Occupational Health Risk Management Research Articles

Evaluation of Occupational Health Risk Management and Performance in China: A Case Study of Gas Station Workers

China has a large number of gas stations, with which thousands of workers are associated. There is abundant online literature documenting the various occupational health risks these workers face. However, this literature has many flaws to address, and it falls short of suggesting measures to manage these risks. This study strives to fill that gap, and aims to improve the occupational health of gas station workers through comprehensive risk management and performance analysis. To this end, a reasonable volume of reliable data, i.e., 208 completed questionnaires, were analyzed through current statistical routines, viz., fuzzy Analytical Hierarchy Process (AHP) and Importance Performance Analysis (IPA). These methods were employed to hierarchically organize the main factors and sub-factors of physical risk management, chemical risk management, biological risk management, physiological risk management and psychological risk management according to their appraised importance, and screen out the risk management stratagem for priority improvement. Research findings reveal that chemical risk and biological risk response schemes have the lowest performance, and need to be prioritized for improvement. Furthermore, this study argues that we can safeguard the occupational health of gas station workers through appropriate risk management strategies. It also elaborates on implications, limitations and future research directions.

Outdoor ambient temperatures and occupational injuries and illnesses: Are there risk differences in various regions within a city?

Increased risk of occupational injuries and illnesses (OI) is associated with hot ambient temperatures. However, the existing evidence of risk estimation is limited to large regions at the city or provincial scales. For effective and localized occupational health risk management, spatio-temporal analysis should be carried out at the intra-city level to identify high-risk areas within cities. This study examined the exposure-response relationship between ambient temperatures and OI at the intra-city scale in Greater Adelaide, Australia. Vulnerable groups of workers, in terms of workers' characteristics, the nature of their work, and workplace characteristics were identified. Further, the projected risk of OI was quantified in various climate change scenarios.The temperature-OI association was estimated using a time-series study design combined with Distributed Lag Non-linear Models. Daily workers' compensation claims (2005–2018) were merged with 5 km gridded meteorological data of maximum temperature (°C) at Statistical Area Level 3 in Greater Adelaide. Region-wise subgroup analyses were conducted to identify vulnerable groups of workers. Future projections (2006–2100) were conducted using downscaled climate projections and the risk was quantified using log-linear extrapolation. The analyses were performed in R 4.1.0.The overall OI risk was 16.7% (95%CI: 10.8–23.0) at moderate heat (90th percentile) and increased to 25.0% (95%CI: 16.4–34.2) at extreme heat (99th percentile). Northern Adelaide had a higher risk of OI for all types of workers at moderate heat, while western regions had a high risk for indoor industries. Southern and eastern regions had a higher OI risk for males, older workers, and outdoor industries at extreme heat. The projected risk of OI is estimated to increase from 20.8% (95%CI: −0.2–46.3) in 2010s to 22.9% (95%CI: −8.0–64.1) by 2050s. Spatio-temporal risk assessment at the intra-city scale can help us identify high-risk areas, where targeted interventions can be efficiently employed to reduce the socio-economic burden of OI.

Occupational health risk management system for greenhouse vegetable growers

Introduction. Prevention of chronic general somatic diseases associated with exposure to harmful working conditions is one of the primary measures to preserve the health of the working population and labor resources of the Russian Federation. However, insufficient attention is paid to the management of occupational health risks of agricultural workers, including greenhouse vegetable growers. Materials and methods. Hygienic and epidemiological studies were carried out based on the methodology for assessing and managing occupational health risks. Results. A complex of harmful occupational factors, including high temperatures and humidity, harmful chemicals, including pesticides, plant dust, and the labor process’s severity simultaneously affect working greenhouse growers. Working conditions were assessed as harmful (classes 3.2-3.3) of occupational risk categories from medium to high. Direct statistically significant correlations were established between the length of occupational service and diseases of the respiratory system, circulatory system, musculoskeletal system, and connective tissue (respectively r = 0.58; r = 0.6; r = 0.35). A high degree of causal relationship with the work in harmful occupational conditions of arterial hypertension (RR = 2.805; EF = 64.35%; CI = 1.498-5.253), radiculopathy of the lumbosacral spine (RR = 2.290; EF = 56%; CI = 1.140- 4.599), an average degree of uterine fibroids (RR = 1.969; EF = 49%; CI = 0.988-3.926) and chronic bronchitis (RR = 1.532; EF = 34.7%; CI = 0.682-3.442), which allows classifying them as occupationally conditioned. The system of preventive measures to minimize occupational risks and prevent occupational diseases has been scientifically substantiated. Conclusion. Current working conditions of greenhouse vegetable growers are characterized by the impact of harmful occupational factors promoting occupationally caused diseases, which requires the implementation of a set of preventive measures based on a risk-oriented approach.

The COVID-19 Impact in Hospital Healthcare Workers: Development of an Occupational Health Risk Management Program

As with the SARS-CoV-1 outbreak in 2003–2004 and the MERS outbreak in 2012, there were early reports of frequent transmission to healthcare workers (HCW) in the SARS-CoV-2 pandemic. Our hospital center identified its first COVID-19 confirmed case on March 9, 2020, in a 6-day hospitalized patient. The first confirmed COVID-19 case in a HCW happened 3 days later, in a nurse with a probable epidemiological link related to the first confirmed patient. Our study’s first objective is to describe and characterize the impact of the first 3 months of the SARS-CoV-2 pandemic on the Centro Hospitalar Universitário Lisboa Norte (CHULN). Our second objective is to report the performance of the CHULN Occupational Health Department (OHD) and the impact of the pandemic on CHULN HCW and its adaptation across national, regional, and institutional epidemiological evolution. Over the first 3 months, 2,152 HCW were screened (which represent 29.8% of the total HCW population), grouped in 100 separate identifiable clusters, each one ranging from 2 to 98 HCW. The most prevalent profession screened were nurses (n = 800; 37.2%) followed by doctors (n = 634; 29.5%). The main source of potential infection and cluster generating screening procedures was co-worker related (n = 1,216; 56.5%). A patient source or a combined patient co-worker source was only accountable for 559 (26%) and 43 (2%) of cases, respectively. Our preliminary results demonstrate a lower infection rate among HCW than the ones commonly found in the literature. The main source of infection seemed to be co-worker related rather than patient related. New preventive strategies would have to be implemented in order to control SARS-CoV-2 spread.

Accelerated Silicosis-An Emerging Epidemic Associated with Engineered Stone. Comment on Leso, V. et al. Artificial Stone Associated Silicosis: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16 (4), 568, doi:10.3390/ijerph16040568.

The systematic review by Leso et al. (16 February 2019) is a timely contribution to the body of knowledge concerning silicosis. It highlights the lack of quality data necessary to inform both occupational health risk management and the clinical management of workers exposed to respirable crystalline silica. This communication highlights current activity being undertaken in Queensland, Australia, that will further inform our knowledge concerning this entirely preventable disease. We are about half-way through a government-funded, case-finding program involving over 800 workers from the engineered stone bench-top fabrication industry. As of 15 February 2019, 99 confirmed cases of silicosis associated with engineered stone work were identified; nearly all were asymptomatic. The empirically observed false negative rate of ILO CXRs in this high-risk group appeared significantly greater than 10%. From pooled data, we hope to develop an appropriate index of exposure to trigger health surveillance using low-dose chest HRCT. Once a worker develops symptoms of silicosis, apart from lung transplantation, there are no treatment options currently available.

Occupational Health Risk Assessment in the Electronics Industry in China Based on the Occupational Classification Method and EPA Model.

The awareness of occupational health risk management in the electronics industry is weak in China, and many Chinese occupational health management regulations have not been effectively implemented. China’s current occupational hazards classification method and the Environmental Protection Agency (EPA) inhalation risk assessment model recognized internationally were used to perform health risk assessments for a chip manufacturing company in the electronics industry in order to determine the existing problems and put forward the optimization proposals of the occupational hazards classification method in China. The results showed that the detected concentrations of toxic and harmful chemicals in all testing points did not exceed the occupational health exposure limits in China. According to the EPA inhalation risk assessment model, the highest values of non-carcinogenic risks of ammonia, chlorine, fluoride, sulfuric acid, hydrogen chloride, ethylene glycol, phosphine, boron trifluoride, isopropanol, benzene, and xylene were 5.10, 67.12, 1.71, 45.98, 1.83, 1.43, 160.35, 46.56, 2.52, 5.55, and 5.37, respectively, which means workers in electronic chip manufacturing companies exposed to these chemicals have higher occupational health risks. However, on the basis of the occupational hazards classification method, the occupational health risks of exposure to the toxic and hazardous chemicals are relatively harmless operations. The evaluation results of the EPA inhalation risk assessment model are generally higher than those of the occupational hazards classification method. It’s recommended to refine the value of occupational exposure limit B, taking more characteristics of the hazard factors into account and fuzzifying the parameters to optimize the occupational hazards classification method. At the same time, it is suggested that the electronic chip manufacturing company should conduct anti-virus risk management covering in three aspects: increasing the awareness of occupational hazards, enhancing system ventilation, and improving personal health management measures.

The identification and management of substance use disorders in anesthesiologists.

The purpose of this article is to review current evidence for the identification and management of substance use disorders in anesthesiologists and to describe an approach to return to practice. Anesthesiologists experience substance use disorders at a rate reported to be 2.7 times that of other physicians. Effective evidence-based treatment is available for physicians with substance use disorders, including anesthesiologists. Significant barriers preventing access to such treatment still exist, some of which are specific to the physician cohort. Standard of care should involve ongoing monitoring of substance use disorders in a chronic disease management paradigm. The outcomes for anesthesiologists treated and monitored for a substance use disorder are similar to those for other physicians and significantly superior to those for the general population. Return to work is possible and is most effectively managed in an occupational health risk management model. The treatment of substance use disorders in anesthesiologists is effective, and a safe return to practice is possible in a majority of cases. National guidelines are needed to ensure equitable access to high-quality treatment and recovery monitoring for all Canadian physicians.

Protection of the vehicle cab environment against bacteria, fungi and endotoxins in composting facilities

Microbial quality of air inside vehicle cabs is a major occupational health risk management issue in composting facilities. Large differences and discrepancies in protection factors between vehicles and between biological agents have been reported. This study aimed at estimating the mean protection efficiency of the vehicle cab environment against bioaerosols with higher precision. In-cab measurement results were also analysed to ascertain whether or not these protection systems reduce workers’ exposure to tolerable levels.Five front-end loaders, one mobile mixer and two agricultural tractors pulling windrow turners were investigated. Four vehicles were fitted with a pressurisation and high efficiency particulate air (HEPA) filtration system. The four others were only equipped with pleated paper filter without pressurisation. Bacteria, fungi and endotoxins were measured in 72 pairs of air samples, simultaneously collected inside the cab and on the outside of the cab with a CIP 10-M sampler.A front-end loader, purchased a few weeks previously, fitted with a pressurisation and high efficiency particulate air (HEPA) filtration system, and with a clean cab, exhibited a mean protection efficiency of between 99.47% CI 95% [98.58–99.97%] and 99.91% [99.78–99.98%] depending on the biological agent. It is likely that the lower protection efficiency demonstrated in other vehicles was caused by penetration through the only moderately efficient filters, by the absence of pressurisation, by leakage in the filter-sealing system, and by re-suspension of particles which accumulated in dirty cabs. Mean protection efficiency in regards to bacteria and endotoxins ranged between 92.64% [81.87–97.89%] and 98.61% [97.41–99.38%], and between 92.68% [88.11–96.08%] and 98.43% [97.44–99.22%], respectively. The mean protection efficiency was the lowest when confronted with fungal spores, from 59.76% [4.19–90.75%] to 94.71% [91.07–97.37%]. The probability that in-cab exposure to fungi exceeded the benchmark value for short-term respiratory effects suggests that front-end loaders and mobile mixers in composting facilities should be fitted with a pressurisation and HEPA filtration system, regardless of whether or not the facility is indoors or outdoors. Regarding the tractors, exposure inside the cabs was not significantly reduced. However, in this study, there was a less than 0.01% risk of exceeding the bench mark value associated with fungi related short-term respiratory effects during an 1-h per day windrow turning operation.Pressurisation and a HEPA filtration system can provide safe working conditions inside loaders and mobile mixer with regard to airborne bacteria, fungi and endotoxins in composting facilities. However, regular thorough cleaning of the vehicle cab, as well as overalls and shoes cleaning, and mitigation of leakage in the filter-sealing system are necessary to achieve high levels of protection efficiency.

Monitoring for Health Hazards at Work

The authors are occupational hygienists—two academics and one practitioner all with well-established credentials. The title is largely intended for occupational hygienists although much of it is useful for a wider readership within the occupational medicine community. The book represents a significant change from previous editions as its layout is focussed into six key thematic areas rather than the highly practical ‘how to’ approach of earlier editions. These sections range from a general chapter on the principles of risk assessment to technical chapters on, for example, the quantification of inhalational exposure. For an occupational physician, some of the material, for instance on dermal exposure, may be too technical. However, the key principles are so clearly elucidated in the more general chapters (an excellent introduction, a risk assessment/communication section) as well as in the beginnings and ends of the more technical chapters that the book’s value is clear. The book fulfils its title well in bringing together all the appropriate elements of the monitoring process for health hazards at work. It is clearly written, comprehensive and up to date. It is realistic in recognizing both the value and downside of quantification within the wider spectrum of occupational health risk management although these authors’ own place in this spectrum is clearly well towards the quantification approach. The book is a very valuable resource for occupational physicians although largely for reference only. Occupational physicianswho are new to the specialty should, however, borrow it from the library so as to read the excellent aspects of the book dealing with general principles.

Risk perception in family health work: study with workers in Southern Brazil

This analytical and qualitative study aimed to identify how workers in the Family Health Strategy perceive the risks they are exposed to at work. Thematic analysis and the reference framework of the work process were used to examine the contents of interviews with 48 subjects (community health agents, nurses, nursing auxiliaries and physicians). The workers noticed the following risks: physical and moral violence, typical work accident, emotional exhaustion, lack of problem-solving ability and occupational disease. The results predominantly show the connection with the object / subject of the work and the social environmental characteristics of the related communities. The study adds to the body of knowledge and can systemize collective and individual technological processes for occupational health risk management in primary health care.

Essential features for proactive risk management

We propose a proactive approach to the management of occupational health risks in emerging technologies based on six features: qualitative risk assessment; the ability to adapt strategies and refine requirements; an appropriate level of precaution; global applicability; the ability to elicit voluntary cooperation by companies; and stakeholder involvement.

Management of occupational health risks in small-animal veterinary practices

Small-animal work is a major element of veterinary practice in the UK and may be hazardous, with high levels of work-related injuries and ill-health reported in Australia and USA. There are no studies addressing the management of occupational health risks arising from small-animal work in the UK. To investigate the sources of health and safety information used and how health and safety and 12 specific occupational health risks are managed by practices. A cross-sectional postal survey of all small-animal veterinary practices in Hampshire. A response was mandatory as this was a Health & Safety Executive (HSE) inspection activity. A total of 118 (100%) practices responded of which 93 were eligible for inclusion. Of these, 99 and 86%, respectively, were aware of the Royal College of Veterinary Surgeons (RCVS) practice standards and had British Small Animal Veterinary Association (BSAVA) staff members, while only 51% had previous contact with HSE (publications, advice and visit). Ninety per cent had health and safety policies, but only 31% had trained responsible staff in health and safety. Specific health hazards such as occupational allergens and computer use were relatively overlooked both by practices and the RCVS/BSAVA guidance available in 2002. Failings in active health risk management systems could be due to a lack of training to ensure competence in those with responsibilities. Practices rely on guidance produced by their professional bodies. Current RCVS guidance, available since 2005, has remedied some previous omissions, but further improvements are recommended.

Strategic Planning for Military Occupational Health Care

This article describes a framework and system for planning appropriate occupational health contributions to military manpower availability and operational capability, and auditing the complete and effectiveness of implementation. Prepared through author-led consensus-seeking serial deliberations with occupational health experts over initial and consequential drafts of, latterly, a populated strategic planning framework based on key stages in a military career. Illustrative examples are provided from the author's experience and, along with referenced sources of further information, the scientific literature. The resulting framework facilitates timely management of occupational health risks to recruiting, retention, operational availability and capability, and the general well-being of military personnel. Monitoring and audit are integral to the activity to provide an evidence-based spiral of refinement of the plan and improvement of outcomes. Key stages of the military career may provide manageable challenge bites for planning with executive and health care colleagues to forecast and control occupational health risks to operational capability and thus contribute to achieving military objectives.

An approach to occupational health risk management for a diversified international corporation.

A risk management program is presented which is effective in handling occupational health risks in a diversified multinational corporation. The three-step program of plant reviews involves initial assessment visits designed to determine the compliance status and degree of sophistication of the occupational health program. These assessments are followed by more formal assurance reviews which include consultation, training, and program support. Finally, formal surveillance reviews are conducted to verify compliance with respect to company and regulatory agency requirements. Each type of review requires planning and adherence to a standardized process to allow comparability of the information generated. Critical elements of this approach include senior management support, knowledge of applicable regulations, and communication of results. Reporting is done on several levels and is designed to communicate relevant information to management from line supervisors to the board of directors. Corrective action, where indicated, is planned by local managers with assistance from other groups as required. Corrective action plan implementation is tracked in conjunction with other mechanisms of occupational health and medical services to assure effective management of these risks.

An Approach to Occupational Health Risk Management for a Diversified International Corporation

An Approach to Occupational Health Risk Management for a Diversified International Corporation