Health status of the Russian population and current problems in occupational medicine and industrial ecology

Major goal of occupational medicine--better health of employees--could be reached through integrated theoretical and practical approaches to the issues assigned to different scientific spheres. The article suggests some principles of new direction in prophylactic medicine. Those principles form a theoretical basis for occupational medicine and industrial ecology: being also a powerful instrument for evaluation and management of occupational and ecologic risk. The authors define group and individual risk, base a concept of residual risk and necessitate further improvement of protecting measures to restrict individual risk for every employee.     

Health status of workers in the city of Moscow and ways of its improvement

The article shows that negative tendencies in occupational health in Moscow are more marked than in other regions and traced mostly to worse socioeconomic situation, drastic decrease in living standards and quality of life, unsatisfactory medical care, abandoned priority of health care for industrial workers, neglected occupational prophylaxis. Obligatory precursors for better occupational health should include policy aimed to improve quality of life and working environment, to provide availability and high quality of medical care (including industrial medical service). That policy should be a part of longstanding programs for health preservation, that is guaranteed by Russian Constitution and Laws on health care and industrial regulations. Better public health is not a function of Health Ministry solely.     

Interactive training versus reading to teach respiratory protection.

A tenet of behavioral education is that interactive training produces superior retention compared with reading. However, this has not often been directly tested and never with practical occupational information in working adults. Adults from diverse occupational backgrounds learned the principles of proper respiratory protection presented (a) in a book, (b) on a computer monitor, (c) through interactive computerized training consisting of textual information and illustrative pictures followed by quizzes and feedback, or (d) passively viewing the information and quizzes in Condition c on a computer monitor. Interactive training produced significantly more correct test answers at immediate posttraining, 1 week, and 2 months. This study demonstrated the superiority of interactive training for teaching occupational safety and health information in working adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A review of in vitro studies: low-frequency electromagnetic fields

In vitro studies of effects of low-frequency (LF) electromagnetic (EM) fields have revealed a variety of sensitive cell-physiologic end-points. Effects have been reported on (1) DNA, RNA, and protein synthesis; (2) cell proliferation; (3) cation fluxes and binding; (4) immune responses; and (5) membrane signal transduction (i.e., hormones, enzymes, and neuro-transmitters). Typically such effects occurred as a result of short-term exposure of cells to EM at frequencies of 100 Hz or less and at low field intensities. The dependency on frequency or modulation, as well as the apparent weak cellular interaction of these LF EM fields, lacks theoretic explanation. It has not been determined whether effects are induced by electric or magnetic fields. Confounding interpretation of the results are phenomena such as (1) transient or time-delayed responses; (2) modulation- and intensity-specific effects, referred to as modulation or intensity "windows;" and (3) general lack of dose- (or dose-rate) response data or EM field thresholds. Consequently, although it is well-established that LF EM fields affect biological systems in vitro, use of these data to assess human health effects is limited. This paper reviews selected published reports of LF EM fields on in vitro systems. Where possible, relevance of the findings to occupational exposures will be assessed, principally by considering the consistency of in vitro and in vivo EM exposure effects and comparison of EM field intensities that affect in vitro systems with occupational EM exposure intensities. Finally, suggestions will be made for the direction of future in vitro research of direct pertinence to potential occupational exposure problems.     

Prevention of infections among surgeons

Accidental exposure to blood may represent a frightening experience for health care workers because of the risk of developing infectious diseases, such as hepatitis B and C virus and HIV infection. Recommendations for follow-up after occupational exposure to HIV- and hepatitis infected blood are presented. Post-exposure chemoprophylaxis decreases the risk of occupational HIV infection after percutaneous exposure and should be administered within two hours. Studies have shown that most accidents could have been avoided with better working routines during operations.     

The descriptive epidemiology of tinea pedis in the community

Tinea pedis is a common inflammatory skin condition due to infection by dermatophyte fungi. A number of epidemiological studies have been completed on the frequency of tinea pedis in the community, particularly sporting and occupational groups and schools. Most studies have focused on small, high-risk populations. These include occupational groups involving manual labour, sporting groups such as swimmers, and those working or living in confined conditions with shared washing facilities, which favour the opportunity for cross-infection. Most studies show that the frequency of tinea pedis is higher in males than females. Tinea pedis infections appear to be least common among children, but do occur, and are commonly misdiagnosed. The difference between clinical disease and confirmed diagnosis by culture is not always clear when statistics of disease frequency have been presented. Clear diagnosis criteria indicating the level of mycologically confirmed diagnosis should be reported in future studies that include statistics on disease frequency. Future epidemiological studies should also aim to be population-based in order to obtain a more complete picture of disease frequency.     

About occupational rehabilitation of stomach cancer patients after radical operation (author's transl)]

Questions of occupational rehabilitation after radical surgery of patients suffering from cancer reach more and more consideration all over the world. To feel as a usefull member of human society is a very important fact for patients operated radically. Stomach cancer is one of the most frequent localisations in the USSR. Respecting the frequency of invalidity this cancer pretends the second place among these diseases. The report is based on a total 249 cases. The total was divided in three groups: in the first were 113 patients working physically, in the second were 64 brainworkers and in the third 72 people, working not in time before operation. Results are showing, that in average three years are necessary for the rehabilitation of physical workers: 26.3% were working at the same place as before, 19% have gotten an easier workingplace and 54.7% were not a work, but 14.7% of them had an old-age pension. These proportions were the same later og at the same place as before. This leads to the recommendation to perform rehabilitation very individually in physical workers, but brainworkers should start working in the first year after operation without restriction.     

A critical note on Geist's "Work satisfaction and scores on a picture interest inventory".

Comments on a paper by H. Geist regarding work satisfaction and scores on an occupational interest inventory (see record 1964-06693-001). The paper reported, among other spectacular data, a correlation coefficient of .999 between a measure of occupational interest and one of occupational satisfaction. Any correlation of this size deserves careful study. This one in particular should be carefully scrutinized, both because it is in an area of considerable practical concern and because similar correlations reported by other investigators have been moderate in size at best, usually around .2 or .3 (e.g., Strong, 1955). Unfortunately, the results reported by Geist will not stand close scrutiny as the paper was laced with statistical errors of a most serious nature. Clearly no confidence can be placed in the author's other calculations, including the correlation of .999, until the author explains these statistical discrepancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Intervention for men who batter.

Reviews the book, Intervention for men who batter by Jeffrey L. Edleson and Richard M. Tolman (see record 1994-97694-000). This volume, written for clinicians and policy-makers, is one of a series of handbooks addressing interpersonal violence. The authors adopt an "ecological" approach which is defined as an integrated and comprehensive view for dealing with men who batter. They advocate a systemic approach that includes multiple systems: the "microsystem" which is personal, the "mesosystem" which itself is composed of interconnecting systems, the "exosystem" which includes indirect influences, the "macrosystem" including cultural/ethnic/social influences, and "chronosystem" including the personal developmental history. Overall, this little volume offers sound, practical advice on how to conduct group treatment for men who batter. It should be useful for experienced clinicians already working in this area or beginning to do so. The details of conducting a thorough clinical assessment and providing individual treatment are missing and might inadvertently contribute to a superficial approach by less trained persons working in this area. The ecological approach to this problem should prove beneficial to policy-makers. A list of recent references specific to men who batter is very useful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospects and problems of stack processing of waste dumps of gold-extraction plants

The long-lived waste dumps of gold-extraction plants, by the amount of gold concentrated in them, are an alternative source of raw materials for the gold-mining enterprises. During the long-term storage of waste dumps, difficult-to-extract gold under the effect of environmental factors is being opened up and can be extracted using the cyanide process. It is established by investigations that the extraction of Au during percolation cyanidation attains 75–82%, and waste dumps can be used for their heap leaching. However, because of a low fineness of mineral formations, percolation of working solutions through the stack bulk and its retention from static destruction are complicated. The technology of pelletizing the waste dumps with the use of predrying with warm air or by mixing with the ore in definite proportions is suggested. To prevent washing out, the stack height should be smaller than that with the use of the ore, and its edges should be protected by natural coatings. Therefore, processing of waste dumps by heap leaching can turn out to be a promising practical direction.     

The job demands-resources model of burnout.

The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources, that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N?=?374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument—the Oldenburg Burnout Inventory—and suggested that this structure is essentially invariant across occupational groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The problem of genetic-biochemical basis of individual sensitivity in occupational medicine

Human sensitivity to various factors of occupational environment (toxic chemicals, aerosols with mostly fibrogenic effects, etc.) depends on individual hereditary features determining adaptation or dysadaptation with subsequent disease. Studies of propensity and resistance in individuals exposed to occupational hazards should cover analysis of genetic basis for polymorphism in certain biochemical systems determining relationships between hazards detoxication and activation, DNA alteration and repair.     

Occupational and occupationally determined diseases

Medical definitions of occupational and professionally conditioned pathology are given in the article together with relevant examples. With the view to account appropriately occupational pathology in accordance with its severity classification based on the degree of working capacity loss is presented. Notions of acute occupational disease (intoxication) and professional accident are determined. International list of occupational diseases is considered. Suggestions intended at promotion of safe working conditions are made on perfection of the Ukrainian list.     

Exploring occupational differences in work–family interaction: Who is at risk?

The aim of this study was to explore occupational differences in work–family interaction (WFI), both regarding the direction of influence (work-to-family vs. family-to-work), and the type of effect (conflict vs. facilitation). A large sample of 8 occupational groups in Norway (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology; N = 3,313) was used to examine which occupational groups are likely to be at risk for work–family conflict and which find WFI the most facilitating. Strong tests for factorial invariance supported the use of the WFI scale and found that it was comparable for the 8 occupational groups. Follow-up analysis demonstrated significant latent mean differences in the 4 dimensions of WFI among the 8 groups. In general, the analyses indicate that those experiencing the least conflict are also among those experiencing the least facilitation. Similarly, with few exceptions, those experiencing the most conflict are also among those experiencing the most facilitation. Subsequent analyses indicate that this applies for both men and women. These results empirically support the orthogonal nature of WFI and suggest that the interaction between work and family may be more permeable in some occupations than others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational stress and dentistry: theory and practice. Part II. Assessment and control

Since dentistry has been identified as being a stressful profession, dentists, with the help of the members of the dental team, must attempt to achieve a relatively stress-free working environment. In addition to recognising potential occupational stressors it is important for dentists to be able to assess their emotional responses to the practice of dentistry and to arrange their daily working lives in such a way as to reduce occupational stress. This paper examines the means by which dentists may assess occupational stress as well as person-centred and/or situation-centred strategies of coping with and controlling occupational stress in general dental practice.     

Suppression by gangliosides of polymerization of glial cytoskeletons prepared from rat astrocytes: a role of sialic acid moiety

There are three reasons for giving serious consideration to technological countermeasures against driver fatigue: 1, fatigue is a persistent occupational hazard for professional drivers; 2, some professional drivers are under considerable pressure to reach their scheduled destination, in spite of feeling drowsy; 3, fatigue adversely affects an individual's ability to assess their own fitness to continue driving. However, there are two reasons for exercising caution in implementing technological countermeasures: 1, their reliability under real traffic conditions is largely unproven; 2, they could be used by unscrupulous drivers to support the continuation of journeys that should have been terminated because of human impairment. This paper draws on the findings of research into the origins, symptoms and development of human fatigue, and on recent research into driver-support systems, to assess the prospects for implementations of technological countermeasures against driver fatigue in the foreseeable future.     

Rapid depletion of plasma tryptophan: a review of studies and experimental methodology

The body mass is one of the major indicators which determine the clinical condition of newborns, influence the rate of neonatal mortality and further development of newborns. In order to prevent malformations it is necessary to identify factors which impair the fetus development and cause fetal hypotrophy. The main objective of the study was to find out whether mothers' occupational work affected the body mass of infants born at term. The study covered a group of 1015 women randomly sampled among those who had delivered their babies in the Polish Mother Memorial Hospital in Lód?, during the years 1992-94. In this group the percentage of working women accounted for 69%. The comparison of the body mass in infants born to women employed and not employed during pregnancy did not indicate differences. However, it was found that male infants born to employed mothers showed a lower body mass than those born to not employed mothers. The effect of some factors modifying infants' body mass was different in the case of not employed women than in those employed. In the group of not employed women a significantly lower body mass in infants was observed in the following subgroups: mothers under 24 years of age, spontaneous abortion of one of previous pregnancies, consumption of large quantity of caffeine (equivalent of > two cups of coffee), and poor economic status. Smoking during pregnancy decreased the body mass of infants in both groups of women. In the group of working women, chronic diseases before pregnancy and diseases involving fever during pregnancy proved to be factors affecting the body mass of infants. The indicators of perinatal medical care (the beginning of medical care and the number of visits during pregnancy) in working women were better than in those not working. None of factors characterizing occupational work affected significantly the body mass of infants. Slightly lower infants' body mass was observed only in those born to mothers working overtime (> 9 hrs daily), involved in hard physical work or working in the environment with harmful chemical and physical factors. According to the data obtained, a negative effect of occupational work on the fetus development should not be overestimated. Nevertheless, the performance of occupational work may aggravate a negative effect of woman's bad health condition on the fetus development.     

False-negative angiograms in subarachnoid haemorrhage due to intracranial aneurysms

In occupational epidemiology, the need to consider the age factor properly influences the choice of study design and analytical techniques. In most studies, age is viewed as a potential confounder. Age is strongly associated with end points of interest in occupational epidemiology (diseases, physiological characteristics, doses of xenobiotics, etc), but to measure age as a confounder it must be associated with the exposure under study. When the exposure of interest is time related-for example, duration of employment, time since first exposure, cumulative exposure-a strong intrinsic association with age can be anticipated, and age will behave as a (usually strong) confounder. When occupational exposures without a direct relation with age-for example, job, department, type of exposure-are evaluated, the degree and direction of confounding bias cannot be anticipated. Control of the confounding effect of age can be accomplished in the design phase of a study by way of randomisation, restriction, and matching. Randomisation is seldom viable in occupational settings. Restriction is rarely used in the case of age. Matching is often used in a case-control study as a method to increase the study efficiency, but it must be followed by proper matched or stratified analysis. Options for age adjustment in the analysis phase involve stratification and regression methods. In longitudinal studies the modified life table analysis is used to take into account the fact that subjects cross categories of age as the study proceeds. Stability of relative measures of effect over age strata favoured the greater use of relative risks than risk differences. In the presence of effect modification the influence of age should not be eliminated; its interaction with exposure should be explicitly considered.     

Overcharging: keeping both feet on the ground and going a step forward

The intrinsic value of animals and their place in human society influence veterinary practice. The role-responsibility of the veterinarian is under pressure of practical circumstances, client requests and constraints of breeding and management systems. A reflection on human needs as related to the intrinsic value and welfare of animals, is required inside and outside the profession. It is in the interest of life to think and act out of total ecological concepts. In order to be better prepared to deal with ethical problems in practice, students should receive adequate training. The assumed value-free research and the need for outside financial support are a hindrance for research projects that aim at sustainability of human and animal life. It is concluded that the profession needs a philosophy about her objectives.     

Drug-induced acute interstitial nephritis

This paper reports the findings of a five-year, three-stage study of the occupational status persistence of 333 physicians who immigrated to Israel from the former Soviet Union in 1990. The first data collection, by way of a structured questionnaire in Russian, was undertaken in 1991, during their participation in preparatory courses for the medical licensure examination. The second and third stages of data collection were undertaken by mail in 1993 and 1995. Data are presented regarding the influence of gender and age on employment status and on the relationship between employment status and psycho-social well-being, including work and general satisfaction, self-esteem, mood, health and overall adaptation, at both stages. The dynamics of occupational integration are investigated by looking at the effects of occupational stability vs occupational change between stage 2 and stage 3 on the psycho social outcome variables. After three years in Israel, men were more likely to be working as physicians than women, and women were more likely to be unemployed. However, after five years, women were equally likely to have found work in their profession, albeit in lower status positions. Younger respondents were more successful than older respondents in passing the licensure examination, finding work in their profession, and entering residency programs. The gap between them did not close between stage 2 and stage 3. At both stage 2 and stage 3, those working as physicians had significantly more positive well-being scores than those not working as physicians. All occupational groups had more positive scores at stage 3 than at stage 2, except for those who were working in non-medically related jobs. The greatest improvement in psycho-social well-being was among those who became physicians between stage 2 and stage 3, compared to those who were not physicians at either stage and those who were physicians at both stages.