive management control and occupational health and safety risks for young temporary workers

A growing body of international research points to an association between precarious employment or contingent work arrangements and a higher incidence of injury, disease and psychological distress as well as inferior knowledge/compliance with occupational health and safety (OHS) standards. Despite this, published research on the OHS problems of young workers in hospitality and other service industries largely ignores the fact that many are engaged on a temporary basis. To address this gap we surveyed 304 young temporary workers employed in Australian outlets of a well‐known multinational fast food chain. Indices assessed included work‐related injuries, exposure to occupational violence, and knowledge of OHS practices and legislative rights. In trying to explain the adverse OHS outcomes associated with contingent work, researchers have repeatedly identi?ed three sets of factors; economic and reward pressures, work disorganisation and regulatory failure. Like most other multinational fast food companies, this ?rm adopted a Fordist production system. Given suggestions that Fordist systems adversely affect worker health and wellbeing, it seemed plausible that the combination of Fordism with reliance on a young casualised workforce would result in markedly inferior OHS outcomes. Contrary to this expectation, workers surveyed had an incidence of injury around the norm for full‐time permanent workers, and an excellent knowledge of risk control measures and OHS legislation. On the other hand, they had limited knowledge of their workers’ compensation entitlements and faced an elevated risk of low‐level occupational violence. Far from exacerbating the situation, the primary reason for the positive injury and knowledge outcomes was the Fordist system that tightly speci?ed tasks and incorporated detailed risk assessment and control procedures. This system was shaped by an overriding concern for the company’s bottom line (hence the worker’s poor knowledge of worker’s compensation – a result more typical of contingent workers) but pervasive controls had bene?ts for an otherwise vulnerable workforce. Ritzer (2000 ) and others have portrayed the Fordist regimes of fast food chains as integral to a system where workers are indoctrinated, class relations obfuscated and covert threats to continued employment used to undermine solidarity. Without denying this, these systems may still constitute a less hazardous working environment for temporary workers than more disorganised work settings. Further research is needed to determine whether the study ?ndings can be generalised or are restricted to this chain or its Australian outlets.     

Health and Safety in Australian Agriculture - Linking Research,Data and Action

ABSTRACT

Almost every week the rural media provide farming communities around Australia with information about health and safety hazards on farms. The results of the increasing research and data collection are being made broadly available. But are we just adding yet another worry to already stressed farmers, farm workers and farm families by this approach?

Until recently, there was little information or support available to farmers to assist them to identify the hazards on their own workplace, to assess the relative risk to health and safety of the many hazards identified, or to plan adoption of effective solutions to reduce risk based on the cash flow of the farming enterprise.

Managing Farm Safety is a program which has been developed through integration of data findings, research findings, farmer responsibilities under OHS Occupational Health and Safety legislation, farm management practicalities, farm cash flow and farmer aspirations. The program will be incorporated into rural education, training and extension services.

The services to farmers and farm families include access to training in farm OHS management, provision of a management tool or kit which includes and on-farm audit, record of education and training for employees, record of farm chemicals usage, and information about risk reduction solutions are available, their relative effectiveness and the cost of each option. The program will be provided in commodity specific format as more of the major industry groups in Australian agriculture move to adopt the approach.

This paper describes the data flow system used in the development and maintenance of this program.     

Health and Safety Adoption from Use of a Risk Assessment Document on Irish Farms

ABSTRACT

Objectives: This article describes levels of implementation of occupational health and safety (OHS) controls on a sample of Irish farms following completion of a risk assessment document (RAD) made available as part of a statutory code of practice (COP) for the agriculture sector. The article describes the legislation mandating the COP and the operation of a prevention initiative (PI) among key stakeholders to develop and promote farmer use of the COP and RAD. Methods: RADs were collected for farmers (N = 475) and the number and type of OHS controls listed for action were tabulated. A farm audit of OHS standards and of implementation of controls listed for action in the RAD was undertaken among a randomly selected sample of farms (N = 94) where the RAD was completed. Results: The study data indicates that farmers used the RAD to a limited extent, and that their focus in its use was on identifying physical rather than organizational controls. An association was found between farmers who actively implemented controls and positive OHS standards. Farm OHS standards were also associated with farmer attitude to OHS, farm enterprise, farmer age category, and work time needed to operate the farm. Conclusions: Overall, the study data suggests that standards of farm management are a crucial determinant of OHS standards. The study data also indicates that having knowledge of required OHS controls does not ensure implementation. Development of social learning in groups is considered as a significant means of increasing OHS farm adoption.     

Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers

Introduction:In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group.Objectives:This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers.Methods:More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated.Results:The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (β=0.468) and perceptions of supervisor support and social support (β=0.710). The perception of both parameters is associated with stress outcomes (β=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001).Conclusions:The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.Key words: Work-related stress, ageing, banking sector     

Physical and ergonomic hazards in the textile, chemical, food, metal products, and woodworking industries in Turkey

Questionnaires were administered in 272 textile, chemical, food, metal products and woodworking firms in ten cities in industry-dense areas to assess the general OHS situation in Turkey. This paper explores the portion related to exposures of workers to physical and ergonomic hazards. OHS experts where available, firm owners, partners, or engineers responsible for safety were asked to answer structured questions regarding percentages of workers exposed to specific hazards. About 65% of respondents reported exposures to noise risks among at least some percentage of employees; 26.3% reported more than 50% of employees were so exposed. In more than 60% of the firms employees were exposed to ergonomic risks related to the need to meet production quotas and the need to maintain constant posture. The most prevalent risk factors in five industries and the relative frequencies of exposed employees are described.     

Associations of Fertility and Pregnancy Outcomes with Leather Tannery Work in Mongolia

Abstract

To our knowledge, reproductive health effects among male leather tannery workers have not been previously investigated. Tannery work involves exposure to chromium, solvents, and other chemicals, which has been associated with adverse pregnancy and fertility outcomes in animals or humans in some studies. This study retrospectively investigates the association of male leather tannery work with preterm delivery, spontaneous abortion, time to pregnancy, and infertility by comparing tannery employees to other workers in Ulaanbaatar, Mongolia. Participants were randomly selected from current employee rosters at eight tanneries and two bread-making companies. The results of this research suggest that tannery work may be associated with reduced fertility in males. The study had limited statistical power, and some factors are likely to have biased findings toward the null hypothesis; other limitations and possible sources of undetermined bias give reason for cautious interpretation. Additional studies should be conducted to further examine fertility among tannery workers.     

Adding Industry and Occupation Questions to the Behavioral Risk Factor Surveillance System: New Opportunities in Public Health Surveillance

ObjectivesIndustry and occupation variables are overlooked in many public health surveillance efforts, yet they are useful for describing the burden and distribution of various public health diseases, behaviors, and conditions. This study is the first ever analysis of the Colorado Behavioral Risk Factor Surveillance System (BRFSS) to describe chronic conditions and risk behaviors by occupation. It is intended to provide a new perspective on this existing data source and demonstrate the value of occupation as a core demographic variable for public health research, policy, and practice.MethodsTwo standardized employment questions were included in the 2012 Colorado BRFSS survey and administered to eligible survey respondents who were employed, self-employed, or out of work for less than one year. Occupation data were coded using the National Institute for Occupational Safety and Health (NIOSH) Industry and Occupation Computerized Coding System. We analyzed health behaviors and conditions by major occupation groups. We calculated prevalence estimates and 95% confidence intervals (CIs).ResultsThe prevalence of chronic conditions, health statuses, and risk behaviors (e.g., smoking and seatbelt use) varied significantly by occupation. For example, compared with all workers (93.6%, 95% CI 92.7, 94.5), significantly fewer workers in farming, forestry, fishing and construction, extraction jobs (87.0%, 95% CI 82.0, 92.0) reported always or nearly always wearing a seatbelt while driving. Additionally, significantly more office and administrative support workers (27.5%, 95% CI 22.5, 32.4) compared with all workers (20.6%, 95% CI 19.3, 22.0) were obese. Further observation and research is needed to understand the effects of occupation on health outcomes and behaviors.ConclusionThere are no other Colorado state-level datasets that link health behaviors and chronic conditions with occupation. This study shows that the prevalence of chronic conditions and risk behaviors varies substantially by occupation. Other states conducting the BRFSS may choose to adopt the NIOSH industry and occupation module and add other questions to further investigate health issues by occupation.Civilian workers in the U.S. spend up to 50% of their waking lives at work or commuting, yet industry and occupation variables are overlooked in many public health surveillance systems.^1–4 This oversight not only poses a challenge for surveillance of work-related injury and illness, but also reduces the ability to examine associations between work and chronic conditions, as well as health behaviors and infectious diseases. Recent state efforts to include industry and occupation questions in the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey have provided data needed to profile the health status of the workforce and describe specific risk factors and health conditions by industrial sector and occupation groups.^5–12 Surveillance efforts that include indicators of disease, injury, and occupation provide opportunities to more specifically describe relationships between work and numerous other factors including health status, chronic diseases, and health behaviors. These examinations can suggest targeted work-related populations and inform public health interventions and prevention efforts.The BRFSS is a random-digit-dial telephone survey of the U.S. adult population aged ≥18 years that is administered annually to households with landline and cellular telephones by state health departments in collaboration with CDC.^13,14 The survey comprises three parts: core survey questions, optional modules, and state-added questions. It collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services and practices. Since its inception in the 1980s, the only question about employment asked of all survey respondents nationwide has been regarding employment status (e.g., employed, student, or retired). The National Institute for Occupational Safety and Health (NIOSH) recently standardized two questions for the BRFSS that collect information about respondents'' current or most recent job. The Occupational Health and Safety Surveillance Program at the Colorado Department of Public Health and Environment sponsored inclusion of these two NIOSH-standard questions as a state-added question on the 2012 Colorado BRFSS. This article summarizes key findings from these new BRFSS data and demonstrates that the prevalence of health statuses, health behaviors, and chronic conditions varies by occupation.     

Factors Associated with Total Restrictions on Smoking at Work and at Home: A Study among Populations in Multiple US States and the US Virgin Islands

Abstract

This study investigated factors associated with smoking restrictions in the workplace and at home in order to better understand the effects of workplace smoking restrictions. Data from the 2006 Behavior Risk Factor Surveillance System were analyzed. Multiple logistic regression was used to determine independent risk factors for potential smoking exposure at work and at home. The population potentially exposed at work were more likely to be young, male, low-income, Latino adults without college degrees or health insurance; they were also more likely to be a current or former smoker and be at risk for heavy drinking. Our study also investigated self-reported restrictions at home and found significant disparities between populations. We conclude that men, Latinos, and young adults are more likely to live in a home with a smoking ban, but are disproportionately exposed to risks at work, presumably against their preferences. Workplace smoking restrictions in 2006 offered unequal protection.     

Social work and toddler overweight risk: Identifying modifiable child and parent factors across the socioeconomic gradient

ABSTRACT

Objective: Childhood obesity is associated with long-term health consequences, yet little is known about the prevalence of child and parent risk factors of overweight across the socioeconomic gradient in early life. This exploratory study documents the prevalence of risk factors that contribute to overweight among toddlers within and across socioeconomic status (SES). Methods: Obesity risk factors were examined within and across SES quintiles in a nationally representative sample. Data were collected from 5,100 mothers and 2-year-old children. Weighted regression models assessed child and parent characteristics that predict toddler weight status in a national sample and samples stratified by SES quintiles. Results: Higher rates of overweight were observed in Q1 (29.2%) and reduced with each successive SES quintile (16.9%—Q5), suggesting a gradient effect. Results indicated factors unique within quintiles, distinct from the full national sample: Q1—motor development; Q2—motor and mental development, maternal BMI, breastfeeding, bottle feeding, introduction of solid foods; Q3—breastfeeding; and Q4–5—introduction of solid foods. Discussion: Findings further existing knowledge of toddler obesity by uncovering risks relevant for specific SES groups. Results yield implications for social workers to refine strategies for improving toddler health and preventing overweight/obesity.     

Critical evaluation of medical, statistical, and occupational data sources in the Kola Peninsula of Russia pertinent to reproductive health studies

Background: The feasibility study described herein was prompted by a report in 1992 of possible reproductive and developmental health concerns among female workers in a Russian nickel refinery. Objective: The primary goal was to ascertain whether medical, statistical, and occupational data bases could be accessed for information about the pregnancy histories, occupational histories, and life-style factors of the women affected. Methods: The project was facilitated by construction of a registry of all births in three towns with a nickel refinery and verification of its contents against patients' records obtained from hospital delivery and gynecology departments and community polyclinics. Municipal Registration Board, Regional Health Statistics Board, and nickel company records were also reviewed. Results: Reproductive/developmental outcome information and workplace histories were acceptable. Sample-size calculations indicated that a cohort or cross-sectional study would be amenable and suitable for the detection of an excess risk for spontaneous abortion with adequate statistical significance and power. Such investigations would need to be supplemented by workplace environmental/biological monitoring assessments for evaluation of exposure to occupational hazardous factors and a worker's questionnaire to obtain information about life-style factors. A case-control design is recommended for the study of congenital defects. Conclusions: A well-designed, comprehensive epidemiology study is technically feasible because of the availability of a favorable pool of study subjects, reproductive/developmental outcome data, information to control for major confounders, and suitable occupational records. Received: 13 July 1998 / Accepted: 7 February 1999     

Disability status: a risk factor in injury epidemiologic research

ObjectiveWe reviewed publications about nonfatal injuries among individuals with existing disabilities.MethodsWe identified original research articles reporting nonfatal injuries among individuals with disabilities by using three approaches: Search the PUBMED and MEDLINE electronic databases; scrutiny of the reference sections of identified publications; search of our own files. Studies that reported odds ratios or rate ratios of injuries for the disability variable and demographic variables of age, gender, race, and school education were included.ResultsA significantly greater risk of injuries was found among individuals with disabilities compared with their peers. Findings were consistent among studies in children, adults, and workers with disabilities. This association did not seem to be explained by physical environmental hazards alone or study bias. We found no original study that developed and evaluated injury prevention programs targeting individuals with disabilities.ConclusionsDisability status should be considered as an important covariate in injury epidemiologic research, particularly in injury research among older populations and in children with special care needs. Future research is needed to develop and to evaluate multidisciplinary interventions to prevent injuries among individuals with disabilities.     

Work accident victims: a comparison between non-standard and standard workers in Belgium

Background: The fast growth of non-standard employment in developed countries highlights the importance of studying the influence of contract type on worker’s safety and health.

Objective: The main purpose of our study is to investigate whether non-standard workers are more injured than standard workers or not. Additionally, other risk factors for occupational accidents are investigated.

Methods: Data from the Belgian surveys on work ability in 2009 and 2011 are used. During their annual occupational health examination, workers were asked to fill in a self-administered questionnaire. In total, 1886 complete responses are collected and analyzed using logistic regression.

Results: Temporary workers did not have higher injury rates than permanent workers [OR 0.5, 95% confidence interval 0.2–1.2]. Low-educated, less-experienced workers and those exposed to dangerous conditions are more frequent victims of occupational accidents.

Conclusion: The present data do not support the hypothesis that non-standard workers have more injuries than standard workers. Our results about occupational accidents derived from a non-representative sample of the Belgian workforce and cannot be generalized due to the heterogeneity in job organization and labor regulations between countries. Further research is needed to extend our findings and to seek other factors that may be associated with work accidents.