Sonographic finding of undescended testes in fetuses at 35-40 weeks: significance and outcome

This paper studies the prevalence of risk factors considered responsible for osteoporosis in women of 4 occupational groups: farmers, blue collar workers, white collar workers/civil servants and housewives. We analyzed nutritional factors associated with osteoporosis in the scientific literature. The total sample comprises of 2185 individuals of which 658 women were taken into the analyses. The data set was based on a health survey conducted in 10 selected rural communities of Styria in Austria between 1995 and 1996. Sociodemographic data, lifestyles, internal and external resources as well as indicators off ill-health were surveyed through standardized personal interviews. The results show that the women of the 4 occupational groups were differently strained regarding nutritional risk factors. Our results suggest that efficient intervention programs to prevent osteoporosis need to specifically focus on the various life contexts of women.     

Factors associated with male workers' engagement in physical activity: white collar vs. blue collar workers

The purpose of this study was to identify factors associated with male workers' participation in different kinds of physical activity, noting differences between white collar and blue collar workers. This study examined the variables, perceived health status, self efficacy, perceived barriers, age, education, income, and job category (Pender, 1987) for their association with physical activity. Self efficacy and perceived health status were the cognitive-perceptual factors that predicted physical activity. Job category (e.g., blue collar vs. white collar) was found to be a highly significant predictor of physical activity. Comparing physical job requirements with the individual worker capacity can suggest to the occupational health nurse physical fitness programs that are most appropriate for individual workers.     

Disorders of the back and spine in construction workers. Prevalence and prognostic value for disability

STUDY DESIGN: A cohort study on back-related morbidity and its impact on early retirement resulting from disability among employees in the construction industry. OBJECTIVE: To describe the prevalence of back-related morbidity according to different measures in various occupational groups and to assess the prognostic value of these measures for early retirement resulting from disability. METHODS: The results of occupational health examinations conducted in 1986-1988 among 4,958 employees of the German construction industry aged 40-64 years were analyzed. Active follow-up evaluation was carried out between October 1992 and July 1994 to ascertain employment status. RESULTS: Compared with that of white-collar employees, no excess risk for self-reported back pain or sciatica was seen for any of the manual professions. In contrast, the age-adjusted prevalence of clinical findings of the spine was elevated among all employees in manual professions, and the prevalence of a recorded diagnosis related to disorders of the back and spine (ICD-9 position 720-724) was elevated among bricklayers compared with white-collar employees. The relative risk of being granted a disability pension in the follow-up period was 1.6 (95% Confidence Interval [Cl], 1.3-2.1) for persons reporting back pain or sciatica, 1.8 (95% Cl, 1.4-2.2) for persons with an abnormal clinical finding of the spine, and 1.5 (95% Cl, 1.2-1.8) for persons with a recorded medical diagnosis related to disorders of the back or spine (ICD-9 720-724). CONCLUSION: Patterns of morbidity varied according to the evaluated morbidity measure. All three measures qualified as significant predictors of disability and helped to identify high-risk occupations and high-risk employees.     

Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence

BACKGROUND: Work-related musculoskeletal disorders cause pain, disability and loss of employment for many workers, including musicians. Although performing arts medicine is a growing field, the health problems of musicians remain under-recognized and under-researched. Therefore, the author undertook a systematic review of published information on the incidence and prevalence of playing-related musculoskeletal disorders (PRMDs) in classical musicians. METHODS: Seven databases were searched for the period 1980 to 1996. The main textbook and performing arts medicine journals were searched manually, as were reference lists of all relevant papers. The author also contacted individuals familiar with the literature of performing arts medicine. Studies were included for review if they reported PRMD incidence or prevalence in classical musicians. Of the 24 studies identified, 18 cross-sectional surveys and cohort studies were reviewed. The author subjectively assessed the studies using criteria modified from an existing evaluation scale and used 4 criteria for data combination. On the basis of prevalence values from the eligible studies, chi 2 tests for heterogeneity were performed. RESULTS: Only one study estimated PRMD incidence. Ten of the 17 prevalence studies were ineligible for data combination, because of low response rates and other methodological problems. In the 7 eligible studies, PRMD point prevalence ranged from 39% to 87% in adult musicians and from 34% to 62% in secondary school music students. The best estimates of PRMD prevalence were derived from the 3 studies that excluded mild complaints; these studies indicated that PRMD prevalence was 39% and 47% in adults and 17% in secondary school music students respectively. Statistical combination of data across studies within each demographic category was not possible. INTERPRETATION: Available data indicate that the prevalence of PRMD in adult classical musicians is comparable to the prevalence of work-related musculoskeletal disorders reported for other occupational groups. Several recommendations for future research are outlined.     

Syndrome X and mortality: a population-based study. Risk Factor and Life Expectancy Research Group

The present report analyzes the prevalence of the cluster of metabolic abnormalities defined as syndrome X (high blood glucose, high blood pressure, low high density lipoprotein (HDL) cholesterol, and high triglycerides) and its impact on cardiovascular disease mortality in a large cohort of men and women (22,561 men and 18,495 women). These individuals were participants in a series of epidemiologic investigations of cardiovascular disease conducted in Italy between 1978 and 1987. They were followed for an average of 7 years, during which time a total of 1,218 deaths occurred (1,003 in men and 215 in women). Deaths were coded according to the International Classification of Diseases, 9th Revision (ICD-9). The prevalence of the full cluster of metabolic abnormalities (syndrome X) was low in the population as a whole, with only 3.0 percent of men and 3.4 percent of women exhibiting the full cluster of abnormalities that comprise syndrome X. The risk of death from all causes and cardiovascular disease increased with increased numbers of metabolic abnormalities in both men and women. Mortality from cancer was significantly increased in women (but not in men) with syndrome X, compared with women with no metabolic abnormalities. Population attributable risks for all cause mortality and cardiovascular disease mortality were 0.06 and 0.09 in men and 0.04 and 0.48 in women when assessed by population cutpoints. These data from a large population-based epidemiologic investigation indicate that the presence of a full cluster of metabolic abnormalities from syndrome X is an important risk factor for cardiovascular disease and all-cause mortality in both men and women, but that the low prevalence of such a cluster in the population reduces the public health impact of syndrome X. The majority of individuals who die from cardiovascular disease present elevations in any one, two, or three of the metabolic abnormalities. The notion of the cluster of metabolic abnormalities (syndrome X) should not distract our attention from established individual risk factors that have been proven to be major causes of cardiovascular disease death and disability in our society.     

Retinoic acid syndrome: a case report

The objective of this study was to investigate the impact of allergy to hymenoptera venom on the occupational activities of patients undergoing immunologic treatment for insect sting anaphylaxis. The design was a cross-sectional study conducted in a sample of 500 out of 1,500 patients undergoing venom immunotherapy for insect sting reaction in 13 allergy clinics in Israel. A self-administered questionnaire was used to collect data about demographic characteristics of patients, severity of the allergic reaction and adverse effects on occupational activities. Of the 204 respondents who were part of the labour force, 48.5% reported adverse effects on routine occupational activities. The factors with a significant influence on the probability of adverse occupational effects were: (1) patient's type of work (blue collar vs. white collar: OR = 3.22, p < 0.001: army vs. white collar: OR = 5.28, p = 0.001); (2) severity of the allergic reaction (severe reaction vs. mild/moderate reaction: OR = 2.34, p = 0.007). Our findings suggest that severe insect sting allergy has an adverse impact on patients' occupational activities. This factor requires special attention by the medical community. Social workers and occupational physicians should collaborate in the assessment and management of these patients.     

Comparison of cardiovascular risk profile between male employees of two automotives companies in France and Sweden. The Coeur Project Group

To determine whether or not the lower rate of coronary disease in France, in comparison with Sweden, might be explained by different cardiovascular risk profiles, a cross-sectional analysis (first step of a longitudinal study) of comparable samples of automotive workers was carried out in corporate occupational health clinics of Renault and Volvo. Traditional cardiovascular risk factors were evaluated and the Framingham coronary risk was estimated for 1000 randomly selected 45-50 years old Caucasian males from each company. Compared with the Frenchmen, the Swedish men consisted of more white collar workers and were slightly older. After adjustment for age and blue/white collar status, the Swedish men showed lower body mass indexes, waist to hip rations and heart rates, lower frequency of treatment of hypercholesterolemia and diabetes than the Frenchmen. The Swedish males also exhibited higher averages of blood cholesterol, low density lipoprotein (LDL) cholesterol and glucose, but lower frequencies of hypercholestrolemia and diabetes, and a higher frequency of family histories of cardiovascular disease. Blood pressure, hypertension prevalence, triglycerides level, and high density lipoprotein (HDL) did not differ between the groups. The average number of traditional risk factors was 1.1/person for the Frenchmen and 0.8/person for the Swedes. However, the coronary risk as estimated using the Framingham index was not different between the groups. This, together with the more frequent family history of cardiovascular disease in Swedish men, suggests a lower susceptibility to risk factors as a possible explanation for the lower cardiovascular disease prevalence reported in France, and/or the possibility that factors not measured were involved.     

Do changes in cardiovascular risk factors explain the increasing socioeconomic difference in mortality from ischaemic heart disease in Finland?

STUDY OBJECTIVE: To estimate the extent to which changes in blood pressure, smoking, and serum cholesterol concentration explain the observed increase in socioeconomic differences in mortality from ischaemic heart disease (IHD) in Finland during the past 20 years. DESIGN: Predicted changes in mortality from IHD were calculated using logistic regression models with the risk factor levels assessed by cross sectional population surveys conducted in 1972, 1977, 1982, and 1987. The subjects included white collar and blue collar workers and farmers. The predicted changes were compared with the observed mortality changes in the same socioeconomic groups in the total population of the same geographical area. SETTING: North Karelia and Kuopio provinces, eastern Finland. PARTICIPANTS: 16,741 men and 16,389 women aged 30-59 randomly drawn from the population registers of the study areas. Mortality data were obtained from the total population in the same areas. MAIN RESULTS: In men, the changes in diastolic blood pressure, total serum cholesterol, and smoking predicted a 28% decline in the mortality from IHD among white collar workers, a 30% decline among blue collar workers, and a 33% decline in farmers. Observed declines in the same socioeconomic groups were 61%, 40%, and 37%, respectively. In women, the predicted decline was 41% among white collar workers, 35% among blue collar workers, and 39% among farmers. The respective observed declines were 57%, 43%, and 20%. CONCLUSIONS: Less than half of the decline in IHD mortality among white collar men was explained by the risk factor changes, while they explained 75% of the decline among blue collar men and 89% of the decline among male farmers. Changes in risk factors did not explain the increasing difference in IHD mortality between the socioeconomic groups, especially among men.     

Mental health differences among retirees and workers: Findings from the normative aging study.

Researchers during the past decade have found little effect of retirement on physical health. However, retirement entails a number of losses, and its effect on mental health, as measured by the prevalence of psychological symptoms, is unclear. We examined psychological symptoms in a sample of 1,513 older men, participants in the Normative Aging Study, using the SCL-90-R (Derogatis, 1983). Analyses of variance indicated that retirees reported more psychological symptoms than did workers, even after controlling for physical health status. Exploratory analyses examining the circumstances of retirement found no effects for length of retirement or part-time employment, but did find effects for the timing of retirement. Both early and late retirees reported more psychological symptoms. Late workers (aged 66 and older) reported the fewest symptoms. Reasons for these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current Perspectives on Occupational Cancer Risks

On the basis of the International Agency for Research on Cancer's evaluations of occupational exposures, 22 occupational agents are classified as human carcinogens and an additional 22 agents as probable human carcinogens. In addition, evidence of increased risk of cancer was associated with particular industries and occupations, although no specific agents could be identified as etiologic factors. The main problem in the construction and interpretation of such lists is the lack of detailed qualitative and quantitative knowledge about exposures to known or suspected carcinogens. The recent examples of recognized occupational carcinogens, such as cadmium, beryllium, and ethylene oxide, stress the importance of the refinement in the methods for exposure assessment and for statistical analysis on the one hand and the potential benefits from the application of biomarkers of exposure and early effect on the other hand. Other trends that may be identified include the increasing practice of multicentric studies and investigations of exposures relevant to white collar workers and women. Finally, there is a need for investigation of occupational cancer risks in developing countries.     

The single-breath nitrogen test in coal miners: factors associated with failure to perform

The objectives of this study were to determine the prevalence of musculoskeletal complaints in a population of lock assemblers in the West Midlands; to follow one group over 12 months and to explore the relationship between survey data, sickness absence information and claims experience. An adapted Nordic Musculoskeletal Questionnaire was used to determine annual and weekly prevalence and annual disability rates for musculoskeletal complaints. There was no statistically significant difference in complaints between the six companies, apart from an increased reporting of neck (p < 0.001), upper back (p < 0.001) and hip (p < 0.05) symptoms at one company (Site 4) during the week prior to the study. When the study was repeated at Site 4 one year later, new employees had significantly fewer complaints of neck and elbow discomfort over the previous year and week, but no difference in wrist complaints was reported. This survey of lock assemblers has highlighted high levels of self-reported upper limb complaints when compared to other referent groups of workers.     

Open-lung biopsy in patients with acute respiratory distress syndrome

Occupational exposures contribute to the morbidity and mortality of many diseases. However, occupational diseases continue to be underrecognized even though they are responsible for an estimated 860,000 illnesses and 60,300 deaths each year. Family physicians can play an important role in improving the recognition of occupational disease, preventing progressive illness and disability in their own patients, and contributing to the protection of other workers similarly exposed. This role can be maximized if physicians raise their level of suspicion for workplace disease, develop skills in taking occupational histories and establish routine access to occupational health resources.     

Career trajectories and older men's retirement

The idea of a long and stable career rewarded by retirement is a fixture of the American social ethos and political economy. The paradox is that many Americans' careers do not fit this image. Here, we examined how the structure of the career, as compared to only those circumstances proximate to retirement, is important for understanding career endings. Based on labor force histories drawn from the National Longitudinal Survey of Older Men, we observed that the occupational roles held through the mid and late career combine additively to influence retirement and disability experiences, with different conditions of work coming into play depending on the career stage. Occupational roles in the mid career also have long-term, indirect effects, operating through the onset of health problems and the adequacy of pension benefits. Although retirement and disability are not hinged to occupational mobility per se, these career endings are sensitive to major discontinuities in the career and work role in terms of unemployment and labor force mobility.     

The interactive effect of chronic exposure to noise and job complexity on changes in blood pressure and job satisfaction: A longitudinal study of industrial employees.

The hypothesis of this study was that noise exposure level and job complexity interact to affect changes in blood pressure (BP) levels and job satisfaction over 2–4 yrs of follow-up. Results showed that among workers exposed to high noise, those with complex jobs showed increases in BP that were more than double shown by those with simple jobs. Under low noise exposure, there was a small increase in BP for workers with complex jobs but about a 3-fold increase in workers with simple jobs. The prevalence of elevated BP showed a similar trend. Job satisfaction increased among workers with complex jobs but was much less in those exposed to high noise. It was concluded that exposure to occupational noise has a greater negative impact on changes in BP and job satisfaction over time among those performing complex jobs. In contrast, job complexity had a clear beneficial effect for workers exposed to low noise. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of digital subtraction radiography for assessment of changes in position of the mandibular condyle

OBJECTIVES: This study evaluated the mortality experience of workers from the styrene-butadiene rubber industry. Concerns about a possible association of 1,3-butadiene and styrene with lymphohaematopoietic, gastrointestinal, and lung cancers prompted the investigation. METHODS: A retrospective follow up study was conducted of 15,649 men employed for at least one year at any of eight North American styrene-butadiene rubber plants. Analyses used standardised mortality ratios (SMRs) to compare styrene-butadiene rubber workers' cause specific mortalities (1943-91) with those of the United States and Ontario general populations. RESULTS: On average, there were 25 years of follow up per subject. The standardised mortality ratio (SMR) was 87 (95% confidence interval (95% CI) 85 to 90) for all causes of death combined and was 93 (95% CI 87 to 99) for all cancers. There was an excess of leukaemia (SMR 131, 95% CI 97 to 174), restricted to hourly workers (SMR 143, 95% CI 104 to 191). For causes of death other than leukaemia, SMRs were close to or below the null value of 100. Results by work area (process group) were unremarkable for non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer. Maintenance workers had a slight increase in deaths from lung cancer, and certain subgroups of workers had more than expected deaths from cancer of the large intestine and the larynx. CONCLUSION: This study found an excess of leukaemia that is likely to be due to exposure to butadiene or to butadiene plus other chemicals. Deaths from non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer did not seem to be related to occupational exposure. The excess deaths from lung cancer among maintenance workers may be due in part to confounding by smoking, which was not controlled for, and in part to an unidentified occupational exposure other than butadiene or styrene. Increases in cancer of the large intestine and larynx were based on small numbers, did not seem to be due to exposure to butadiene or styrene, and may be chance observations.     

Women's occupational health: a critical review and discussion of current issues

Action to improve women's occupational health has been slowed by a notion that women's jobs are safe and that any health problems identified among women workers can be attributed to unfitness for the job or unnecessary complaining. With increasing numbers of women in the labor force, the effects of work on women's health have recently started to interest health care providers, health and safety representatives and researchers. We begin our summary of their discoveries with a discussion of women's place in the workplace and its implications for occupational health, followed by a brief review of some gender-insensitive data-gathering techniques. We have then chosen to concentrate on the following four areas: methods and data collection; directing attention to women's occupational health problems; musculoskeletal disease; mental and emotional stress. We conclude by pointing out some neglected occupational groups and health issues.     

Occupational stress: measuring job pressure and organizational support in the workplace

Person-environment fit and demand-control theoretical models developed to explain stress and strain in the workplace have guided the construction of most measures of occupational stress. The strengths and limitations of 8 job stress measures are briefly reviewed, and the Job Stress Survey (JSS), designed to assess the severity and frequency of occurrence of 30 specific sources of occupational stress, is described in some detail. Factor analyses of responses to the JSS items identified Job Pressure and Lack of Organizational Support as major dimensions of occupational stress for male and female employees in a wide variety of work settings. JSS Index, scale, subscale, and item scores assess general and specific aspects of the work environment that are most distressing for individual workers and that adversely affect groups of employees.     

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.     

étude de quelques déterminants de l’anxiété face au passage à la retraite.

This article presents 2 studies aimed at exploring some retirement anxiety predictors including the Big-five personality traits, anxiety, depression, sense of coherence, social support, subjective health, dyadic adjustment, specification and construction of personal goals, subjective age, masculinity, femininity, time of retirement. Participants (N = 175 and N = 134) were older workers and nearing retirement. Regression and discriminant analyses revealed that the main predictors were: age, sense of coherence, anxiety, neuroticism, conscientiousness, specification and construction of personal goals, masculinity, time of retirement, dyadic satisfaction, and dyadic consensus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Best estimate of the magnitude of mortality due to occupational exposure to hazardous substances

OBJECTIVES: With a proportionate attributable risk approach, to estimate the magnitude of premature mortality induced by exposure to hazardous substances in the Australian workforce. METHODS: Estimates of the magnitude of mortality induced by exposure to hazardous substances in the Australian work-force were calculated by the proportionate attributable risk approach after careful consideration of options for methodological refinements. The main data sources used were unit mortality datasets (individual deidentified death records), and tabulations when these were unavailable. RESULTS: The estimated number of deaths that occurred in Australia each year from occupational exposure to hazardous substances was 2290; 78% of these were men. The rate of mortality attributable to occupational exposure to hazardous substances was three to four times greater in male workers than in female workers. Male (productive) person-years of life lost (PYLL) were generally eight times higher than female PYLL. Cancer was the prime cause of death, followed by renal, cardiovascular, neurological, and chronic respiratory disease. Acute toxic episodes accounted for a small proportion of mortality but yielded a much larger proportion of PYLL, reflecting the relatively young ages of those who experienced fatal effects. CONCLUSIONS: Although national estimates of the proportions of mortality attributable to occupational exposure to hazardous substances seemed to be validly derived, uncertainties remain associated with the lack of an empirical basis for derivation of proportionate risk fractions used in the calculations. The finding of an appreciable burden of mortality that is attributable to past occupational exposure to hazardous substances emphasises the necessity for occupational health and safety authorities to measure and reduce worksite exposures. There is also an incentive to encourage the construction of appropriately designed cohort studies across industries and occupational groupings so that, ultimately, risk estimates may be directly calculated and applied to total workforce data for the definitive estimation of the magnitude of harm induced by occupational exposure to hazardous substances.