Occupational health in Yugoslavia

Occupational health in Yugoslavia was once well organized in accordance with WHO declarations and ILO conventions and recommendations. Since the 1990s, the system has been disrupted by destruction of the former Yugoslavia, wars, refugees, changes in the economy, and NATO bombardment. Economic trends, main industries, and employment and unemployment conditions in Yugoslavia are presented. The organization of occupational health services, their tasks, and prevailing problems are discussed. Occupational diseases and relevant research and educational opportunities are described. The authors conclude by suggesting approaches to improving worker's health in the future.     

Agricultural Occupational Health Nurse Training and Certification

ABSTRACT

The 1989 report “Agriculture at Risk: A Report to the Nation'' called for more trained health professionals to meet the manpower needs for control of occupational health and safety in farming communities. This report indicated the need for 8,000 occupational health nurses in agriculture when there were few trained professionals in this area. Iowa's Center for Agricultural Safety and Health started an agricultural health nurse training program in 1987. As its nurse-directed, hospital-based network of agricultural occupational health clinic programs expanded, and as the Iowa Department of Public Health's Occupational Health Nurse in Agricultural Communities (OHNAC) program grew, a greater need developed for formalized training and certification.

In response, a national working group convened to study the feasibility, curriculum, certification, and delivery mechanisms for such a program. The planning phase produced a “Feasibility and Recommendations'' document. A future implementation phase will finalize the curriculum and offer a workshop course featuring a modular curriculum combining distance learning with localized hands-on training. Continuing education credit and certification features will be developed, with possible partial credit towards certification in the American Board of Occupational Health Nurses, and curriculum area recognition in the American Association of Occupational Health Nurses.     

Everyday occupations prioritised by older adults participating in reablement. A cross-sectional study

Abstract

Background: Little knowledge exists regarding which occupations older adults prioritize as rehabilitation goals in reablement and what factors are associated with their preferences.

Objectives: To explore which occupations older people with functional decline find important to improve, which of these they prioritize as their rehabilitation goals, and what factors are associated with these priorities.

Materials and methods: A cross-sectional study was undertaken with a sample of 738 older adults from a nationwide trial evaluating the effects of reablement in Norway. The nine occupational sub-areas of the Canadian Occupational Performance Measure were used as a framework for analyses.

Results: Participants identified a multitude of occupations as challenging. Functional mobility was the most frequently identified and prioritized sub-area. Significant associations were found between prioritized occupations and health condition, sex, living status, education, walking speed and motivation.

Conclusions: This study found both abundance and diversity in the occupational problems and prioritized goals of older adults, with mobility being a key priority regardless of health condition.

Significance: It is important that reablement continues to be a person-centered intervention embracing the possibility to choose meaningful occupations. Occupational Therapists and other health professionals should address mobility when improving occupational performance in older adults.     

Gynecologic pain related to occupational stress among female factory workers in Tianjin,China

Abstract

Background: Dysmenorrhea, dyspareunia, and non-cyclic pelvic pain are health concerns for factory workers in China and may be increased by occupational stress.

Objectives: To estimate the prevalence and demographic and occupational factors associated with three types of gynecologic pain among female factory workers in Tianjin.

Methods: The study included 651 female workers from three factories in Tianjin, China. Logistic regression models were estimated to determine associations between occupational stress and gynecologic pain.

Results: Occupational stress including high job strain, exhaustion, and stress related to working conditions was a risk factor for gynecologic pain. High job strain and poor job security were associated with an increased risk for dysmenorrhea. Compulsory overtime and exhaustion were associated with increased non-cyclic pelvic pain. Working overtime and exhaustion were associated with increased dyspareunia.

Conclusions: As China’s population of female factory workers grows, research on the reproductive health of this population is essential.     

Health Care Delivery in Cummins Engine Company

The development and function of a unique not-for-profit cooperative venture to deliver community-wide occupational health services to large and small industries is described.

Designed by myself and Cummins Engine Company, known as the Columbus Occupational Health Association (COHA), operations began in 1970. Definitive care of occupational injuries, environmental health surveys, and extensive preventive medicine programs are offered to employees of member companies on a fee-for- service basis. Companies may join on approval of the Board of Directors. To date, 18 companies (15,000 employees) have joined.

Cummins’ leadership in this venture is an excellent example of commitment to community citizenship and “corporate responsibility.”     

Discussion of Occupational Health in Lebanon: Overview and Challenges

Abstract

The global shipping industry relies upon the developing world to dispose of retired deep-sea vessels through the Process of shipbreaking. In doing so the industry avoids the burdens of complying with developed world standards for the management of hazardous waste. Occupational and environmental health (OEH) risks associated with dismantling of beached ships, primarily in India and Bangladesh, are significant. Worldwide concerns about these risks, which arose in the late 1990s, and activism by domestic organizations appear to be gathenng momentum for global and domestic OEH reforms. This article addresses recent developments in charactenzing these risks and in proposals to control them.     

The illusion of client-centred practice

Abstract

Aim: A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession’s philosophical basis and espoused commitment to client-centred practice. Findings: The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession’s espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine’s expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession’s core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Conclusion: Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.     

Mining concepts of health responsibility using text mining and exploratory graph analysis

Background: Occupational therapists need to know about people’s beliefs about personal responsibility for health to help them pursue everyday activities.

Aim: The study aims to employ state-of-the-art quantitative approaches to understand people’s views of health and responsibility at different ages.

Methods: A mixed method approach was adopted, using text mining to extract information from 233 interviews with participants aged 5 to 96 years, and then exploratory graph analysis to estimate the number of latent variables. The fit of the structure estimated via the exploratory graph analysis was verified using confirmatory factor analysis.

Results: Exploratory graph analysis estimated three dimensions of health responsibility: (1) creating good health habits and feeling good; (2) thinking about one’s own health and wanting to improve it; and 3) adopting explicitly normative attitudes to take care of one’s health. The comparison between the three dimensions among age groups showed, in general, that children and adolescents, as well as the old elderly (>73 years old) expressed ideas about personal responsibility for health less than young adults, adults and young elderly.

Conclusions: Occupational therapists’ knowledge of the concepts of health responsibility is of value when working with a patient’s health, but an identified challenge is how to engage children and older persons.     

Responses to “Texaco and Its Consultants”

Abstract

The burden of occupational illnesses and injuries in the developing world is now enormous. Local experts in occupational health and safety are needed to address the growing worker and environmental health problems brought about by global industrial expansion, but such expertise is lacking. The author describes a 15-week, online, instructor-led course, Principles of Environmental and Occupational Health, that was offered to international students over two semesters. She suggests the needs that must be determined and recommends collaborative development of a real-time, on-line curriculum to enhance the training of professionals in occupational and environmental health.     

Occupational identity of adolescents with ADHD: A mixed methods study

Background: Occupational identity (OI) is shaped by occupational experiences over time and has been studied among individuals with a variety of health conditions. Adolescents with ADHD face numerous challenges in their occupational performance that may threaten their OI.

Objective: This study sought to compare the occupational identities of adolescents with and without ADHD and to gain a deeper understanding of the characteristics of OI among adolescents with ADHD.

Methods: Sixty-four adolescents with (n?=?21) and without ADHD (n?=?43) were interviewed using the Occupational Performance History Interview (OPHI-II). A mixed methodology was applied, using quantitative and subsequent qualitative content analyses of 10 interviews, with a directed approach.

Results: OPHI-II OI interval scores and 7/11 items of the OI scale were significantly lower in the ADHD group compared to controls. In the qualitative content analyses, three major themes were found: (i) the meaning of success in academic participation, (ii) the consequences of not succeeding in academic participation and (iii) self-explanations for not succeeding in academic participation.

Conclusion: Findings demonstrate the presence of OI challenges among adolescents with ADHD. Occupational therapy intervention may be needed in order to promote occupational adaptation.     

Occupational acute pesticide poisoning: a cross-sectional study of Turkish vegetable and fruit farmers based on self-reported symptoms and job characteristics

Background:Occupational pesticide poisoning is an important public health concern worldwide, especially in developing countries.Objectives:This study was aimed at determining the prevalence and risk factors of acute pesticide poisoning (APP) among the vegetable and fruit farmers in Karacabey District in northwest Turkey.Methods:The study group consisted of 565 farmers. The dependent variable of the study is APP defined according to the World Health Organization’s APP case definition matrix. The study’s independent variables are the farmers’ sociodemographic characteristics and the preventive measures they use when they are applying pesticides. The chi-square and logistic regression analysis analyzed the relationship between the dependent and independent variables.Results:A total of 64 (11.3%) farmers reported APP and 75% of them presented to a health institution due to symptoms. The factors associated with increased risk of APP were: illiteracy (odds ratio (OR)=2.5), 14 years and less farming experience (OR=3.3), not reading the pesticide labels (OR=6.4), and contact with liquid pesticides (OR=2.3).Conclusions:The study shows that approximately one out of ten farmers experience APP. Training programs should be planned and monitored to improve farmers’ awareness of the dangers of pesticides, and they should be encouraged to adopt and implement protective measures.Key words: Acute pesticide poisoning, farmers, prevalence, risk factors     

Obesity,Health and Quality of Life: A Conversation to Further the Vision in Occupational Therapy

ABSTRACT

Occupational therapy is one of the most powerful professions to support the development of healthy lifestyles, promote health and well-being and empower individuals, communities and populations, especially those impacted by or at risk for obesity. Development of healthy lifestyles enhances and promotes quality of life. This article discusses the need for occupational therapy professionals to explore the many possibilities that enable lifestyle change for people at risk for or who are obese or overweight. Embracing and integrating health promotion and wellness into everyday practice, particularly for those impacted by obesity, is emphasized.     

Increasing the Number of Trained Health and Safety Professionals in Agricultural Medicine: Evaluation of the “Building Capacity” Program, 2007–2013

ABSTRACT

The University of Iowa began training health care professionals to care for farmers’ occupational health needs since 1974. In order to geographically expand this training to practicing health and safety professionals, the “Building Capacity: A National Resource of Agricultural Medicine Professionals” program was developed and launched in 2006. The model began in 1987 as a program of Iowa’s Center for Agricultural Safety and Health. In 2006, with funding from the National Institute for Occupational Safety and Health (NIOSH), Great Plains Center for Agricultural Health (GPCAH), the program was expanded beyond the Iowa borders. The principal component of the program, the 40-hour course, Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals—the Core Course (AMCC) is now being offered to health and safety professionals in nine states in the United States, in Australia, and a modified version presented in Turkey. An initial paper evaluated the first phase of the program, years 2007–2010. This paper compares the first phase (2007–2010) with the second phase (2011–2013), which has involved over 500 health and safety professionals. This paper also describes evaluation of the course and changes resulting from the evaluation. Finally, this paper describes best practices for operating this program and makes recommendations for future courses, as well as other trainings within the field.     

Health inequalities in different age groups: the case of type 2-diabetes: a study with health insurance and medication data

Objectives:This study investigates social differentials in the prevalence of diabetes type 2 in women and men in a health insurance population. It is considered whether social gradients are present over different age strata. Methods:Analyses were performed with records obtained from a German statutory health insurance comprising 77294 women (31.8%) and men (68.2%) of at least 20 years. Occupational status was used as indicator of socio-economic position. Individuals with diabetes were identified using information about antidiabetic medication or by hospital diagnoses according to ICD9. The analyses were performed for the entire insurance population and for different age strata (<40yrs/40–55yrs/>55yrs).     

Improvisation as an Adaptive Strategy for Occupational Therapy Practice

ABSTRACT

As health care environments become increasingly complex, practitioners must develop new adaptive skills to master practice. The idea of using theatrical improvisation (improv) in health care is relatively new. Occupational therapy students were taught a module of improvisational techniques as part of an academic seminar, learning improvisation rules, and enacting solutions to typical daily professional challenges. The purpose of this article is to recommend improvisational techniques as an adaptive skill to effectively blend art and science for occupational therapy practice in fast-paced and unpredictable health care environments.     

Modeling of occupational exposure to accidentally released manufactured nanomaterials in a production facility and calculation of internal doses by inhalation

Background: Occupational exposure to manufactured nanomaterials (MNMs) and its potential health impacts are of scientific and practical interest, as previous epidemiological studies associate exposure to nanoparticles with health effects, including increased morbidity of the respiratory and the circulatory system.

Objectives: To estimate the occupational exposure and effective internal doses in a real production facility of TiO₂ MNMs during hypothetical scenarios of accidental release.

Methods: Commercial software for geometry and mesh generation, as well as fluid flow and particle dispersion calculation, were used to estimate occupational exposure to MNMs. The results were introduced to in-house software to calculate internal doses in the human respiratory tract by inhalation.

Results: Depending on the accidental scenario, different areas of the production facility were affected by the released MNMs, with a higher dose exposure among individuals closer to the particles source.

Conclusions: Granted that the study of the accidental release of particles can only be performed by chance, this numerical approach provides valuable information regarding occupational exposure and contributes to better protection of personnel. The methodology can be used to identify occupational settings where the exposure to MNMs would be high during accidents, providing insight to health and safety officials.     

Health inequalities in different age groups: the case of type 2-diabetes: a study with health insurance and medication data

Summary Objectives:This study investigates social differentials in the prevalence of diabetes type 2 in women and men in a health insurance population. It is considered whether social gradients are present over different age strata. Methods:Analyses were performed with records obtained from a German statutory health insurance comprising 77294 women (31.8%) and men (68.2%) of at least 20 years. Occupational status was used as indicator of socio-economic position. Individuals with diabetes were identified using information about antidiabetic medication or by hospital diagnoses according to ICD9. The analyses were performed for the entire insurance population and for different age strata (<40yrs/40–55yrs/>55yrs). Results:The analyses revealed considerable social differences in diabetes risks. Considering the whole insurance population with the highest socio-economic category as reference group, the odds ratio (OR) for skilled non-manuals was OR=2.9, for skilled manuals it was OR=4.7, and OR=5.6 for unskilled and semi-skilled individuals. After stratifying the insurance population into three age groups the social gradients were reproduced for each stratum, but their magnitudes increased with age. Conclusions:In the health insurance population considered health inequalities with respect to diabetes are considerable, and they are persisting after stratification into age groups.     

Occupational Health Indicators for South Africa

Abstract

Indicators, statistics gathered from a larger pool because they have the power to summarize or to serve as indirect or proxy measures for information that is lacking, would be valuable in appraising occupational health status in a country provided data are both feasible and relatively inexpensive to collect. A generally accepted set of occupational health indicators does not exist. This project aimed to compile a set for South Africa. An initial set of possible indicators was compiled and then rated by key informants. A committee of the National Centre for Occupational Health selected a final set of 16 indicators. The indicators and limited data collected on some of them are presented with commentary. The validity and the impact of the indicators need to be formally assessed.     

Urogenital infection symptoms and occupational stress among women working in export production factories in Tianjin,China

ObjectiveTo assess the prevalence of urogenital infection symptoms and their association with occupational stress among women working in export production factories in China.MethodsSix hundred and thirty-eight women workers in three factories in Tianjin, China were surveyed. Information was collected on women's demographic characteristics, levels of occupational stress, and urogenital infection symptoms. Data were analyzed using multiple logistic regression.ResultsAmong the 638 women who provided information on urogenital symptoms, 30.9% reported at least one symptom: 27.9% reported abnormal discharge, 2.4% reported genital sores, and 6.3% reported pain with urination. Feeling exhausted was associated with an increased risk for reporting genital sores [OR=1.35 (1.05, 1.73)] and pain with urination [OR=1.21 (1.06, 1.39)], while reporting low job security was significantly associated with reporting at least one symptom of urogenital infection [OR=1.51 (1.03, 2.20)].ConclusionsMany women working in China's export factories report symptoms of urogenital infection. Occupational stress may be linked to an increased risk for urogenital infection. Focused efforts are needed to improve accessibility to reproductive health services for women working in China's export production factories.