Health Risk Assessment Program Research Articles

Effects of occupational exposure to dust on chest radiograph, pulmonary function, blood pressure and electrocardiogram among coal miners in an eastern province, China

BackgroundCoal dust is one of the most serious risk factor that leads to respiratory diseases and cardiovascular diseases in miners. This study aimed to observe the effects of occupational dust exposure on chest radiograph, pulmonary function (PF), blood pressure (BP) and electrocardiogram (ECG) indexes in coal miners and explore the related risk factors.MethodsIn the Chinese Occupational Disease Monitoring and Occupational Health Risk Assessment Program, a total of 11,061 subjects in 2015 and 12,597 subjects in 2016 were recruited in this study. The chest radiograph, PF, BP and ECG of coal miners were surveyed using radiograph machine, spirometer, sphygmomanometer and electrocardiograph, respectively.ResultsThe prevalence of aberrant BP was the highest in coal miners, followed by abnormal ECG, PF and radiograph. Significant differences in abnormal BP, ECG, PF and radiograph of coal miners were closely associated with age, years of dust exposure, smoking, drinking, working types and size of mines. A total of 80 persons diagnosed with coal workers’ pneumoconiosis (CWP) in 2015–2016, which occupied 0.34% of the coal miners.ConclusionAbnormal BP, ECG, PF and radiograph of coal miners are highlighted health problems in China and require serious attention. Feasible health promotion and protective facilities should be adopted to guarantee coal miners’ health.

Application of Public Health Risk Assessment Methodology for Typhoon Disaster in China

Objective We conducted a public health risk assessment program for the Guangxi Zhuang Autonomous Region for typhoon disaster, to provide scientific evidence for public health emergency response and preparedness. Methods The public health risk assessment model for natural disaster is established through literature reviews, brainstorming, Delphi’s expert consultation and evaluation, based on theories of management, sociology and epidemiology. Basic data related to natural disasters and public health were extensively collected before the risk assessment. 34 public health experts from different professional fields identify the risk factors based on the basic data, conduct risk analysis according to the scoring criterion, calculate the risk values of risk factors according to the evaluation model, and then conduct the risk evaluation. Results 20 major public health risks which could seriously affect the Guangxi Zhuang Autonomous Region for typhoon disaster, were identified and assessed. The results of risk analysis showed that trauma, typhoid or paratyphoid, cholera, infectious diarrhea and hepatitis A were the top five high risk factors. Conclusion This study is the first time to apply the risk assessment theory for public health emergency preparedness before the natural disaster. Try to establish assessment index system, and then calculate risk value by semi-quantitative assessment method. This study provides a technical support for early warning surveillance and dynamic risk assessment of public health events. It will eventually improve capacity of public health emergency preparedness and response on natural disaster.

Lessons learned from pre-implementation activities to integrate a web-based personalized health risk assessment program in diverse primary care settings

Risk assessment, which can target preventive care to individuals' disease risk, is becoming an increasingly important strategy for improving population health. However, numerous barriers limit the collection and synthesis of the data necessary for risk-stratification. Leveraging health IT may prove critical in overcoming these barriers and improving uptake of preventive guidelines. To this end, NHGRI is funding implementation of MeTree, a patient-facing health risk assessment program with just-in-time education/clinical decision support, into 5 diverse U.S. healthcare systems. We developed a mixed-methods pre-implementation process to facilitate uptake of MeTree that highlights implementation support needs. Here we present findings from 2 of the 5 systems.

Real-world application of MedsCheck opportunities

Despite the observation that age-specific mortality rates from coronary artery disease have declined by nearly 40% in Canada over the past several decades, this disease continues to be the leading cause of death and morbidity for Canadians.1 Advances in pharmacy practice, the expectation that pharmacists take a more active role in and responsibility for medication management and patient health outcomes, and high patient accessibility provide an important opportunity for pharmacists to identify and manage cardiovascular risk factors. Indeed, numerous trials have clearly demonstrated the positive impact of pharmacist care in managing patients with hypertension, hyperlipidemia and diabetes.2-8 In light of the changing pharmacist scope of practice and remuneration opportunities, we sought to implement a community pharmacists’ heart health risk assessment program using MedsCheck and subsequent interventions on surrogate heart health outcomes in patients with moderate to high Framingham Risk Scores (FRS).

Effect of a Web-based Health Risk Assessment with Tailored Feedback on Lifestyle among Voluntary Participating Employees: A Long-term Followup Study

Background: Primary prevention of cardiovascular disease (CVD) by means of web-based Health Risk Assessment (HRA) with tailored feedback for individual health promotion is promising. We evaluated the effects on lifestyle of such a HRA program among employees of a Dutch worksite. Methods: We conducted a prospective follow-up study among employees who voluntarily participated in a webbased HRA including tailored feedback, offered to them by their employer. The program includes a multi-component HRA through a web-based electronic questionnaire, biometrics and laboratory evaluation. Results are combined with health behavior change theory to generate tailored motivating and educating health recommendations. Upon request, a health counseling session with the program physician is available. Follow-up data on lifestyle were collected one year after initial participation. Primary outcomes were the changes relative to baseline in proportions meeting recommendations for physical activity, fruit and vegetable intake, smoking and alcohol consumption. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program a year later. Results: A total of 142 employees completed follow-up measurements after mean 15 months. The proportion with a total physical activity amount of ≥ 150 minutes/week increased from 46% to 71% (p<0.001). The proportion with a physical activity pattern according to local recommendation (at least 30 minutes of moderate intensity physical activity on at least five days a week) was not increased. No differences were found in the proportions meeting recommendations for daily intake of fruit and vegetables, of moderate alcohol consumption, and smoking cessation. Changes were not explained by additional health counseling or increased health consciousness within the company. Conclusions: Among employees who voluntarily participated in a web-based HRA with tailored feedback the proportion with a total physical activity of ≥ 150 minutes/week increased by 25%. Web-based HRA programs with tailored feedback could help employers to enhance employee physical activity.

COMMUTE BEHAVIOR ASSESSMENT, SIMULATION OF COMMUTE PATTERNS AND EXPOSURE TO AIR POLLUTION IN THE REGION OF BASEL, SWITZERLAND

Background and Aims: Our aim is to develop a multi-modal commute model which is able to simulate both travel patterns and commute exposure to traffic-related air pollution in the region of Basel. This study is part of the project “Transportation, Air Pollution, and Physical Activities (TAPAS)”; a 6-city integrated health risk assessment program of active travel policies. Methods: Firstly, travel patterns are simulated by means of a Geographic Information System (GIS) model using extensive information from the Swiss 2005 Microcensus database, which provides temporally and spatially resolved data on travel behavior. Secondly, environmental parameters of the built environment and personal factors that may influence adults’ choice of active and passive transportation modes are investigated on a route scale. Finally, exposure to air pollution is estimated by combining the commute patterns with predictions from air pollution models. Exposure in different commute modes and microenvironments are validated with personal measurements of PM2.5 and ultrafine particles (UFP) (10-300nm) in three different seasons for typical commute routes. Simulating variations of commute patterns will allow us to test scenarios of change in commute behavior on exposure distribution. Results: The proportion of active transport on the total distance of trips to work within the study area is 29.2%. Our first results of 24-hours personal PM2.5 measurements reveal significantly higher exposures during commuting than outdoor urban background exposure levels. Average commute exposure to PM2.5 (59.7±35.0 µg/m3) was about three-fold higher than average daily PM2.5 exposure (21.3±18.6 µg/m3). UFP measurements similarly show higher exposures during commuting as well as indoor cooking events. Conclusions: Preliminary results indicate significantly higher air pollution exposures during commuting in Basel. Results will be further examined and commuter exposure will be quantified. Thus, the study will contribute to a better understanding of population’s commute behavior and exposure to harmful air pollutants during daily commuting.

Participation in a workplace web-based health risk assessment program

Web-based health risk assessment (HRA) programs can be effective in primary prevention of cardiovascular diseases (CVD). Insight into determinants of participation could improve implementation in the workplace. To evaluate determinants of participation and reasons for non-participation in a web-based HRA offered to 5125 employees at four Dutch financial and information technology services companies. The study consisted of a questionnaire to compare sex, age, self-rated health, smoking, current work ability and sick leave between participants and non-participants in the HRA program, as well as reasons for non-participation. HRA participation rate was 37% (1907/5125) and 14% of the non-participants (423/3102) completed the non-participant questionnaire. There were no differences between participants and non-participants in sex, education level, smoking, and current work ability. Compared with non-participants, participants were older (44 versus 41 years, P < 0.001). Among participants, 85% rated their health as 'good' or 'very good', compared with 78% among non-participants (P < 0.001); 88% of the participants reported fewer than 10 days sickness absence in the previous year, compared with 86% of the non-participants (P < 0.05). Reported reasons for non-participation included lack of time (39%) and not being aware of the opportunity to participate (11%). Evaluation of demographic, health-related, and work-related determinants of participation in a web-based HRA showed differences between participants and non-participants in self-rated health and absenteeism. Implementing a less time-consuming HRA process and providing adequate information to employees prior to inviting them may be necessary to reach larger proportions of employees, including those with less favourable health and work characteristics.

Derivation of Health-Based Screening Levels for Evaluating Indoor Surface Contamination

Abstract This paper describes the development of U.S. Army Public Health Command (Provisional) Technical Guide 312, Health Risk Assessment Methods and Screening Levels for Evaluating Office Worker Exposures to Contaminants on Indoor Surfaces Using Surface Wipe Data. Surface sampling of indoor surfaces may be performed to determine whether a building is safe for re-entry following an event (for example, fire, pesticide application) or change in building use (for example, laboratory to administrative office). Surface wipe sampling results may be used to assess either the degree of contamination before cleanup or to determine whether post-abatement (also post-remediation, post-clearance) actions were effective. The U.S. Army Public Health Command (Provisional) Environmental Health Risk Assessment Program has conducted risk assessments based on surface wipe sampling data and, over time, has evolved the methodology into a technical guide. The technical guide addresses the need to develop an approach to characterize potential health risk to exposed populations using surface wipe sampling results and to provide surface wipe screening levels to facilitate initial assessments. The methodology provides a means to estimate office worker exposures from inhalation of resuspended particles, dermal contact, and incidental ingestion exposure routes. Potential chemical health risks from aggregated intakes are evaluated using conventional U.S. Environmental Protection Agency risk assessment methods.

Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback

BackgroundPrimary prevention programs at the worksite can improve employee health and reduce the burden of cardiovascular disease. Programs that include a web-based health risk assessment (HRA) with tailored feedback hold the advantage of simultaneously increasing awareness of risk and enhancing initiation of health-behaviour change. In this study we evaluated initial health-behaviour change among employees who voluntarily participated in such a HRA program.MethodsWe conducted a questionnaire survey among 2289 employees who voluntarily participated in a HRA program at seven Dutch worksites between 2007 and 2009. The HRA included a web-based questionnaire, biometric measurements, laboratory evaluation, and tailored feedback. The survey questionnaire assessed initial self-reported health-behaviour change and satisfaction with the web-based HRA, and was e-mailed four weeks after employees completed the HRA.ResultsResponse was received from 638 (28%) employees. Of all, 86% rated the program as positive, 74% recommended it to others, and 58% reported to have initiated overall health-behaviour change. Compared with employees at low CVD risk, those at high risk more often reported to have increased physical activity (OR 3.36, 95% CI 1.52-7.45). Obese employees more frequently reported to have increased physical activity (OR 3.35, 95% CI 1.72-6.54) and improved diet (OR 3.38, 95% CI 1.50-7.60). Being satisfied with the HRA program in general was associated with more frequent self-reported initiation of overall health-behaviour change (OR 2.77, 95% CI 1.73-4.44), increased physical activity (OR 1.89, 95% CI 1.06-3.39), and improved diet (OR 2.89, 95% CI 1.61-5.17).ConclusionsMore than half of the employees who voluntarily participated in a web-based HRA with tailored feedback, reported to have initiated health-behaviour change. Self-reported initiation of health-behaviour change was more frequent among those at high CVD risk and BMI levels. In general employees reported to be satisfied with the HRA, which was also positively associated with initiation of health-behaviour change. These findings indicate that among voluntary participating employees a web-based HRA with tailored feedback may motivate those in greatest need of health-behaviour change and may be a valuable component of workplace health promotion programs.

Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

Introduction:A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.Methods:We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.Results:A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001) in the high-risk category (baseline CVD risk ≥20%). Changes were not explained by additional health counseling, medication, or an increase in health consciousness within the company.Conclusions:Voluntary participation in a Web-based HRA with tailored feedback at the worksite reduced CVD risk by nearly 18% among participants at high CVD risk and by nearly 5% among all participants. Web-based HRA could improve CVD risk in similar populations. Future research should focus on the persistence of the effects underlying the CVD risk reduction.

The Medicare health risk assessment program

The Medicare health risk assessment program

Evaluation of an Employee Health Risk Appraisal Program

1. After 2 years of employee participation, a computerized health risk assessment program managed by occupational health nurses was evaluated to determine whether health risk factor levels had undergone any significant change. 2. Data on 387 hospital employees were examined. Statistically significant reductions in risk factor levels were found for diastolic blood pressure, serum cholesterol, and smoking. The risk factor "weight" remained unchanged from year 1 to year 2 for both groups. 3. These findings suggest that the nursing interventions of focused, written feedback on risk factors, private counseling, and risk reduction education classes may have been important in motivating employees to make significant lifestyle changes.