Occupational Health Care System Research Articles

근로자의 산업보건지식이 보건관리자의 직무중요도 인식에 미치는 영향 - 중규모 제조 사업장을 중심으로 -

Purpose: This study was conducted to analyze the factors affecting the perception of job importance of manufacturing occupational health managers in the manufacturing field. Methods: The subjects of this study were a total of 200 manufacturing workers, and a self-reported online survey was conducted to collect the data. Results: The average knowledge score was 7.81 out of 10 points and it revealed the higher the knowledge score on occupational health, the higher the perception of job importance of occupational health managers. Conclusion: Based on the results of this study, it is necessary to increase the knowledge of occupational health and the ability of workers to protect themselves and cope with emergencies and harmful factors. In addition, it will be necessary to promote the occupational health care system operated by qualified health managers in the workplace. Also, continuing education for health managers should be supported to improve their educational and administrative competency, and to develop various skills of making educational contents.

Validation of the disease experience questionnaire for working age adults with chronic conditions

Abstract Background Working age adults diagnosed with chronic diseases are growing in prevalence and not all of them manage to stay at work. Chronic conditions need a long-term response from the (occupational) health care system, which, however, is structured mostly around acute episodes. The aim was to develop and validate a questionnaire tapping working age patients' lived experiences with their chronic disease. Methods Based on a qualitative study, the 13-item Disease Experience Questionnaire (DEQ) was developed for persons in working age. DEQ taps 3 types of disease experiences: 1) Disruption: hopelessness and irreparable loss; 2) Meaningful: an opportunity to set new life priorities; 3) Episode: an inconvenient period to be overcome. Items were filled out online by 2,028 persons diagnosed with chronic headache, autism, HIV, neurofibromatosis, CKD or sarcoidosis. Several proxy variables and demographics were measured. Data were analyzed with PCA, reliability analysis, correlations with criterion variables and ANOVA to compare levels of disease experiences across groups differing in age, education and work status. Results Disruption was valid for all disease groups. Lower educated and non-working persons had significantly higher Disruption levels. Meaningful was valid for the total sample, the autism, HIV and sarcoidosis groups. Cronbach's alphas were .755 and .661 respectively. Episode was only valid for the HIV group (Cronbach's alpha .632). Levels of Meaningful and Episode did not differ in relation to age, education or work status. Correlations with criterion variables were in the expected directions. Conclusions DEQ is a valid tool for identifying disease experiences in working age adults with diverse chronic diseases. The disease experience of persons with HIV, for which also the Episode subscale can be helpful, differs from that of persons with other chronic diseases. The Disruption and Meaningful subscales can help to tailor (occupational) health care to patient needs. Key messages The Disease Experience Questionnaire (DEQ) is a valid tool to identify disease experiences in the working age population with chronic diseases. The DEQ Disruption and Meaningful subscales can help to tailor (occupational) health care to patient needs.

Employee Health Screening in One of Iranian Gas Companies

Background: Employee examination is one of the requirements of the occupational health care system. The present study aimed to evaluate the current health status of the staff working in an Iranian gas company to prevent, follow-up, and treat the disease.
 Methods: This cross-sectional descriptive-analytical study was conducted on the data collected from health screening of 94 service personnel in one of the gas companies in Iran. Data were collected by the 4-sheet forms of occupational examinations containing the following information: demographic data, general health status (blood pressure, smoking, allergy history, surgery, occupational accidents, body mass index), cardiovascular system, musculoskeletal, liver, kidney, gastrointestinal, clinical examination, paraclinical evaluations of the internal gland, cholesterol, triglycerides, liver enzymes, and hematopoietic system (CBC). Data were analyzed using SPSS 25.
 Results: All participants were male with an average (Standard Deviation) age and BMI of 42.96 ± 8.00 and26.83 ± 4.08, respectively. The participantschr('39') body mass index indicated that 45 staff (48.38%) were overweight and 15 individuals (16.12%) were in the range of obesity. The participants had history of smoking (22.3%), cholesterol above 200 (27.7%), and triglycerides above 300 (8/5%). The rate of hypermetropia, musculoskeletal disease, hypertension, high blood concentration and low blood platelets, hyperglycemia, cardiovascular disease, and kidney disease were 25.80%, 24.5%, 9.6%, 56.4%, 7.4%, 1.1%, and 12.8%, respectively.
 Conclusion: Although the studied company has a yearly occupational medical examination, the workers have not been provided with a comprehensive report and appropriate feedback. Therefore, it is essential to follow up the health reports and examinations and refer the patients to the related physicians.

The way towards Migrant Sensitive Occupational Health Care System

Abstract Background The European Union (EU) is facing to the demographic challenge of the ageing society on the one hand and a growing influx of migrants on the other hand. Although since 2008 WHO repeatedly called member states for developing ’migrant sensitive’ health care system, still there is a significant shortage in education programs, aiming to build the required human capacity in general, and on the field of occupational health, no any initiative could be observed aiming to empower the service providers with the additional knowledge and skills for facilitating the safe integration of the migrant workforce into the EU’s economy. Objectives University of Pécs Medical School (UPMS) has integrated migrant and ethnic minority health - as a new overarching topic - in its optional and/ or regular training program. Occupational health and migration belongs to the compulsory part of the education. Results Each study year more than two hundreds Hungarian, English and German speaking medical students meet at least at a ’sensitization’ level the migrant specific aspects of occupational health. In order to improve and - in the need - even extend our program on this field, we have launched a ’quick response’ questionnaire research among the students, asking for their opinion, how they see the importance and necessity of this topic within the frame of their medical training. 67 % of the 2012 students highly and/ or mostly agreed with our initiative and 87 % founded the topic very relevant. The majority of the students have expressed that the training has changed their views. Conclusions The endowers of UPMS, as a WHO Collaborating Centre on the field of migration heath training and research are in accordance with WHO newly adopted ’Strategy and action plan for refugee and migrant health and achieves every year several hundreds of medical students who are already ’sensitized’ towards the health of migrants. Key messages EU economy needs migrant sensitive health workforce ont he field of occupational health. Medical studens understood the need for migration health training.

The prophylactic operational model integrated with occupational healthcare - Prophylactic of some types of cancers among women

Periodical medical examinations are mandatory for employees in Poland. This rule makes a unique opportunity during occupational health services for implementation of prophylactic activities focused on early diagnosis of various diseases, including cancers. Epidemiological data about cancers is alarming and what is more, further increase in development of cancers is being predicted in population overall. The highest incidence of cancers in the case of Polish women belongs to breast cancer (21.7% of diagnosed cancers in general), while the morbidity rate for uterine cancer, ovarian cancer and cervical cancer amounts to 7.4%, 4.7% and 3.5%, respectively. The aim of this study was to elaborate an algorithm of prophylactic activities integrated with the occupational healthcare system, based on medical literature review and guidelines concerning prophylaxis of selected cancers. Polish cancers' prophylaxis programs related to risk factors were presented in this publication and practical indications for occupational healthcare physicians were worked out. Med Pr 2018;69(4):439-455.

Occupational health nursing in hungary.

This article is the first about occupational health nursing in Hungary. The authors describe the Hungarian health care and occupational health care systems, including nursing education and professional organizations for occupational health nurses. The Fundamental Law of Hungary guarantees the right of every employee to healthy and safe working conditions, daily and weekly rest times and annual paid leave, and physical and mental health. Hungary promotes the exercise of these rights by managing industrial safety and health care, providing access to healthy food, supporting sports and regular physical exercise, and ensuring environmental protection. According to the law, the responsibility for regulation of the occupational health service lies with the Ministry of Human Resources. Safety regulations are under the aegis of the Ministry of National Economy.

0308 Prevalence of leucopenia among industry workers 2000–2009

ObjectivesTo estimate the prevalence of leucopenia among industrial workers 2000–2009.MethodsThe study population comprises workers from manufacturing industries of the Bahia State, Brazil, who had annual compulsory medical checkups in a...

Occupational health and health care in Russia and Russian Arctic: 1980–2010

Background. There is a paradox in Russia and its Arctic regions which reports extremely low rates of occupational diseases (ODs), far below those of other socially and economically advanced circumpolar countries. Yet, there is widespread disregard for occupational health regulations and neglect of basic occupational health services across many industrial enterprises.Study design and methods. This review article presents official statistics and summarises the results of a search of peer-reviewed scientific literature published in Russia on ODs and occupational health care in Russia and the Russian Arctic, within the period 1980–2010.Results. Worsening of the economic situation, layoff of workers, threat of unemployment and increased work load happened during the “wild market” industrial restructuring in 1990–2000, when the health and safety of workers were of little concern. Russian employers are not legally held accountable for neglecting safety rules and for underreporting of ODs. Almost 80% of all Russian industrial enterprises are considered dangerous or hazardous for health. Hygienic control of working conditions was minimised or excluded in the majority of enterprises, and the health status of workers remains largely unknown. There is direct evidence of general degradation of the occupational health care system in Russia. The real levels of ODs in Russia are estimated to be at least 10–100 times higher than reported by official statistics. The low official rates are the result of deliberate hiding of ODs, lack of coverage of working personnel by properly conducted medical examinations, incompetent management and the poor quality of staff, facilities and equipment.Conclusions. Reform of the Russian occupational health care system is urgently needed, including the passing of strong occupational health legislation and their enforcement, the maintenance of credible health monitoring and effective health services for workers, improved training of occupational health personnel, protection of sanitary-hygienic laboratories in industrial enterprises, and support for research assessing occupational risk and the effectiveness of interventions.

Occupational diseases in Murmansk Oblast: 1980–2010

Background. Official statistics tend to underestimate the incidence of occupational disease (OD) nationally and regionally in Russia.Objectives. The general aim was to obtain an accurate estimate of ODs in Murmansk Oblast in 1980–2010 and to determine the rate of specific types of ODs among cohorts of workers who had been exposed to the hazardous factors causing the disease.Materials and methods. Data were retrieved from the Murmansk Oblast ODs database for the oblast and 2 enterprises – Apatite JSC and Kolskaya MSC – which contributed to more than half of the ODs in the oblast in 1980–2010. The total number of ODs and 5 specific categories (musculoskeletal, respiratory, nervous diseases, hearing loss and vibration disease) were analysed.Results. The total rate of ODs among workers of main shops in both enterprises who were actually exposed to harmful factors were extremely high: the rate for Apatite JSC was 25 times higher than in Russia and 15 times higher than in Murmansk Oblast, while the rate for Kolskaya MSC was about 30 and 20 times greater than in Russia and in Murmansk Oblast, respectively; in the 2000s the difference reached 100–150 times. The rise in reported ODs in both enterprises corresponded to the time when intensive medical examinations were conducted by the Kola Research Laboratory for Occupational Health (KRLOH) in Kirovsk. A similar pattern was also observed for the sub-categories of musculoskeletal, respiratory, nervous diseases, hearing loss and vibration disease. It is likely that the true burden of OD is even higher due to misdiagnosis, reluctance of workers concerned about job security to present for care and the lack of reliable information on working conditions needed to establish a causal link between disease and occupational exposure.Conclusions. As with many other regions across Russia, ODs in Murmansk Oblast are grossly underestimated. Serious problems exist in the Russian occupational health care system and the collection of occupational health statistics that require urgent, fundamental reform.

From Periphery to Player: Strategically Positioning Occupational Therapy Within the Knowledge Translation Landscape

Knowledge translation has emerged as a critical force across health research, funding, policy, and practice. Occupational therapy finds itself on the periphery of this emerging field, but opportunities specific to occupational therapy systems can facilitate a shift in which the profession develops its role as a key player. As occupational therapy increasingly recognizes the essential role of knowledge translation in health care, strategic action to create knowledge translator roles, technology, resources, opportunities, and communities of practice will be needed to align occupational therapy academic and health care systems with knowledge translation imperatives that increasingly shape the health care landscape.

How is the New Public Management applied in the occupational health care system? - decision-makers' and OH personnel's views in Finland.

BackgroundIn many countries occupational health care system is in change. Occupational health studies are mainly focused on occupational health substance and content. This study offers new perspectives on municipal OHS and its operations from management perspective.AimThe aim of this study is to analyse how New Public Management (NPM) doctrines are applied in the Finnish occupational health care system (OHS). The main focus is to describe and compare the views of decision-makers' and OH workers within the framework of NPM.MethodsThe data were collected by semi-structured interviews from 17 municipal decision-makers' and 26 municipal OH workers. Data was analyzed by examining coded data in a theory-driven way according to Hood's doctrine of NPM.ResultsThe doctrines were not as compatible with the OH personnel view as with the decision-makers' view. Decision-makers and OH personnel highlighted the strict criteria required for operation evaluation. Moreover, decision-makers strongly accentuated professional management in the public sector and the reorganization of public sector units. These were not equally relevant in OH personnel views. In OH personnel views, other doctrines (more attention to performance and accomplishments, emphasizing and augmentation of the competition and better control of public expense and means test) were not similarly in evidence, only weak evidence was observed when their importance viewed as medium by decision-makers. Neither of the respondents group kept the doctrine of management models of the private sector relevant.ConclusionsThe NPM and Hoods doctrine fitted well with OH research. The doctrine brought out view differences and similarities between decision-makers and OH personnel. For example, policymakers highlighted more strongly the structural change by emphasizing professional management compared to OH personnel. The need for reorganization of municipal OH, regardless of different operational preconditions, was obvious for both decision-makers and OH personnel. The adaptation of more clarify management to a municipal context is not trouble-free. The municipality systemic structure, complex operational environment, and reconciliation of political and officer authority set challenges to management of municipalities.

Reducing the risk of type 2 diabetes with nutrition and physical activity – efficacy and implementation of lifestyle interventions in Finland

The prevalence of type 2 diabetes has been increasing in Finland, in parallel with a gradual increase in overweight and obesity during the past decades. The expanding prevalence of type 2 diabetes brings along complications, most importantly CVD. Therefore, it is extremely important to implement activities to prevent type 2 diabetes. In the present paper, the clinical evidence for the prevention of type 2 diabetes is presented with the Finnish diabetes prevention study. In addition, the paper discusses the practical implementation of prevention of type 2 diabetes using three different types of prevention programmes as examples: FIN-D2D, including risk-screening and repeated consultation in primary health-care; FINNAIR, a workplace-targeted intervention project involving airline employees; and the good ageing in Lahti region (GOAL) programme, a community-based prevention programme. FIN-D2D, the FINNAIR project and the GOAL programme have shown that screening for type 2 diabetes risk and implementing large-scale lifestyle intervention in primary health-care are feasible. However, the crucial questions still are whether it is possible to replicate the results concerning effectiveness of lifestyle intervention in primary and occupational health-care systems. Furthermore, it remains to be shown whether it is possible to achieve the same results in different health-care settings, cultures, regions and age groups, especially in adolescents and young adults among whom the increase in the incidence has been the highest. In addition, the importance of co-operation among all sections of society, citizens' awareness of healthy lifestyles and the social inequalities in health must be emphasised because the diabetes epidemic cannot be solved only by concentrating on preventive actions carried out by health-care systems.

Finnish guidelines for workplace drug testing

The Finnish guidelines for workplace drug testing outlined here represent what is considered the best practice for workplace drug testing to be followed in Finland. The guidelines are based on the act on the protection of privacy in working life (759/2004), the occupational health care act (1383/2001) and the decree on workplace drug testing (218/2005). They start by defining situations in which workplace testing is allowed and continue up to the point where the certificate is submitted to the employer. The role of the occupational health care system is crucial in the procedure. The guidelines include the best practice procedures to be followed by laboratories providing workplace drug testing services. The laboratory recommendations are based on general principles established internationally. In the Finnish guidelines, accreditation is an absolute prerequisite for a laboratory functioning as a workplace drug testing laboratory. The laboratory section of the guidelines includes specimen collection, laboratory organisation, analysis procedure, quality assurance and quality control measures. These largely conform to the European laboratory guidelines for legally defensible workplace drug testing published by the European workplace drug testing society (EWDTS), but there are differences. In addition to using urine as a specimen, the Finnish guidelines also encompass blood.

An assessment of occupational health care in the Netherlands (1996–2005)

The extensive Dutch occupational health care system of the past decade has not led to the desired outcomes, namely, a decrease of work absenteeism and the associated costs. To assess the differences between in-house and external occupational health care services in the process quality of occupational health care provided. In total, 26 interviews were conducted with chief executive officers of occupational health services (OHS). The responses and other relevant policy documents were analysed and described. A key component of this process was to compare differences between in-house and external services. Notable differences in quality were found to exist between in-house and external occupational health care systems, with the in-house occupational health care services offering the highest process quality. Our findings suggest that the effectiveness of OHS is mainly dependent on their structure (in-house versus external) and on economic factors (profit driven versus not for profit).

Respiratory symptoms, subjective annoyance and asthma in a moisture damaged central hospital

Rationale Moisture damage and associated microbial growth cause annoyance and impaired health in residential buildings and work places. This study describes consequences of moisture damage in a large hospital building. Methods A questionnaire was sent to the personnel of a central hospital (n=2258). Information of moisture damage and associated microbial exposure was obtained from the occupational health care system and construction authorities of the hospital. The mental hospital (n=202) and the pediatric hospital (n=135) with severe moisture damage were compared to less damaged parts of the hospital. Results Respiratory irritation symptoms, such as cough, chest tightness and hoarseness were reported in the damaged areas. The prevalence of doctor diagnosed asthma was significantly higher (9.0%) in the moisture damaged parts of the hospital (p<0.05). No differences were found in reported prevalence of allergic rhinitis or atopic eczema. Subjective annoyance due to indoor air factors was highest in the pediatric hospital, and also visible signs of moisture damage were common (26%). Visible mold growth was reported by 11% of the respondents and 72% were not satisfied with the ventilation system in the mental hospital. Nurses and assistant nurses had highest prevalence of respiratory allergies compared to physicians and blue-collar workers. Conclusions Exposure to moisture damage was associated with asthmatic symptoms and asthma in hospital personnel. Insufficient ventilation and subjective annoyance due to poor indoor air quality reduced work satisfaction. Improvement of indoor air quality by remediation of moisture damage is important in reducing the health risk for workers and patients.

Conceptualizing sports medicine as occupational health care: illustrations from professional rodeo and wrestling.

The purpose of this article is to propose a sociological model of sports medicine that conceptualizes it as occupational health care. All occupational health care systems can be summarized according to three types: elite, managed, and primitive. These types reflect the quality of health care provided, the social class membership of workers, and workers' value to employers. The author presents ethnographic data to illustrate the social dynamics of primitive occupational health care delivered to rodeo cowboys and local professional wrestlers. This care is primitive because these athletes have relatively low economic value as workers, and the rugged individualism of their sports' subcultures supports a system of health care that is inexpensive, nonmedical in its philosophy, personalistic in the structure of its practitioner-patient relationship, and incidental in its delivery.

Present condition of health information control and attitudes of occupational health professionals in collecting and utilizing health information in workplaces

Since the Labor Safety and Health Law of Japan provides that the employer is responsible for taking custody of personal information obtained in periodic health examinations, we are anxious about infringement of privacy. This study was conducted to investigate the present condition of health information control in each workplace and attitudes of occupational health professionals in collecting and utilizing personal health information by means of self-administered mail questionnaires. The numbers of respondents were a total of 549 (physicians: 237, public health nurses: 175, nurses 122, others & unknown: 15). The major results were as follows. 1. Percentage of workplaces in which only health professionals can know personal health data from periodic health examinations was 24% altogether, but it was 39% in large workplaces where full-time occupational physicians were working. 2. More than half of the respondents were of the opinion that the results of routine health activities could be presented in academic conferences unconditionally or under comprehensive approval of the representative of each workplace. 3. About a half of the respondents believed that it was necessary to consider the intention of each examinee in utilizing blood specimen collected at health examinations for research purposes, even though personal identification had been erased. 4. There were many differences among types of occupation or age groups in the attitude to changing the procedure for health examination. And it was the majority opinion that personal health data provided to the employer should be the minimum in order to protect individual benefits. 5. The proportion of physicians who felt it necessity to ask about the occupational history at the employment health examination was significantly higher than that of public health nurses. 6. When a disease was discovered, there were great differences among types of disease in the attitude to give the name or condition of the disease to the employer without the consent of the patient or his family. In view of these results, we feel that occupational health professionals are in a dilemma in introducing modern ideas which lay stress on privacy into the Japanese occupational health care system which is still operating on the basis of traditional paternalism.

Health surveillance of forestry workers exposed to hand-arm vibration in Wakayama from 1974 to 1996.

To clarify the trends in the number and the severity of vibration syndrome in Wakayama for these 23 years, the records of the medical examinations for vibration syndrome were analyzed with 4,652 (a total of 9,920) private forestry workers exposed to hand-arm vibration. The number of the subjects who took the medical examinations reached a maximum of 1,242 in 1978. After that, it decreased year by year, but remained at about 300 or less from 1988. There was a corresponding increase in age and the number of years of operating chain saws among the subjects examined. The compensated cases reached a maximum number of 393 cases in 1977, and then a drastic decrease was noted. Year by year there was an increase in the number of cases whose medical examinations revealed no abnormality. The regional occupational health care system including the surveillance card, which has been active since 1975, has probably contributed to the decrease or prevention of occurrence of vibration syndrome in Wakayama.

Health care of work stress: a review

In order to clarify the health effects of work stress and possible strategy for its prevention and treatment, we reviewed the literature on work stress as follows: 1) Review was made on 12 major psychosocial work stressors, 4 acute reactions to stress, disease outcome of work stress, measurement methods of those variables, and theoretical models of work stress. 2) Epidemiological studies of the effects of work stressors on cardiovascular diseases, psychological distress and mental disorders in Japan were reviewed. Also, work stress in specific occupations such as software engineers, nurses and female researchers was reviewed. 3) The following strategies for the prevention and treatment of the health effects of work stress were reviewed: i) surveillance of work stress, ii) improvement of psychosocial work environment, iii) education and information dissemination, and iv) reinforcement of occupational mental health services. Finally, the need for further investigation on the health effects of work stress and on the possible programs for the prevention and treatment in occupational health care system was discussed.

Farmers' occupational health programme in Finland, 1979–1987

At the beginning of 1985, the National Board of Health in Finland issued directives for the initiation of farmers' occupational health services in municipal health care centres. The directives were based on the evaluation study on farmers' occupational health services in Finland. The main aim of this study is to analyse the current problems of the farmers' occupational health care system and to analyse how effective the system is. The efficiency of the occupational health services has been surveyed with postal inquiries twice, first in 1982 and later in 1986. The farmers' knowledge of appropriate means for reducing hazardous exposures had improved significantly since the initiation of the occupational health services. The effect of the occupational health services was evident particularly in the more effective use of personal safety devices. The limited resources at the municipal health care centres form the main obstacle in the provision of occupational health services for all farmers who would like to have them. 25–35% of the farmers in Finland (total 45,000 farmers) are willing to participate in the occupational health care system. Participation is voluntary for self-employed farmers.