Non-occupational Conditions Research Articles

Concentration, sources and health effects of silica in ambient respirable dust of Jharia Coalfields Region, India

BackgroundThe concentration of silica in occupational conditions is well defined and estimated around the world. Many countries in the world have developed air standards for occupational conditions based on the percent silica in ambient air. This is due to the pulmonary effect caused by silica yielding diseases like silicosis and pneumoconiosis. In India, occupational exposure to silica dust is regulated by Directorate General of Mine Safety (Tech.) (S&T) Circular No. 1 of 2004 Under Reg. 123 of Coal Mines Regulations, 1957 for any metal/non-metal mining operations estimated gravimetrically. As no silica standards are prescribed in India for non-occupational conditions, venturing into such analysis was well envisaged and perceived.MethodologyAir sampling was done at identified locations through high-volume samplers for 24 h, twice a week in pre-monsoon season (March to June) and the Whatman filter paper was sonicated at sufficient speed to isolate dust particles for energy dispersive X-ray.ResultsThe percentage of silica in “PM10” was found lowest in mining sites (15%), and highest in transportation sites (35%) and mid-value for mixed sites (24%). Thus, risk level gets magnified due to addition of finer dust generated in transportation and mixed sites than mining due to diesel driven vehicles. Burning of any fossil fuel generates high percentage of finer dust (< 2.5 µm).ConclusionsThere should be proper prescribed standard for silica for non-occupational conditions.

Appreciation and job control predict depressive symptoms: results from the Study on Mental Health at Work

ObjectiveDepressive symptoms are a leading cause of disability retirement and sick leave. The aim of this study was to assess the risk of depressive symptoms in German employees and its associations with factors from both the occupational and the non-occupational domain and gender.MethodsIn the second wave of the German Study of Mental Health at Work (SMGA), a representative sample of 2640 German employees (52% women) was studied. Depressive symptoms were assessed with the PHQ-9 questionnaire. Psychosocial occupational and non-occupational conditions were assessed with quantitative interviews. In this cross-sectional sample, the association of these factors with depressive symptoms was examined using logistic regression models.ResultsFactors from both the occupational and the non-occupational domain were associated with risk of depressive symptoms. Low appreciation from superior (ORmen 2.1 (95% CI 1.2–3.7); ORwomen 3.2 (95% CI 2.1–4.8)), low job control (ORmen 2.9 (95% CI 1.6–5.4); ORwomen 1.6 (95% CI 1.0–2.5)), and critical life events (ORmen 3.0 (95% CI 1.6–5.4); ORwomen 2.3 (95% CI 1.5–3.7)) had the strongest association with risk of depressive symptoms. The association with quantitative demands was stronger in caregivers than in non-caregivers. The results indicated possible differences in the associations of working conditions between men and women, and between family caregivers and non-caregivers.ConclusionFactors from both work and private life are associated with depressive symptoms, especially appreciation, job control, and critical life events. Gender differences, with respect to appreciation and influence at work, suggest a more gender sensitive approach to psychosocial occupational health research and interventions.

SURVEILLANCE PROGRAM IDENTIFIES HEALTH OUTCOMES FOR FORMER WORKERS

According to the US Bureau of Labor Statistics, the average age of retirement is 62. While many retirees may have employer-provided or other access to healthcare, others have limited access to affordable care until full Medicare eligibility at 65. Regardless of access, retirees with toxic occupational exposures may not have providers with specialized knowledge of tests or diagnoses for exposure-related health conditions, especially those with long-latency. The National Supplemental Screening Program for U.S. Department of Energy Former Workers is described here as a nationwide program providing recurring (every 3 years) integrated health screenings designed to identify both occupational and non-occupational conditions in the context of exposure so that early identification can enable appropriate and timely diagnoses and treatments to improve health outcomes. Since September 2005, there has been 18,518 initial exams for former workers, of whom 5,461 returned for rescreening exams through April 2019. The average age of those returning was significantly younger at initial exam (63.4 years) compared to those who did not return (65.1 years). The most common occupational condition was noise-induced hearing loss not attributable to natural, age-related loss (67%). Rare and long-latency occupational health conditions, such as asbestosis or silicosis, were identified at rates expected (1-4%). The most common non-occupational condition was elevated body mass index (BMI>25, 77.3%), followed by hypertension (20.7%), of which 50% had no prior knowledge or clinical diagnosis. In conclusion, occupational health surveillance programs can provide value for identifying non-occupational health conditions and as a supplementary source of health information and care.

Descriptive Study of sickness absence in the health care sector of Catalonia (2009-2012)

To describe the incidence and evolution of sickness absence (SA) for non-occupational and occupational illness/injury in the population of workers in Catalonian Health Centers based on the definition of a set of common indicators. The study population consisted of 25,964 workers from 30 health centers in Catalonia, during 2009-2012. Information on SA episodes was obtained from records of the Directorate of Human Resources. SA indicators were defined, and SA incidence rates and temporal evolution were calculated, depending on the length and type of episode, and the size and activity of health centers. SA incidence rates for non-occupational illness and injury showed a decreasing trend during 2009-2012. Smaller centers had lower SA rates for non-occupational conditions than larger centers (p〈0.001). Social health centers had higher SA rates of non-occupational illness and injury, especially those with a very short duration (p〈0.001). Primary care centers had the lowest SA occupational illness and injury rates, with the highest rates occurring in the social health centers, especially long-term centers (p〈0.001). The differences in incidence rates of SA detected by type of activity of the health centers could be due to differences in working conditions.

Breath gas concentrations mirror exposure to sevoflurane and isopropyl alcohol in hospital environments in non-occupational conditions

Anaesthetic gases and disinfectants are a primary source of air contamination in hospitals. A highly sensitive sorbent-trap methodology has been used to analyse exhaled breath samples with detection limits in the pptv range, which allows volatile organic compounds (VOCs) to be detected at significantly lower levels (5–6 orders of magnitude below) than the recommended exposure limits by different organizations. Two common VOCs used in hospital environments, isopropyl alcohol (IPA) and sevoflurane, have been evaluated. Forced-expiratory breath samples were obtained from 100 volunteers (24 hospital staff, 45 hospital visitors and 31 external controls).Significant differences for IPA were found between samples from volunteers who had not been in contact with hospital environments (mean value of 8.032 ppbv) and people staying (20.981 ppbv, p = 0.0002) or working (19.457 ppbv, p = 0.000 09) in such an environment. Sevoflurane, an anaesthetic gas routinely used as an inhaled anaesthetic, was detected in all samples from volunteers in the hospital environment but not in volunteers who had not been in recent contact with a hospital environment. The levels of sevoflurane were significantly higher (p = 0.000 24) among staff members (0.522 ppbv) than among visitors to the hospital (0.196 ppbv). We conclude that highly sensitive methods are required to detect anaesthetic gas contamination in hospital environments.

'Ability' Means Ability: An Ability-Centric Interpretation that Reinvigorates the Pregnancy Discrimination Act's Protections for Pregnant Workers

Congress enacted the Pregnancy Discrimination Act, 42 U.S.C. § 2000e(k), to protect pregnant workers’ rights in the workplace, but the Act has been all but abandoned by legal scholars and courts. The prevailing Circuit Court majority rule interprets the Pregnancy Discrimination Act as merely extending Title VII to encompass pregnant workers. With the exception of prohibiting overt pregnancy discrimination, this majority rule as been entirely inadequate in preventing employers from instituting employment accommodation rules unfavorable to pregnant workers. As the rule stands, pregnant workers lack many protections necessary to accomplish the Pregnancy Discrimination Act’s goals, including equal treatment and inclusion in the workforce. As a result, most scholars have abandoned the Pregnancy Discrimination Act and instead encourage new and creative congressional action to address this pregnancy protection dearth. However, this Article explains that there remains untapped potential in the Pregnancy Discrimination Act as it is currently written. This Article proposes that scholars and courts reconsider the Pregnancy Discrimination Act in light of the legal framework in McDonnell Douglas v. Green, 411 U.S. 792 800-02 (1973), which courts apply when evaluating pregnancy discrimination claims for disparate treatment. By interpreting the Pregnancy Discrimination Act’s meaning with regard to the McDonnell Douglas legal framework, this Article demonstrates that pregnant workers are entitled to extensive employment protections beyond those already in place. In particular, the Pregnancy Discrimination Act, when properly applied, actually prohibits employment policies that exclude pregnant workers from otherwise available workplace accommodations simply because pregnancy is not an on-the-job condition. Accordingly, this Article demonstrates that employment policy accommodations that distinguish between occupational and non-occupational conditions violate the Pregnancy Discrimination Act when applied disadvantageously to pregnant workers.

Red-Alarm against Fibers Concentration of Asbestos in Atmospheric Urban Area of Tehran Capital of Iran

Asbestos is the natural silicate minerals with attractive physical properties such as; resistant to fire, electrical and chemical solvents. It composes of six types of materials include; Serpentine group; Chrysotile, Amphibole groups; amosite (Brown), Crocidolite (Blue) and other materials. It is popular for low cost favorable properties. All the six types have asbestiform fiber crystal, and can induce carcinogen in human. It was generally used during the boom of the industrial revolution since 1866, and the first publish of the unhealthy effect of asbestos reported nearly 30 years after industrial usage since 1899. The most common usage types of asbestos consist of chrysotile and the crocidolite. All the current types widely use in the building structures, brake pads (1) and clutch disc (2). Daily inhalation of asbestos occurs in the ambient air of cities which associated with poor air quality control. This event leads to generation of asbestosis disease (3), cancer development and mortality (4) and morbidity among at-risk population, such as asbestos –exposed workers (5), non-occupational subjects, people who living in the asbestos fibers exposed environment (6). Corresponding author: Agin Kh, MD. Associated Professor of the Respiratory Medicine. Logman Hakeem General Teaching Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail: khosrow.agin@yahoo.com & Agin@sbmu.ac.ir Long time exposure with asbestos leads to the development of chronic lung disease. It can be developed as occupational and non-occupational conditions (7, 8). Mesothelioma and lung cancer are the known causes of the asbestos exposure (9). In addition, it produces risk development of esophageal gastric, colorectal cancer (10) and head and neck squamous cell carcinoma (11). Children also are at risk of cancer by asbestos inhalation (12). The accepted threshold for asbestos is 100 fiber/liter that measured by phase-contrast optical microscopy (PCM) (13). There is a direct relationship between high level of asbestos in air and lung cancer (14). The first use of asbestos in Iran returns to World War II during the foundation of railroad and beginning product of cement manufacture in 1958 (15). Meanwhile, asbestos is producing up to 55000 tones cement in Iran annually, and near the 94% of produced cement that used in our country. The current output predominantly detected in the manufacture of building material (16), as pipe in the water delivery network (5000 Kilometer), brake pads (17) and pad shoes (15, 18). The most common types of asbestos observed in the ambient urban area of Tehran, including; Chrysotil (60%), tremolite (10%), antophylline (10%) (19). The rate of asbestos in air of Tehran- Iran was 68 times higher in the USA in 2009 (19). Our ministry of health in 2013 reported that the asbestos levels in the Tehran was 50-100 times more than the standard definition of the world (20). It seems that the deadline of depreciating has been finalized to the issue of asbestos fibers in our atmospheric cities. It requires a national decision, though the creating practice planes in reducing the level of usage and replacement that with safe materials.

Death Related to Ibuprofen, Valdecoxib, and Medical Errors

Death Related to Ibuprofen, Valdecoxib, and Medical Errors

Occupational conditions exceed the importance of non-occupational conditions and ill health in explaining future unemployment among women and men.

Unemployment is relatively common today, but the importance of work characteristics in relation to future unemployment has seldom been studied. The relation between occupational and non-occupational factors, as well as ill health, in 1993 and unemployment in 1997 has been examined using an exploratory approach. Both analyses of associations and cluster analysis have been performed. Reduced psychological well-being and some occupational factors mainly related to job insecurity and, among women, also few opportunities for development at work--were found to be risk indicators for unemployment later on. To some extent, also earlier unemployment periods predicted unemployment in 1997. The influence of reduced psychological well-being and earlier unemployment periods on the associations between occupational factors in 1993 and 1997 consisted mainly of a decrease of the influence of job insecurity. Seven clusters were identified. One of them was male dominated, where the level of unemployment was very high and the individuals had reduced psychological well-being, insecure working conditions and demanding living conditions. The female equivalent was characterised by a high level of unemployment, multi-demands at work and poor musculoskeletal health. Reduced psychological well-being and job insecurity were risk indicators for later unemployment among both genders, as were also few opportunities for development at work among women. These factors predicted unemployment, also when age and other non-occupational factors were taken into consideration. The cluster analysis identified groups of individuals with highly demanding occupational and non-occupational conditions in 1993 and a high level of unemployment in 1997.

Gender differences in the effects from working conditions on mental health: a 4-year follow-up.

The overall aim was to examine how working conditions in 1993 influenced the occurrence of poor mental health in 1997 among women and men from the general population. Also, the relative importance of other living conditions in relation to poor mental health in 1997 was examined. A sample from the general Swedish population (originally examined in 1969) was followed up in 1993 and 1997. Data from these follow-ups were analysed, and both bivariate and multivariate analyses of associations between occupational and non-occupational conditions in 1993 and poor mental health in 1997 -- defined as sub-clinical depression, reduced psychological well-being and high alcohol consumption -- were performed. Several occupational risk indicators were identified for poor mental health among women, especially sub-clinical depression and high alcohol consumption. Occupational factors such as shift work, job strain, no education at the employer's expense, low occupational pride, low stimulation at work and poor social support were related to poor mental health among women. For poor mental health among men, mainly sub-clinical depression, shift work and low occupational pride were identified as risk indicators. Non-occupational factors related to poor mental health among women were poor quality of social contacts, demanding life events, physical inactivity, high perceived physical load outside work and inadequate coping strategies. Among men, smoking and inadequate coping strategies were related to poor mental health. The difference between women and men, regarding the numbers of identified occupational and non-occupational risk indicators, may partly be explained by the gender-segregated labour market, and partly by other explanations. In our study, we have not succeeded in collecting the relevant information about occupational conditions that is important for men's mental health.

Occupational and nonoccupational risk indicators for incident and chronic low back pain in a sample of the swedish general population during a 4-year period: An influence of depression?

The objectives of this study were to examine the relation between occupational and nonoccupational conditions and both incident (IBLP) and chronic low back pain (CLBP), aswellasdepression, among women and men. Data from a4-year follow-up of a study group consisting of 420 participants of both genders from the general Swedish population were analysed. Occupational risk indicators were predictors for both ILBP and CLBP. Depression was not found to be a predictor for either IBLP or CLBP among women, but was a predictor for CLBP among men. Among women, depression had some risk indicators in common with ILBP and appeared to be a concurrent outcome rather than a risk indicator. Low back pain in 1993 was not a predictor for depression in 1997 in either women or men. Occupational conditions are of relevance in relation to both incident and CLBP. Nonoccupational conditions were stronger predictors for CLBP than for ILBP but had some predictive value also for ILBP.

Medical Management of Occupational and Non-Occupational Conditions

Presenting Author: Daniel E. Conrad, MD; Corporate Medical Director; Lockheed-Martin Energy Systems, Inc.; Oak Ridge, TN

Effects of Silica Exposure Among Railroad Workers

Abstract A medical and environmental evaluation of maintenance-of-way railroad employees has been conducted. Information was gained from chest radiography, spirometry, respiratory symptoms, and employment and personal habit histories. Environmental monitoring consisting of personal air samples was conducted to assess employee exposure to respirable crystalline silica and to develop exposure control strategies. Radiographic evaluation revealed no cases of silicosis or other occupationally induced lung diseases among 501 workers examined. In addition, pulmonary function deficits related to surrogates of silica exposure were absent. However, an expected and ordinary number of nonoccupational conditions and minor impairments were identified. While most environmental monitoring results were within acceptable limits, some samples for specific equipment operators indicated respirable silica exposures exceeding the American Conference of Governmental Industrial Hygienists guideline of 100 μg/m3 of air. Owing to t...

Scope and interprofessional relations of occupational medicine.

Occupational health is preventive medicine in the working environment. The industrial physician gives attention to the healthfulness of the conditions and materials of the work and performs certain services; the latter embrace physical examinations, referral of patients to their family physicians when non-occupational disease is found, health education and counseling, emergency or palliative treatment for certain nonoccupational conditions, immunization against diseases to which workers are occupationally exposed, and certain nonoccupational preventive health services. There must be free communication and mutual understanding between plant physician and family physician. In situations requiring mediation by a third party the county medical society's grievance committee should hear both sides. The problems and procedures of the industrial physician should be set forth at meetings under the auspices of state medical societies. Such presentations help to foster good relations between plant and family physicians.

Internal derangement of the knee joint in miners.

Internal derangements of the knee joint appear to be prevalent among British coal-miners. In recent years such injuries have accounted for between 15 and 30 % of all cases admitted to the rehabilitation units provided in each coal-field, and at which a large proportion of miners suffering from acute orthopaedic disabilities are treated, as well as some of those suffering from the more chronic orthopaedic conditions. Occupational and non-occupational conditions are treated alike at these centres. Precise figures are not available for the incidence of these internal derangements among miners, for notification of them is not made to the Inspectorate of Mines, nor is it likely that all are reported at collieries. An indication of their frequency is given by the fact that about 150 such cases (including cases of injury to a collateral ligament, but not of bursitis) are treated annually at the residential rehabilitation unit which serves the South Wales coal-field. If to these is added the number of cases treated solely at hospitals and at the small rehabilita tion units attached to some of their orthopaedic departments, we may assume that certainly not less than 200 fresh cases occur annually in a working population of under 110,000 men. Figures of a similar order are obtained from the English and Scottish coal-fields. Such an incidence is probably higher than that in heavy industry outside the mines in Britain. Figures for a South Wales steelworks employing over 8,000 men (Jones, J. G., 1956, personal communication) suggest that steelworkers suffer an annual incidence of comparable knee joint injuries which is little more than half that experienced by miners. It is known that in other countries also this problem is a large one. In Germany, about 600 fresh cases of meniscus lesions are said to occur annually in the Ruhr coal-field, where damage to a meniscus in mineworkers is accepted for compensa tion; it is suggested that the nature of their work, often performed in a crouching posture, results in degeneration of the meniscus (Husten, 1953). In studies undertaken among miners in Lancashire, Kellgren and Lawrence (1952) and Lawrence (1955) demonstrated a high prevalence of symptoms referable to the knee joint. These workers seem not to have investigated the connexion between various types of injury to the joint and the osteo-arthritis in which they were mainly interested. But they demon strated osteo-arthritic changes radiologically in the knee joints of 17 to 35% of sample populations of underground workers aged 40-50 years, and after investigation of various possible aetiological factors stated that apart from injury to the knee we have found no factor in mining which appears causally related to osteo-arthritis. Bonar (1950), analysing 200 cases of meniscectomy among Scottish miners, noted that injury to the menisci was commonest among coal-face workers, and from his figures it appears that they suffered an incidence 72% above that for miners as a whole. Smillie (1951), whose profound studies of injuries of the knee joint are largely based on his experience among Scottish miners, stresses the aetiological importance of work in narrow seams. It seemed worthwhile to undertake some further examination of the extent of this problem, and particularly to investigate the nature of the accidents and other types of trauma which may be responsible for these injuries. The material for study consisted of patients undergoing rehabilitation at a residential unit in South Wales during 1953. One hundred consecutive cases of presumed damage to a knee cartilage were studied, including 22 cases where a final decision to perform meniscectomy had not been reached, but in which there seemed a likelihood that a meniscus lesion would ultimately declare itself. In 78 cases meniscectomy had been performed, and lesions of a cartilage sufficient to account for 121

Medical Care in Industry

IN organizing medical care in the widest sense of the term, industry is confronted with two entirely different problems: (1) the occupational accidents and diseases, and (2) the accidents and diseases not caused by or incidental to employment. In line with modern concepts, extensive preventive activities and health education, as well as provisions for treatment, must be part of the program for the protection of workers in the plants. Community services of this type greatly influence the frequency and the severity of nonoccupational conditions causing absenteeism or impeding the efficiency of the worker.