Occupational Physicians' Attitudes and Practices in Relation to Occupational Cancer Prevention A Qualitative Study in Southeastern France

Abstract

We conducted a qualitative survey of 20 occupational physicians (OPs) in southeastern France in 2008 to study their attitudes and practices regarding the prevention of occupational cancers. Occupational physicians' practices regarding occupational cancers centered mainly on prevention. Numerous difficulties impeded these activities: attitudes that minimized the carcinogenic risks by employers and employees, the absence or inadequacy of mandatory risk assessment to identify health hazards, and difficulties in obtaining individual exposure forms, which employers are supposed to complete to identify employees exposed to carcinogens. Other problems were related to the resources available to OPs and the constraints on their time. Finally, some OPs reported that they lacked selfefficacy. The results of this study suggested the need to strengthen OPs' initial training, draft and adopt good practice guidelines for various aspects of their practices, and improve collaborations between OPs and other professionals specialized in the prevention of occupational risks.     

The Decline and Imminent Fall of U.K. Governmental Occupational Health: A Tale of Forgotten Lessons and Missed Opportunities

Abstract

Governmental efforts to monitor and regulate occupational health and safety hazards in the United Kingdom have been seriously etiolated by recent developments emanating from the HSC and the HSE that gut already indequate strategies in ways that favor industry prerogatives over workers, and by governmental inattention.     

Occupational health hazards among health care personnel working in public health facilities in Bhubaneswar,India

Background

Health care personnel working in public health facilities comprise a major part of the health care workforce in India and are exposed to a variety of workplace hazards.

Aim

To assess the occupational health hazards and associated risk factors among health care personnel working in public health facilities in Bhubaneswar.

Subject and methods

A cross-sectional study was conducted involving 172 health care personnel working in 22 urban primary health centers and four community health centers in the Bhubaneswar Block of the Khordha district in the state of Odisha, during the period from January to December 2017. Relevant data were collected using a semi-structured interview schedule.

Results

Overall, 143 (83.1%) of the participants reported experiencing occupational health hazards, with 89 (51.7%) encountering biological hazards and 130 (75.6%) experiencing non-biological hazards. Stress (38.9%), assault (38.4%), needlestick injury (34.3%), and direct contact with contaminated specimens/body fluids (32.6%) were the most frequently experienced occupational hazards. Multivariate regression analysis revealed that female gender, health care personnel other than doctors, working overtime, dissatisfaction with workplace atmosphere, and not using the necessary personal protective equipment (PPE) were independent predictors for experiencing a biological hazard. Similarly, female gender, presence of family conflict, and not using the required PPE were found to be independent predictors for experiencing non-biological hazards.

Conclusion

Health care personnel in public health facilities experience multiple hazards in their workplaces. Results indicate the need for designing and implementing strategies to promote the occupational health of this important section of society.

     

Médecins du travail et cancers professionnels : attitudes,opinions et pratiques. Une recherche qualitative dans le Sud-Est de la France

BackgroundA qualitative study was conducted in 2008 of occupational physicians (OPs) in south-eastern France to document their attitudes, opinions and practices on prevention and screening of occupational cancers. This was done to provide elements to prepare the questionnaire of a quantitative study in 2009.MethodsSemi-structured interviews were conducted using a structured interview guide with 20 OPs. The data collected were subjected to an analysis of thematic content type.ResultsThe analysis revealed that OPs face many difficulties when preventing occupational cancers. For most of OPs, these difficulties appeared related to “external factors”: lack of involvement of employers and minimization of risks by employers and employees. Lack of time, overload and, for some OPs, perceived lack of independence towards employers, were also mentioned as barriers to cancer prevention. This study also suggested hypotheses related to OPs themselves (internal factors): perceived lack of effectiveness and, trend to minimize the risks of occupational cancer in their geographical area. Finally, the results suggest a significant heterogeneity of OPs’ practices regarding occupational cancer screening.ConclusionThese results raise several hypotheses that will be addressed further in the quantitative survey. They warn about the difficulties of a profession that seems to encounter a demographic and identity crisis.     

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.     

Trends in exposure of veterinarians to physical and chemical hazards and use of protection practices

Objectives To determine whether exposure to physical and chemical occupational hazards and use of protective practices has changed in recent veterinary graduates, and to describe trends in exposure to occupational hazards and use of protective practices over time. Methods This paper reports on a retrospective cohort study of veterinarians who graduated from any of the four Australian veterinary schools between 1960 and 2000 and were currently in clinical practice. A self-completed postal questionnaire was used to collect personal details, professional history since graduation, and details of occupational hazards and protective practices used. The prevalence of occupational hazards and use of protective practices was examined by decade of graduation adjusting for gender, type of practice and number of hours worked. Results After adjusting for other factors, recent graduates tended to take more X-rays than early graduates—graduates since 1990 were 2.59 times more likely to take more than seven X-rays a week compared with graduates before 1970. Recent graduates were also more likely to personally restrain animals during X-rays but were more likely to use X-ray protection. Of those who undertook surgery, recent graduates were more likely to use anaesthetic waste gas scavengers. Over time, veterinary jobs have become more likely to involve longer hours of surgery, but shorter periods of driving. The use of scavengers for waste anaesthetic gas has increased markedly over time from 3.8% of jobs commencing in the 1960s to over 70% for jobs commencing since 1997. Conclusions This survey is, to our knowledge, the first to examine trends in the occupational health and safety practices of veterinarians. We have shown that occupational health issues are still important in veterinary practice, with most veterinarians exposed to a number of physical and chemical hazards and many using inadequate protection.     

An Occupational Risk Survey of a Refractory Brick Company in Ha Noi,Viet Nam

Abstract

Viet Nam has an increasing need for building materials, including refractory bricks. Little is known regarding the occupational hazards incurred in brick manufacturing. To determine the occupational health hazards posed by a refractory brick operation in Ha Noi, Viet Nam, a cross-sectional occupational risk survey was conducted, focusing on respirable dust hazards. It included an industrial hygiene walk-through and gravimetric dust analysis. Noise, heat, lack of head protection, and dust exposure were hazards identified at the brick-manufacturing site. Respiratory protection involved a three-layer cloth mask that had not been tested for efficacy. Silica dust exposure levels exceeded the Vietnamese permissible exposure level by almost fivefold based on gravimetric assessment and estimated silica content. This brick manufacturing site contains significant injury and respiratory illness hazards. Further investigations are necessary to begin to develop occupational safety measures at the site.     

The Epidemiology of Blood-Contaminated Needlestick Injuries Among Veterinarians in Portugal

ABSTRACT

Needlestick injuries (NIs) are considered a substantial occupational health and safety hazard in contemporary health care practice. Unlike human medicine where much effort has been devoted to reduce the incidence of these events, the same aggressive approach has not been used in veterinary medicine. This study investigated the occurrence of blood-contaminated NIs in Portuguese veterinarians. Participants of a veterinary meeting were asked to complete a questionnaire-based survey. Univariate and multivariate logistic regression analyses were performed to produce predicted probabilities for NI episodes in veterinarians. From the total of 373 enrolled veterinarians, 293 (78.5%) reported having had at least one NI during their professional life. Veterinarians working with dogs were more likely to have experienced a NI (adjusted odds ratio [aOR]: 145.74, P < .001). The high level of NIs observed in these professionals shows that NIs are a potential occupational health problem in Portuguese veterinarians, with the possibility for transmission of haematogenous zoonosis.     

Agricultural Health and Safety Performance in Australia

ABSTRACT

This study aimed to determine the proportion of Australian farming enterprises with systems and processes that meet current regulatory and industry standards for health and safety. Data from 683 farming enterprises were drawn from a nationally stratified random sample representing seven commodity sectors: beef cattle, cotton, dairy, horticulture, grain growing, sheep, and sugar cane. Results indicated low levels of implementation for farm health and safety plans as well as induction for new workers and contractors. Improvements to control major safety hazards are required for farm machinery and implements, farm vehicles, reducing exposure of children to hazards, and the use of helmets when riding quad bikes, motorbikes, and horses. There were considerable variations between commodity sectors. There remains significant scope to enhance the safety of farmers in Australia.     

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.     

Big Data in occupational medicine: the convergence of -omics sciences,participatory research and e-health

Background:New occupational hazards and risks are emerging in our progressively globalized society, in which ageing, migration, wild urbanization and rapid economic growth have led to unprecedented biological, chemical and physical exposures, linked to novel technologies, products and duty cycles. A focus shift from worker health to worker/citizen and community health is crucial. One of the major revolutions of the last decades is the computerization and digitization of the work process, the so-called “work 4.0”, and of the workplace.Objectives:To explore the roles and implications of Big Data in the new occupational medicine settings.Methods:Comprehensive literature search.Results:Big Data are characterized by volume, variety, veracity, velocity, and value. They come both from wet-lab techniques (“molecular Big Data”) and computational infrastructures, including databases, sensors and smart devices (“computational Big Data” and “digital Big Data”).Conclusions:In the light of novel hazards and thanks to new analytical approaches, molecular and digital underpinnings become extremely important in occupational medicine. Computational and digital tools can enable us to uncover new relationships between exposures and work-related diseases; to monitor the public reaction to novel risk factors associated to occupational diseases; to identify exposure-related changes in disease natural history; and to evaluate preventive workplace practices and legislative measures adopted for workplace health and safety.Key words: work 4.0, new information and communication technologies, exposomics, occupational medicine     

Gendered Bodies: Recruitment,Management and Occupational Health in Northern Thailand's Electronics Factories

SUMMARY

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.     

Work-related Injuries and Illnesses in Botswana

Abstract

In Botswana over 1,000 work-related accidents resulting in more than three days' absence from work are reported annually, including about 60 fatalities. Hardly any work-related diseases are reported, despite suspicion that they are prevalent. An analysis of 498 cases in Gaborone district for the year 2000 indicates that road traffic accidents accounted for about 80% of all workrelated fatalities, and that the majority of the victims of fatal accidents were government employees. Most accidents occurred in places of employment not regulated by any legislation enforcing occupational safety and health. There is a need for Botswana to put in place performance-based legislation requiring all employers to identify and control hazards. Employers should be encouraged to implement occupational safety and health management systems to improve their safety performances al1d enhance productivity.     

Occupational Health in Lebanon: Overview and Challenges

Abstract

This paper discusses the challenges facing the field of occupational health in Lebanon following 15 years of war. It examines the opportunities for advancing this field and for bringing Lebanese standards up to par with internationll ones. Challenges include the minor contribution of industry to the overall economy, its perception as non hazardous, the lack of standards and enforcement, the scarcity of data, and the obscurity of occupational health on the national agenda. Opportunities, on the other hand, have arisen from the need to rebuild the infrastructure and revive tourism, public awareness of the potential hazards of industries in densely populated areas, international pressure, and the return of professionals in occupational health. The safety and salubriousness of workplaces are perceived as minor concerns in Lebanon, yet desire for economic recovery may prove to be an incentive for increased action on this issue. Three potential approaches for action are presented.     

Karl Morgan and Alice Stewart,Survivors on the Nuclear Stage

Abstract

Background:

Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings.

Objective:

To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India.

Methods:

We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators.

Results:

A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%).

Conclusion:

More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services.     

Occupational electromagnetic spectrum hazards and the significance of artificial optical radiation: country report for Greece

Background:The electromagnetic spectrum spans over an enormous range from 0 up to more than 10²⁰ Hz in the deep ionizing region, significant exposures exist in specific occupational environments. Between the ionizing and the electromagnetic fields (EMF) part of the spectrum, the ‘optical radiation’ (OR) region has specific properties. Comparative and concise evaluation enables action prioritization.Methods:Following the transposition and implementation periods of the artificial optical radiation (AOR) and EMF European Directives, the Hellenic Ministry of Labour in collaboration with the Greek Atomic Energy Commission (EEAE) and the National Technical University of Athens, conducted thorough occupational exposure investigation in Greece. Using dedicated measuring equipment and procedures, the majority of EMF emitting installations in Greece and also AOR emitting installations including arc welding, lasers and PC monitors has been assessed.Results:Measurement results from occupational settings reveal that it is the non-coherent metal arc welding AOR that can pose even sub-second overexposures. Rare EMF overexposures are manageable and EMF concern is not justified. Maintenance procedures demand proper attention. Preliminary laser safety assessment reveals OHS gaps and potential eye and skin hazards. Blue light exposure from computer monitors is well below safety limits.Conclusions:This electromagnetic spectrum risk assessment conducted in Greece enables the justification of the real occupational hazards, in this sense: i) EMF exposure assessment has to be concentrated to maintenance procedures; ii) AOR measuring setups are challenging and standardized measurement procedures are missing, and iii) AOR overexposures from arc welding pose significant eye and skin hazards.     

Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses

Background  

Evidence-Based Medicine (EBM) is an important method used by occupational physicians (OPs) to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice.     

Work environment and occupational risk assessment for small animal Portuguese veterinary activities

The professional work of small animal veterinary staff encompasses a wide diversity of demanding tasks. This has prompted a number of studies covering physical, chemical, biological, ergonomic, or psychological hazards, as well as their health effects upon veterinary workers. However, such results were obtained from self-reported surveys (via paper or online). This study reports the identification of potential hazards and provides a risk assessment of 15 veterinary clinics based on data from walk-through surveys, interviews with workers, and quantification of indoor air quality parameters including concentration of volatile organic compounds (total, isoflurane, and glutaraldehyde). The risk arising from X-ray exposure was unacceptable in seven clinics; X-ray examination should be discontinued in the absence of isolated radiation rooms, poor safety practices, and lack of personal protective equipment. Ergonomic-related hazards and work practices should be revised as soon as possible, considering that improper postures, as well as moving and lifting heavy animals are major causes of musculoskeletal disorders. The risk levels were, in general, small or medium (acceptable) with regard to exposure to physical hazards (such as bites, scratches, cuts, and burns) and biological hazards. It was observed that the indoor air quality parameters including temperature, respirable particulate matter and total volatile organic compounds do not indicate a comfortable workplace environment, requiring clinics' attention to keep the safe environment. The veterinarians and nurses were exposed to isoflurane (above 2 ppm) during surgery if an extractor system for waste gas was used instead of a scavenging system. Finally, veterinary workers did not possess any type of training on occupational safety and health issues, even though they recognized its importance.     

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

Abstract

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

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.