Working in clients' homes: the impact on the mental health and well-being of visiting home care workers

The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.     

Working Conditions of Brazilian Immigrants in Massachusetts

Brazilian immigration to Massachusetts and other states in the US grew significantly in the last two decades. There is a lack of data about the working conditions and health and safety hazards faced by Brazilian immigrant workers. We surveyed over 500 workers in Eastern Massachusetts through a community-based participatory research project to explore occupational and immigration factors that may represent a risk to the health of Brazilian immigrant workers, who mostly work in the construction, housecleaning, and food services segments of the state labor force. Our pilot study suggests that Brazilian immigrant workers are exposed to chemical, ergonomic, physical, and psychosocial job hazards and have experienced a variety of health symptoms that may be associated with these work environment exposures. Since most Brazilian workers have not received proper training to recognize the hazards, there is an urgent need for the implementation of culturally adequate training programs and enforcement of safety and health regulations to prevent occupational injuries and fatalities.     

An overview of health and safety in the Colorado cannabis industry

Background

Understanding worker health and safety in the rapidly growing legal U.S. cannabis industry is important. Although little published research exists, workers may be exposed to biological, chemical, and physical hazards. This study investigated the Colorado cannabis industry workforce and both physical and psychosocial hazards to worker health and safety.

Methods

Two hundred and fourteen Colorado cannabis workers completed an online survey after in‐person and online recruitment. Participants answered questions about their occupation, job tasks, general well‐being, occupational health and safety, cannabis use, and tobacco use.

Results

Colorado cannabis workers were generally job secure and valued safety. However, they regularly consumed cannabis, expressed low concerns about workplace hazards, reported some occupational injuries and exposures, and reported inconsistent training practices.

Conclusions

Working in the cannabis industry is associated with positive outcomes for workers and their organizations, but there is an imminent need to establish formal health and safety training to implement best practices.

     

Child labor in Ghana cocoa production: focus upon agricultural tasks, ergonomic exposures, and associated injuries and illnesses

OBJECTIVES: The goal of this study was to determine the occupational hazards experienced by children harvesting cocoa in western Ghana in order to design a vocational literacy life skills curriculum and radio social messaging campaign with a safety component to decrease hazardous work exposures in child agricultural work. METHODS: An observational analysis was conducted of children aged 9 through 17 based upon personal interviews of agricultural workers, focus groups, and direct observation of work practices and activities. Job site analysis incorporated task mapping, job hazard review, and a review of equipment and use of protective gear. RESULTS: Children and young people aged 9 through 17 are exposed to hazardous occupational exposures including strenuous work, sharp tools, and pesticides. Lack of training in proper safety practices and inadequate personal protective equipment were commonly noted. Injuries and illnesses included musculoskeletal disorders, sprains, strains, lacerations to the head, fractures, eye injuries, rashes, and coughing. CONCLUSION: Children working in cocoa harvesting are exposed to physical and chemical hazards without proper training or personal protective equipment. Unless safety interventions occur, there are potential long-term adverse health consequences.     

An integrated comprehensive occupational surveillance system for health care workers

BACKGROUND: Workers in the health care industry may be exposed to a variety of work-related stressors including infectious, chemical, and physical agents; ergonomic hazards; psychological hazards; and workplace violence. Many of these hazards lack surveillance systems to evaluate exposures and health outcomes. The development and implementation of a comprehensive surveillance system within the Duke University Health System (DUHS) that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of health care workers (HCWs) is presented. METHODS: Human resources job and work location data were used to define the DUHS population at risk. Outcomes and exposure data from existing occupational health and safety programs, health promotion programs, and employee health insurance claims, were linked with human resources data and de-identified to create the Duke Health and Safety Surveillance System (DHSSS). RESULTS: The surveillance system is described and four examples are presented demonstrating how the system has successfully been used to study consequences of work-related stress, hearing conservation program evaluation, risk factors for back pain and inflammation, and exposures to blood and body fluids (BBF). CONCLUSIONS: Utilization of existing data, often collected for other purposes, can be successfully integrated and used for occupational health surveillance monitoring of HCWs. Use of the DHSSS for etiologic studies, benchmarking, and intervention program evaluation are discussed.     

Identifying and prioritizing gaming workers' health and safety concerns using mapping for data collection

BACKGROUND: This research was prompted by the clinical presentation of workers from a variety of gaming occupations with injuries and illnesses and multiple health and safety concerns. METHODS: Using participatory action research principles, 51 gaming workers in Ontario and 20 gaming workers in Manitoba were consulted during a series of focus group sessions. Mapping exercises were used to survey the participants about their health concerns, perceived occupational hazards and the impact of working conditions on their personal lives. Participants were then asked to prioritize their concerns and make recommendations for improvements. RESULTS: Gaming workers from both provinces identified similar health, hazard and psycho-social concerns. They prioritized the issues of stress, ergonomics, indoor air quality (including second-hand smoke and temperature), biological hazards, physical hazards and noise. CONCLUSIONS: This study points to a need to more fully investigate and address health and safety issues in the gaming industry. It also demonstrates the effectiveness of a worker-driven, participatory consultation.     

Occupational risks and injuries in non-agricultural immigrant Latino workers

BACKGROUND: To investigate occupational health in urban immigrant Latino workers, using a community-based method. METHODS: A survey was administered through consecutively selected door-to-door interviews. RESULTS: Response rate was 80% (n = 427). Average time in the US was 7.6 years, and average job tenure was 2.8 years. Twenty-five reported exposures to over 10 different hazards, and 18% thought these hazards had harmed their health. Only 31% received any job safety training; 55% had no workers' compensation coverage. Of the 47 (11%) with a work injury in the past 3 years, 27% reported difficulty obtaining treatment, 91% lost time from work (median = 13 days) and 29% had to change jobs because of the injury. The annual occupational injury rate was 12.2/100 full-time workers, compared to an expected rate of 7.1. CONCLUSIONS: Urban immigrant workers have increased risk of occupational injuries, with adverse outcomes.     

An aging workforce and injury in the construction industry

The relatively large birth cohort between 1946 and 1964, combined with the economic recession in the first decade of the 21st century, have led to an increase in the proportion of older workers in the US workplace. Understanding the health and safety needs of an aging workforce will be critical, especially in the construction industry, where physical job demands are high. This paper reviews the epidemiologic literature on the impact of age on injury among workers in the construction industry in terms of cause, type, and cost. PubMed was searched by using the following terms: older workers, construction, construction industry, injury, and age. The available studies reported that, among the construction industry workforce, older age at injury was related to higher injury costs but not to number of injuries. The higher injury costs associated with worker age are likely due in part to the severity of the injuries sustained by older workers. Identification of injury trends and subsequent analytical research efforts designed to ascertain factors associated with injury among older construction workers are needed for employers to effectively manage a health and safety program that addresses the needs of the aging worker.     

Cumulative effects of job characteristics on health

We examine whether the job characteristics of physical demands and environmental conditions affect individual's health. Five-year cumulative measures of these job characteristics are used to reflect findings in the biological and physiological literature that indicate that cumulative exposure to hazards and stresses harms health. To create our analytic sample, we merge job characteristics from the Dictionary of Occupational Titles with the PSID data set. We control for early and also lagged health measures and a set of pre-determined characteristics to try to address concerns that individuals self-select into jobs. Our results indicate that individuals who work in jobs with the 'worst' conditions experience declines in their health, though this effect varies by demographic group. We also find some evidence that job characteristics are more detrimental to the health of females and older workers. Finally, we report suggestive evidence that earned income, a job characteristic, partially cushions the health impact of physical demands and harsh environmental conditions for workers. These results are robust to inclusion of occupation fixed effects.     

Workplace injury or “part of the job”?: Towards a gendered understanding of injuries and complaints among young workers

Epidemiological studies have found that teenage workers have higher occupational injury rates than adult workers, and that young males are a particularly high-risk subgroup. However, there have been few studies to date that have explored qualitatively young workers' everyday understandings and experiences of occupational health risks. Based on focus groups conducted with Canadian urban and suburban teenagers aged 16-18 years, this paper explores young workers' understandings and experiences of occupational health risks, and their gendered nature. The respondents were employed in a diverse range of jobs. The findings suggest that young workers experience a number of minor injuries and physical complaints related to their work. These injuries were typically seen as "part of the job" because they happened frequently and were of low severity. Also, the experience of these injuries as "part of the job" was informed by the young workers' perceived lack of control to improve or alter the conditions of their work. Furthermore, young workers' complaints and concerns were systematically discounted and this happened in a gendered fashion. Whereas the females emphasized how their complaints were actively disregarded by their superiors, males (and some females in male-dominated work settings) described how they stifled their complaints in order to appear mature among their (older) co-workers. Comparisons with qualitative studies of adult workers suggest that accepting some risks and injuries as "part of the job" is not peculiar to young workers. The implications of these findings for improving workplace safety for young workers are discussed.     

Current status of employment and labor of occupational nurses in external agencies for industrial health

The purposes of this study were to survey the actual conditions of the employment status and activities of occupational health nurses who are employed in Japanese Industrial Health Organizations (IHOs), and to investigate whether the OHNs provide quality health services to employees. We mailed 1,780 questionnaires to nurses who belong to 92 IHOs (members of the National Federation of Industrial Health Organizations). A total of 976 questionnaires were returned (54.8% valid response rate) and 968 questionnaires were considered eligible for analysis. The results showed the following issues: 1) most public health nurses belonged to the department of occupational health service, but they did not have enough experience with industrial hazards or workers safety or health; 2) public health nurses want to participate more directly in care for workers; 3) Public Health Nurses provided health counseling in the charge of their enterprises, but they did not take managerial roles, including place-of-work patrol, attendance to safety, and health committees in their workplaces; 4) they were not satisfied with the present roles demanded by the other staff and their managers; 5) they did not have enough opportunities to attend the job training. Together, the results of this study suggest that the OHNs in IHOs need to have more opportunities to perform their expertise in industrial health & safety and job training in order to provide autonomous health services to the workers.     

Occupational hazards of municipal solid waste workers

The removal of municipal solid waste is a job associated with a variety of physical, chemical, and biological hazards. Municipal solid waste workers (MSWWs) have a risk of fatal occupational injuries that is much higher than for the general workforce. Among this group of workers, non-fatal injuries are mainly musculoskeletal. Other common injuries are fractures, ocular trauma, and bites, and diseases include skin and gastrointestinal disorders. Workers at municipal solid waste incinerators are exposed to a variety of concerning substances, such as heavy metals, respirable quartz dust, dioxins, furans, and mutagens. Workers can be protected by using safety procedures on and around garbage trucks and with personal protective equipment. The burden of morbidity due to occupational exposure to bioaerosols and carcinogens among MSWWs is unknown.     

Occupational hazards to health care workers: report of a conference

Health care workers are exposed to an array of physical, chemical, biological, and psychosocial hazards. At a national conference in Seattle May 11-13, 1983, hospital occupational medicine programs were characterized as lagging far behind those in industries with comparable illness and injury rates. Participants and speakers recommended that health care workers be trained to recognize occupational hazards; that epidemiologic, laboratory, and clinical studies be undertaken to discern trends and establish the mechanisms of effects from hazardous exposures; and that adequate employee health and safety programs be established in health care settings.     

Job characteristics and problems related to home care services for the elderly. A comparison among employment categories in Sapporo

OBJECTIVE: The aims of this study were to describe job characteristics for daytime and shift workers in home care services for the elderly and to clarify health care in the work setting, social support, and job satisfaction and possibilities. METHODS: A self-reported questionnaire was given to 433 home care workers, both full time and part time (more than 15 hours), at 35 institutions that provide home care services to residents of Sapporo (return rate; 80.2%). The following issues were investigated: job content (physical care, assistance with housework, and advice), specialty, job satisfaction, possibilities, job training, health care and social support. The results were compared among employed types: full-time and part-time daytime and shift workers using the t-test or the Fisher's test. RESULTS: The participants demonstrated high dissatisfaction with wages, physical uneasiness themselves and limited social support from their supervisors. Especially full-time workers were dissatisfied with the payment, whereas part-time workers complained about insufficient attention to the prevention of lumbago. It was found that part-time daytime workers were given insufficient on-job-training and education for prevention of infection, and that full-time shift workers greatly wished to leave the employment. However, the home care workers were satisfied with their job itself and expected to continue their work. Furthermore, half of the part-time workers hoped to work full time. CONCLUSIONS: Health management and educational training for part-time workers may be necessary to improve the quality of care services and protection of health. Promotion of full time employment and reconsideration of working condition might be necessary to provide sufficient home care services.     

Health of caregivers in child care

BACKGROUND: Child care workers play an important role in caring for children attending child care yet there is little research regarding their health. METHODS: The study consisted of focus groups with child care workers and a survey, conducted as part of a larger study known as the Healthy Child Care Study, which focused on children. The study investigated carers working in formal child care [long day care (LDC) and family day care (FDC)]. RESULTS: Questionnaires to caregivers in centres showed that 86% had taken sick leave in the previous year and 75% of staff had taken leave for infectious illness. Carers in FDC reported that 24% had taken sick leave in the previous year and 12% of carers had taken leave for infectious illness. Of responding caregivers from centres, 22% were cigarette smokers while in FDC homes, 8% of carers smoked. In focus groups, carers reported that their major areas of health concern were stress, infectious illness and physical trauma such as lifting injuries. CONCLUSIONS: Child care workers in LDC took more sick leave than those in FDC but this is not necessarily due to more illness. Child care workers are a diverse and important group that require further research.     

绵阳市涪城区乡村卫生人员工作压力、工作倦怠与工作满意度调查

目的了解绵阳市涪城区基层卫生人员工作压力、工作倦怠和工作满意度状况,为相关部门制定和完善有关政策提供参考依据。方法采用文献研究与问卷调查相结合的方式进行了调查。结果调查对象中,95.9%的卫生人员都感到有不同程度的工作压力;有明显的工作倦怠感的占相当比例（83.8%）;工作满意度调查中有超过半数（58.1%）的卫生人员为＂基本满意＂。工作压力、工作倦怠和工作满意度三者之间存在一定关联。结论卫生人员的工作压力需要一定缓解;卫生人员的工作倦怠需要有效干预;卫生人员的工作满意度有待进一步提高。     

Mental health in mine workers: a literature review

The mining environment is hazardous for worker’s health. It can affect the mental health, triggering symptoms and diseases, such as anxiety, job stress, depression, sleep disorders, mental fatigue and other. The aim of this study was to describe and analyze the scientific literature about the mental health in mine workers and to summarize the findings. The method used was scoping review. The principal outcomes were the following: evidence in the last 12 years in the topic was focused in four themes 1) Psychological problems & personal factors (38.2%); 2) Psychosocial problems & health related factor (23.6%); 3) Well-being (21.1%) and 4) Physical problems & organization factors (17.1%). Several affections, symptoms, characteristics or disorders were inquired about mine worker’s mental health, such as job strain, unsafety experiences, poor quality of sleep, non-subjective well-being, job unsatisfaction, social-relations conflict, risk of accidents and injuries, musculoskeletal disorders (MSDs), substance abuse, dangerous working conditions and demanding job organization, and so on. For those factors, Mining could expose to serious mental health problems to a part of their workers. It’s necessary to deepen the elaboration of international policies and carry out more scientific research and suggestions to make programs on the topic.     

Work Organization and Health Among Immigrant Women: Latina Manual Workers in North Carolina

Objectives. We sought to describe work organization attributes for employed immigrant Latinas and determine associations of work organization with physical health, mental health, and health-related quality of life.Methods. We conducted a cross-sectional survey with 319 employed Latinas in western North Carolina (2009–2011). Measures included job demands (heavy load, awkward posture, psychological demand), decision latitude (skill variety, job control), support (supervisor control, safety climate), musculoskeletal symptoms, mental health (depressive symptoms), and mental (MCS) and physical component score (PCS) health-related quality of life.Results. Three fifths reported musculoskeletal symptoms. Mean scores for depression, MCS, and PCS were 6.2 (SE = 0.2), 38.3 (SE = 0.5), and 42.8 (SE = 0.3), respectively. Greater job demands (heavy load, awkward posture, greater psychological demand) were associated with more musculoskeletal and depressive symptoms and worse MCS. Less decision latitude (lower skill variety, job control) was associated with more musculoskeletal and depressive symptoms. Greater support (supervisor’s power and safety climate) was associated with fewer depressive symptoms and better MCS.Conclusions. Work organization should be considered to improve occupational health of vulnerable women workers. Additional research should delineate the links between work organization and health among vulnerable workers.Immigrant and low-income workers constitute a vulnerable population that is at significant risk for occupational injury and illness. These workers often have the most demanding jobs in the most dangerous industry sectors (e.g., agriculture, construction).1-5 When they work in less hazardous sectors, such as manufacturing, they generally work in industries such as poultry and meat processing, which have substantial hazards and few protections.6-7 These manufacturing hazards include exposure to toxicants (e.g., cleaners, solvents), exposure to biological materials (e.g., feces, dander), repetitive motion injuries, slips and falls, and lacerations and amputation from sharp tools and machinery.Although addressing conventional risk factors (e.g., chemical and mechanical exposures) remains important for improving the health of immigrant and low-income workers, greater attention is being given to how work organization affects their health and safety.5,8 The National Institute for Occupational Safety and Health (NIOSH)9 defines “work organization” as the processes and organizational practices that influence job design. Work organization domains include the timing of when work is performed, such as shifts and hours worked, seasonality, and flexibility; the physical and psychological demands of work; the control or decision latitude workers have, including variation in effort and choice in performing work; and style of supervision and support, including supervisor support and control and work safety climate.10,11Work organization has most often been considered in its effects on job satisfaction and health of white-collar workers. Although work organization is believed to be particularly influential in the health and safety of vulnerable workers, little research has examined work organization and health outcomes for vulnerable populations such as immigrant workers.5,8,12 Even less research has focused on work organization among immigrant women. For example, recent analyses of work organization and health among US immigrant workers in agriculture13-15 and construction16-18 have shown that, among agricultural workers, job demands are associated with poorer physical health13; high worker control is associated with better mental health14; and poor safety climate is associated with greater musculoskeletal discomfort.15 Among construction workers, poor work safety climate is associated with poor work safety behavior.16 However, participants in these studies have been almost exclusively male.Recent analyses of work organization and health among immigrant poultry processing workers have included a substantial number of women.19-22 These analyses showed that management practices, such as poor safety commitment, and job design, such as authority, variety, psychological workload, frequent awkward posture, and repetitive movement, are associated with risk of recent musculoskeletal problems, respiratory problems, and self-reported injury or illness.19-21 In a similar way, organizational hazards, including low job control and high psychological demand, are associated with increased risk for epicondylitis, rotator cuff syndrome, and back pain.22 However, these analyses have not focused on women or on gender differences. A qualitative analysis of female immigrant household domestic workers in Spain reported that such work organization factors as job control affect health.23,24The job demand–control–support model10,11 provides a framework for examining the association of work organization and health among women immigrant manual workers. This model posits that jobs with greater physical and psychological demand or stressors will result in poorer health. However, jobs with greater control or decision latitude can result in better health and can offset the effects of demand leading to poor health. Finally, support of peers and supervisors, including perceived safety climate25 (how workers perceive supervisors’ valuing safety over production) reduces occupational injury and buffers the effects of job demands.The place of work organization in the health of immigrant women is particularly important. These women have major family, child care, and domestic responsibilities that they need to integrate into their work responsibilities.12,26 Immigrant women are also extremely vulnerable to workplace physical and sexual harassment, as they often do not speak English, do not know their rights, and may lack proper work documents.27-29This analysis had 2 goals. The first was to delineate work organization attributes of full-time employed immigrant Latinas with manual occupations. The work organization attributes included indicators of job demands, decision latitude, and support. The second goal was to determine the associations of work organization attributes with health characteristics of these women, including physical health, mental health, and health-related quality of life. We tested 3 hypotheses: (1) greater job demands will be associated with poorer physical health, mental health, and health-related quality of life; (2) greater decision latitude will be associated with better physical health, mental health, and health-related quality of life; and (3) greater job support (higher perceived supervisor control, better job safety climate) will be associated with better physical health, mental health, and health-related quality of life.