The demographic and contextual correlates of work‐related repetitive strain injuries among canadian men and women

Background

The study sought to identify gender differences in work‐related repetitive strain injuries (RSI), as well as examine the degree to which non‐work factors such as family roles interact with gender to modify RSI risk. Another aim is to examine whether there are potential provincial differences in work‐related RSI risk.

Methods

The 2003/2005 Canadian Community Health Survey included over 89,000 respondents who reported working in the past 12 months. Separate multi‐level models for men and women were used to identify the correlates of work‐related RSIs.

Results

Women reported sustaining more work‐related RSIs than men. Also, having one or more children in the household was associated with lower work‐related RSI risk for females. Both men and women in British Columbia reported higher work‐related RSI rates than in Ontario.

Conclusions

Gender contributes to RSI risk in multiple and diverse ways based on labor market segregation, non‐work exposures, and possibly biological vulnerability, which suggests more tailored interventions. Also, the provincial differences indicate that monitoring and surveillance of work injury across jurisdictions can assist in province‐wide prevention and occupational health and safety evaluation. Am. J. Ind. Med. 56:1180–1189, 2013. © 2013 Wiley Periodicals, Inc.     

Multiorgan failure in critically ill patients

Of 1136 patients admitted consecutively to two medical-surgical intensive care units, 100 were found to have multiorgan failure, defined as failure of more than two organ systems. The average duration of stay in the intensive care units was 13.4 days. The overall death rate was 78% compared with 12.8% for patients without multiorgan failure. The most common initiating illnesses or insults were sepsis, surgery, accidental trauma and cardiogenic shock. Of potential risk factors studied, shock, sepsis, surgery, pre-existing organ disease and age over 65 years were the most common. Although sepsis occurred before or during the course of multiorgan failure in 78 patients, in only 34 was sepsis judged to be the prime insult leading to multiorgan failure. Surgery during the course of multiorgan failure had neither an adverse nor beneficial effect on outcome. The mean number of organ systems failing was 4.36 for survivors and 5.03 for nonsurvivors. The most common systems to fail were central nervous, cardiovascular and respiratory.     

Variation in Health and Health Care Use by Socioeconomic Status in Winnipeg,Canada: Does the System Work Well? Yes and No

Health varies with socioeconomic status; those with higher incomes or who are better educated can expect to have better health. The success of the Canadian universal health care system in delivering care according to need was assessed. Consistent gradients in all-cause and cause-specific mortality according to neighborhood income characteristics are evident among Winnipeg residents. Poorer, less healthy groups receive more acute hospital care and have more contacts with general practitioners. Surgical rates and contacts with specialist physicians, however, show less variation by socioeconomic status. One reason may be that members of higher socioeconomic groups have the skills required to negotiate for surgery when they develop conditions, like joint pain, that are less critical. The move toward organized priority lists in Canada may remedy this situation. As access to health care is more equalized, improvement in the health of lower and middle socioeconomic groups will occur through changes in social policy like improvement of educational opportunities.     

Aggregation-related association of lipid with the cytoskeleton of rabbit and human platelets prelabeled with [3H]palmitic acid. Similar effects of adenosine diphosphate- and thrombin-induced aggregation.

To investigate the association of lipid with the cytoskeleton of platelets during aggregation, rabbit and human platelets were isolated and labeled with [3H]palmitic acid; lipid extraction showed approximately 80% in phospholipid. Limited aggregation was induced with ADP or thrombin, and the cytoskeleton was isolated after lysis with 1% Triton X-100, 5 mM EGTA. Cytoskeleton from unactivated platelets had approximately 0.03% of the total label in the platelets, but after aggregation with ADP (2 microM) or thrombin (0.1 U/ml) for 20-30 s, 1.5-8% of the label was with the cytoskeleton. Fibrinogen enhanced aggregation and the association of label with the cytoskeleton; incorporation of label increased exponentially as aggregation proceeded, decreased exponentially during deaggregation, and appeared to be related to the number of sites of contact. Inhibitors that increase cyclic AMP inhibited aggregation and cytoskeletal labeling, but aspirin had no effect. Some experiments were done with DNase I and Ca2+ in the Triton X-100 lysis medium to cause actin depolymerization, under conditions in which the Ca2+-dependent protease activity was inhibited. This greatly reduced the association of label with the cytoskeleton at early time points, but when aggregation had proceeded further, a large proportion of the label was not dissociated by this treatment. These findings, electron microscopy, and the enrichment of the cytoskeleton of aggregated platelets with only some of the membrane proteins that were labeled by the 125I-lactoperoxidase method, indicated that with limited aggregation, the 3H-labeled lipid was mainly associated with the cytoskeleton and not with trapped membrane fragments resulting from incomplete lysis. Since the pattern of cytoskeleton labeling ([3H]palmitate) and the selective association of some membrane proteins with the cytoskeleton/lipid complex was the same with ADP and thrombin, the reactions must be dependent on aggregation and not on events associated with the release of granule contents.     

How many employees receive safety training during their first year of a new job?

OBJECTIVE: To describe the provision of safety training to Canadian employees, specifically those in their first year of employment with a new employer. DESIGN: Three repeated national Canadian cross-sectional surveys. SUBJECTS: 59 159 respondents from Statistics Canada's Workplace and Employee Surveys (1999, 2001 and 2003), 5671 who were in their first year of employment. MAIN OUTCOME: Receiving occupational health and safety training, orientation training or office or non-office equipment training in either a classroom or on-the-job in the previous 12 months. RESULTS: Only 12% of women and 16% of men reported receiving safety training in the previous 12 months. Employees in their first 12 months of employment were more likely to receive safety training than employees with >5 years of job tenure. However, still only one in five new employees had received any safety training while with their current employer. In a fully adjusted regression model, employees who had access to family and support programs, women in medium-sized workplaces and in manufacturing, and men in large workplaces and in part-time employment all had an increased probability of receiving safety training. No increased likelihood of safety training was found in younger workers or those in jobs with higher physical demands, both of which are associated with increased injury risk. CONCLUSIONS: From our results, it would appear that only one in five Canadian employees in their first year of a new job received safety training. Further, the provision of safety training does not appear to be more prevalent among workers or in occupations with increased risk of injuries.     

The relation among vessel injury, thrombus formation, and platelet survival in rabbits

Continuous or repeated injury of rabbit aortae by indwelling vascular catheters caused the deposition of platelets on the injured vessels and the formation of thrombi rich in platelets and fibrin at sites where flow was most disturbed and injury was most extensive. Incorporation of 51Cr platelets into the thrombi reached a maximum between 3 and 24 hr. The platelet-fibrin-rich thrombi remained reactive to circulating platelets for at least 14 days. Continuing reactivity of thrombi and the turnover of platelets in the thrombi were accompanied by an increase in the proportion of platelets that separated in the least dense fraction on Stractan density gradients. Platelet survival was also shortened (43.5 +/- 5.9 hr in animals with catheters, compared with 62.6 +/- 4.5 hr in animals with a sham operation), indicating that some platelets that had taken part in thrombus formation or had interacted with the injured vessel wall were rapidly cleared from the circulation. Platelets from rabbits that had had indwelling aortic catheters in place for 3 or 6 days survived significantly longer than those from animals with a sham operation upon injection of the platelets into normal animals; thus, continuous turnover of platelets on injured vessels and thrombi, and the clearance of altered platelets, leads to a population of younger platelets that survive longer. The continuing reactivity of thrombi may in part account for repeated occlusive episodes in vascular disease. The contribution of thrombin generation and fibrin formation to the platelet-rich thrombi is substantial and warrants the ongoing evaluation of treatment with a combination of anticoagulant and antiplatelet agents in arterial thrombosis and in thrombus formation on vascular catheters.     

Expression of fibrinogen on the surface of ADP-stimulated platelets: comparison of human and rabbit platelets

Fibrinogen is a cofactor in the aggregation of human platelets and must be added to suspensions of washed human platelets for extensive aggregation to occur in response to ADP. Although the patterns of fibrinogen binding and dissociation during platelet aggregation and deaggregation are similar for human and rabbit platelets, washed rabbit platelets aggregate extensively when stimulated with ADP even in the absence of added fibrinogen. To determine whether secreted fibrinogen was present on the surface of ADP-stimulated platelets and available to support aggregation, the binding of 125I-F(ab')2 fragments of anti-fibrinogen antibodies to formaldehyde-fixed platelets was measured. Although no fibrinogen was detected on human platelets either before or after treatment with ADP, fibrinogen was expressed on the surface of rabbit platelets after stimulation with ADP. However, this secreted fibrinogen did not dissociate during deaggregation of the platelets. Thus, the aggregation of rabbit platelets in the absence of exogenous fibrinogen may be supported by secreted fibrinogen, but a fibrinogen-independent component has not been completely ruled out.     

Social and economic consequences of workplace injury: a population-based study of workers in British Columbia, Canada

BACKGROUND: Existing research suggests that workplace injuries can have significant economic and social consequences for workers; but there are no quantitative studies on complete populations. METHODS: The British Columbia Linked Health Database (BCLHD) was used to examine 1994 injured workers who lost work time due to the injury (LT) and a group of injured individuals who did not lose time after their injuries (NLT). Three outcomes were explored: (1) residential change, (2) marital instability, and (3) social assistance use. Logistic regression adjusted for several individual and injury characteristics. RESULTS: LTs were more likely to move and collect income assistance benefits, and less likely to experience a relationship break-up than the NLTs. LTs off work for 12 or more weeks were more likely to receive income assistance than LTs off for less time. CONCLUSIONS: The increased risk suggests that the long-term economic consequences of disabling work injury may not be fully mitigated by workers compensation benefits.     

Enhanced platelet accumulation onto injured carotid arteries in rabbits after aspirin treatment.

Prostacyclin (PGI2) is a powerful inhibitor of platelet aggregation, but its role in the pathogenesis of arterial thrombosis is uncertain. We have studied the thrombogenic effect of inhibiting PGI2 production by aspirin (ASA) in carotid arteries of rabbits given 0, 3, 10, or 100 mg ASA/kg either 1, 3, 6, or 20 h beforehand. Platelet accumulation onto injured carotid arteries was enhanced with ASA in a dose of 10 mg/kg. A higher dose of ASA (100 mg/kg) had no further effect. The enhanced thrombogenic effect of ASA persisted for at least 20 h and was associated with a decrease in vessel wall PGI2 production. There was a strong inverse correlation (r = 0.55, P less than 0.01) between PGI2 production and platelet accumulation. The findings suggest that the margin of safety in obtaining an antithrombotic effect of ASA and producing a potential thrombotic effect in arteries may not be as large as predicted by studies using cultured endothelial cells or experimentally induced thrombosis in veins.