Health problems of automobile mechanics in Nigeria

A questionnaire-based survey was conducted among automobile mechanics and allied technicians in a semiurban city. Three hundred people were interviewed. The questionnaire sought information on health problems associated with work, the presence of chronic illness and where workers seek help when they fall ill. The interview was followed by an examination of the hands for dermatitis. Musculoskeletal disorders were the commonest work-related health problems reported by respondents. Of the 50 respondents who recorded musculoskeletal disorders, 27 (54%) had low back pain. Seventy-five (25%) of the respondents had signs of hand dermatitis: commonest among panel beaters and welders. Hand dermatitis and musculoskeletal disorders are the predominant health problems among automobile mechanics. Recommendations for improved health and safety include health education programmes aimed at eliminating hazardous work practices such as sucking of petrol and poor lifting techniques. This study has shown that workers in small-scale industries are willing to accept assistance and advice on improving the health and safety of their workforce.     

Low back pain problems among steelworkers

The associations between low-back pain and occupational work loads, life-style factors, and sociodemographic factors were examined in 469 steel plant workers (436 males, 33 females), mean age (sd): 40 (12) years. Fifty-one per cent had experienced low-back pain during the preceding year. The strongest associations were found between recent low-back pain and domestic recreational activities (> or = h/wk vs 0-2 h/wk), and between recent low-back pain and work pace (too fast vs. adequate), odds ratios (95% confidence limits) being respectively 3.0 (1.5-5.8), and 2.3 (1.2-4.2). We considered a subject to have a particularly severe history of low-back pain if he or she due to low-back trouble (i) had ever been admitted to a hospital, (ii) had ever had to change work or, (iii) had had more than one week's sick-leave accumulated during the preceding year. There was a strong association between a severe low-back pain history and life-time occupational exposure to heavy and frequent lifting on the job. Forty-seven per cent of severe low-back pain events could be ascribed to heavy and frequent lifting, provided the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low-back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work environment.     

Working conditions, living conditions and physical health problems declared among penitentiary administration personnel in France

A cross-sectional epidemiological survey was conducted among prison staff in France to investigate the relationships between working conditions and health. The sample included men and women 20 to 64 years old belonging to all categories of prison personnel: prison guards, administrative staff, socioeducational workers, technicians, health care workers, and managers (n = 4587, response rate 45.7%). A mailed self-administered questionnaire was used to assess sociodemographic characteristics, working conditions, and physical and mental disorders. Multiple logistic regression analyses were conducted to determine the effects of working conditions and social relationships on health of prison staff. However, the results reported here only concern 17 health disorders: body mass index, sick leave, medication use, accidents, digestive disorders, lower extremities and back disorders, hypertension, hemorrhoids, arthritis, skin disorders, urinary infections, chronic bronchitis, cholesterol, gastric ulcer, respiratory infections, ocular disorders. The living non professional conditions mostly associated with health disorders were financial difficulties (OR: 1.9 for digestive disorders, 1.8 for gastric ulcer, 1.7 for medication use) and irregularity of meals (OR = 1.5 for digestive disorders, and hypertension). In the occupational environment, the factors most associated with health disorders are seniority (OR = 4.2 for arthritis, 2.3 for cholesterol) and constraints (OR = 1.7 for lower extremities disorders). In spite of some limits associated to this kind of study, relationships between occupational and non occupational factors and physical health conditions were observed; the results also pointed out the protective role of the social relationships for health conditions.     

Respiratory disease in workers exposed to colophony solder flux fumes: continuing health concerns

The objectives of this study were to establish the prevalence of respiratory, eye, nose and throat symptoms of likely work-relation in workers exposed to colophony solder flux fumes and to assess their lung function. A cross-sectional study was conducted in four medium-sized electronics firms in which control measures to capture solder flux fume were absent or visibly ineffective. All female solders and women working adjacent to soldering stations completed an administered questionnaire concerning symptoms, work history and current soldering frequency. Measurements were made of their forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) during the course of a working shift, using a Vitallograph-Compact portable spirometer. Using weekly hours of soldering as a crude index of current exposure, workers were classified into high (> or = 37 h/wk) and low (< or = 20 h/wk) exposure groups, and their health responses were compared in the analysis. Individuals with symptoms suggestive of work-related asthma were also asked to provide serial peak flow measurements over a further 2-week period, and adequate returns were charted and read by two physicians experienced in the diagnosis of occupational asthma. Data were collected on 152 female workers (overall participation rate = 97%). Symptoms of recurrent, persistent wheeze and/or chest tightness were reported by 75 (49%) of interviewees; 36 (24%) gave a history typical of occupational asthma and six more (4%) a history of pre-existing asthma worsened at work. Twenty-one (14%) of the workforce complained of recurrent breathlessness on moderate exertion; 41 workers (27%) had work-related symptoms of the nose or throat and 25 (16%) had work-related eye symptoms. The odds ratios for 'all wheeze', shortness of breath, and work-related eye, nose and chest symptoms were all significantly greater (raised about 4-5 fold) in women who soldered > or = 37 h/wk when compared with those soldering < or = 20 h/wk. After adjustment by logistic regression for atopy, age and smoking status even higher risk estimates were generally obtained. The odds ratios (OR) and 95% confidence intervals (CI) for high vs. low were: for 'all wheeze', OR = 7.2, CI = 2.5-20.7; for work-related eye symptoms, OR = 5.2, CI = 1.4-19.8; for work-related nasal symptoms, OR = 4.0, CI = 1.4-11.1 and for occupational asthma symptoms, OR = 5.2, CI = 1.4-14.2. Mean FEV1 and FVC percentage difference from expected were slightly lower in full-time solderers than in part-time solderers, but the differences were not significant. Thirty-seven of the 51 workers (73%) who were asked to carry out serial peak flow measurements completed an adequate return: 27 of these records confirmed the presence of asthma, and in all of the cases the history suggested onset post-dating employment in soldering. Eleven peak flow records were indicative of occupational asthma. The health problems associated with colophony solder flux were documented over 18 years ago, but are still clearly apparent in situations where adequate control has not been achieved.     

Occupational asthma in a latex doll manufacturing plant

BACKGROUND: Occupational asthma caused by latex has been reported in health care workers and workers in glove manufacturing plants. OBJECTIVE: We report occupational asthma from latex in a newly identified occupational setting, a latex doll manufacturing plant. METHODS: We evaluated an index case of asthma associated with work in a latex doll manufacturing plant by performing a workplace challenge and evaluating the work environment. We then performed an occupational survey and skin testing of 22 workers in the doll manufacturing plant. RESULTS: The patient, a 21-year-old woman, had severe immediate bronchospasm within minutes of beginning a workplace challenge where sanding of latex parts was performed. Two of 22 workers surveyed (including the patient) reported flushing, rhinoconjunctivitis, and wheezing on exposure to sanded doll parts. These two workers were the only subjects surveyed to have a history of atopy and positive immediate-type skin test responses to a raw latex extract and to common aeroallergens. CONCLUSIONS: Sanding or grinding of solid latex during the manufacturing process may result in a significant incidence of occupational asthma and rhinoconjunctivitis from latex sensitization. Atopic workers appear to be most susceptible to developing latex sensitivity in this setting.     

Back pain and agricultural work among farmers: an analysis of the Colorado Farm Family Health and Hazard Surveillance Survey

BACKGROUND: Back pain is the most prevalent occupational health problem experienced by much of the world's workforce. However, agricultural work-related back pain occurring among US farmers working on small operations or family farms is usually not included in surveillance. With data collected by Colorado Farm Family Health and Hazard Surveillance Survey, this study reports characteristics of and risk factors for back pain among adult farmers living in eight Colorado counties. METHODS: A stratified probability sample of 500 farms was selected in proportion to the number of farms in study areas. During the 4-year period from 1993 through 1996, 458 farms were enrolled in the study and 759 farmers were interviewed using a questionnaire. Information on self-reported back pain and potential risk factors among 742 white farmers was evaluated and reported here. RESULTS: A total of 194 farmers (26.2%) reported to have had at least one episode of back pain lasting for 1 week or more. Males had a slightly higher prevalence of back pain than females (28.6% vs. 22.5%) and the lower back was the predominantly affected part of body among both males and females. In 45.4% of males and 43.9% of females back pain was brought on by repeated activities. Males' activities at work were more likely to cause back pain while females' activities at home were more likely to cause back pain. Three factors were found to be significantly associated with back pain: being depressed (odds ratio (OR) = 3.68, 95% confidence interval (CI) = 2.23-6.09), farming/ranching as main activities (OR = 1.66, CI = 1.17-2.36), and worked in agriculture for 10 to 29 years (OR = 1.62, CI = 1.14-2.30). CONCLUSIONS: Our analyses indicate that back pain is an occupational health problem among farmers on small operations or family farms and that back pain affected males and females differently. The finding of significant positive associations between depression, farming activities, and back pain warrants further attention.     

Society of Gastroenterology Nurses and Associates, Inc. (SGNA) Endoscopic Disinfectant Survey results compared with control group

Disinfectant surveys from responding members of the American Society of Postanesthesia Nurses were divided into two groups based on whether or not they considered themselves to be exposed to disinfectants in their work environment. Their survey responses were then compared with those obtained previously from members of the Society of Gastroenterology Nurses and Associates, Inc., who were regularly exposed to 2% alkaline glutaraldehyde in the work setting. There were significant differences among the groups in the percentage of respondents who reported having headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue. These findings support the association of these complaints with 2% alkaline glutaraldehyde exposure. In contrast, there were no significant differences among the groups in the percentage of respondents who reported having asthma, rhinitis, chest pain, nausea, diarrhea, muscle/joint pain, visual disturbances, or dermatitis.     

A case-control study of multiple myeloma and occupation

Lifetime job histories from a population-based, case-control study were analyzed to investigate the relationship between multiple myeloma and employment in various occupations and industries. Interviews were obtained from 89% (692) of eligible incident cases and 83% (1683) of eligible controls. An elevated risk was observed among persons ever employed as painters [odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.2-3.6], particularly for those employed for 10 or more years (OR = 4.1, 95% CI = 1.8-10.4). A small excess risk was observed among agricultural workers employed for 10 or more years (OR = 1.3, 95% CI = 1.0-2.2), with a higher relative risk observed among farm laborers (OR = 1.8, 95% CI = 1.0-4.0). Among agricultural workers who reported having been highly exposed to pesticides, the OR was 5.2 (95% CI = 1.6-21.1). Some evidence, based on smaller numbers, was also found to support an association with firefighting and employment in the petroleum- and coal-products manufacturing industries. Little evidence was found to support the previously noted association with wood exposure, and no evidence for an association with employment in the rubber or petroleum refining industries was found. This study lends further support to previously reported associations between multiple myeloma and employment among painters and agricultural workers.     

Habitual physical activity in a population residing in the city of Barcelona

OBJECTIVES: To describe the sociodemographic distribution of habitual physical activity and to analyse its relationship with self-perceived health status and occupational status, among the population older that 16 years of age in the city of Barcelona, Spain. METHODS: A sample of 1,885 adult men and 2,196 women answered the Health Interview Survey of Barcelona in 1992. Those whose habitual activity required high physical exertion or walking were considered as active. Bivariate and multivariate analyses adjusting logistic regression models were used to study the relationship between habitual physical activity and the rest of variables, for each occupational situation. RESULTS: Fifty six percent of adults reported being physically active. Physical activity was lower among workers than non workers, although workers reported more physical exertion (14.5% in men and 8.0% in women). Physical activity was associated with occupation and educational level among male workers, but only with occupation among female workers. In the non working population, physical activity was lower among those who perceived their health status as fair or poor, compared with those that described it as good or very good, (ORa in men was 0.2, 95% confidence interval = 0.1-0.5; ORa in women was 0.5, 95% confidence interval = 0.3-0.8). CONCLUSIONS: More than half of the Barcelona population were physically active in an habitual manner. Among workers, this activity was mainly determined by the occupation. Non-workers with a poor self-perceived health status did less physical activity.     

Glycine receptor reduction within segmental gray matter in a rat model in neuropathic pain

OBJECTIVES: To determine the prevalence rates of self-reported sleep complaints and their association with health-related factors. DESIGN: A cross-sectional study. SETTING: People living in the community. PARTICIPANTS: A total of 2398 noninstitutionalized individuals, aged 65 years and older, residing in the Veneto region, northeast Italy. MEASUREMENTS: Odds ratios for the association of sleep complaints with potential risk factors. RESULTS: The prevalence of insomnia was 36% in men and 54% in women, with increased risks for women (odds ratio (OR) = 1.69, 95% CI: 1.3-2.1), depression (OR = 1.93, 95% CI, 1.5-2.5), and regular users of sleep medications (OR = 5.58, 95% CI, 4.3-7.3). About 26% of men and 21% of women reported no sleep complaints. Night awakening, reported by about two-thirds of the participants, was the most common sleep disturbance. Women and regular users of sleep medications had significantly increased odds for insomnia and for not feeling rested upon awakening in the morning. Depressive symptomatology was more strongly associated with insomnia and night awakening than with awakening not rested, whereas physical disability was more strongly associated with awakening not rested than with the other two sleep disturbances. CONCLUSION: Our findings show that sleep complaints, highly common among older Italians, are associated with a wide range of medical conditions and with the use of sleep medications. Further longitudinal studies are needed to investigate the causes and the negative health consequences of sleep disturbances to improve both the diagnosis and treatment.     

Occupational respiratory allergy in bakery workers: a review of the literature

Baker's asthma has long been recognized as a serious disease among workers in the bakery industry and the number of cases with baker's asthma is steadily increasing. This paper presents a review of the available literature on baker's allergy with a special focus on the allergens involved, the epidemiologic research and issues on exposure assessment, evidence of exposure-response-relationships, and possible prevention strategies. A large number of potential allergens have been identified and are described here. At present little is known about the incidence of baker's allergy. On the other hand, a large number of cross-sectional studies have been performed, showing that sensitization and work-related symptoms are common among bakery workers. Only atopy and exposure level have consistently been reported as determinants of this occupational disease. Age, gender, and smoking habits do not seem to be associated with sensitization or work-related respiratory symptoms. Recently, immunochemical methods have been developed to measure specific allergens in the bakery industry, which have been used to unravel the role of allergen exposure in the development of baker's asthma. Clear exposure-response-relationships have been found. The implications of these recent findings for prevention strategies and standard setting are discussed.     

Occupational health through primary health care clinics in Singapore

The training of primary health care workers in occupational health is important for the provision of occupational health care to the workforce. In Singapore, over 400 Designated Factory Doctors, mostly general practitioners, have been trained. Occupational health is also incorporated in the training of family medicine trainees. Referral centres for cases of suspected work-related diseases are also available. Two specialist occupational health clinics function within Government polyclinics serving the large working population in Singapore. One such clinic operates every Wednesday morning at the Jurong Polyclinic. In the last four years, 485 patients with work-related complaints were seen. There were 268 cases (55%) of occupational skin disease, 74 patients (15%) with respiratory complaints, 38 patients (8%) with acute toxic exposures and 36 patients (7%) with musculoskeletal complaints. Three hundred and forty-nine of the referrals (72%) came from the Jurong Polyclinic doctors, with small numbers from other polyclinics and neighbouring private practitioners. The experience gained in conducting this clinic demonstrated that significant numbers of diseases seen at the polyclinic are work-related in varying degrees. Hence, there is a need for the further development of occupational health care delivery within the primary health care system. This can be achieved by improving occupational health training for all primary health care workers, providing an occupational health resource person at primary health care centres, and raising the awareness of such referral facilities in occupational medicine.     

Fatal and non-fatal childhood injuries in Metropolitan Toronto, 1986-1991

OBJECTIVE: To estimate the prevalence of human immunodeficiency virus (HIV) infection among health care workers who donate blood. DESIGN: Point prevalence survey of blood donors. SETTING: 20 U.S. blood centers that participate in an ongoing interview study of HIV-seropositive blood donors. MEASUREMENTS: Prevalence rates for HIV in persons who reported being health care workers were measured directly for 6 of the 20 blood centers. For the other 14 centers, we derived the numerator from the interview study in the same manner used for the 6 centers; we estimated the denominator using blood collection logs at those centers and extrapolations from the survey completed at the 6 blood centers. RESULTS: Between March 1990 and August 1991, 8519 health care workers donated blood at 6 hospitals and other medical facilities. Three persons were HIV seropositive: Two reported being health care workers and having nonoccupational risk factors for HIV infection; the occupation and other possible risk factors of the third seropositive donor could not be determined. Therefore, the highest overall prevalence of HIV infection among health care worker donors at these 6 centers was 0.04% (3 of 8519; upper limit of 95% CI, 0.1%). We estimated that during the same period, approximately 36,329 health care workers were tested for HIV at all 20 centers. Twenty-seven persons infected with HIV who donated at hospitals were identified; 7 did not return for interviews, so their health care occupations could not be verified. Thus, the highest estimated overall prevalence of HIV infection among health care worker donors at the 20 centers was 0.07% (27 of 36,329; upper limit of CI, 0.1%). Of the 20 known health care worker donors, 11 reported nonoccupational risks for HIV infection; 3 of the remaining 9 health care workers described occupational blood exposures that could have resulted in transmission of HIV. CONCLUSIONS: Blood donors can serve as a sentinel cohort when evaluating the risk for occupationally acquired HIV infection. These findings suggest that among the many health care worker donors in this study, HIV infection attributable to occupational exposure was uncommon.     

Clinico-statistical investigation about cement dermatitis in Italy]

To define the prevalence of cement dermatitis (allergic contact dermatitis-ACD-and irritant contact dermatitis-ICD), two retrospective studies have been carried out in Italy: the first one based on the analysis of dermatitis cases ascribable to cement as defined by INAIL (Italian Institute for Industrial Accidents Insurance) from 1984 to 1992; the second one by surveying cement dermatitis cases in workers in the building industry aged between 16 and 70 carried out by Istituto di Clinica Dermatologica dell'Università di Bari from 1988 to 1994. The survey on INAIL data showed that in the years take into account 5,290 dermatitis cases included in item 41 of the occupational diseases table have been defined. About 80% of these cases have been observed in workers working as bricklayers and floor-layers. Therefore, given the remarkable exposure to cement in these professions, the prevalence of cement dermatitis in Italy has been estimated to 6 cases/province/year, even though it has not been possible recognize the clinical form of cement dermatitis. Moreover, the study showed that disabling cutaneous after-effects eligible for compensation have been observed in 30% of the cases defined by INAIL. The allergologic study carried out by Clinica Dermatologica has not only defined the incidence of contact dermatitis (ACD and ICD), in building workers, but it has also extrapoled dermatitis cases due to cement. As a whole, in the years taken into account, 166 occupational or mixed ACD cases and 77 occupational or mixed ICD have been diagnosed. The incidence of contact dermatitis ascribable to cement has equalled 79% among ACD and 88% among ICD, with a ratio of about 2 to 1 in favour of allergic forms. Among the chemicals tested, potassium bichromate showed the highest frequency of cases positive to patch tests. The skin site the most affected by cement dermatitis is hand, followed by upper limbs, lower limbs and feet. In the province of Bari, in the years taken into account, an average incidence of 28.4 cases per year of the two forms of cement dermatitis has been observed.     

CMV infection and cytomegalovirus disease in immunodepressed patients

An active entomologic survey was conducted by a team of trained health workers in a rural area endemic for Chagas' disease in central Brazil. They used pyrethrum as a flushing agent and 4,232 houses were inspected for triatomine bugs both inside and in the immediate environs. Houses with Triatoma infestans or evidence of an established colony were identified and defined as infested houses (cases). The building and environmental characteristics of 161 randomly selected infested houses were compared with 161 matched, noninfested houses (controls) that were the shortest distance from the infested house. Domestic and peridomestic potential risk factors associated with house infestation by Triatoma infestans were assessed by logistic regression analysis. Incomplete house construction (odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.5-4.1) was confirmed as a risk factor related to the presence or evidence of Triatoma infestans in the dwellings. The study also disclosed a statistically significant association between the presence of rats (OR = 1.6, 95% CI = 1.1-2.6) and indoor crop storage (OR = 2.3, 95% CI = 1.1-5.2) and house infestation. Further experimental field studies using tagged rodents should be conducted to assess their epidemiologic role in the domestic chain of Trypanosoma cruzi transmission.     

Occupational eczema in gardeners and greenhouse workers in the county of Funen

The aims of the study were to assess the prevalence of and association between occupational dermatitis and possible risk factors in gardeners and greenhouse workers living on Funen, describe the distribution of different types of eczema and detect the allergens most commonly involved. A cross-sectional study, based on a postal questionnaire and subsequent patch testing of selected persons was carried out in 1958 gardeners. The response rate was 84.6%, and among 250 persons patch tested the most frequently sensitizing occupational allergens were plants of the Compositae family and the fungicide captan. Allergic occupational contact dermatitis was suspected in 43 persons (17%). Irritant eczemas outnumbered allergic eczemas and both were most often caused by plants. The lifetime prevalence of occupational dermatitis was 19.6%. Occupational mucosal symptoms, working with Compositae and training as a gardener in females were significantly associated with an increased prevalence of occupational eczema, whereas sex, age and personal atopy seemed to be of less importance.     

Occupational asthma due to latex in health care workers

Immediate hypersensitivity reactions ranging from mild urticaria to life threatening anaphylaxis after exposure to natural rubber latex have been reported frequently in health care workers while occupational asthma due to latex exposure is less well studied. The results of specific challenge tests and immunological tests in four health care workers with work related respiratory and skin disorders induced by the use of latex gloves are described. Occupational asthma was confirmed in three subjects by specific challenge tests. All had a positive skin test reaction to the latex extract; specific IgE antibodies were detected in only one subject. The fourth subject had a negative specific inhalation and skin test reaction to the latex extract. Peak expiratory flow monitoring at work and away from work showed a pattern consistent with work related asthma. These findings confirm that latex is a cause of occupational asthma in health care workers.     

Molecular tools for presymptomatic testing in multiple endocrine neoplasia type 1

This study sought to determine the prevalence of upper-extremity musculoskeletal disorders (UEMSDs) among keyboard operators in Sao Paulo, Brazil, and to compare this prevalence with that among other office workers. One hundred and thirty keyboard operators (mean age 33 years, 60 male/70 female) and 138 office workers (mean age 35 years, 82 male/56 female) from two computing centers were interviewed by a research assistant using a standardized questionnaire. Symptomatic subjects, defined as those who reported upper extremity pain or lost work time due to pain in the preceding 12 months, were examined by a rheumatologist. Mean (SD) lengths of employment were 9 (6) years for keyboard operators and 8 (6) years for office workers. Upper-extremity pain during the preceding seven days was reported by 66 keyboard operators (51%) and by 18 office workers (13%) (p < 0.0001); during the preceding 12 months, by 90 keyboard operators (69%) and by 26 office workers (19%) (p < 0.0001). UEMSDs were diagnosed following physical examination in 50 keyboard operators and in 12 office workers (9%) (p < 0.0001). Tenosynovitis was the most common disorder diagnosed among the keyboard operators (n = 23). Among the keyboard operators the prevalence of UEMSDs was significantly lower for males (p = 0.017, OR = 0.38, 95%CI = 0.17-0.86). The presence of a diagnosed UEMSD was significantly associated with duration of employment (p = 0.005) and lack of or insufficient rest breaks (p = 0.012). Keyboard operators had significantly more UEMSDs than did office workers. Strategies aimed at the reduction of repetitive strain injuries among keyboard operators, such as the provision of adequate work breaks, should be evaluated.     

Health conditions among the currently employed

This report presents national estimates of the prevalence and incidence of selected health conditions and their work-related consequences among currently employed persons 18 years of age and over. The major health conditions presented include back pain; hand discomfort; dermatitis; eye, nose, and throat irritation; and work injuries. Also presented are estimates of the distribution of workers on selected physical activities and exposures at work. Data are presented by age, sex, race, ethnicity, education, and broad occupational category.