Changes in exposure to 'life stressors' in the Aboriginal and Torres Strait Islander population, 2002 to 2008

The Negative Life Events Scale (NLES) has been included in nationally representative surveys of the Indigenous and Australian population since 2002 as a measure of exposure to a range of 'life stressors'. There has been limited reporting or analysis of estimates of the NLES from these surveys. This paper reports changes in exposure to stressors from 2002 to 2008 for the Indigenous population, and examines inter-relationships between eleven NLES items. Data for the 2006 Australian population is also included for comparative purposes.

The development of a conceptual model and self-reported measure of occupational health and safety vulnerability

Injuries at work have a substantial economic and societal burden. Often groups of labour market participants, such as young workers, recent immigrants or temporary workers are labelled as being "vulnerable" to work injury. However, defining groups in this way does little to enable a better understanding of the broader factors that place workers at increased risk of injury. In this paper we describe the development of a new measure of occupational health and safety (OH&S) vulnerability. The purpose of this measure was to allow the identification of workers at increased risk of injury, and to enable the monitoring and surveillance of OH&S vulnerability in the labour market. The development included a systematic literature search, and conducting focus groups with a variety of stakeholder groups, to generate a pool of potential items, followed by a series of steps to reduce these items to a more manageable pool. The final measure is 29-item instrument that captures information on four related, but distinct dimensions, thought to be associated with increased risk of injury. These dimensions are: hazard exposure; occupational health and safety policies and procedures; OH&S awareness; and empowerment to participate in injury prevention. In a large sample of employees in Ontario and British Columbia the final measure displayed minimal missing responses, reasonably good distributions across response categories, and strong factorial validity. This new measure of OH&S vulnerability can identify workers who are at risk of injury and provide information on the dimensions of work that may increase this risk. This measurement could be undertaken at one point in time to compare vulnerability across groups, or be undertaken at multiple time points to examine changes in dimensions of OH&S vulnerability, for example, in response to a primary prevention intervention.

Farmers’ work-day noise exposure

Objective: This study aims to understand the extent offarmers’ exposure to hazardous noise, and trial and testthe ability of an on-farm noise audit report to improve awareness and preventative action towards farm based noise hazards.Design: Visits were made to working farms where noiseand dosimetry measurements undertaken. During return visits, the noise measurements were explained ina brief report. A follow-up questionnaire was imple-mented gathering feedback on the use or otherwise ofthe report.Setting: Working farms in Western Victoria and SEQueensland including dairy, beef, wool, prime lamb andcropping.Participants: Participants were 14 female and 37 male farm workers.Interventions: Noise exposure assessment of dailyactivities through dosimetry; measurements of noisy tasks and machinery; supply and interpretation of anoise audit report.Main outcome measures: Participants were suppliedwith a ‘noise report’ of their workplace together with an explanation of the report’s meaning to farm workers.Results: Men and women have similar at risk expo-sures. The average noise exposure was 1.09 Pa2h(LAeq,8h= 85.3 dB). This implies 163 000 Australian agricultural workers are at risk from hazardous noise.On-farm noise audit reports were a relevant and valuable feedback to farmers in relation to their potential noise hazards.Conclusions: Of those measured 51%, and by extrapo-lation 163 000 Australian agricultural workers, have noise exposure levels greater than the recommendedAustralian Standard of 1.01 Pa2h (85 dB). Men and women are equally exposed. On-farm noise auditreports are an effective feedback to increase awareness and improve hearing health

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

Objective: To describe OH&S vulnerability across a diverse sample of Canadian workers.
Methods: A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment.
Results: More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub-group. Younger workers and those in smaller workplaces experienced signficantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness- and empowerment-related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability.
Conclusion: Knowing how labor market sub-groups experience different types of vulnerability can inform better-tailored primary prevention interventions.

Ocular exposure to UV-B in sunlight: the Melbourne Visual Impairment Project model

Quantification of ocular exposure to ultraviolet-B radiation (UV-B) has become an important public health issue, with reports that the ozone layer is being depleted worldwide. Ocular exposure to UV-B is determined by ambient UV-B levels, the duration of outdoor exposure, the proportion of ambient UV-B that reaches the eye, and the use of ocular protection. We have developed a simplified model for quantifying lifetime ocular UV-B exposure that can be used in large epidemiological surveys. Exposure to UV-B is assessed and quantified using a model based on personal exposure over the six summer months. Data available for a population-based sample of 1150 people in the age range 40-98 years revealed a distribution in average annual lifetime ocular UV-B exposure similar to that reported in a previous study on which this model is based, and also demonstrate that people can recall lifetime personal behaviour related to ocular protection. It takes 12 minutes on average to collect these data. This model can be employed by researchers worldwide for uniform assessment of ocular UV-B exposure.

The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: findings from the Australian Temperament Project

OBJECTIVE: To investigate the interactions between low parental warmth and monitoring at age 13-14 years and disordered eating attitudes and behaviours at age 15-16 years. METHOD: Data on 1300 (667 females) adolescents and their parents were drawn from The Australian Temperament Project (ATP), a 30 year (15 wave) population based longitudinal study of social-emotional development. Parent participants completed surveys on parenting practices in late childhood, and adolescent participants reported disordered eating using the drive for thinness and bulimia subscales of the Eating Disorder Inventory (EDI) and an additional body dissatisfaction scale. Interaction was examined on the additive scale by estimating super-additive risk; i.e., risk in excess of the sum of individual risks. RESULTS: For boys, neither parental warmth or monitoring, nor their interaction, was related to disordered eating. For girls, low parental warmth (alone) was associated with bulimic behaviours. In contrast, exposure to both low monitoring and warmth was associated with ∼3½-fold, ∼4-fold and ∼5-fold increases in the odds of reporting body dissatisfaction, drive for thinness and bulimia, respectively. For body dissatisfaction and drive for thinness, risk associated with joint exposure exceeded the sum of individual risks, suggesting an additive interaction between parenting styles. CONCLUSION: Further investment in family-level interventions that focus on promoting parental monitoring behaviour and a warm parent-child relationship remain important strategies for preventing a range of disordered eating behaviours in adolescents.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke

BackgroundChildren's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children's health worldwide.ObjectivesTo determine the effectiveness of interventions aiming to reduce exposure of children to ETS.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, ERIC, and The Social Science Citation Index & Science Citation Index (Web of Knowledge). Date of the most recent search: September 2013.Selection criteriaControlled trials with or without random allocation. Interventions must have addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0 to 12 years). All mechanisms for reduction of children's ETS exposure, and smoking prevention, cessation, and control programmes were included. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions.Data collection and analysisTwo authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcome measures, no summary measures were possible and results were synthesised narratively.Main resultsFifty-seven studies met the inclusion criteria. Seven studies were judged to be at low risk of bias, 27 studies were judged to have unclear overall risk of bias and 23 studies were judged to have high risk of bias. Seven interventions were targeted at populations or community settings, 23 studies were conducted in the 'well child' healthcare setting and 24 in the 'ill child' healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether the visits were to well or ill children, and another included both well and ill child visits. Thirty-six studies were from North America, 14 were in other high income countries and seven studies were from low- or middle-income countries. In only 14 of the 57 studies was there a statistically significant intervention effect for child ETS exposure reduction. Of these 14 studies, six used objective measures of children's ETS exposure. Eight of the studies had a high risk of bias, four had unclear risk of bias and two had a low risk of bias. The studies showing a significant effect used a range of interventions: seven used intensive counselling or motivational interviewing; a further study used telephone counselling; one used a school-based strategy; one used picture books; two used educational home visits; one used brief intervention and one study did not describe the intervention. Of the 42 studies that did not show a significant reduction in child ETS exposure, 14 used more intensive counselling or motivational interviewing, nine used brief advice or counselling, six used feedback of a biological measure of children's ETS exposure, one used feedback of maternal cotinine, two used telephone smoking cessation advice or support, eight used educational home visits, one used group sessions, one used an information kit and letter, one used a booklet and no smoking sign, and one used a school-based policy and health promotion. In 32 of the 57 studies, there was reduction of ETS exposure for children in the study irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure, but rather aimed to reduce symptoms of asthma, and found a significant reduction in symptoms in the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions.Authors' conclusionsWhile brief counselling interventions have been identified as successful for adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any one intervention reduced parental smoking and child exposure more effectively than others, although seven studies were identified that reported motivational interviewing or intensive counselling provided in clinical settings was effective.