Occupational Health Community Research Articles

Occupational Health Informatics.

Occupational Health Informatics is the field concerned with the optimal use of information to maximize occupational health and well-being, achieved by multidisciplinary professionals using appropriate technologies. The occupational health community should advocate for the recording of occupation in electronic health record systems. Data linkages can be created between occupation, disease, function and exposures to inform occupational functionality, recognition and recording of occupational diseases, disability accommodation and work as a health outcome.

Cinquentenário da Revista Brasileira de Saúde Ocupacional: um marco para celebrar o passado e construir o futuro

Abstract The Brazilian Journal of Occupational Health (RBSO) is a reference journal within the occupational health and safety community. It is dedicated to publishing scientific articles that contribute to the critical analysis of current and pertinent issues concerning the relationship between work and health. In 2023, RBSO celebrates its 50th anniversary. This editorial note is dedicated to reporting on the commemorative event, describing the main topics covered in the presentations and discussions, with the aim of documenting this important moment, which can be considered a milestone for celebrating the past and building the future of RBSO. This event offered a crucial opportunity not only to celebrate RBSO’s five decades of existence but also to bring together a community deeply committed to scientific publishing in the field of occupational health. It brought valuable reflections, proposals, and recommendations aimed at strengthening both the journal and the field it represents. The presence and active participation of the editorial team, along with the invited attendees, played an indispensable role in the success of this gathering. During this event, RBSO reaffirmed its dedication to keep enhancing its editorial standards, drawing from the experiences and ideas that have been discussed.

WORK TIME AND WORK STYLE REFORM AMONG PHYSICIANS IN JAPAN

Background: The April 2019 amendment of the Labor Standards Act in Japan led to a current ongoing work style reform. The amendment set the monthly overtime cap at 100 hours, but physicians are exempt for the next five years. The work style reform for physicians aims to ensure both their health and well-being and to provide appropriate community medicine. From April 2024, the maximum overtime permitted for physicians will be 100 hours a month and 960 hours a year. Community medicine hospitals, however, will have a different time limit and their physicians will be allowed to work up to 100 hours a month and 1,860 hours a year overtime. Junior/senior residents can also apply for exemption by registering for accredited training programs. Exempt physicians are required to comply with additional measures to ensure their good health and well-being.
 Objectives: This paper proposes promotion strategies for work style reform for physicians in Japan.
 Method: The Japan Medical Association Physicians’ Work Style Reform Committee developed proposals using the Delphi methods.
 Results: To manage physicians’ work time, an objective understanding of real work conditions, a review of employment agreements, active use of occupational health teams, task shifting, support for female physicians, and KAIZEN (a Japanese business philosophy) activities are important. The roles fulfilled by occupational health physicians, hospital directors, supervisors, physicians, patients, and community medicine systems are summarized from the perspective of comprehensive management.
 Conclusions: The Japanese health care system defines the work style of Japanese physicians. However, physicians as highly specialized professionals can more or less choose any workplace. A physician being aware of their characteristics and independently choosing their own work style would give meaning to an appropriate work–life balance. True work style reform should aim for this.

Characterization and Separation of Platinum-Based Antineoplastic Drugs by Zwitterionic Hydrophilic Interaction Liquid Chromatography (HILIC)–Tandem Mass Spectrometry, and Its Application in Surface Wipe Sampling

Platinum-based antineoplastic drugs (PtADs) are among the most important and used families of chemotherapy drugs, which, even showing severe side effects and being hindered by drug resistance, are not likely to be replaced clinically any time soon. The growing interest in the occupational health community in antineoplastic drug (AD) surface contamination requires the development of increasingly fast and easy high-throughput monitoring methods, even considering the lack of harmonized legally binding regulation criteria. Thus, a wipe sampling method together with zwitterionic hydrophilic interaction liquid chromatography (HILIC-Z)–tandem mass spectrometry (MS/MS) analysis was developed for the simultaneous evaluation of oxaliplatin, cisplatin, and carboplatin surface contaminations. A design of experiments approach was used to optimize the chromatographic conditions. Limits of quantification ranging from 2 to 5 ng/mL were obtained from interday and intraday repetitions for oxaliplatin and carboplatin, and between 170 and 240 ng/mL for cisplatin. The wipe desorption procedure is equivalent to other AD sampling methods, enabling a fast sample preparation, with an LC-MS/MS analysis time of less than 7 min.

Measuring performance within the ageing workforce

Working environment is constantly changing with working population increasing in terms of ageing, feminization and immigration. Due to the changes in the working pattern, new emerging risks have been introduced at the workplace along with many challenges that employers are called to manage. While ageing has been identified by Occupational Safety and Health (OSH) community as an emerging risk, organisations stand in need of guidelines on how to manage this additional challenge. Occupational Health and Safety Performance (OHSP) is acknowledged as one of the factors affecting the future of an organisation and should be considered when dealing with OSH management with the aim to accomplish Industrial System Productivity (ISP). Nowadays, OSH management should be able to adapt to changes and consider emerging risks within the risk assessment, the procedures and policies.The aim of this paper is to introduce guidelines and practical solutions on OSH management helping the employers and employees adapt to the changing working environment, while explicitly considering individual’s characteristics. Using the focus group method, factors affecting the ability to work have been identified and valued. In particular, the Work Individual Performance (WIP) tool is introduced as a tool which is specifically designed to identify factors, potentially affecting the performance of the workers and assist the employers in the identification and implementation of protective and preventive measures, focusing on worker’s well-being, OHSP and ISP. The tool has been tested in 2019, during a research which took place in Cyprus involving the police workforce (559 police officers).

COVID 19'da N95 maskesinin yeniden kullanımı pandemik stratejiler ve ihtiyat

COVID-19, the current global pandemic is of tremendous concern to the occupational health community, because health care professionals would face the greatest risk of exposure. There are various rumors and myths circulating in the social media and other various online platforms regarding the reuse of N-95 respirators during the pandemic situation and hence it is essential to explore this current scenario based on the working mechanism and various decontamination and reuse strategies of N-95 respirators. Although various modes of disinfection of N95 respirators discussed above, the prime necessity is the vigilance of each and every method of disinfection. Improper method of disinfection is dangerous since it serves as the source of infection of COVID-19 and various other life threatening infections.

Risk versus benefit: Should not audiologists assess this in the context of occupational noise-induced hearing loss in the mining industry?

BackgroundHearing conservation programmes (HCPs) are an important aspect of occupational health efforts to prevent occupational noise-induced hearing loss (ONIHL). In low- and middle income (LAMI) countries, where the incidence of ONIHL is significant, it is important to deliberate on the risk or benefit of HCPs.ObjectivesThis article is an attempt at highlighting important strategic indicators as well as important variables that the occupational health and audiology community need to consider to plan efficacious HCPs within the South African mining context.MethodThe current arguments are presented in the form of a viewpoint publication.ResultsOccupational audiology vigilance in the form of engagement with HCPs in the mining industry has been limited within the South African research and clinical communities. When occupational audiology occurs, it is conducted by mid-level workers and paraprofessionals; and it is non-systematic, non-comprehensive and non-strategic. This is compounded by the current, unclear externally enforced accountability by several bodies, including the mining industry regulating body, with silent and/or peripheral regulation by the Health Professions Council of South Africa and the Department of Health. The lack of involvement of audiologists in the risk or benefit evaluation of HCPs during their development and monitoring process, as well as their limited involvement in the development of policies and regulations concerning ear health and safety within this population are probable reasons for this.ConclusionsIncreased functioning of the regulatory body towards making the employers accountable for the elimination of ONIHL, and a more central and prominent role for audiologists in HCPs, are strongly argued for.

Obituary

Obituary

Synthetic biology and occupational risk

ABSTRACTSynthetic biology is an emerging interdisciplinary field of biotechnology that involves applying the principles of engineering and chemical design to biological systems. Biosafety professionals have done an excellent job in addressing research laboratory safety as synthetic biology and gene editing have emerged from the larger field of biotechnology. Despite these efforts, risks posed by synthetic biology are of increasing concern as research procedures scale up to industrial processes in the larger bioeconomy. A greater number and variety of workers will be exposed to commercial synthetic biology risks in the future, including risks to a variety of workers from the use of lentiviral vectors as gene transfer devices. There is a need to review and enhance current protection measures in the field of synthetic biology, whether in experimental laboratories where new advances are being researched, in health care settings where treatments using viral vectors as gene delivery systems are increasingly being used, or in the industrial bioeconomy. Enhanced worker protection measures should include increased injury and illness surveillance of the synthetic biology workforce; proactive risk assessment and management of synthetic biology products; research on the relative effectiveness of extrinsic and intrinsic biocontainment methods; specific safety guidance for synthetic biology industrial processes; determination of appropriate medical mitigation measures for lentiviral vector exposure incidents; and greater awareness and involvement in synthetic biology safety by the general occupational safety and health community as well as by government occupational safety and health research and regulatory agencies.

Designing exposure registries for improved tracking of occupational exposure and disease.

Registries are one strategy for collecting information on occupational exposure and disease in populations. Recently leaders in the Canadian occupational health and safety community have shown an interest in the use of occupational exposure registries. The primary goal of this study was to review a series of Canadian exposure registries to identify their strengths and weaknesses as a tool for tracking occupational exposure and disease in Canada. A secondary goal was to identify the features of an exposure registry needed to specifically contribute to prevention, including the identification of new exposure-disease relationships. A documentary review of five exposure registries from Canada was completed. Strengths and limitations of the registries were compared and key considerations for designing new registries were identified. The goals and structure of the exposure registries varied considerably. Most of the reviewed registries had voluntary registration, which presents challenges for the use of the data for either surveillance or epidemiology. It is recommended that eight key issues be addressed when planning new registries: clear registry goal(s), a definition of exposure, data to be collected (and how it will be used), whether enrolment will be mandatory, as well as ethical, privacy and logistical considerations. When well constructed, an exposure registry can be a valuable tool for surveillance, epidemiology and ultimately the prevention of occupational disease. However, exposure registries also have a number of actual and potential limitations that need to be considered.

The Relative Salience of Daily and Enduring Influences on Off-Job Reactions to Work Stress.

Work stress is an important determinant of employee health and wellness. The occupational health community is recognizing that one contributor to these relationships may be the presence of negative off-job reactivity to work, which we argue involves continued thoughts directed towards work (cognitive reactivity), continued negative mood stemming from work (affective reactivity), and the alteration of post-work behaviours in response to work factors (behavioural reactivity). We explored the relative contributions of daily work stressors, affective traits, and subjective job stress perceptions to negative off-job reactivity. These relationships were evaluated in a study of hospital nurses (n = 75), who completed trait measures and then provided self-assessments of daily work stress and off-job reactions for four work days. The results of several multilevel analyses indicated that a main-effects model best described the data when predicting cognitive, affective, and behavioural reactivity from daily work stressors, affective traits, and subjective job stress perceptions. A series of multilevel dominance analyses revealed that subjective job stress perceptions dominated the prediction of behavioural reactivity, while trait negative affect dominated the prediction of affective reactivity. Theoretical implications and the relative salience of daily and enduring contributors to negative off-job reactivity are discussed. Copyright © 2015 John Wiley & Sons, Ltd.

OSHwiki goes live – a new web platform to connect the occupational safety and health community

OSHwiki goes live – a new web platform to connect the occupational safety and health community

Respiratory Sensitization & Sickness from Welding/Burning Isocyanate Containing Paints

The purpose of this paper is to make the environmental and occupational health community aware of a serious health risk associated with the common practice of burning industrial paint off of metal surfaces during or prior to welding. On four occasions bystanders and welder/burner personnel have experienced illness as a result of being exposed to the combustion products of isocyanate paints that were being burned off metal surfaces. In each case, the burning and the exposed people were outside in an open environment where the health risk was thought to be minimal due to the open environment with nominal wind movement through the work area. In one case, the person (a burner) developed permanent sensitization to phthalic anhydride as a result of the exposure. Phthalic anhydride was determined to be decomposition product of burned isocyanate paint. In the other three cases (which involved very short exposures), between two and six people became ill but did not develop sensitization. Their symptoms included dizziness, nausea, headache, and breathing difficulty the severity of which varied from very uncomfortable to temporarily incapacitating. This paper discusses the circumstances associated with each event, the approach used to determine that phthalic anhydride was a decomposition product, and some practical things that can be done to avoid having employees become victims of exposure.

Student Internships with Unions and Workers: Building the Occupational Health and Safety Movement

One of the most successful programs to recruit young professionals to the occupational safety and health field was launched more than 35 years ago, in 1976. Created by the Montefiore Medical Center's Department of Social Medicine collaborating with Tony Mazzocchi of the Oil, Chemical and Atomic Workers International Union (OCAW), it placed medical, nursing, and public health students in summer internships with local unions to identify and solve health and safety problems in the workplace. The experience of working with and learning from workers about the complex interactions of political, economic, and scientific-technological issues surrounding workplace conditions inspired many students to enter and stay in our field. Many former interns went on to make important medical and scientific contributions directly linked to their union-based projects. Former interns are now among the leaders within the occupational health and safety community, holding key positions in leading academic institutions and governmental agencies.

The Need for Industry and Occupation Standards in Hospital Discharge Data

Occupational injuries and illnesses affect the productivity of the U.S. workforce, yet public health surveillance in the United States does not adequately track and report these incidents. Adding industry and occupation standards to US hospital data collection would enable physicians, researchers, and payors to accurately account for occupational injuries and illnesses as well as support prevention initiatives. The authors petitioned for the inclusion of standards for industry and occupation within hospital data; however, additional support from the occupational and environmental health community is needed to move the petition to adoption. This article discusses the policy implications and benefits to occupational medicine and public health provided by collecting industry and occupation in hospital discharge data, as well as the process of initiating a data change request with the National Uniform Billing Committee.

Preventing diabetes: will NICE guidance do what it says on the tin?

The goal of the programme was to achieve a 7% reduc-tion in body weight and physical activity of moderateintensity for at least 150 minutes per week. The cumula-tive incidence of diabetes was 4.8, 7.8 and 11.0 cases per100 person-years in the lifestyle, metformin and controlgroups, respectively. This reduction in incidence equatedto one case of diabetes prevented for every seven peoplewith IGT treated for three years in the lifestyle interven-tion group, compared with 14 for the metformin group. In addition, a review has also indicated that the numbersneeded to treat (NNT) to prevent one case of type 2 dia-betes with lifestyle intervention in people at risk of diabetesis dramatically low at 6.4 (over 1.8 to 4.6 years).

A Model of Integrative Care for Low-Back Pain

While previous studies focused on the effectiveness of individual complementary and alternative medical (CAM) therapies, the value of providing patients access to an integrated program involving multiple CAM and conventional therapies remains unknown. The objective of this study is to explore the feasibility and effects of a model of multidisciplinary integrative care for subacute low-back pain (LBP) in an academic teaching hospital. This was a pilot randomized trial comparing an individualized program of integrative care (IC) plus usual care to usual care (UC) alone for adults with LBP. Twenty (20) individuals with LPB of 3-12 weeks' duration were recruited from an occupational health clinic and community health center. Participants were randomized to 12 weeks of individualized IC plus usual care versus UC alone. IC was provided by a trained multidisciplinary team offering CAM therapies and conventional medical care. The outcome measures were symptoms (pain, bothersomeness), functional status (Roland-Morris score), SF-12, worry, and difficulty performing three self-selected activities. Over 12 weeks, participants in the IC group had a median of 12.0 visits (range 5-25). IC participants experienced significantly greater improvements at 12 weeks than those receiving UC alone in symptom bothersomeness (p=0.02) and pain (p=0.005), and showed greater improvement in functional status (p=0.08). Rates of improvement were greater for patients in IC than UC in functional status (p=0.02), bothersomeness (p=0.002), and pain scores (p=0.001). Secondary outcomes of self-selected most challenging activity, worry, and the SF-12 also showed improvement in the IC group at 12 weeks. These differences persisted at 26 weeks, but were no longer statistically significant. It was feasible for a multidisciplinary, outpatient IC team to deliver coordinated, individualized intervention to patients with subacute LBP. Results showed a promising trend for benefit of treating patients with persistent LBP with this IC model, and warrant evaluation in a full-scale study.

Work-related health advice in primary care

The dangers of long-term sickness absence and worklessness are well recognized. In the UK, the occupational health (OH) community was challenged to seek new partners to support health in working age people. A National Health Service OH service and Leicestershire general practice set up a pilot clinic to provide work-related health advice in primary care. To recruit 100 patients to an OH clinic in general practice and record their demographic characteristics, diagnoses and occupational outcomes. Pre-booked 30 min appointments for work-related health consultations in general practice were offered over 12 months. Consultations were recorded electronically and questionnaire feedback invited 3-6 months later. The main outcome was subjective reporting of benefit and workplace adjustments. Ninety-six patients attended OH appointments in general practice, 86 were in employment: 49 on sick leave at the time of their consultation and 10 were workless. Mental health and musculoskeletal problems accounted for the most common diagnoses. Following their consultation, 29% of patients reported workplace adjustments which were beneficial to them. None of the workless reported a return to employment. Patients will access work-related health advice in primary care. Extended OH consultations by general practitioners can achieve positive self-reported outcomes for patients in employment.

Workplace Health Protection and Promotion

Traditionally, health protection and health promotion activities have operated independently of each other in the workplace. Health protection has usually been viewed as encompassing the activities that protect workers from occupational injury and illness ranging from basic safety training to the us

Use of O*NET as a job exposure matrix: A literature review

O*NET is a publicly available online database that describes occupational features across US job titles and that has been used to estimate workplace physical and psychosocial exposures and organizational characteristics. The aim of this review is to describe and evaluate the use of O*NET as a job exposure matrix. A review of the peer-reviewed published and gray literature was conducted. Twenty-eight studies were found that used O*NET to estimate work exposures related to health or safety outcomes. Each was systematically evaluated across eight main features. Many health outcomes have been studied with O*NET estimates of job exposures. Some studies did not use conceptual definitions of exposure; few studies estimated convergent validity, most used predictive validity. Multilevel analysis was underutilized. O*NET is worthy of exploration by the occupational health community, although its scientific value is still undetermined. More studies could eventually provide evidence of convergent validity. O*NET has the potential to allow examination of occupational risks that might have otherwise been ignored due to missing data or resource constraints on field data collection of job exposure information.