Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002

BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.     

Shift work and occupational medicine: an overview

In modern society, more and more people work during 'non-standard' working hours, including shift and night work, which are recognized risk factors for health, safety and social well-being. Suitable preventive and protective measures are required to mitigate the adverse effects and ensure that the worker can cope satisfactorily. These are based mainly on the organization of shift schedules according to ergonomic criteria and on specific medical surveillance. Occupational medicine has to consider very carefully the several factors (psycho-physiological, pathological and social) that can influence tolerance and/or maladaptation.     

Non-fatal injuries in the West Virginia logging industry: using workers' compensation claims to assess risk from 1995 through 2001

BACKGROUND: The logging industry has a high rate of both fatal and non-fatal injuries in comparison to other industries, and plays a vital role in WV's economy. METHODS: Workers' compensation (WC) injury claims and employment data were summarized to examine patterns and rates of non-fatal logging injuries in WV from 1995 through 2001. RESULTS: The average annual rate of injury claims was 16.0 per 100 workers per year with rates remaining relatively steady over the 7-year study period. The highest rates of injury were a result of being struck by an object, typically trees, snags, or logs. CONCLUSIONS: WV loggers most often file injury claims as a result of being struck by trees and tree parts, snags, and logs. Assessment of risk is a critical component in helping regulators, researchers, and the logging industry develop viable prevention strategies to reduce the incidence and severity of logging-related injuries.     

The impact of educational interventions on primary health care workers' knowledge of occupational exposure to blood or body fluids

AIM: To assess the impact of educational interventions on primary health care workers' knowledge of management of occupational exposure to blood or body fluids. METHODS: Cluster-randomized trial of educational interventions in two National Health Service board areas in Scotland. Medical and dental practices were randomized to four groups; Group A, a control group of practices where staff received no intervention, Group B practices where staff received a flow chart regarding the management of blood and body fluid exposures, Group C received an e-mail alert containing the flow chart and Group D practices received an oral presentation of information in the flow chart. Staff knowledge was assessed on one occasion, following the educational intervention, using an anonymous postal questionnaire. RESULTS: Two hundred and fifteen medical and dental practices were approached and 114 practices participated (response rate 53%). A total of 1120 individual questionnaires were returned. Face to face training was the most effective intervention with four of five outcome measures showing better than expected knowledge. Seventy-seven percent of staff identified themselves as at risk of exposure to blood and body fluids. Twenty-one percent of staff believed they were not at risk of exposure to blood-borne viruses although potentially exposed and 16% of exposed staff had not been immunized against hepatitis B. Of the 856 'at risk' staff, 48% had not received training regarding blood-borne viruses. CONCLUSIONS: We found greater knowledge regarding management of exposures to blood and body fluids following face to face training than other educational interventions. There is a need for education of at risk primary health care workers.     

Impact of a latex policy on an acute NHS hospital: an audit

BACKGROUND: A latex policy was introduced in 1999 in a large, acute UK hospital. AIM: To audit the impact of the policy. METHOD: Semi-structured interview of the managers of 40 wards between April 2001 and July 2002. RESULTS: A policy was available on only 26 (65%) of the wards. Compliance with the policy was limited to 20 (50%) wards. CONCLUSIONS: Compliance with the policy was low in the hospital. Staff and patients are being unnecessarily exposed to the hazard of latex.     

Screening for high-risk and elevated alcohol consumption in day and shift workers by use of the AUDIT and CDT

BACKGROUND: Alcohol consumption levels and drinking patterns have been reported to vary between day and shift workers, although the results have been conflicting. Previous results indicate that questions about alcohol habits may be asked in the workplace. However, no studies have evaluated the Alcohol Use Disorders Identification Test (AUDIT) or the alcohol biomarker carbohydrate-deficient transferrin (CDT) in serum for this purpose. AIM: To investigate, in conjunction with routine health examinations, whether there is any difference between permanent day and shift workers in high-risk alcohol consumption, according to the AUDIT and CDT. Gamma-glutamyl transferase (GGT) in serum was included mainly as a comparison test. METHODS: The employees who attended for a regular health examination during the study period were offered voluntary alcohol screening with the AUDIT and CDT. RESULTS: Altogether, 990 employees (day, two-shift, and three-shift workers) participated in the study, 194 (20%) of whom screened positive with the AUDIT and/or CDT. There were no significant differences in the screening results between day and shift workers, whereas significantly fewer of the two-shift workers (odds ratio=0.5, 95% confidence interval=0.3-0.9) screened positive with CDT. CONCLUSIONS: The present findings on employees who attended for regular health examinations suggest that shift workers did not show a higher level of risky alcohol consumption than day workers, according to the results with the AUDIT, CDT and GGT. On the contrary, the two-shift workers appeared to drink significantly less.     

Characteristics of working hours and the risk of occupational injuries among hospital employees: a case-crossover study

Objectives:We investigated the association of working hours with occupational injuries in hospital shift work.Methods:Registry data of occupational injuries of hospital employees from 11 towns and 6 hospital districts were linked to daily payroll data to obtain working hours for 37 days preceding the first incidence of the injury (N=18 700). A case-crossover design and associated matched-pair interval analysis were used to compare working hour characteristics for three separate hazard windows among the same subjects. Conditional logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI).Results:We found an elevated risk of an occupational injury for workdays with evening shifts (OR 1.09, 95% CI 1.03–1.14) and workdays following night shifts (OR 1.33, 95% CI 1.17–1.52). After excluding commuting injuries, the risk increased during the evening shifts (OR 1.15, 95% CI 1.09–1.23) and the work days following night shifts (OR 1.44, 95% CI 1.24–1.69), but was no more significant during the morning shifts. Injury risk increased following a week of ≥5 morning shifts or ≥3 evening shifts, but did not increase according to the number of preceding night shifts or quick returns. The length of the work shift (OR 1.22, CI 1.06–1.42) – not the length of the weekly working hours – was associated with an increased risk.Conclusions:The results indicate an increased occupational injury risk during the evening shifts and during work days following night shifts, with the risk increasing according to the number of evening but not night shifts.     

女性医护人员的生殖健康现状及其影响因素

女性医护人员工作强度高,经常接触各种药物、放射线等危害因素,这些职业危害因素可对其生殖健康造成影响。本文就女性医护人员生殖健康现状、对生殖健康的认知情况、影响生殖健康的主要因素等问题进行综述。重点分析倒班工作、化学毒物及物理因素对生殖健康的影响。     

Evaluation of the burden of logging injuries using West Virginia workers' compensation claims data from 1996 to 2001

BACKGROUND: The risks associated with logging are well documented, however little work has been done on estimating the economic impact of injuries among loggers. METHODS: West Virginia Workers' Compensation claims data for the period 1996-2001 was used to assess the economic burden of logging injuries in the state. RESULTS: There were 1,371 claimants during this period with the highest number of claims (39%) in the 25-34 years age category. The total cost of injuries was over US dollars 14 million. The most severe injuries, traumatic brain injuries (TBI), thoracic, cervical, and lumbar, resulted in the highest medical costs, indemnity costs and permanent disability. The average medical cost for logging-related to TBI was US dollars 198,048 compared to US dollars 15,321 for other major industries. CONCLUSIONS: The magnitude of the economic costs underscores the need for active research of injury prevention among loggers and for greater attention to occupational safety and health programs.     

A registry-based case-control study of risk factors for the development of multiple non-fatal injuries on the job

Using compensation records of Taiwan, we conducted a case-control study nested within a cohort of 77,846 active workers who experienced at least one incidence of non-fatal work-related injury between 1994 and 1996 in order to explore factors associated with risk of sustaining multiple non-fatal injuries in the workplace. Cases (n = 2,616) were workers with more than three incidences of non-fatal injury during the study period and controls (n = 3,974) were randomly sampled from workers who experienced only one incidence of non-fatal injury during the same period. Compared with construction workers, workers employed in mining and quarrying (OR = 2.7), manufacturing (OR = 1.2), commerce (OR = 1.6), transport, storage and communication (OR = 1.3) and social, personal and community service (OR = 1.4) were all at significantly elevated risk of multiple non-fatal injuries. Both age and wage showed a significant dose-response effect on the risk of developing multiple non-fatal injuries. The preliminary analysis suggests that workers in certain industries are at significantly elevated risks of multiple work-related non-fatal injuries, in particular those in the mining and quarry industries. Additionally, further preventive measures should be aimed at protecting older workers from such injuries and further studies would help provide more specific interpretations on the positive association between higher wage earning and risk of multiple non-fatal injuries.     

A longitudinal study of the influence of shift work on serum uric acid levels in workers at a telecommunications company

BACKGROUND: Hyperuricemia is a lifestyle-related disease. Although there have been many previous reports about the association of serum uric acid (UA) levels with lifestyle, including eating habits and alcohol intake, there has been no report of a longitudinal study of the relationship between serum UA levels and shift work. AIMS: To clarify the influence of shift work on serum UA levels in Japanese workers. METHODS: This was a 4-year cohort study of 15 871 workers at a telecommunications company. Pooled logistic regression analyses by sex were performed, with job schedule type, age, body mass index (BMI), lifestyle and the results of blood chemistries as covariates. RESULTS: In males, shift work, part-time work, BMI, consumption of alcohol (less than twice per week, two to five times per week or more than five times per week) and little preference for vegetables were positively associated with the development of increased serum UA (>or=8 mg/dl in males, >or=6 mg/dl in females). In females, age, BMI and a history of smoking were positively associated with the development of increased serum UA. CONCLUSION: This study revealed that shift work is independently related to increased serum UA in males.     

Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore

AIMS: To describe the psychological impact of severe acute respiratory syndrome (SARS) on health care workers in a regional general hospital 2 months post-outbreak. METHOD: Doctors and nurses were encouraged to participate. The survey consisted of self-report measures: demographics, the General Health Questionnaire (GHQ) 28 and Impact of Events Scale (IES). A questionnaire enquiring about changes in life's priorities due to SARS and circumstances that helped with coping was used. Participation was strictly voluntary and responses anonymous. RESULTS: In total 177 out of 661 (27%) participants [40 out of 113 (35%) doctors and 137 out of 544 (25%) nurses] had a GHQ 28 score >or=5. Doctors [P = 0.026, odds ratio (OR) = 1.6 and 95% confidence interval (CI) = 1.1-2.5] and single health care workers were at higher risk (P = 0.048, OR = 1.4 and 95% CI = 1.02-2.0) compared to nurses and those who were married. Approximately 20% of the participants had IES scores >or=30, indicating the presence of post-traumatic stress disorder (PTSD). Four areas were classified as more important using factor analysis: health and relationship with the family, relationship with friends/colleagues, work and spiritual. The areas for coping strategies were clear directives/precautionary measures, ability to give feedback to/obtain support from management, support from supervisors/colleagues, support from the family, ability to talk to someone and religious convictions. Support from supervisors/colleagues was a significant negative predictor for psychiatric symptoms and PTSD. Work and clear communication of directives/precautionary measures also helped reduce psychiatric symptoms. CONCLUSIONS: Many health care workers were emotionally affected and traumatized during the SARS outbreak. Hence, it is important for health care institutions to provide psychosocial support and intervention for their health care workers.