International Code of Conduct (Ethics) for Occupational Health and Safety Professionals

Abstract

This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.     

Gendered bodies: recruitment,management and occupational health in northern Thailand's electronics factories

This paper explores workers' experiences and understandings of occupational health hazards in the electronics industries of northern Thailand. Women form the bulk of the lower-level workforce as operators responsible for assembling the parts that make up microchip components. Drawing data from 16 months of research in workers' dormitories, formal and informal interviews and questionnaire surveys, in this paper I explore how gender relations are central to the organization and experience of work in these industries. I identify "work process" health hazards resulting from the physical working environment, and "workplace" health hazards relating to the organizational and social pressures of the working environment. Musculoskeletal pain, eye strain, chemical exposure, stress, improper use of safety equipment and accidents all impact upon women workers' health. Additionally, risk behaviors such as amphetamine and alcohol use, and unprotected sex, are associated with the social context of factory work.     

Perspectives for Workplace Health Promotion in Latin America and the Caribbean

Abstract

The Latin American and Caribbean region is witnessing the emergence of discussion on workplace health promotion (WHP). The authors propose WHP as an equitable collective action targeting primarily work hazards and their determinants. It has its economic-political “macro” level and a downstream “micro” level. On the macro level, neoliberalism, privatization, and deregulation threaten equitable health and labor issues. Effective labor and health legislation and a fair degree of social redistribution of resources support WHP. Micro-scale WHP is important for contextual reasons and social diffusion, and can literally save lives. Worker involvement, free association of workers, public health affiliation, the precautionary principle, sensitization and training, employer responsibility for healthy working conditions, coalitions between workers and health professionals, and preference for reduction of direct work hazards over modification of personal lifestyles are basic tenets of WHP.     

Comparison of occupational health problems of employees and self-employed individuals who work in different fields

Abstract

We used a representative sample of the working population of Korea to compare the occupational health problems of employees and self-employed individuals who performed different types of work. The Korean Working Conditions Survey (KWCS) of 2014 was used to compare the working conditions and occupational safety and health (OSH) issues of employees and self-employed individuals performing different types of work. Relative to paid employees, self-employed individuals were older, more likely to perceive their health as bad, and had less education, longer working hours, more exposure to workplace ergonomic hazards, more musculoskeletal problems, and poorer mental well-being. Relative to those performing “mental work” or “emotional work”, individuals performing “physical work” were more vulnerable to OSH problems. In conclusion, self-employed individuals in the sample were more vulnerable to OSH problems.     

Health discourse and within-group stigma in professional BDSM

This article directly deals with health and stigma within practices of erotic labor. Scant previous literature has focused on erotic laborers' perceptions of stigma and the ways in which regimes of stigmatization operate within their particular social worlds. I use the commercial BDSM (Bondage, Discipline, Sadism, Masochism) “dungeon” as a strategic research site to investigate these workers' conceptions and management of their own stigma, and I find that discourses about stigma are inextricably entwined with concerns about health and wellbeing. Data are derived from ethnographic fieldwork with professional dominatrices (“pro-dommes”) who work in New York City and San Francisco as well as in-depth interviews conducted between September 2007 and April 2008. Counter to stereotypes of erotic laborers as violent or as vectors of disease, BDSM workers are in fact not only concerned about safety but professionally invested in it, reinforcing it through an identity politics of hierarchies of erotic labor. There are multiple implications of this work for public perception and policy—implications that could only be brought to light through the ethnographic method.     

My body,my self

This satirical paper gives the reader a tour of the author's own body with appropriate caveats regarding social emphasis on women's outward appearance at the expense of health, comfort, and creative work. The decision about whether a woman should give in to social pressure and follow fashion, or opt for mental and physical health is within the power of the body's owner; in other words, “my self.”;     

Occupational hearing loss in Washington state, 1984–1991: I. statewide and industry-specific incidence

This study examined non-federal workers' compensation claims accepted for hearing-related conditions in Washington state during 1984–1991. Seventy percent of 6,539 filed claims were accepted (n = 4,547); most accepted claims resulted in disability compensation (n = 3,660; 80%). A transient 50-fold increase in claims from one worksite accounted for one-third of all hearing-related claims in the state for 2 years. The number and incidence of accepted claims from all other worksites increased significantly across the study period. The incidence was 0.3 per 10³ workers per year, overall, but was at least five-fold higher in industries that accounted for half of accepted claims, and reached 38- to 71-fold higher in some industries. This study indicates: 1) workers' compensation claims under-estimate the true frequency of occupational illness, representing only the “tip of the iceberg;” 2) hearing loss is a growing problem in occupational health; and 3) workers' compensation data are potentially useful to identify specific high-incidence industries for possible interventions. Am. J. Ind. Med. 33:519–528, 1998. © 1998 Wiley-Liss, Inc.     

Postmodern Social Work in Interdisciplinary Contexts

Abstract

This paper describes a university-based, maternal child health, interdisciplinary training project designed to assist health professionals in working with neurodevelopmentally at-risk children and their families. It discusses a role for social work educators and practitioners that brings to the table varied, conceptual questions that are intertwined with more traditional social work intervention in a postmodern approach to interdisciplinary teaming. A case example illustrates the integration of these two approaches and the inquiries that social work can initiate to facilitate “making space” both between the team and family and between members of the team in a dynamic, postmodern, interdisciplinary context.     

Importance of evaluating the context within which notification occurs

Workers' response to notification about health effects from exposure to toxic materials is determined not just by the content of the message but also by the “context” within which notification occurs, that is, the workers' prenotification knowledge, attitudes, and experiences concerning environmental health risks in general as well as the health problem that is the subject of the notification. In many cases, workers already have a high level of awareness of environmental health issues and are also aware that their work environments could be bad for their health, before receiving official notification of a particular health risk. This is one reason why worker notification programs often have limited impacts on the workers' health behaviors. To understand this process, researchers should assess workers' baseline attitudes and behaviors and study how they affect response to notification. Persons conducting notification programs should evaluate workers' prenotification attitudes, knowledge, and behaviors, and use this information in planning notification efforts. © 1993 Wiley-Liss, Inc.     

Living “In-between”—Vietnamese Canadian Women's Experiences: Implications for Health Care Practice

Intercultural living—a living that dwells “in-between” spaces of cultures—how it is conceptualized and what its lived experiences might mean, can give the direction for how we ought to care for one another. Drawing from my research with Vietnamese Canadian women, I argue that many immigrant women live and practice health care in “in-between” spaces, spaces that belong neither to East nor to West. Thus, supporting immigrant women's health care practices requires the removal of social ideologies that set apart the West and the “Other.” To provide equal and quality health care, caring should occur within in-between spaces, spaces that belong to both those who provide and those who receive health care services.     

Systematic comparative content analysis of 17 psychosocial work environment questionnaires using a new taxonomy

Background: Many questionnaires have been developed to measure how psychosocial characteristics are perceived in a work environment. But the content validity of these questionnaires has rarely been questioned due to the absence of a reference taxonomy for characteristics of work environments.

Objectives: To propose an exhaustive taxonomy of work environment characteristics involved in psychosocial risks and to apply this taxonomy to questionnaires on workplace psychosocial factors.

Methods: The taxonomy was developed by categorizing factors present in the main theoretical models of the field. Questionnaire items most frequently cited in scientific literature were retained for classification.

Results: The taxonomy was structured into four hierarchical levels and comprises 53 categories. The 17 questionnaires analyzed included 927 items: 59 from the “physical environment” category, 116 from the “social environment” category, 236 from the “work activity” category, 255 from the “activity management” category, and 174 from the “organizational context” category.

Conclusions: There are major content differences among analyzed questionnaires. This study offers a means for selecting a scale on the basis of content.     

ON THE RECURRENCE OF OCCUPATIONAL INJURIES AND WORKERS' COMPENSATION CLAIMS

This paper represents the first study to estimate counts of individual occupational injuries and claims over long spells of working life (up to 13 years) in the USA. It explores data from the National Longitudinal Survey of Youth 1979. I found that 37% of all surveyed workers who had experienced one on‐the‐job accident reported at least one additional injury, but only 56% of all occupational injuries and illnesses resulted in workers' compensation claims. I estimated different count models to assess the effect of different individual worker and job characteristics on individual injury counts and workers' compensation claims counts. Lower educational levels, less tenure, work in dangerous industries and unskilled occupations, and job demands are found to be important determinants of multiple on‐the‐job injuries. The most interesting results, however, refer to the role played by individuals' pre‐injury characteristics: early exposure to dangerous jobs is among the main determinants of higher counts of occupational injuries later in life. Early health limitations are also significant predictors of recurrent workers' compensation claims. These results provide new evidence about the important role played by both the health and the socioeconomic status of young people as determinants of their future occupational injuries. Copyright © 2012 John Wiley & Sons, Ltd.     

PubMed search strings for the study of agricultural workers' diseases

Background

Several optimized search strategies have been developed in Medicine, and more recently in Occupational Medicine. The aim of this study was to identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of agricultural workers' diseases.

Methods

We selected the Medical Subjects Heading (MeSH) term agricultural workers' diseases and six MeSH terms describing farm work (agriculture, agrochemicals NOT pesticides, animal husbandry, pesticides, rural health, rural population) alongside 61 other promising terms. We estimated proportions of articles containing potentially pertinent information regarding occupational etiology to formulate two search strategies (one “more specific,” one “more sensitive”). We applied these strategies to retrieve information on the possible occupational etiology among agricultural workers of kidney cancer, knee osteoarthritis, and multiple sclerosis. We evaluated the number of needed to read (NNR) abstracts to identify one potentially pertinent article in the context of these pathologies.

Results

The “more specific” search string was based on the combination of terms that yielded the highest proportion (40%) of potentially pertinent abstracts. The “more sensitive” string was based on use of broader search fields and additional coverage provided by other search terms under study. Using the “more specific” string, the NNR to find one potentially pertinent article were: 1.1 for kidney cancer; 1.4 for knee osteoarthritis; 1.2 for multiple sclerosis. Using the sensitive strategy, the NNR were 1.4, 3.6, and 6.3, respectively.

Conclusion

The proposed strings could help health care professionals explore putative occupational etiology for agricultural workers' diseases (even if not generally thought to be work related). Am. J. Ind. Med. 56:1473–1481, 2013. © 2013 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals, Inc.     

Listening to food workers: Factors that impact proper health and hygiene practice in food service

Background

Foodborne disease is a significant problem worldwide. Research exploring sources of outbreaks indicates a pronounced role for food workers'' improper health and hygiene practice.

Objective

To investigate food workers'' perceptions of factors that impact proper food safety practice.

Method

Interviews with food service workers in Baltimore, MD, USA discussing food safety practices and factors that impact implementation in the workplace. A social ecological model organizes multiple levels of influence on health and hygiene behavior.

Results

Issues raised by interviewees include factors across the five levels of the social ecological model, and confirm findings from previous work. Interviews also reveal many factors not highlighted in prior work, including issues with food service policies and procedures, working conditions (e.g., pay and benefits), community resources, and state and federal policies.

Conclusion

Food safety interventions should adopt an ecological orientation that accounts for factors at multiple levels, including workers'' social and structural context, that impact food safety practice.     

The Clinical Supervisor-Practitioner Working Alliance

Abstract

The focus of my presentation this morning is the core dynamics and skills of the supervisor-practitioner working alliance, or what I will refer to as the working relationship. I will present a model that suggests that the use of certain communication, relationship and problem-solving skills by the supervisor can influence the development of a positive working relationship with the supervisee, and that this working relationship is the medium through which the supervisor influences the practitioner. I stress the words “influence” because a central assumption of this approach is that both supervision and direct practice are interactional in nature. The supervisor and the supervisee each play a part in the process. The outcome of supervision is the result of how well each contributes to the process. This morning's presentation focuses on the supervisor's role. One of the discussions is the concept of the “parallel process.” While the role of the supervisor and the purpose of supervision are quite different from counseling and therapy, nevertheless there are striking parallels in the dynamics and skills. There is a suggestion that “more is caught than taught” and that our supervisees watch us very closely. Whether we like it or not, whether we are aware of it or not, our supervisees learn more about practice from the way we work with them than from what we say about their actual practice. Supervision is not therapy. In fact, supervisors who are seduced into a therapeutic relationship with their supervisees actually model poor practice since they lose sight of the true purpose of clinical supervision and their role in the process.     

Desarrollo de un instrumento de evaluación formativa del agente comunitario de salud

To validate a formative evaluation instrument of the community health agent.DesignMethodological study with a quantitative approach.LocationCarried out in two municipalities in the South of Brazil.Participants40 nurses for 350 community health agents.ParticipantsThe instrument was developed based on a competency framework of the Ministry of Health. The principal component analysis method was used for factor analysis. Internal validity and reliability were measured by Cronbach's alpha. The intraclass correlation coefficient, the Student's t test for paired samples and the ANOVA analysis of variance were used.ResultsThe factor analysis produced a factor structure with six factors and the 52 competencies of the original instrument were maintained. The final version of the instrument was structured into six domains: “Micro-area monitoring” (12 competencies), “Health promotion” (nine competencies), “Prevention and monitoring of specific groups and morbidities” (10 competencies), “Prevention and monitoring of environmental and social risk” (nine competences), “Planning and evaluation” (seven competences), “Teamwork” (five competences). Cronbach's alpha coefficient was 0.981, the test and the new test was p = 0.851 by the Student's t-test, and the ICC was 1.0.ConclusionsThe validated instrument constitutes an important reference in the discussion of the work of the Community Health Agent in the current context of public health policies. In addition to supporting the role of nurses in the supervision/in-service training of these professionals.     

Comparing Social Work's Role in Renal Dialysis in Israel and the United States

SUMMARY

This paper demonstrates the use of clinical data-mining in a study of social work interventions with dialysis patients in two countries, the US and Israel. We aimed to examine the role of social workers in improving kidney patient outcomes and to determine the potential of readily available patient information for studying this process. The findings showed considerable differences between the patient samples in both countries, as far as the socio-demographic background was considered. In spite of this, there were numerous similarities in the type of psycho-social problems and reactions, as well as the social workers' interventions. Differences which arose in various patient states and outcomes were examined in light of variations in the health care systems and socio-cultural contexts of renal dialysis in both sites.     

Equidad y autonomía del paciente en las estrategias de atención a personas con enfermedades crónicas en los servicios de salud de España

ObjectiveTo examine the chronic care models of the different Spanish health services and to discuss the ethical questions derived from implementing some of their components.MethodNarrative review of care strategies and programmes for chronic patients in the different Autonomous Communities, searching in official health departments’ web pages, using the terms “Programmes”, “Strategies”, “Chronic patients”, and “Chronicity”.Results15 programmes were found. Most of them include all components of the chronic care model, “decision-making support” being under-represented. The main conflicts in the autonomy of patients arise from the use of big data to stratify the population and from telemonitoring. The stratification of population does not consider the social factors that accompany the disease.ConclusionsChronic care strategies should consider the autonomy and privacy of patients in the use of clinical data and telemonitoring. In order to be equitable, they would have to provide an integrated health care system, incorporating measures to reduce the inequalities due to the social determinants that accompany the disease.     

Self‐employed individuals performing different types of work have different occupational safety and health problems

Introduction

We assessed the occupational safety and health (OSH) issues of self‐employed individuals in Korea.

Methods

The working conditions and OSH issues in three groups were analyzed using the Korean Working Conditions Survey of 2014.

Results

Among self‐employed individuals, “Physical work” was more common among males, whereas “Emotional work” was more common among females. Self‐employed individuals performing “Mental work” had more education, higher incomes, and the lowest exposure to physical/chemical and ergonomic hazards in the workplace. In contrast, those performing “Physical work” were older, had less education, lower incomes, greater exposure to physical/chemical and ergonomic hazards in the workplace, and more health problems. Individuals performing “Physical work” were most vulnerable to OSH problems.

Conclusion

The self‐employed are a heterogeneous group of individuals. We suggest development of specific strategies that focus on workers performing “Physical work” to improve the health and safety of self‐employed workers in Korea.

     

The Role of Values and Experience in Determining Social Workers' Attitudes Toward Euthanasia and Assisted Suicide

ABSTRACT

This article reports results of a study examining the impact of personal and professional values and experience on 122 hospital social workers' attitudes toward euthanasia and assisted suicide. Respect for self-determination was rated as the most important consideration in end-of-life issues. Predictors of social workers' agreement that euthanasia should be legal were: self-determination, religious beliefs, educational level (BSW/MSW), and for assisted suicide were: religious beliefs, belief in the potential for abuse, educational level and participation in ethics training. The findings underscore the need for social workers' awareness of how an interplay of personal and professional factors in potentially explosive ethical issues may influence practice in health care settings.