Identification of barriers to and facilitators for the implementation of occupational road safety initiatives

To explore potential barriers to and facilitators for implementing occupational road safety initiatives, in-depth interviews were conducted with personnel from four major Australian organizations. Twenty-four participants were involved in the interviews comprising 16 front line employees and eight managers. The interviews identified that employees perceived six organizational characteristics as potential barriers to implementing occupational road safety initiatives. These included: prioritisation of production over safety; complacency towards occupational road risks; insufficient resources; diversity; limited employee input in safety decisions; and a perception that road safety initiatives were an unnecessary burden. Of these organizational characteristics, prioritisation of production over safety and complacency were the most frequently cited barriers. In regards to facilitators, participants perceived three organizational characteristics as potential facilitators to implementing occupational road safety initiatives. These included: management commitment; the presence of existing systems that could support the implementation of initiatives; and supportive relationships. Of these organizational characteristics, management commitment was the most frequently cited facilitator.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Background: During December 2010 and January 2011, torrential rainfall in Queensland resulted in the worst flooding in over 50 years. We carried out a community-based survey to assess the health impacts of this flooding in the city of Brisbane. Methods: A community-based survey was conducted in 12 flood-affected electorates using postal questionnaires. A random sample of residents in these areas was drawn from electoral rolls. Questions examined sociodemographic information, the direct impact of flooding on the household, and perceived flood-related health impacts. Outcome variables included perceived flood-related effects on overall and respiratory health, along with mental health outcomes measured by psychosocial distress, reduced sleep quality and probable post-traumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and health outcome variables, adjusted for current health status and socioeconomic factors. Results: 3000 residents were invited to participate in this survey, with 960 responses (32%). People whose households were directly impacted by flooding had a decrease in perceived overall health (OR 5.3, 95% CI: 2.8–10.2), along with increases in psychological distress (OR 1.9, 1.1–3.5), decreased sleep quality (OR 2.3, 1.2–4.4), and probable PTSD (OR 2.3, 1.2–4.5). Residents were also more likely to increase usage of both tobacco (OR 6.3, 2.4–16.8) and alcohol (OR 7.0, 2.2–22.3) after flooding. Conclusions: There were significant impacts of flood events on residents’ health, in particular psychosocial health. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood‐related health impacts.

Health matters for subscribers to community-supported agriculture

There are a variety of reasons and motivations for people to subscribe to community-supported agriculture (CSA) schemes, many of which include social, ethical, environmental, and economical benefits. The global rise of food allergies and food related health issues in recent years has led to a growing number of initiatives particularly in developing countries to raise more awareness of the current situation amongst individuals, organisations, and government bodies, and to plan for its implications for the existing food and health systems. Based on a mixed method research conducted in Australia, this paper argues that personal health matters are one of the key motivators for consumers to seek out alternative food systems, particularly CSA initiatives. In addition, it presents the willingness for consumers to seek out information about the food they consume and proposes that technology plays a key role in being used as a conduit to share and investigate information relating to alternative food systems. Further research is required to determine the variety of benefits and opportunities alternative food systems can provide consumers with food related health issues.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Objective To assess the effects of the 2011 floods in Brisbane, Australia, on residents’ physical and mental health. Methods Residents who had been affected by the floods completed a community-based survey that examined the direct impact of flooding on households and their perceived physical and mental health. Outcome variables included overall and respiratory health and mental health outcomes related to psychological distress, sleep quality, and posttraumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and perceived health outcome variables, adjusted for current health status and sociodemographic factors. Results Residents whose households were directly affected by flooding were more likely to report poor overall (Odds Ratio [OR] 5.3; 95% CI, 2.8-10.1) and respiratory (OR 2.3; 95% CI, 1.1-4.6) health, psychological distress (OR 1.9; 95% CI, 1.1-3.5), poor sleep quality (OR 2.3; 95% CI, 1.2-4.4), and probable PTSD (OR 2.3; 95% CI, 1.2-4.5). Conclusions The 2011 Brisbane floods had significant impact on the physical and psychosocial health of residents. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts, particularly those related to mental health.

Traffic-related fine and ultrafine particle exposures of professional drivers and illness : An opportunity to better link exposure science and epidemiology to address an occupational hazard?

Exposures to traffic-related air pollution (TRAP) can be particularly high in transport microenvironments (i.e. in and around vehicles) despite the short durations typically spent there. There is a mounting body of evidence that suggests that this is especially true for fine (b2.5 μm) and ultrafine (b100 nm, UF) particles. Professional drivers, who spend extended periods of time in transport microenvironments due to their job, may incur exposures markedly higher than already elevated non-occupational exposures. Numerous epidemiological studies have shown a raised incidence of adverse health outcomes among professional drivers, and exposure to TRAP has been suggested as one of the possible causal factors. Despite this, data describing the range and determinants of occupational exposures to fine and UF particles are largely conspicuous in their absence. Such information could strengthen attempts to define the aetiology of professional drivers' illnesses as it relates to traffic combustion-derived particles. In this article, we suggest that the drivers' occupational fine and UF particle exposures are an exemplar case where opportunities exist to better link exposure science and epidemiology in addressing questions of causality. The nature of the hazard is first introduced, followed by an overview of the health effects attributable to exposures typical of transport microenvironments. Basic determinants of exposure and reduction strategies are also described, and finally the state of knowledge is briefly summarised along with an outline of the main unanswered questions in the topic area.

Bomb disposal in the tropics : a cocktail of metabolic and environmental heat

Bomb technicians perform their work while encapsulated in explosive ordnance disposal (EOD) suits. Designed primarily for safety, these suits have an unintended consequence of impairing the body’s natural mechanisms for heat dissipation. Purpose: To quantify the heat strain encountered during an EOD operational scenario in the tropical north of Australia. Methods: All active police male bomb technicians, located in a tropical region of Australia (n=4, experience 7 ± 2.1 yrs, age 34 ± 2 yrs, height 182.3 ± 5.4 cm, body mass 95 ± 4 kg, VO2max 46 ± 5.7 ml.kg-1.min-1) undertook an operational scenario wearing the Med-Eng EOD 9 suit and helmet (~32 kg). The climatic conditions ranged between 27.1–31.8°C ambient temperature, 66-88% relative humidity, and 30.7-34.3°C wet bulb globe temperature. The scenario involved searching a two story non air-conditioned building for a target; carrying and positioning equipment for taking an X-ray; carrying and positioning equipment to disrupt the target; and finally clearing the site. Core temperature and heart rate were continuously monitored, and were used to calculate a physiological strain index (PSI). Urine specific gravity (USG) assessed hydration status and heat associated symptomology were also recorded. Results: The scenario was completed in 121 ± 22 mins (23.4 ± 0.4% work, 76.5 ± 0.4% rest/recovery). Maximum core temperature (38.4 ± 0.2°C), heart rate (173 ± 5.4 bpm, 94 ± 3.3% max), PSI (7.1 ± 0.4) and USG (1.031 ± 0.002) were all elevated after the simulated operation. Heat associated symptomology highlighted that moderate-severe levels of fatigue and thirst were universally experienced, muscle weakness and heat sensations experienced by 75%, and one bomb technician reported confusion and light-headedness. Conclusion: All bomb technicians demonstrated moderate-high levels of heat strain, evidenced by elevated heart rate, core body temperature and PSI. Severe levels of dehydration and noteworthy heat-related symptoms further highlight the risks to health and safety faced by bomb technicians operating in tropical locations.

Managing health risks of extreme weather events : need for a systematic approach

The Climate Commission recently outlined the trend of major extreme weather events in different regions of Australia, including heatwaves, floods, droughts, bushfires, cyclones and storms. These events already impose an enormous health and financial burden onto society and are projected to occur more frequently and intensely. Unless we act now, further financial losses and increasing health burdens seem inevitable. We seek to highlight the major areas for interdisciplinary investigation, identify barriers and formulate response strategies.

Alternate healing and medicine : the roles of naturopathy, homeopathy, osteopathy, chiropractic and medical practice in the health system

This thesis is concerned with understanding the roles of four alternate healing systems and medical practice in the community's health behaviour. The four alternate systems are naturopathy, homoeopathy, osteopathy and chiropractic. The research reported developed from work supported by the Committee of Inquiry into Chiropractic, Osteopathy, Homoeopathy and Naturopathy conducted under the chairmanship of Professor E. C. Webb set up by the Australian Government in 1975. The study concentrates on the factors which influence individual clients in their decisions to consult healers for treatment. An underlying assumption is that an analysis of the processes that effect such decisions will lead to further knowledge of the community's attitudes towards the functions of alternate healing and medicine. A review of the historical backgrounds and current status of the four alternate healing systems leads to the conclusion that they differ in a variety of areas. These areas include treatment modalities, historical backgrounds, occupational development and rapprochement with medicine. Homoeopathy, osteopathy and chiropractic emerged as distinct approaches to healing late in the nineteenth century. Naturopathy tends to be a philosophy or style of life as much as a health system in its own right. Their relationships with medicine also vary; osteopathy and naturopathy receive some acceptance, some homoeopaths are tolerated, whilst chiropractic is ostracised and vilified. A common paradigm of treatment underlies all four alternate approaches to healing. They all eschew the use of synthetic pharmaceuticals and invasive treatments and accept an indigenous theory of disease and a belief in the vis medicatrix naturae or the healing power of nature. An inevitable concomitant of this paradigm is that they believe that healing and health must be self-engendered. They rest within the client and his or her actions, not within the hands, skills or power of the healer. It is these characteristics combined with the alternate healers ' claims to espouse a similar scientific rationale for their approaches, and their functioning as parallel healers to medicine, that establishes their special relationship with medicine. This relationship become s more problematic in the face of medicine's hegemony and claim to unique legitimacy as the community's sole healing system. The interaction between these systems and medical practice can be gauged through articles related to the four alternate healing systems that have appeared in the medical literature. Interest has been cyclical but appears to have markedly increased in the past two decades. In this period it has included exploratory and descriptive writing; concern with controlling and/or eradicating the healers; desire to protect an ignorant and vulnerable public and. finally understanding and exploration of what the alternate healers might have to offer. At the same time, the public or institutionalized role has been one of denial and suppression through ostracism and legal constraints. In spite of medicine's position the alternate healing systems have found growing community acceptance so that it is problematical and probably unacceptable now to consider their use as a 'deviant ' health action. Increasing interest in the characteristics of clients has provided a consensus that they are similar to the adult population and are more likely to suffer from musculoskeletal and chronic illnesses. They are no more likely to be neurotic or gullible than the general community, but probably more practical and more oriented towards an active involvement in the healing process. The impact of these issues is explored, through comparing the strategies taken into account when choosing a treatment. These include attending one of the alternate healers exclusively for a condition; attending an alternate healer and a medical practitioner for the same problem; attending a medical practitioner solely or not consulting any healer. Respondents from surveys of alternate healer clients and the general community were classified according to their use of these four strategies, and the influences on their decisions at different stages of the treatment decision making process were compared.

Occupational health psychology

In this chapter, the occupational stress process and implications for the management of occupational health and safety in organisations are discussed. The chapter begins by introducing occupational stress as a process by which stressors (e.g. time pressure) result in strains (e.g. ill health). The consequences of stress, to both the individual and the organisation are discussed, and several key sources of occupational stress are also described. Theories of occupational stress that attempt to explain how stressors lead to strain and also describe different job resources (e.g. autonomy, support, and security) that can alleviate the detrimental effects of occupational stressors are then presented. The management of occupational stress at both the individual and organisational levels is also discussed. In the subsequent section, work-life balance and various ways work impacts on life and vice versa are described. The management of work-life conflict and the effectiveness of initiatives designed to address imbalance between work and life are then discussed. Finally, occupational health and safety is described with a particular focus on primary prevention as well as the legislative frameworks that guide psychosocial risk management in Australian organisations.

The Europeanisation of occupational health services: A study of the impact of EU policies

This study concerns Framework Directive 89/391/EEC on health and safety at work, which encouraged improvements in occupational health services (OHS) for workers in EU member states. Framework Directive 89/391/EEC originally aimed at bringing the same level of occupational health and safety to employees in both the public and private sectors in EU member states. However, the implementation of the framework directive and OHS varies widely among EU member states. Occupational health services have generally been considered an important work-related welfare benefit in EU member states. The purpose of this study was to analyse OHS within the EU context and then analyse the impact of EU policies on OHS implementation as part of the welfare state benefit. The focus is on social, health, and industrial policies within welfare state regimes as well as EU policy-making processes affecting these policies in EU member states. The research tasks were divided into four groups related to the policy, functions, targets,and actors of OHS. The questions related to policy tried to discover the role of OHS in other policies, such as health, social, and labour market policies within the EU. The questions about functions sought to describe the changes, as well as the path dependence, of OHS in EU member states after the framework directive. The questions about targets were based on the general aims of WHO and the ILO in relation to equity, solidarity, universality, and access to OHS. The questions on actors were designed to understand the variety of stakeholders interested in OHS. The actors were supranational (EU, ILO, and WHO), national (ministries, institutes, and professional organisations), and social partners (trade unions and employers organisations). The study data were collected by interviewing 92 people in 15 EU member states, including representatives of ministries, institutions, research,trade unions, employers organisations, and occupational health organisations. Other documents were collected from the Internet,databases, libraries, and conference materials for a systematic review of the policies, strategies, organisation, financing, and monitoring of OHS in EU member states. Different analytical methods were used in the data analysis. The main findings of the study can be summarised as follows. First, occupational health services is a context-dependent phenomenon, which therefore varies according to the development of the welfare state in general, and depends on each country s culture, history, economy, and politics. The views of different stakeholders in EU member states concerning the impact and possibilities of OHS to improve health vary from evidence-based opinions to the sporadic impact of OHS on occupational health. OHS as a concept is vaguely defined by the EU, whereas the ILO defines OHS content. The tasks of OHS began as preventive and protective services for workers. However, they have moved towards multidisciplinary and organisational development as well as the workplace health promotion sphere.Since 1989 OHS has developed differently in different EU member states depending on the starting position of those states, but planning and implementation are crucial phases in the process toward better OHS coverage, equity, and access. Nevertheless, the data used for the planning and legitimisation of OHS activities are mainly based on occupational health data rather than on OHS data. This makes decisions on political or policy grounds inaccurate. OHS is still an evolving concept and benefit for workers, but the Europeanisation of OHS reflects contextual changes, such as the impact of the internal market, competition, and commercialisation on OHS. Stronger cooperation and integration with health, social, and employment services would be an asset for workers, because of new epidemics, an epidemiological shift towards new risks, an ageing labour market, and changes in the labour market. Different methods and approaches are needed in order to study the results of integrated services. In the future, more detailed information will be needed about the actual impact of EU policies on OHS and decision-making processes in order to get OHS into different policies in the EU and its member states. Further results and effects of OHS processes on occupational health need to be analysed more carefully. The adoption of a variety of research strategies and a multidisciplinary approach to understand the influence of different policies on OHS in the EU and its member states would highlight the options and opportunities to improve workers occupational health. Key subject headings: Occupational health services, EU policy, policymaking,framework directive 89/391/EEC

Influences of the Oceans on Human Health and Well-Being

Human health and well-being are tied to the vitality of the global ocean and coastal systems on which so many live and rely. We engage with these extraordinary environments to enhance both our health and our well-being. But, we need to recognize that introducing contaminants and otherwise altering these ocean systems can harm human health and well-being in significant and substantial ways. These are complex, challenging, and critically important themes. How the human relationship to the oceans evolves in coming decades may be one of the most important connections in understanding our personal and social well-being. Yet, our understanding of this relationship is far too limited. This remarkable volume brings experts from diverse disciplines and builds a workable understanding of breadth and depth of the processes – both social and environmental – that will help us to limit future costs and enhance the benefits of sustainable marine systems. In particular, the authors have developed a shared view that the global coastal environment is under threat through intensified natural resource utilization, as well as changes to global climate and other environmental systems. All these changes contribute individually, but more importantly cumulatively, to higher risks for public health and to the global burden of disease. This pioneering book will be of value to advanced undergraduate and postgraduate students taking courses in public health, environmental, economic, and policy fields. Additionally, the treatment of these complex systems is of essential value to the policy community responsible for these questions and to the broader audience for whom these issues are more directly connected to their own health and well-being.

The justice-workplace health relationship:The mediating role of emotions

Purpose - The purpose of this paper is to examine the mediational effects of positive and negative emotions in the relationship between organisational justice and health. Design/methodology/approach - This cross-sectional research obtained data from 206 workers employed within the financial/banking, manufacturing, and retail industries in Barbados. Findings - Structural equation modelling analyses revealed that positive and negative emotions completely mediated the effects of relational justice (but not procedural justice) on overall health. Research limitations/implications - Research was cross-sectional, and relied on self-report measures. The findings suggest that employers must properly evaluate their health and safety policies and practices in the organisation to ensure that aspects of the psychosocial work environment are being properly implemented, managed, and monitored, to ensure that individuals' health and well-being are not at risk. Originality/value - The paper represents a first attempt to investigate the roles of positive and negative emotions in the justice-health relationship in a different cultural context such as the Caribbean. Justice has been rarely researched as a psychosocial work stressor. The study described in the paper focused on multiple health outcomes. Copyright © 2012 Emerald Group Publishing Limited. All rights reserved.

A Quantitative Study of Social Capital Components, Self-Reported Health Status and Social Determinants of Health

This quantitative descriptive co-relational study used telephone survey interviews and stratified random sampling to collect data related to Social Capital (SC) and its components (trust and safety, reciprocity, civic engagement and collective action) and selected determinants of health variables in Niagara Region, Canada. Among the four components of social capital, trust and safety levels were highest among all participants (m=5.42, SD=1.0), with community engagement yielding the lowest mean score for the sample (m=1.93, SD=.8). Reciprocity had the strongest association with all other components of SC (r=0.51). Those most likely to report low levels of SC and health were unattached and low-income females. Males were more likely to report higher trust and safety levels and higher levels of self-rated health. In this study, a linear relationship between self-reported health status and SC was not found. Marital and employment status were associated with differences in mean scores of SC and self-reported health.

Reproductive Tourism in Argentina: Clinic Accreditation and its Implications for Consumers, Health Professionals and Policy Makers

A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent ‘players’ in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.