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.     

Occupational injury among cooks and food service workers in the healthcare sector

BACKGROUND: Incidence of occupational injury is anticipated to be high among cooks and food service workers (CFSWs) because of the nature of their work and the types of raw and finished materials that they handle. METHOD: Incidents of occupational injury, resulting in lost time or medical care over a period of 1 year in two health regions were extracted from a standardized operational database and with person years obtained from payroll data, detailed analysis was conducted using Poisson regression modeling. RESULTS: Among the CFSWs the annual injury rate was 38.1 per 100 person years. The risk of contusions [RR, 95% CI 9.66 (1.04, 89.72)], burns [1.79 (1.39, 2.31)], and irritations or allergies [3.84 (2.05, 7.18)] was found to be significantly higher in acute care facilities compared to long-term care facilities. Lower risk was found among older workers for irritations or allergies. Female CFSWs, compared to their male counterparts, were respectively 8 and 20 times more likely to report irritations or allergies and contusions. In respect to outcome, almost all irritations or allergies required medical visits. For MSI incidents, about 67.4% resulted in time-loss from work. CONCLUSIONS: Prevention policies should be developed to reduce the hazards present in the workplace to promote safer work practices for cooks and food service workers.     

Feasibility of Brief Intervention in the Workplace for the Detection and Treatment of Excessive Alcohol Consumption

Abstract

The aim of this study was to see whether brief intervention, a method used in the health care services, can be useful in the workplace. At routine health check-ups carried out by the occupational health service (ORS), employees were offered the opportunity to check their alcohol-use habits. Of the 333 employees who were offered alcohol-use screening, only six (2%) failed to participate. Of the remaining 327, 21% (n = 68) screened positive for excessive alcohol consumption and were contacted by the ORS. The majority of these, 43 (62%), accepted a further check-up of their alcohol consumption. A much higher percentage of those who were contacted by telephone (80%) than those who were contacted by letter (17%) subsequently came to the OHS. One probable spin-off effect of the project was that 23 persons outside the screened group contacted the OHS about their alcohol abuse problems. The results indicate that it is feasible to use screening and secondary preventive methods at the workplace to discover alcohol abuse.     

A Commentary on the Unique Developmental Considerations of Youth: Integrating the Teenage Cortex into the Occupational Health and Safety Context

Abstract

This commentary responds to Sudhinaraset and Blum's article in this issue, and seeks to integrate a growing body of development research into existing occupational health and safety (OHS) research, policy and practice. We suggest that it is useful to distinguish between research questions regarding minimum age restrictions for hazardous tasks and jobs from research questions about the degree to which developmental factors contribute to elevated work injury risk for youth compared to adults. Epidemiological evidence indicates that known OHS risk factors adversely affect workers of all ages to a similar extent; a balanced approach is needed to integrate emerging developmental research with existing epidemiological research so that the abilities of young workers are not prejudged solely on the basis of age and brain maturation. Further, the heterogeneity of cognitive and self-regulatory functioning at any age suggests that architectural principles of Universal Design be employed in OHS training and hazard reduction.     

Coverage of work related fatalities in Australia by compensation and occupational health and safety agencies

Aims: To determine the levels of coverage of work related traumatic deaths by official occupational health and safety (OHS) and compensation agencies in Australia, to allow better understanding and interpretation of officially available statistics.

Methods: The analysis was part of a much larger study of all work related fatalities that occurred in Australia during the four year period 1989 to 1992 inclusive and which was based on information from coroners' files. For the current study, State, Territory, and Commonwealth OHS and compensation agencies were asked to supply unit record information for all deaths identified by the jurisdictions as being due to non-suicide traumatic causes and which were identified by them as being work related, using whatever definitions the agencies were using at the relevant time. This information was matched to cases identified during the main study.

Results: The percentage of working deaths not covered by any agency was 34%. Only 35% of working deaths were covered by an OHS agency, while 57% were covered by a compensation agency. The OHS agencies had minimal coverage of work related deaths that occurred on the road (to workers (8%) or commuters (3%)), whereas the compensation system covered these deaths better than those of workers in incidents that occurred in a workplace (65% versus 53%). There was virtually no coverage of bystanders (less than 8%) by either type of agency. There was marked variation in the level of coverage depending on the industry, occupation, and employment status of the workers, and the type of injury event involved in the incident.

Conclusions: When using data from official sources, the significant limitations in coverage identified in this paper need to be taken into account. Future surveillance, arising from a computerised National Coroners Information System, should result in improved coverage of work related traumatic deaths in Australia.

     

Prevalence of occupational injury and its contributing factors among rubber tappers in Galle,Sri Lanka

Background: Rubber tapping involves carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injury among this vulnerable working population.

Objective: To assesses the prevalence, severity, and contributing factors associated with occupational injury among Sri Lankan rubber tappers and to identify possible interventions to improve occupational safety.

Methods: A questionnaire was administered to 300 Sri Lankan rubber tappers. The associations between tapper characteristics and injury within the last year were examined using log-binomial regression models. Short response answers were analyzed using qualitative content analysis.

Results: 300 tappers reported 594 injuries in the previous 12 months, and missed 1,080 days of work. The prevalence of one or more injuries was 49%. Factors associated with injury were being female, working an additional job, tapping with a two-handed approach, and depressive symptomology. Qualitative findings suggest three interventions to address injuries: (1) landscaping, (2) personal protective equipment, and (3) provision of eyeglasses.

Conclusions: Work-related injuries are common among Sri Lankan rubber tappers. These results highlight the importance of working with and including informal workers in the creation of Sri Lankan occupational health and safety regulations. We believe that the three interventions identified by respondents could help to reduce the risk of occupational injury among rubber tappers.     

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.     

Perceived occupational balance and well-being among people with mental illness living in two types of supported housing

Abstract

Background: People with psychiatric disabilities often struggle with maintaining a satisfying occupational balance. Knowledge about factors of relevance for occupational balance in this group is therefore vital for improving their support.

Aim: The aim was to describe perceptions of occupational balance among people with psychiatric disabilities living in supported housing (SH) or in own flat/house with housing support (OHS). Potential importance of housing context and socio-demographic, well-being and recovery factors for occupational balance was also explored.

Methods: Participants from SH (N?=?155) and OHS (N?=?111) responded to questionnaires about sociodemographic situation, well-being (self-rated health, life satisfaction and self-mastery), personal recovery and occupational balance (work, leisure, home chores, self-care and general balance assessed by SDO-OB).

Results: A majority in both groups reported being in balance regarding all five domains of occupational balance. The OHS group reported being more under-occupied for home chores and self-care. Self-mastery was the most important contributor in both groups in the domains of work, domestic chores and self-care. Day center attendance was vital for general occupational balance.

Conclusion: Both groups generally perceived occupational balance. Control over one’s life situation and possibilities for regularly participating in occupations outside the home environment should receive high priority in housing support.     

System Failure: Work Organization and Injury Outcomes among Latino Forest Workers

ABSTRACT

Objectives: Forestry services is a hazardous industry with high job-related injury, illness, and fatality rates. The Northwest workforce is largely Spanish-speaking, Latino, and immigrant, working in poor conditions with insufficient attention paid to safety and health. Institutional racism fundamentally shapes the structural vulnerability of Latino immigrant workers. Given this context, we sought to understand how workplace organizational factors and safety climate affect job-related injuries in this industry.

Methods: We developed 23 case studies from personal interviews after selecting from an initial participant survey pool of 99 Latino forest workers in southern Oregon who had been injured at work in the previous 2 years. Workers were recruited through snowball sampling and door-to-door canvassing. Questions spanned work conditions, tasks, employer safety practices, injury experience, medical treatment, and workers’ compensation benefits.

Results: Workers reported broken bones, chainsaw lacerations, back pain, heat and pesticide illnesses, and other occupational injuries. One-third of the cases fell into a Systems Functional category in which they reported their injuries to their supervisors and received medical treatment and workers’ compensation benefits. The remaining two-thirds experienced System Failures with difficulties in receiving medical treatment and/or workers’ compensation benefits, employer direction to not report, being fired, or seeking alternative home remedies.

Conclusion: Workers employed by companies with more indicators of safety climate were more likely to obtain adequate treatment for their injuries and fully recover. Workers for whom interpretation at medical exams was provided by someone unaffiliated with their employers also reported better treatment and recovery outcomes.     

Expression of concern: false claim to be free of conflicts in asbestos biopersistence debate

Abstract

Background: Participatory training on occupational health is widely used in the world. Evaluations of local experiences are necessary to its successful performance.

Objectives: The project evaluated the effectiveness of participatory training on occupational health improvement in small and medium enterprises of China, and explored local practice experiences.

Methods: Participatory training was provided to 525 welding workers from 25 small and medium enterprises in ship building and machinery manufacturing industries. This training consisted of interactive learning, worksite assessment and group discussion on laws/regulations, safety of machine operation, prevention of slips and trips, fire/explosion prevention, ergonomics, and recognition and prevention of other workplace hazards. Workers completed knowledge, attitude, and practice and worksite assessement questionnaires before and 3 months after intervention.

Results: Knowledge, attitude, and practice scores were significantly increased through the training. An inventory of workplace safety modifications was proposed by participants and many were fixed by workers and employers. Health management and personal protective equipment provision/use were most often improved, but improvements in engineering control and health-related accommodations remained unsatisfactory.

Conclusions: Workers could recognize and fix workplace hazards after the participatory training. More efficient measures in China are to be explored to improve implementing solutions, especially on preventive engineering and human ergonomics.     

Prevalence and risk factors associated with work-related eye injuries in Bosnia and Herzegovina

Background: Eye injuries are a prevalent workplace injury and cause substantial disability when vision is impaired.

Objective: To examine work-relatedness of demographic, injury, and clinical characteristics of eye injuries in a large clinic in Bosnia and Herzegovina.

Methods: We performed a nine-year retrospective study of patients admitted with an eye injury to the Canton Hospital in Zenica, Bosnia and Herzeogvina. Controlling for age and sex, we used logistic regression to examine the influence of work-relatedness on patient and injury characteristics and clinical outcomes.

Results: Of 258 patients, 71 (27.5%) had work-related and 180 (69.8%) had non-work-related eye injuries. Work-related eye injury was associated with age, education, occupation, and injury type. Agricultural workers were eight times more likely to experience work-related eye injury (95%CI = 1.21–152.0) compared to manual workers. Work-relatedness of injury did not predict final visual acuity or length of hospital stay.

Conclusion: Promotion of eye safety is needed countrywide. Occupational eye protection is a priority due to the relatively proportion of eye injuries and the workplace being a relatively controlled environment.     

Occupational health in South Korea

The government-initiated Annual Workers Health Examination Program and the Industrial Accident Compensation Program both of which are delivered from outside the workplace mainly by a handful of service agents have remained the cornerstones of occupational health and safety (OHS) policy in South Korea since the 1960s. Initially, policies centered on the technical dimensions of OHS problems. This acultural approach is no longer efficient, and the scope of problems that can be dealt with is limited. The injury rate has gone down from 6 to less than 1 injury per 100 insured workers, but since the 1980s there has been no sign of improvement in the death rate from industrial accidents, and future improvement in the injury rate is not expected. As South Korea is facing major economic and social changes, review of current OHS policy is also underway. International collaborations and comparisons will surely add thoughtful perspectives to this discussion.     

Trauma in Hispanic Farm Workers in Eastern North Carolina

Abstract

Context: In spite of the attention directed at the problem of occupational injuries within the farm environment and at the general health status of migrant farm workers in the United States, there have been no studies focusing on the risk for traumatic injury in general for this disadvantaged group.

Purpose: Trauma affecting Eastern North Carolina Hispanic farm workers was quantified and certain risk factors were found.

Methods: Through chart review and retrieval of trauma registry information, patient occupational history, injury patterns, treatment variables as well as outcome and hospital charges were determined and compared with data for Hispanic construction workers and other service area males.

Findings: Two hundred fifty-six Hispanic farm workers were admitted to the trauma center from July1992 to June 2002, which is comparable to the risk (0.1%) of being admitted to the trauma center for an age-matched service area male. Only 5% of injuries occurred during farm work, 21% were penetrating injuries, and in 66% ofcases (compared to 51% for other age-matched males) alcohol was involved.

Conclusion: Most trauma affecting Hispanic farm workers in Eastern North Carolina is not directly occupational and happens in conjunction with recreational activity, where alcohol is an important risk factor. The human and financial cost resulting from such injuries is of such magnitude that it deserves consideration by everybody who is involved in shaping policies in agriculture, immigration and rural public health.     

Occupational health and safety among commercial sex workers

The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety.     

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.     

The global expansion of precarious employment, work disorganization, and consequences for occupational health: a review of recent research.

In this review of a range of studies on the health and safety effects of precarious employment in industrialized societies published since 1984, the authors examine the overall findings and methodological issues and identify areas in need of further research. Of the 93 published journal articles and monographs/book chapters reviewed, 76 studies found precarious employment was associated with a deterioration in occupational health and safety (OHS) in terms of injury rates, disease risk, hazard exposures, or worker (and manager) knowledge of OHS and regulatory responsibilities. Of the more than 25 studies each on outsourcing and organizational restructuring/downsizing, well over 90 percent find a negative association with OHS. The evidence is fairly persuasive for temporary workers, with 14 of 24 studies finding a negative association with OHS. The evidence is less strong for small business, and a handful of studies on part-time workers found no clear association with negative OHS outcomes (in some cases the reverse). Further research is needed to more clearly link health effects to particular business practices and neoliberal policies and to explore the regulatory implications of the growth of precarious employment. The authors suggest some ways to conceptualize the association between precarious employment and occupational health.     

Living Conditions,Access to Healthcare Services,and Occupational Health and Safety Conditions of Migrant Seasonal Agricultural Workers in the Çukurova Region

Objective: Migrant seasonal agricultural workers who are employed in one of the most hazardous occupations in Turkey experience difficulties in accessing health-care services. The aim of this study is to investigate the living conditions, access to health-care services, and occupational health and safety conditions of migrant seasonal agricultural workers in the Çukurova region.

Methods: Four hundred migrant seasonal agricultural workers were contacted in the county of Karata? located in the province of Adana, Turkey. A four-section questionnaire was administered using face-to-face interview techniques.

Results: The mean age of the participants was 32.8 ± 12.4 years. One-fourth of the participants did not have any social security coverage. Almost all had a monthly income below minimum wage, and 98% were living in tents. One-fifth experienced health problems in the last year, and 63% of them visited a health-care facility for diagnosis and treatment. About 3.3% of the participants sustained injuries at work, and only 23% of them visited a health-care facility.

Conclusion: The findings of the study show that migrant seasonal agricultural workers in Turkey have insufficient working conditions, wages, accommodation facilities, nutrition opportunities, health conditions, and occupational health and safety conditions. This insufficiency negatively affects life qualities of the workers, utilization of health-care services, and their occupational health status and safety.     

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.     

Occupational health and safety in cannabis production: an Australian perspective

The legal Australian cannabis industry has been rapidly expanding due to increased awareness of the plant’s therapeutic potential, as well its diverse range of applications including biofuel, textiles, building materials, food, nutritional supplement, and animal feed. The objective of this paper is to describe the current landscape of the commercial Australian cannabis industry, summarise occupational health and safety (OHS) hazards in cannabis-related working environments, and provide suggestions for safeguarding worker health and well-being in this emerging industry.

A comprehensive search of peer-reviewed and grey literature published between 1900 and 2017 was undertaken to identify case studies and original epidemiological research on OHS hazards associated with the cannabis cultivation and the manufacture of cannabis-based products. The review found that the majority of OHS studies were undertaken in the hemp textile industry during the late twentieth century, with a small number of articles published from a variety of occupational environments including forensic laboratories and recreational marijuana farms. Cannabis harvesting and initial processing is labour intensive, and presents a physical hazard Depending on the operation, workers may also be exposed to a variety of biological, chemical, and physical hazards including: organic dusts, bioaerosols, pollen/allergens, volatile organic compounds, psychoactive substances (tetrahydrocannabinol [THC])), noise, and ultraviolet radiation.

Little research has been undertaken on the exposure to inhalable organic dust and other bioaerosols during the commercial cultivation and manufacture of cannabis-based products. Furthermore, there is an absence of Australian-based research and OHS guidance materials to help professionals develop risk management strategies in this evolving industry.

It is recommended that:

• Investigation into the toxicological properties of cannabis dusts, specifically in relation to potential occupational exposures during cultivation and manufacture, should be a priority.

• The interim adoption of the respirable cotton dust exposure standard of 0.2 mg/m³ for workplace exposure in hemp facilities until a cannabis workplace exposure standard is developed, and that exposure to medicinal cannabis containing THC are kept as low as reasonably practicable.

• An industry partnership be established for the development of an Australian health and safety guideline for the production of medicinal cannabis and hemp.

• A classification to meet the requirements of the Global Harmonization Scheme should be undertaken to ensure consistency in the use of safety and risk phrases in cannabis-related industries.

     

Working conditions,psychosocial environmental factors,and depressive symptoms among wage workers in South Korea

Background: In South Korea, the number of workers suffering from mental illnesses, such as depression, has rapidly increased. There is growing concern about depressive symptoms being associated with both working conditions and psychosocial environmental factors.

Objectives: To investigate potential psychosocial environmental moderators in the relationship between working conditions and occupational depressive symptoms among wage workers.

Methods: Data were obtained from the wage worker respondents (n = 4,095) of the Korean National Health and Nutrition Examination Survey of 2009. First, chi-square tests confirmed the differences in working conditions and psychosocial characteristics between depressive and non-depressive groups. Second, multivariate logistic regression analysis was performed to examine the moderating effects of the psychosocial environmental factors between working conditions and depressive symptoms.

Results: After adjusting for potential covariates, the likelihood of depressive symptomatology was high among respondents who had dangerous jobs and flexible work hours compared to those who had standard jobs and fixed daytime work hours (OR = 1.66 and 1.59, respectively). Regarding psychosocial factors, respondents with high job demands, low job control, and low social support were more likely to have depressive symptoms (OR = 1.26, 1.58 and 1.61, respectively).

Conclusions: There is a need to develop non-occupational intervention programs, which provide workers with training about workplace depression and improve social support, and the programs should provide time for employees to have active communication. Additionally, companies should provide employees with support to access mental healthcare thereby decreasing the occurrence of workplace depression.