Outpatient laparoscopic cholecystectomy: safe and cost effective?

OBJECTIVE: Reports on the aetiology and risk of occupational rhinitis in different occupations are scarce. METHOD: The purpose of this study was to find the occupations with an increased risk of occupational rhinitis. Age and gender differences in occupational rhinitis and occupational asthma were also compared, and the most common causes of occupational rhinitis were analysed. DESIGN: This study covered the cases of occupational rhinitis and asthma reported to the Finnish Register of Occupational Diseases during the years 1986-1991. The cases on the Register were linked to the longitudinal census data file from the Finnish censuses. RESULTS: During 1986-1991, 1244 new cases of occupational rhinitis (474 women and 497 men) and 1867 new cases of occupational asthma (916 women and 951 men) were reported to the Register. Animal dander, flours, wood dusts, textiles, phthalic acid anhydrides and storage mites were important causes of occupational rhinitis. The highest relative risk of occupational rhinitis was among furriers, the age-standardized rate ratio (SRR) was 30.0. Bakers and livestock breeders had also a markedly elevated relative risk (SRR = 22.0). Men had the highest incidence of occupational rhinitis at the age of 25-29 years and among women the incidence gradually increased and reached the peak in the group 40-44 years of age. CONCLUSION: Furriers, bakers, and livestock breeders had the most elevated relative risk of occupational rhinitis. Occupational rhinitis cases reported at a younger age than asthma, suggesting that rhinitis often precedes asthma.     

Occupational pathology: present and future

Formed 75 years ago, occupational pathology has defined structure of occupational morbidity, determined principles of occupational diseases' pathogenesis and pathomorphosis, demonstrated dependence of occupational entities on acting occupational hazards, described clinical manifestations of occupational diseases, emphasized informative diagnostic complexes. Diagnosis in occupational pathology now is established on basis of etiology. Manifold activities helped to form a system preventing health disorders caused by occupational hazards. Topical problem is to elaborate and put into practice some criteria for compensation of occupational damage with differential expert assessment of functional disorders caused either by occupational disease or by general one. Prospective trend could be to create a system organizing and managing workers' health on workplace and to put "protection by time" principle into practice with forecasting risk of occupational diseases and dose-effect dependence. Another prospect is to elaborate and put into practice a training in social and psychologic adaptation for occupational managers and industrial workers.     

Adolescents' participation in organized activities and developmental success 2 and 8 years after high school: Do sponsorship, duration, and intensity matter?

Using data from the National Education Longitudinal Study, the authors examined relations between educational, civic, and occupational success in young adulthood and the duration and intensity of participation in organized activities during high school. They also examined these relations as a function of sponsorship (i.e., school- vs. community-sponsored organized activities). They found that youths who participated in organized activities for 2 years demonstrated more favorable educational and civic outcomes in young adulthood than those who participated for 1 year. More intensive participation was also associated with greater educational, civic, and occupational success in young adulthood--particularly among youths who participated in activities for 2 years. Educational attainment often mediated the relations between temporal measures of participation and young adult civic and occupational outcomes. With the exception of analyses examining occupational success, findings varied little as a function of sponsorship. Of note, analyses revealed that both temporal measures of participation were positively associated with young adult outcomes as many as 8 years after high school. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Morbidity of occupational diseases in Poland in the years 1994-1996

The authors analysed all cases of occupational diseases diagnosed in Poland over the last three years. The following variables were considered: age, gender of patients, duration of exposure to factors inducing occupational disease, nosologic units, and the types of work places by the European Activity Classification and their localization by voivodships. The obtained results helped to formulate the following conclusions: 1. The number of occupational diseases in the period under study ranged annually between 11,156 and 11,320 cases. The incidence rates (number of cases/100,000 employed) fell within 116-131. 2. The general incidence of occupational diseases was shaped by: hearing impairment, chronic diseases of voice organs, communicable and invasive diseases, pneumoconioses, skin diseases, vibratory syndrome and poisoning. 3. The majority of diagnosed diseases occurred at least after 10 years of occupational exposure to causal factor. 4. The highest incidence of occupational diseases by the European Activity Classification was observed in mining and quarrying, manufacture, education and health services. 5. The analysis of the occupational disease incidence in individual work places indicated a number, however small, of enterprises which are a major source of these diseases.     

Incorporating a mulitilevel perspective into occupational stress research: Theoretical, methodological, and practical implications.

In recent years, scholars in organizational behavior and public health have recognized the value of multilevel modeling. This article draws from both of these fields to illustrate the benefits of incorporating a multilevel perspective into the study of occupational stress. The authors identify key multilevel issues in occupational stress in terms of (a) individual-level analyses, (b) group-level analyses, and (c) cross-level analyses. They integrate the theoretical points with statistical models to help illustrate how one can test multilevel occupational stress propositions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Noxious fumes in a medical center: chemical and psychological aspects

Due to spine-loading activities nursing professionals have a relatively high incidence/prevalence of low back pain. As lumbar disc disorders can be regarded as occupational diseases (since January 1993, occupational disease BK 2108, normally more than 10 years of exposition, lumbar disc disorders with pain and reduced motility) international literature is reviewed. Own results of different prevalence-, case-control- and incidence studies (relative risk for lumbago sciatica/odds ratio for disc prolaps appr. 3-6 depending on age and occupational age) are presented. Finally the question of compensation and prevention of disc disorders is discussed.     

Development and test of a model linking safety-specific transformational leadership and occupational safety.

The authors developed, tested, and replicated a model in which safety-specific transformational leadership predicted occupational injuries in 2 separate studies. Data from 174 restaurant workers (M age=26.75 years, range=15-64) were analyzed using structural equation modeling (LISREL 8; K. G. J?reskog & D. S?rbom, 1993) and provided strong support for a model whereby safety-specific transformational leadership predicted occupational injuries through the effects of perceived safety climate, safety consciousness, and safety-related events. Study 2 replicated and extended this model with data from 164 young workers from diverse jobs (M age=19.54 years, range=14-24). Safety-specific transformational leadership and role overload were related to occupational injuries through the effects of perceived safety climate, safety consciousness, and safety-related events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Influence of education and occupation on the incidence of Alzheimer's disease

OBJECTIVE: Several cross-sectional studies have found an association between Alzheimer's disease (AD) and limited educational experience. It has been difficult to establish whether educational experience is a risk factor for AD because educational attainment can influence performance on diagnostic tests. This study was designed to determine whether limited educational level and occupational attainment are risk factors for incident dementia. DESIGN: Cohort incidence study. SETTING: General community. PARTICIPANTS: A total of 593 nondemented individuals aged 60 years or older who were listed in a registry of individuals at risk for dementia in North Manhattan, NY, were identified and followed up. INTERVENTIONS: We reexamined subjects 1 to 4 years later with the identical standardized neurological and neuropsychological measures. MAIN OUTCOME MEASURES: Incident dementia. RESULTS: We used Cox proportional hazards models, adjusting for age and gender, to estimate the relative risk (RR) of incident dementia associated with low educational and occupational attainment. Of the 593 subjects, 106 became demented; all but five of these met research criteria for AD. The risk of dementia was increased in subjects with either low education (RR, 2.02; 95% confidence interval [Cl], 1.33 to 3.06) or low lifetime occupational attainment (RR, 2.25; 95% Cl, 1.32 to 3.84). Risk was greatest for subjects with both low education and low life-time occupational attainment (RR, 2.87; 95% Cl, 1.32 to 3.84). CONCLUSIONS: The data suggest that increased educational and occupational attainment may reduce the risk of incident AD, either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.     

Microgravity and its implication for fermentation biotechnology

A population-based occupational fatality surveillance system was used to identify 452 work-related fatalities in Kentucky over a 3-year period. Three hundred eighty-six workers less than 65 years old were included in this analysis of potentially productive years of life lost (PPYLL). A total of 9,275 years of potentially productive life were lost due to these occupational fatalities, costing the state economy $148 million in lost wages. Most of this loss (70%) was in the industries of transportation/communication/public utilities, manufacturing, mining and construction. The transportation/communication/public utilities division alone accounted for 21.4% of the total lost earnings. The agriculture/forestry/fishing division exceeded all others in potentially productive years of life lost. However, because of its lower mean income and older ages at death, that division ranked fifth in lost earnings. This article demonstrates that prevention resources should be directed at the agriculture, transportation, and logging industries, and to the prevention of fatalities caused by tractors, motor vehicle crashes, and falling objects, to be most effective in reducing the enormous economic burden of occupational fatalities.     

Using audioteleconferencing to link occupational therapy graduate students in the United States and Canada

Lack of access to graduate education in the United States and Canada is a frustration for many occupational therapists who wish to further their careers. One way to overcome lack of access is to use technology to bridge the distances. The occupational therapy schools at the Medical University of South Carolina, Charleston, and Dalhousie University, Halifax, Nova Scotia, have collaborated for several years to provide graduate occupational therapy courses via audioteleconferencing. A general overview of the progress made in the project, as well as its design and unique features, is discussed. The major recommendation is that more occupational therapy schools could use distance education to collaborate when resources are few and needs are great. Such efforts benefit both faculty members and students.     

Predicting adult occupational environments from gender and childhood personality traits.

To test aspects of a theory of the role of personality and gender on the development of vocational interests and their subsequent effects on adult occupational choices, the authors of this study examined associations among childhood personality traits, gender, and occupational environments more than 40 years later. Participants (N = 587) were assessed on the Big Five by their teachers when the participants were between 6 and 12 years old. In middle-age (late 40s), the participants reported their occupation. Holland's (1997) RIASEC vocational types (Realistic, Investigative, Artistic, Social, Enterprising, Conventional) were used to characterize the job environments of reported occupations. Childhood Openness/Intellect and Conscientiousness, but no other Big Five traits, were associated with occupational environments. For the most strongly sex-typed work environments, associations with Openness/Intellect were moderated by gender. These findings suggest that the roots of the strongest gender-stereotyping effects in occupations may be found not only in the social factors associated with gender but also in the individual differences of children related to Openness/Intellect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational skin and respiratory diseases among hairdressers

OBJECTIVES: The occurrence and causes of hairdressers' occupational skin and respiratory diseases were studied. METHODS: Of a random sample of 500 female hairdressers aged 15-54 years, 355 were available for study. Of the 189 reporting work-related skin and respiratory symptoms in a computer-aided telephone interview on exposure and health, 130 underwent a physical examination, lung function tests, prick and patch testing, and nasal and lung provocation tests. An occupational disease was diagnosed when the causality between exposure and disease was probable and the clinical tests supported the diagnosis. RESULTS: The telephone interview revealed a life-time prevalence of 16.9% for hand dermatoses, 16.9% for allergic rhinitis, and 4.5% for asthma among the hairdressers. In the clinical investigations, the prevalence was 2.8% for occupational dermatoses, 1.7% for occupational rhinitis, and 0.8% for occupational asthma. Ammonium persulfate caused 90% of the respiratory diseases and 27% of the hand dermatoses. Paraphenylenediamine, natural rubber latex, and skin irritation were also causes of hand dermatitis. Allergy to human dandruff (8.6%) and Pityrosporum ovale (12.1%) was common. Previously diagnosed atopic diseases increased the risk for occupational skin or respiratory disease 3-fold (odds ratio 2.9, 95% confidence interval 1.1-7.9). Of the cases, 37.5% (6 of 16 persons) had to change occupations during a 3-year follow-up. CONCLUSIONS: Work-related skin and respiratory symptoms are common among hairdressers. Often a specific cause (eg, ammonium persulfate) can be found if occupational diseases are suspected and diagnosed. Hairdressers with atopic diseases are at risk of developing occupational skin and respiratory diseases.     

The risk of Parkinson's disease with exposure to pesticides, farming, well water, and rural living

We assessed exposure to pesticides, farming, well water use, and rural living as risk factors for Parkinson's disease (PD) in a population-based case-control study consisting of men and women > or = 50 years of age who had primary medical care at Henry Ford Health System in metropolitan Detroit. Enrolled PD patients (n = 144) and control subjects (n = 464) were frequency-matched for age, race, and sex. When adjusted for these variables and smoking status, there was a significant association of occupational exposure to herbicides (odds ratio [OR], 4.10; 95% CI, 1.37, 12.24) and insecticides (OR, 3.55; 95% CI, 1.75, 7.18) with PD, but no relation was found with fungicide exposure. Farming as an occupation was significantly associated with PD (OR, 2.79; 95% CI, 1.03, 7.55), but there was no increased risk of the disease with rural or farm residence or well water use. The association of occupational exposure to herbicides or insecticides with PD remained after adjustment for farming. The association of farming with PD was maintained after adjustment for occupational herbicide exposure and was of borderline significance after adjustment for occupational insecticide exposure. These results suggest that PD is associated with occupational exposure to herbicides and insecticides and to farming and that the risk of farming cannot be accounted for by pesticide exposure alone.     

Combination insulin and sulfonylurea therapy in insulin-requiring type 2 diabetes mellitus

OBJECTIVES: To identify ethical dilemmas experienced by occupational and physical therapists working in the UK National Health Service (NHS). To compare ethical contexts, themes and principles across the two groups. DESIGN: A structured questionnaire was circulated to the managers of occupational and physical therapy services in England and Wales. SUBJECTS: The questionnaires were given to 238 occupational and 249 physical therapists who conformed to set criteria. RESULTS: Ethical dilemmas experienced during the previous six months were reported by 118 occupational and 107 physical therapists. The two groups were similar in age, grade, and years of experience. Fifty of the occupational therapy dilemmas occurred in mental health settings but no equivalent setting emerged for physical therapy. Different ethical themes emerged between the two groups, with the most common in occupational therapy being difficult/dangerous behaviour in patients and unprofessional staff behaviour, and for physical therapists resource limitations and treatment effectiveness. No differences were found in the ethical principles used. CONCLUSION: The ethical dilemmas reported by the therapists were primarily concerned with health care ethics, rather than the more dramatic ethics reported in much of the biomedical ethics literature. Differences were found between the two professional groups when ethical contexts and themes were compared but not when ethical principles were compared. This suggests that educators and researchers need to be aware of work settings and the interdisciplinary nature of employment as well as ethical principles held by individual therapists.     

Physical activity and risk of colorectal cancer in men and women

We examined the association between self-reported occupational and recreational physical activity and the subsequent risk of colorectal cancer in a population-based cohort in Norway. During a mean follow-up time of 16.3 years for males and 15.5 years for females, 236 and 99 colon cancers and 170 and 58 rectal cancers were observed in males and females, respectively, among 53,242 males and 28,274 females who attended the screening between 1972 and 1978. Physical activity at a level equivalent to walking or bicycling for at least four hours a week during leisure-time was associated with decreased risk of colon cancer among females when compared with the sedentary group (RR = 0.62, 95% CI 0.40-0.97). Reduced risk of colon cancer was particularly marked in the proximal colon (RR = 0.51, 95% CI 0.28-0.93). This effect was not observed for occupational physical activity alone, probably due to a narrow range of self-reported physical activity at work among females. However, by combining occupational and recreational physical activity we observed an inverse dose-response effect as increasing total activity significantly reduced colon cancer risk (P for trend = 0.04). Among males 45 years or older at entry to the study, an inverse dose-response effect was observed between total physical activity and colon cancer risk (P for trend = 0.04). We also found in males a stronger preventive effect for physical activity in the proximal as compared to distal colon. In addition, we found a borderline significant decrease in colon cancer risk for occupational physical activity in males 45 years or older when compared to the sedentary group (RR = 0.74, 95% CI 0.53-1.04). All results were adjusted for age, body mass index, serum cholesterol and geographic region. No association between physical activity and rectal cancer was observed in males or females. The protective effect of physical activity on colon cancer risk is discussed in regard to energy balance, dietary factors, age, social class, body mass index and gastrointestinal transit time.     

Introduction to the Special Section on Psychological and Behavioral Approaches to Occupational Health.

The history of the International Commission on Occupational Health is deeply bound to that of the 20th century. First and only international scientific society of such an importance, it was founded in 1906 to bring solutions to the problems caused by a great number of occupational injuries and diseases due to the developing of industry. With the passing years, from a small medical group it has become a multidisciplinary society, present in 90 countries, where researchers, government authorities, and practitioners are coexisting in a permanent exchange between practice and research. It is composed of international scientific committees, which organize regular conferences and meet every 3 years on the occasion of the great International Congress in Occupational Health. Owing to the changes due to the new technologies of work and to the globalization of economy, the orientation of its activities is in progress: larger opening toward developing countries and the phenomenon of development in general, emphasis on prevention in occupational health, and opening of a new field of research on the psychosocial factors and work organization. At the first conference on this theme, held in Copenhagen in August 1998, occupational health and occupational psychology specialists to meet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sensitivity to latex and other rubber substances--an important occupational risk for health personnel (case report)

Sensitization to latex and rubber additives has been acknowledged during the last 10 years as a major occupational health problem among health-care workers. In sensitized persons, respiratory and/or skin symptoms may be present. Pathophysiologic mechanisms of senzitisation involve allergic reactions types I and IV (Coombs and Gell). In this case report we described a female health-care worker with sensitization to latex and rubber additives simultaneously present on the skin and in the respiratory system, caused by wearing protective rubber gloves. The complex diagnostic procedure involved in determination of occupational allergic diseases is discussed.     

Present and future activities of the IAEA on internal dosimetry: lessons learned from international intercomparisons

The International Atomic Energy Agency (IAEA) conducts safety activities to support the assessment of occupational exposure due to intakes of radionuclides; a comprehensive set of safety documents will soon be completed. In recent years, extensive improvements in measurement techniques, phantoms and computational tools have been made. Thus, it is important for laboratories involved in internal dosimetry to undergo performance testing procedures to demonstrate the correctness of the methods applied and also to determine the consistency of their results with those obtained by other laboratories. Several intercomparisons were organised, and they revealed significant differences among laboratories in their approaches, methods and assumptions, and consequently in their results. This paper presents the current and future IAEA activities in support of assessment of occupational exposure due to intakes of radionuclides in the IAEA Member States, as well as the lessons learned from several intercomparison exercises in the last 5 years.