Functional capacity of people with early osteoarthritis: a comparison between subjects from the cohort hip and cohort knee (CHECK) and healthy ageing workers

Objective

The prevalence of osteoarthritis (OA) increases, but the impact of the disorder on peoples’ functional capacity is not known. Therefore, the objective of this study was to compare self-reported health status and functional capacity of subjects with early OA of hip and/or knee to reference data of healthy working subjects and to assess whether this capacity is sufficient to meet physical job demands.

Methods

Self-reported health status and functional capacity of 93 subjects from the Cohort Hip and Cohort Knee (CHECK) were measured using the Short-Form 36 Health Survey and 6 tests of the Work Well Systems Functional Capacity Evaluation. Results were compared with reference data from 275 healthy workers, using t-tests. To compare the functional capacity with job demands, the proportions of subjects with OA performing lower than the p₅ of reference data were calculated.

Results

Compared to healthy workers, the subjects (mean age 56) from CHECK at baseline reported a significantly worse physical health status, whereas the women (n = 78) also reported a worse mental health status. On the FCE female OA subjects performed significantly lower than their healthy working counterparts on all 6 tests. Male OA subjects performed lower than male workers on 3 tests. A substantial proportion of women demonstrated functional capacities that could be considered insufficient to perform jobs with low physical demands.

Conclusions

Functional capacity and self-reported health of subjects with early OA of the hips and knees were worse compared to healthy ageing workers. A substantial proportion of female subjects did not meet physical job demands.     

Differences in predictors for return to work following musculoskeletal injury between workers with and without somatic comorbidities

Purpose

In workers with musculoskeletal injuries, comorbidity is associated with worse return to work (RTW) outcomes. In the context of RTW, it is unclear whether associations between predictors and RTW are similar or different for workers with and without comorbidity. This study aims to investigate differences and similarities between workers with and without comorbidity in 12-month predictors for RTW in workers who are absent from work due to a musculoskeletal injury.

Methods

All workers with lost-time claims who were off work at baseline were selected from the Early Claimant Cohort (Canada) (n = 1,566). Follow-up data on RTW were available of 810 workers after 12 months. Predictors included demographic, health-related, and work-related factors. Differences between coefficients of the groups with and without comorbidity were tested.

Results

Low household income was a predictor for RTW in workers without comorbidity only. Better mental health was a predictor for RTW in workers with comorbidity only. Higher education, less pain intensity, better general health, less bodily pain, better physical health, and a positive supervisor response were predictors for RTW in the total group.

Conclusions

Injured workers with and without comorbidity should be considered as two distinct groups when focusing on mental health or household income.     

Observations of Group Care Worker-Child Interaction in Residential Youth Care: Pedagogical Interventions and Child Behavior

Background

The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children.

Objective

The aim of the current study was to observe the pedagogical interventions of group care workers within residential youth care and their associations with child behaviors.

Methods

Group care worker interventions and child behaviors were videotaped during structured observations. Participants included 95 children (64 % boys, M _age = 9.19) and 53 group care workers (74 % female, M _age = 33.79 years). A coding system was developed to code pedagogical interventions and child behaviors.

Results

It showed that group care workers mainly used positive pedagogical interventions (warmth/support and positive control) and seldom used negative pedagogical interventions (permissiveness and negative control). Frustration and anger of children was associated with positive controlling interventions and permissiveness of group care workers. The hypothesis that child anxiety and nervousness is associated with warm and supportive interventions could not be confirmed.

Conclusions

Pedagogical interventions should be part of education, training, and supervision of group care workers.     

A Challenging Job: Physical and Sexual Violence Towards Group Workers in Youth Residential Care

Background

Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about sexual harassment in addition to physical victimization of social workers in youth residential or group care.

Objective

We investigated the prevalence of physical and sexual victimization of youth care workers in residential care and tested whether characteristics of the group care workers and the type of care facility influenced this prevalence.

Methods

One hundred seventy-eight participants reported whether they had experienced verbal threat, physical threat, physical violence, verbal sexual harassment, and physical sexual harassment by one or more of the youth they worked with in a 1-year period.

Results

Eighty-one percent of the group workers experienced violence. Most incidents were verbal threats, but about half of the participants experienced physical violence. Youth care workers from secure care were most at risk for experiencing physical and verbal violence and workers from juvenile detention facilities were most at risk for experiencing sexual harassment. Rates of violence were increased for participants working with children with a mild intellectual disability. Gender of the youth care workers was not related to the rate of victimization, but age was: younger group workers reported more incidents than older group workers.

Conclusions

The high levels of violence in residential youth care indicate that residential care is not the best workplace for professionals nor the best rearing setting for youth. Alternative care settings, such as treatment in a family-type environment, should be explored.     

The impact of a recent relapse on patient-reported outcomes in subjects with multiple sclerosis

Purpose

In this study, we estimate the impact of a recent relapse on physical and mental health in subjects with relapsing-remitting multiple sclerosis (RRMS) using validated patient-reported outcome (PRO) measures.

Methods

Subjects enrolled in the Comprehensive Longitudinal Investigation of MS at the Brigham and Women??s Hospital with RRMS were eligible for enrollment. Subjects with a clinical visit within 45?days of a relapse were identified and divided into groups based on whether the relapse occurred before (recent relapse) (n?=?59) or after the visit (pre-relapse) (n?=?31). A group of subjects with no relapses was also identified (remission) (n?=?336). PRO measures in these three groups were compared. All outcomes were compared using a t test and linear regression controlling for age, disease duration, sex, and EDSS.

Results

Subjects with a recent relapse had significantly worse functioning on several physical and mental health scales compared to subjects in remission even after adjusting for potential confounders. Subjects with a recent relapse also showed significant deterioration on PRO measures over 1?year compared to subjects in remission (P?<?0.05 for each comparison). Subjects in the pre-relapse group were not significantly different than subjects in remission.

Conclusions

Clinical relapses have a measurable effect on PRO in subjects with RRMS.     

Cooling Towers contribute to the high seroprevalence of Legionella pneumophila antibody among hotel workers

Objectives

Regular disinfection work of the cooling towers (CTs) were carried out according to schedule, nevertheless 89.6% of the CTs were still found to be colonized by Legionella pneumophila in our survey in Changzhou city, China. The aim of the study was to observe the effect of L. pneumophila on workers exposed to contaminated cooling towers (CT).

Methods

A total of 364 subjects were randomly selected for the serum testing and the questionnaire survey. They were either from the hotel with contaminated CTs or without CTs (used as control). heir serum anti-L. pneumophila antibodies were tested using commercial IFA kits.

Results

The results showed that the prevalence of anti-L. pneumophila group 1 antibodies in the exposed population was significantly higher than control subjects (OR?=?2.845, P?=?0.019). The possible confounding factors were analyzed. Questionnaires results analysis found that the frequency of flu-like symptoms in the exposed group was also significantly higher; and the indoor air quality was related to the serum anti-L. pneumophila group 1.

Conclusions

The L. pneumophila contaminated CTs contribute to the high seroprevalence of anti-L. pneumophila antibodies; tap water and shower water are also possible contamination resources.     

Across-shift changes of exhaled nitric oxide and spirometric indices among cotton textile workers

Objectives

For the purpose of evaluation of exhaled NO as an index of airway inflammation, we assessed changes in fractional exhaled NO (FeNO) across a work shift and its relationship with respiratory complaints.

Material and Methods

Chronic and work-aggravated respiratory complaints were assessed using a questionnaire in 89 male textile workers. FeNO and spirometry were performed before and after a work shift and all the changes were registered.

Results

A significant increase in FeNO after a work shift was observed. Post-shift FeNO was significantly higher among the subjects with chronic respiratory complaints. There was an obvious decrease in FVC, and FEV₁ after a work shift; however, we couldn’t find a significant relationship between changes in respiratory parameters and concentration of inhalable dusts.

Conclusions

FeNO increase after a work shift along with pulmonary function decrement and higher post-shift FeNO among subjects with respiratory complaints makes across-shift FeNO a non-invasive test for assessment of airway hyper-responsiveness in textile workers.     

Workers' load and job-related stress after a reform and work system change in a hospital kitchen in Japan

Objectives

Many kitchen work environments are considered to be severe; however, when kitchens are reformed or work systems are changed, the question of how this influences kitchen workers and environments arises. The purpose of this study is to examine whether there was a change in workload and job-related stress for workers after a workplace environment and work system change in a hospital kitchen.

Methods

The study design is a pre–post comparison of a case, performed in 2006 and 2008. The air temperature and humidity in the workplace were measured. Regarding workload, work hours, fluid loss, heart rate, and amount of activity [metabolic equivalents of task (METs)] of 7 and 8 male subjects pre- and post-reform, respectively, were measured. Job-related stress was assessed using a self-reporting anonymous questionnaire for 53 and 45 workers pre- and post-system change, respectively.

Results

After the reform and work system change, the kitchen space had increased and air-conditioners had been installed. The workplace environment changes included the introduction of temperature-controlled wagons whose operators were limited to male workers. The kitchen air temperature decreased, so fluid loss in the subjects decreased significantly. However, heart rate and METs in the subjects increased significantly. As for job-related stress, although workplace environment scores improved, male workers’ total job stress score increased.

Conclusions

These results suggest that not only the workplace environment but also the work system influenced the workload and job stress on workers.     

Cadmium and hypertension in exposed workers: A meta-analysis

Objectives

In the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers.

Materials and Methods

After analyzing all the relevant articles found in the literature, 6 publications were selected.

Results

A higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects.

Conclusions

Cadmium in occupationally-exposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.     

Respiratory health and breath condensate acidity in sawmill workers

Purpose

The aim of the study was to evaluate exhaled breath condensate acidity (EBC pH) as a biomarker of airway response to occupational respiratory hazards present in sawmill.

Methods

Sixty-one sawmill workers in total (26 from Sawmill 1 and 35 from Sawmill 2) provided EBC samples at the beginning and at the end of the working week. Respiratory symptoms, lung function, bronchodilator test and atopy status were assessed. Occupational environment was checked for the levels of respiratory hazards.

Results

Airborne dust concentrations were below threshold limit value. Endotoxin in Sawmill 1 and Sawmill 2, and moulds in Sawmill 1 were at the levels able to induce inflammatory response in the airways. Mould levels were 2.5 times higher in Sawmill 1 than in Sawmill 2. Compared to Sawmill 2 workers, lower spirometry values, higher prevalence of dry cough and positive bronchodilator test were found in Sawmill 1 workers. Monday EBC pH values did not differ between sawmills, but declined after one working week in Sawmill 1 workers (from 7.88 to 7.49, P = 0.012) and not in Sawmill 2 workers. Similar results were obtained when only respiratory healthy non-smokers were analysed. Monday-to-Friday change of other respiratory parameters was not observed.

Conclusion

The results suggest EBC pH as a biomarker of acute respiratory effects related to occupational exposure to respiratory hazards in sawmills, presumably increased mould levels. The effect was present even at subclinical level, namely in respiratory healthy subjects. The long-term health implications remain unclear and should be evaluated in a follow-up study.     

Assessment of occupational health problems and physiological stress among the brick field workers of West Bengal,India

Objectives

The brick field industry is one of the oldest industries in India, which employs a large number of workers of poor socioeconomic status. The main aim of the present investigation is i) to determine the prevalence of musculoskeletal disorders among brick field workers, ii) to determine the prevalence of respiratory disorders and physiological stress among brick field workers compared to control workers.

Material and Methods

For this study, a total of 220 brick field workers and 130 control subjects were selected randomly. The control subjects were mainly involved in hand-intensive jobs. The Modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Thermal stress was also assessed by measuring the WBGT index. The pulmonary functions were checked using the spirometry. Physiological assessment of the workload was carried out by recording the heart rate and blood pressure of the workers prior to work and just after work in the field.

Results

Brick field workers suffered from pain especially in the lower back (98%), hands (93%), knees (86%), wrists (85%), shoulders (76%) and neck (65%). Among the brick-making activities, brick field workers felt discomfort during spading for mud collection (98%), carrying bricks (95%) and molding (87%). The results showed a significantly lower p value < 0.001 in FVC, FEV₁, FEV₁/FVC ratio and PEFR in brick field workers compared to the control group. The post-activity heart rate of the brick field workers was 148.6 beats/min, whereas the systolic and diastolic blood pressure results were 152.8 and 78.5 mm/Hg, respectively.

Conclusions

This study concludes that health of the brick field workers was highly affected due to working in unhealthy working conditions for a long period of time.     

Safety and adherence of Umezu polyphenols in the Japanese plum (Prunus mume) in a 12-week double-blind randomized placebo-controlled pilot trial to evaluate antihypertensive effects

Objectives

Medications or lifestyle changes to prevent or improve hypertension often press considerable efforts on patients suffering from mild hypertension. Capsules including Umezu polyphenols (UP), polyphenols in Japanese plums, may help them to control their blood pressure (BP). The aim of this study is to evaluate the effectiveness of UP on BP and its safety.

Methods

A total of 15 healthy workers without antihypertensive medication who had some concerns about their BP, preferably normal-high BP or hypertension level 1, were randomized in a double-blind manner into UP ingesting and placebo groups. Each subject was instructed to take four capsules daily for 12 weeks (daily UP dose, 800 mg for the UP ingesting group; and 0 mg for the placebo group). These subjects were followed for 12 weeks, and their BP both at home and at the examination site, as well as self-perceived quality-of-life outcomes and possible side effects, was monitored during that period. Group × time interactions on BP changes were examined.

Results

All of the 15 subjects completed the 12-week intervention trial. The BP changes did not significantly differ between the UP ingesting and placebo groups, neither at the examination site nor at home. But during the study period, no adverse effects were observed.

Conclusions

No remarkable effect of UP on BP was observed. However, a higher dose of UP was confirmed safe and high in adherence in this 12-week randomized controlled trial. Its effect on BP and other outcomes shall be confirmed in a larger sample.     

Skin symptoms in bakery and auto body shop workers: associations with exposure and respiratory symptoms

Purpose

Despite the importance of skin exposure, studies of skin symptoms in relation to exposure and respiratory symptoms are rare. The goals of this study were to describe exposure–response relationships for skin symptoms, and to investigate associations between skin and respiratory symptoms in bakery and auto body shop workers.

Methods

Data from previous studies of bakery and auto body shop workers were analyzed. Average exposure estimates for wheat allergen and isocyanates were used. Generalized linear models were constructed to describe the relationships between exposure and skin symptoms, as well as between skin and respiratory symptoms.

Results

Data from 723 bakery and 473 auto body shop workers were analyzed. In total, 5.3 % of bakery and 6.1 % of auto body shop workers were female; subjects’ mean age was 39 and 38 years, respectively. Exposure–response relationships were observed in auto body shop workers for itchy or dry skin (PR 1.55, 95 % CI 1.2–2.0) and work-related itchy skin (PR 1.97, 95 % CI 1.2–3.3). A possible exposure–response relationship for work-related itchy skin in bakery workers did not reach statistical significance. In both groups, reporting skin symptoms was strongly and significantly associated with reporting respiratory symptoms, both work-related and non-work-related.

Conclusions

Exposure–response relationships were observed for skin symptoms in auto body shop workers. The lack of significant exposure–response associations in bakery workers should be interpreted cautiously. Workers who reported skin symptoms were up to four times more likely to report respiratory symptoms. Improved awareness of both skin and respiratory outcomes in exposed workers is needed.     

Cameroon mid-level providers offer a promising public health dentistry model

Background

Research on the mal-distribution of health care workers has focused mainly on physicians and nurses. To meet the Millennium Development Goal Five and the reproductive needs of all women, it is predicted that an additional 334,000 midwives are needed. Despite the on-going efforts to increase this cadre of health workers there are still glaring gaps and inequities in distribution. The objectives of this study are to determine the perceived barriers and motivators influencing final year midwifery students?? acceptance of rural postings in Ghana, West Africa.

Methods

An exploratory qualitative study using focus group interviews as the data collection strategy was conducted in two of the largest midwifery training schools in Ghana. All final year midwifery students from the two training schools were invited to participate in the focus groups. A purposive sample of 49 final year midwifery students participated in 6 focus groups. All students were women. Average age was 23.2?years. Glaser??s constant comparative method of analysis was used to identify patterns or themes from the data.

Results

Three themes were identified through a broad inductive process: 1) social amenities; 2) professional life; and 3) further education/career advancement. Together they create the overarching theme, quality of life, we use to describe the influences on midwifery students?? decision to accept a rural posting following graduation.

Conclusions

In countries where there are too few health workers, deployment of midwives to rural postings is a continuing challenge. Until more midwives are attracted to work in rural, remote areas health inequities will exist and the targeted reduction for maternal mortality will remain elusive.     

Dietary folic acid intake differentially affects methionine metabolism markers and hippoccampus morphology in aged rats

Purpose

Folic acid (FA) is an emerging nutritional factor in the pathogenesis of diverse neurodegenerative disorders by still unknown mechanisms. The hippocampus is altered during the loss of cognitive abilities in humans and selectively affected when homocysteine increases. The aim was to evaluate the potential protective role of folic acid in the maintenance of biochemical markers related to the methionine cycle, as well as the integrity of the hippocampus as part of the brain in aged rats.

Methods

Male Sprague–Dawley rats (18 months old) were assigned to four different folic acid groups (0 mg FA/kg diet, deficient; 2 mg FA/kg diet, control; 8 mg FA/kg diet, moderate supplementation; 40 mg FA/kg diet, extra supplementation) for 30 days. We evaluated several parameters related to the methionine cycle. In addition, hippocampus areas were immunostained for specific neuronal markers and astrocytes.

Results

Serum folate levels increased according to FA dietary level (p < 0.01). There was a significant increase in the serum homocysteine concentrations in the folic acid-deficient diet group (p < 0.01). However, brain S-adenosylmethionine and S-adenosylhomocysteine did not differ significantly between the folic acid groups. Consequently, the methylation ratio was also unchanged. The morphometric analysis did not show any differences in the number of neurons and astrocytes between groups, except when comparing the folic acid-deficient diet versus folic acid-supplemented diet in the striatum of the hippocampus.

Conclusions

Clearly, the dietary FA deficiency negatively affects the methionine metabolism biomarkers, while excessive supplementation seems to be unnecessary for optimal maintenance of the methylation cycle and hippocampus integrity.     

Pandemic and seasonal vaccine coverage and effectiveness during the 2009–2010 pandemic influenza in an Italian adult population

Objectives

To evaluate the response to pandemic vaccination and seasonal and pandemic vaccine effectiveness (VE) in an Italian adult population, during the 2009?C2010 influenza season.

Methods

Data were recorded by interviewing 19,275 subjects (??35?years), randomly recruited from the general population of the Moli-sani project. Events [influenza-like illness (ILI), hospitalization and death], which had occurred between 1 November 2009 and 31 January 2010 were considered. VE was analyzed by multivariable Poisson regression analysis.

Results

Pandemic vaccine coverage was very low (2.4%) in subjects at high-flu risk, aged 35?C65?years (N?=?8,048); there was no significant preventive effect of vaccine against ILI. Seasonal vaccine coverage was 26.6% in the whole population (63% in elderly and 21.9% in middle-aged subjects at high-flu risk). There was a higher risk to develop ILI in middle-age [VE: ?17% (95% CI: ?35,?1)] or at high flu-risk [VE: ?17% (95% CI: ?39, 2)] vaccinated groups.

Conclusions

Coverage of pandemic vaccine was very low in a Southern Italy population, with no protective effect against ILI.     

Prevalence of exposure to occupational risks during pregnancy in Spain

Objectives

We describe reported exposures to main categories of occupational agents and conditions in Spanish pregnant workers.

Methods

Women were recruited at 12th week of pregnancy from main public gynaecological consults to be included in the INMA Spanish cohorts study (n?=?2,058). Through personal interviews with structured questionnaires, information on working situation and working conditions during pregnancy was obtained.

Results

Fifty percent of the women reported frequent exposure to physical load (standing, heavy lifting) and 45?% reported exposure to three or more indicators of job strain. Exposure to at least one physical agent (noise, vibrations, etc.) affected 25?% of the women. Exposure to chemicals was reported by 20?% of the women, mostly including solvents and cleaning products. Eight percent of the women worked at night shifts. Job strain was more prevalent in office workers and industrial operators. Industrial workers showed the highest prevalence of exposure to chemical and physical pollutants.

Conclusions

Our data suggest that working conditions of pregnant women may need increased control in Spain.     

Prevalence of respiratory symptoms and disorders among rice mill workers in India

Objectives

Lung function tests have become an integral part of assessment of pulmonary disease. Diseases of the respiratory system induced by occupational dusts are influenced by the duration of exposure. The aim of the study is to investigate the impairment of lung function and prevalence of respiratory symptoms among the rice mill workers.

Methods

A total of 120 rice mill workers from three districts of Karnataka were included in this study. Fifty urban dwellers from the same socio-economic level were selected as controls. The study included clinical examination, assessment of respiratory symptoms, pulmonary function test, measurement of peak expiratory flow rate, absolute eosinophil count, ESR estimation, total IgE estimation and radiographic test.

Results

The present study has shown that the rice mill workers complained of several types of respiratory disorders like phlegm (40.8 %), dyspnea (44.2 %), chest tightness (26.7 %), cough (21.7 %), and nose irritation (27.5 %). Rice mill workers exposed to dust presented significantly (p < 0.05) lower levels of FVC (3.44 ± 0.11), FEV₁ (2.73 ± 0.15) and PEFR (304.95 ± 28.79) than the controls. The rice mill workers are having significantly higher absolute eosinophil counts, total IgE and ESR than control groups. The hematological findings suggest that the harmful effects may be linked to both non-specific irritation and allergic responses to rice husk dust among rice mill workers.

Conclusion

Dust exposure in the working environment affects the lung function values and increased the respiratory symptoms among the rice mill workers.