Exploratory Study on Occupational Health Exposure to Chemical Agents, in a Public Hospital in Valencia, Venezuela. Preliminar Assessment

Descriptive study that identified chemical agents (AQ) use and training on risk management and waste disposal techniques in a public Hospital in Valencia. A questionnaire was answered by 48 workers. Information obtained was: personal data, occupational history, AQ used; knowledge of risk management and waste disposal. There were 16 occupations from 12 “High Risk” areas. “Adult emergency” was the one with more workers (11 individuals), followed by “sterilization” and “clinical laboratory” (7 each) and oncology (5). The remained areas had less than 8.3% workers. The most used anesthetic agents were: Halothane, Enfluorane and Isofluorane 4.17% each and main antineoplastics used were: Doxorubicin 16.67% and Paclitaxel, 5-Fluoracil and Etoposide, 8.33% each. The most mentioned substances were: alcohol (70.8%) and Chlorine (64.6%). None of the answers regarding knowledge of AQ’ risk management and waste disposal was satisfactory. Statistical associations between training and several variables such as age, time in their job and being or not a professional, resulted non-significant. The correlation between training and the knowledge of AQ’s management was significant (p < 0.001). Participants showed that their knowledge about chemical occupational risk factors they are exposed to is still insufficient. Therefore, this theme should be included in graduate course curricula. These results provide important data and will serve as a pilot research for the follow up Phase II study that will include clinical aspects and environmental and biological monitoring.

Relationship between physical capacity and quality of life in workers university

Aim: Examine the relationship between the functional capacity and the quality of life related to health in university workers. Methodology: Cross-sectional study in 146 subjects, divided in two groups: Low functional Capacity (< 9 METs) and High functional Capacity (> 9.1 METs). We evaluated quality of life related to health (HRQOL-Health Questionnaire SF-12) and functional capacity (Questionnaire PAR/PAF) as indicators of health status. Results: 47.3% (69 men) and 52.7% (78 women). The average age of the groups was 35.0 ± 9.7 years (range 19,0-60,0 years). For HRQOL, the average found in the population assessed was 45.2 ± 4.42 (range 33,0-58,1) and 43.8 ± 6.87 (range 19,8-43,8) in components Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12), respectively p = NS. Significant differences were found when comparing functional ability and sex, p<0,001 in both groups. Similarly, sex and mental component MCS-12 (group of Lower Functional) p = 0,049 as well as women and the physical component PCS-12, p = 0,05 between groups. Finally, a better score in HRQL observed in the group of High Capacity and functional components in both sex OR 0.59 (0.25-1.38). Conclusions: The results of this study demonstrate the relationship between High functional Capacity and a better HRQOL in this population.

Workers' compensation for occupational hearing loss: what we know or don't know

This papers looks at workers' compensation laws for each state to determine if there have been any updates in the laws since a 2000 survey by Dobie and Megerson. The study also examines what information is available to audiologists testing patients in workers' compensation claims.

Collaboration between infection control and occupational health in three continents: a success story with international impact

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.

Chronic pesticide poisoning from persistent low-dose exposures in Ecuadorean floriculture workers: toward validating a low-cost test battery

Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador’s floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis, we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone – the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings.

Health and safety on construction sites in Ghana

The state of health and safety on construction sites in Ghana was investigated using first hand observation of fourteen (14) construction project sites in 2009 and 2010. At each site, the construction project, workers and the physical environment of the site were inspected and evaluated against health and safety indicators taken from the literature. The results reveal a poor state of health and safety on Ghanaian construction sites. The primary reasons are a lack of strong institutional framework for governing construction activities and poor enforcement of health and safety policies and procedures. Also, Ghanaian society does not place a high premium on health and safety of construction workers on site. Interviews with workers indicated that injuries and accidents are common on sites. However, compensation for injury is often at the discretion of the contractor although collective bargaining agreements between Labour unions and employers prescribe obligations for the contractor in the event of injury to a worker.

‘In the air’ and below the horizon: migrant workers in UK construction and the practice-based nature of learning and communicating OHS

Local, tacit and normally unspoken OHS (occupational health and safety) knowledge and practices can too easily be excluded from or remain below the industry horizon of notice, meaning that they remain unaccounted for in formal OHS policy and practice. In this article we stress the need to more systematically and routinely tap into these otherwise ‘hidden’ communication channels, which are central to how everyday safe working practices are achieved. To demonstrate this approach this paper will draw on our ethnographic research with a gang of migrant curtain wall installers on a large office development project in the north of England. In doing so we reflect on the practice-based nature of learning and sharing OHS knowledge through examples of how workers’ own patterns of successful communication help avoid health and safety problems. These understandings, we argue, can be advanced as a basis for the development of improved OHS measures, and of organizational knowing and learning.

Ethics of care in supporting disabled forced migrants: interactions with professionals and ethical dilemmas in health and social care in the South-East of England

This article explores the interactions between disabled forced migrants with care needs and professionals and the restrictive legal, policy and practice context that health and social care professionals have to confront, based on the findings of a qualitative study with 45 participants in the South-East of England. In-depth interviews were conducted with 15 forced migrants who had diverse impairments and chronic illnesses (8 women and 7 men), 13 family caregivers and 17 support workers and strategic professionals working in social care and the third sector in Slough, Reading and London. The legal status of forced migrants significantly affects their entitlements to health and social care provision, resulting in prolonged periods of destitution for many families. National asylum support policies, difficult working relationships with UK Border Agency, higher eligibility thresholds and reduced social care budgets of local authorities were identified as significant barriers in responding to the support needs of disabled forced migrants and family caregivers. In this context, social workers experienced considerable ethical dilemmas. The research raises profound questions about the potential and limitations of health and social care policies, provision, and practice as means of protection and support in fulfilling the human rights of forced migrants with care needs.

Workers with elderly dependants: employment law’s response to the latest care-giving conundrum

This paper considers how employment laws are being used in response to what we have termed ‘the eldercare/workplace conundrum’. It is well known that people are now living longer but health is still failing in a significant percentage of older people, meaning that many adults require care for longer, albeit to varying degrees and for varying amounts of time. Many of these individuals will receive care from relatives or close friends who are participating in the labour market: this is increasingly likely as adults are expected / wanting to remain in paid work for longer, often into their 60s and 70s. The requirements of elderly dependants can cause these workers huge difficulties and dilemmas as they attempt, across time, to accommodate the particular needs of the person for whom they wish to provide care, often a loved one, and meet the particular demands of their employment relationship. In this paper we consider why this is an area of social policy that warrants effective legal engagement and consider, drawing on various examples of legal responses in other countries that face similar conundrums, what might improve legal engagement in this area.

Nontraditional employment: the careers of temporary workers

This chapter focuses upon the careers of temporary workers. Temporary employment for many workers presents a route to permanent employment. Other workers, however, get trapped into temporary employment or cycle between unstable jobs and spells of unemployment. Predictors of such transitions are multiple. We selected two broad categories, namely perceived employability from the area of career research and health and well-being from the area of occupational health and well-being research. The overall conclusion is that the association between temporary employment and both perceived employability and health and well-being is inconclusive. This suggests that there are boundary conditions that may make some temporary workers successful and others not. Risk factors include dynamics related to the dual labor market, including lower job quality, lower investments on the part of employers, and negative stereotyping of temporary workers as second-class citizens. On the positive side, many temporary workers have learned to manage their careers in the sense that they invest in training and in continuous job search.

Stigma and risky behaviors among male clients of sex workers in the UK in 2001

This paper builds on existing theoretical work on sex markets (Della Giusta, Di Tommaso, and Strøm, 2009a). Using data from the British Sexual Attitudes Survey, we aim to replicate the analysis of the demand for paid sex previously conducted for the US (Della Giusta, Di Tommaso, Shima and Strøm, 2009b). We want to test formally the effect of attitudes, risky behaviors and personal characteristics on the demand for paid sex. Findings from empirical studies of clients suggest that personal characteristics (personal and family background, self-perception, perceptions of women, sexual preferences etc), economic factors (education, income, work) as well as attitudes towards risk (both health hazard and risk of being caught where sex work is illegal), and attitude towards relationships and sex are all likely to affect demand. Previous theoretical work has argued that stigma plays a fundamental role in determining both demand and risk, and that in particular due to the presence of stigma the demand for sex and for paid sex are not, as has been argued elsewhere, perfect substitutes. We use data from the British Sexual Attitudes Survey of 2001 to test these hypotheses. We find a positive effect of education (proxy for income), negative effects of professional status (proxies for stigma associated with buying sex), positive and significant effects of all risky behavior variables and no significant effects of variables which measure the relative degree of conservatism in morals. We conclude with some policy implications.

Risks Associated With Tendinitis: Effects From Demographic, Socioeconomic, and Psychological Status Among Brazilian Workers

Background Self-reported tendinitis/tenosynovitis was evaluated by gender, age group, skin color, family income, and educational and psychological status. Methods The study was carried out in a representative sample of formally contracted Brazilian workers from a household survey. A total of 54,660 participants were included. Occupations were stratified according to estimated prevalences of self-reported injuries. Non-conditional logistic regression was performed, and all variables were analyzed in two occupational groups. Results The overall prevalence rate of tendinitis/tenosynovitis was 3.1%: 5.5% in high-prevalence occupations (n=10,726); and 2.5% in low-prevalence occupations (n=43,934). White female workers between the ages of 45 and 64 years and at a higher socioeconomic level were more likely to report tendinitis/tenosynovitis regardless of their occupational category. An adjusted OR = 3.59 [95% CI: 3.15-4.09] was found between tendinitis/tenosynovitis and psychological status. Conclusion Among formally contracted Brazilian workers, higher income can imply greater physical and psychological demands that, regardless of occupational stratum, increase the risk of tendinitis/tenosynovitis. Am. J. Ind. Med. 53:72-79, 2010. (C) 2009 Wiley-Liss, Inc.

Dietary Quality and Associated Factors among Factory Workers in the Metropolitan Region of Sao Paulo, Brazil

The workplace is a manageable community-based setting for ensuring proper nutrition. This study aimed to evaluate dietary quality and associated factors among adult workers at a cosmetics factory in the metropolitan area of Sao Paulo, Brazil. This factory was actively participating in the Brazilian Workers` Meal Program, which was created to ensure workers` nutritional health. In this cross-sectional study, data on 202 adult workers were assessed using questionnaires (sociodemographic, anthropometric, and lifestyle characteristics) administered during August and September 2006. Dietary intake, measured by 24-hour dietary recall, was used to calculate the modified Healthy Eating Index (HEI). A repeated administration of the 24-hour dietary recall was applied in a random subsample to calculate the modified HEI adjusted for the within-person variation in intake. Mean adjusted modified HEI scores were analyzed using multiple linear regression adjusted for energy. The mean adjusted modified HEI score was 72.3 +/- 8.0. The lowest adjusted modified HEI components scores were ""milk and dairy products"" (4.4 +/- 3.2) and ""sodium"" (3.7 +/- 3.1). Two percent of workers had ""poor diet"" (adjusted modified HEI score <51 points) and the majority (87%) had ""diet that needs modification"" (adjusted modified HEI score between 51 and 80), despite their participation in the meal program. Adjusted modified HEI scores were considerably higher for men (74.7 +/- 7.0) than for women (66.9 +/- 8.2) and for normal body mass index (calculated as kg/m(2)) (73.3 +/- 7.8) than for overweight/obese (70.9 +/- 8.1). Based on these results, the vast majority of workers were found to have diets that needed improvement. Individuals with higher-quality diets were more likely to have lower body mass index and to be male. J Am Diet Assoc. 2010;110:786-790.

Nutritional information of meals supplied by companies, participating in the workers` meal program in Sao Paulo, Brazil

Objective. To compare the nutritional value of meals provided by companies participating in the Workers` Meal Program in the city of Sao Paulo, Brazil, to the nutritional recommendations and guidelines established by the Ministry of Health for the Brazilian population. Methods. The 72 companies studied were grouped according to economic sector (industrial, services, or commerce), size (micro, small, medium, or large), meal preparation modality (prepared on-site by the company itself, on-site by a hired caterer, or off-site by a hired caterer), and supervision by a dietitian (yes or no). The per capita amount of food was determined based on the lunch, dinner, and supper menus for three days. The nutritional value of the meals was defined by the amount of calories, carbohydrates, protein, total fat, polyunsaturated fat, saturated fat, trans fat, sugars, cholesterol, and fruits and vegetables. Results. Most of the menus were deficient in the number of fruits and vegetables (63.9%) and amount of polyunsaturated fat (83.3%), but high in total fat (47.2%) and cholesterol (62.5%). Group 2, composed of mostly medium and large companies, supervised by a dietician, belonging to the industrial and/or service sectors, and using a hired caterer, on averaged served meals with higher calorie content (P < 0.001), higher percentage of polyunsaturated fat (P < 0.001), more cholesterol (P = 0.015), and more fruits and vegetables (P < 0.001) than Group 1, which was composed of micro and small companies from the commercial sector, that prepare the meals themselves on-site, and are not supervised by a dietitian. Regarding the nutrition guidelines set for the Brazilian population, Group 2 meals were better in terms of fruit and vegetable servings (P < 0.001). Group I meals were better in terms of cholesterol content (P = 0.05). Conclusions. More specific action is required targeting company officers and managers in charge of food and nutrition services, especially in companies without dietitian supervision.

Occupational airborne contamination in South Brazil: 2. Oxidative stress detected in the blood of workers of incineration of hospital residues

One of the most useful methods for elimination of solid residues of health services (SRHS) is incineration. However, it also provokes the emission of several hazardous air pollutants such as heavy metals, furans and dioxins, which produce reactive oxygen species and oxidative stress. The present study, which is parallel to an accompanied paper (Avila Jr. et al., this issue), investigated several enzymatic and non-enzymatic biomarkers of oxidative stress in the blood (contents of vitamin E, lipoperoxidation = TBARS, reduced glutathione = GSH, oxidized glutathione = GSSG, and activities of glutathione S-transferase = GST, glutathione reductase = GR, glutathione peroxidase = GPx, catalase = CAT and superoxide dismutase = SOD), in three different groups (n = 20 each) exposed to airborne contamination associated with incineration of SRHS: workers directly (ca. 100 m from the incinerator) and indirectly exposed (residents living ca. 5 km the incineration site), and controls (non-exposed subjects). TBARS and GSSG levels were increased whilst GSH, TG and alpha-tocopherol contents were decreased in workers and residents compared to controls. Increased GST and CAT activities and decreased GPx activities were detected in exposed subjects compared to controls, while GR did not show any difference among the groups. In conclusion, subjects directly or indirectly exposed to SRHS are facing an oxidative insult and health risk regarding fly ashes contamination from SRHS incineration.