Occupational Health Personnel Research Articles

Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation.

Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings. We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare. Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases. Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.

Research on quantitative evaluation of revise requirements of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004)

Objective: To conduct quantitative evaluation on the revise requirements of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004) , clarify the problems and suggestions during its implementation for improvement, and provide a basis for the revision of the standard. Methods: From April to September 2021, stratified convenient sampling method was adopted and semi-open questionnaire was used to investigate the occupational health personnel in CDC, occupational prevention and control institutes, employers, third-party technical service institutions and universitie. The entropy weight of each index and the score based on entropy weight of GBZ 159 were calculated. Spearman rank correlation analysis was used to describe the correlation between the two indexes and radar chart was drawn for comprehensive evaluation. Results: A total of 151 questionnaires were received from the respondents, of which 147 were valid, with an effective recovery rate of 97.35%, involving 29 provinces, autonomous regions and municipalities. The median G scores of the necessity and urgency of GBZ 159 revision based on entropy weight were 2.84 and 3.17, respectively, and the difference was statistically significant (M=-25.50, P<0.001) . The trend of the score G of necessity and urgency based on entropy weight was basically the same for all secondary items (r(s)=0.9998, P<0.001) , and the score G of urgency based on entropy weight was higher than that of necessity. The highest score G of necessity and urgency based on entropy weight was "3.13 long time sampling", which were 7.56 and 8.23 respectively. This was followed by "3.12 short time sampling", which were 7.19 and 7.13 respectively. Conclusion: GBZ 159 has encountered some new problems and challenges in the implementation process, and some of its technical indicators have been out of line with the actual practice of occupational health at present. These are the two items that urgently needs to be revised and improved, such as "3.13 long time sampling" and "3.12 short time sampling" and other items need to be revised and improved.

Oral cancer screening: what can the healthcare system do to reduce the burden of disease?

Due to its high incidence and mortality, oral cancer makes a group of diseases of public health importance. Oral screening is a simple three-step procedure: the first step is questioning the patient about his/her smoking/drinking habits, secondly, visual inspection of the oral cavity, and finally, palpation of regional lymph nodes. If precancerous conditions or any form of oral cancer are suspected, the task is to send the examined person to oral clinical care. The examination can routinly be performed by dentists, but also by general practitioners and occupational health personnel. The difficulty of oral screening arises from the fact that most of the patients are of low socio-economic status. The organization of oral screening is the responsibility of the healthcare system personnel: their task is to identify the high-risk persons and to direct them to the scene of the screening. Orv Hetil. 2023; 164(38): 1497-1505.

A cross-sectional survey study on impact of sitting postures in Trikashoola w.s.r. to Low Back Pain among Information Technology Professionals

Occupational health aims at the promotion and maintenance of highest degree of physical, mental and social well being of workers in all occupations. Now, around world the occupational health personnel are witnessing the emergence of health related problems in computer users. Sadathura, the person who are continuously exposed to illness because of their professions. Panyajivi is one among them. 21st century integrates technology where computer’s plays an important role in people’s life, which makes them to sit for long hours. Trikashoola is one among the Vatavyadhi. Vata Dosha is considered to be main reason for pain. Low back pain is a disease of modernization due to desk jobs and the sitting position, poor work station design (desk), bad postures, type of chair and use of foot rest. Back pain is the second most frequent reason for visiting a physician and the common pain syndrome in developed and in developing countries. Ergonomics is concerned with human engineering. Bengaluru is the India’s largest I.T hub, also called as Silicon Valley of India and home for large number of Information Technology Professionals. 311 subjects were included in this survey study. The diagnosis was done through Oswestry disability index scale.

Assessing Attitudes and Participation Regarding a Pilot COVID-19 Workplace Vaccination Program in Southern Germany Considering the Occupational Health Perspective-A Mixed Methods Study.

This mixed methods study retrospectively assessed attitudes and participation of employees, occupational health personnel, and key personnel regarding the rollout of a pilot COVID-19 workplace vaccination program in five German companies in May/June 2021 in Baden-Württemberg (Southern Germany) by combining survey data and qualitative interviews. A total of 652 employees completed a standardized questionnaire and we conducted ten interviews with occupational health personnel and key personnel with other professional backgrounds organizing the pilot workplace vaccination program. Survey data were analyzed descriptively and interviews were audio recorded, transcribed verbatim, and analyzed using qualitative content analysis. Employees participated widely in COVID-19 vaccinations at their workplaces, and most employees (n = 608; 93.8%) had a full COVID-19 immunization at the time of the survey. The main advantages of the pilot COVID-19 workplace vaccination program were seen in the flexible and time-saving vaccination offer as well as the trust in and long-standing relationship with occupational health physicians. The main disadvantage of the pilot vaccination offer was increased workload for occupational health personnel, especially during the roll-out phase of the program. The pilot COVID-19 workplace vaccination program was predominantly positively assessed, and the important role of occupational health services in managing the COVID-19 pandemic was highlighted. The main criticisms of the COVID-19 workplace vaccination program related to the high organizational and administrative burden. Findings from our study can support the development of future programs for the administration of generally recommended vaccination in the workplace setting in Germany.

A Systematic Analysis of Biological, Sociodemographic, Psychosocial, and Lifestyle Factors Contributing to Work Ability Across the Working Life Span: Cross-sectional Study

As employees age, their physical and mental abilities decline and work ability decreases, enhancing the risk for long-term sick leave or even premature retirement. However, the relative impact of biological and environmental determinants on work ability with increasing age is poorly understood in terms of their complexity. Previous research has shown relationships between work ability and job and individual resources, as well as specific demographic and lifestyle-related variables. However, other potentially important predictors of work ability remain unexplored, such as personality traits and biological determinants, including cardiovascular, metabolic, immunological, and cognitive abilities or psychosocial factors. Our aim was to systematically evaluate a wide range of factors to extract the most crucial predictors of low and high work ability across the working life span. As part of the Dortmund Vital Study, 494 participants from different occupational sectors, aged between 20 and 69 years, completed the Work Ability Index (WAI) assessing employee's mental and physical resources. A total of 30 sociodemographic variables were grouped into 4 categories (social relationships, nutrition and stimulants, education and lifestyle, and work related), and 80 biological and environmental variables were grouped into 8 domains (anthropometric, cardiovascular, metabolic, immunologic, personality, cognitive, stress related, and quality of life) and have been related to the WAI. Using the analyses, we extracted important sociodemographic factors influencing work ability, such as education, social activities, or sleep quality, and identified age-dependent and age-independent determinants of work ability. Regression models explained up to 52% of the WAI variance. Negative predictors of work ability were chronological and immunological age, immunological inefficiency, BMI, neuroticism, psychosocial stress, emotional exhaustion, demands from work, daily cognitive failures, subclinical depression, and burnout symptoms. Positive predictors were maximum heart rate during ergometry, normal blood pressure, hemoglobin and monocyte concentration, weekly physical activity, commitment to the company, pressure to succeed, and good quality of life. The identified biological and environmental risk factors allowed us to evaluate work ability in its complexity. Policy makers, employers, and occupational safety and health personnel should consider the modifiable risk factors we identified to promote healthy aging at work through focused physical, dietary, cognitive, and stress-reduced preventive programs, in addition to well-balanced working conditions. This may also increase the quality of life, commitment to the job, and motivation to succeed, which are important factors to maintain or even enhance work ability in the aging workforce and to prevent early retirement. ClinicalTrials.gov NCT05155397; https://clinicaltrials.gov/ct2/show/NCT05155397. RR2-10.2196/32352.

The effect of physical activity breaks, including motor-cognitive coordination exercises, on employees' cognitive functions in the workplace.

The findings of the effectiveness of physical activity on adults' cognitive abilities have not yet been transferred into corresponding fields of application. The present study evaluates a motor-cognitive coordination programme in a company to improve employees' cognitive performance in the short and medium term. A total of 67 employees - 32 men and 35 women aged between 19 and 61 years - participated in this study, and 55 completed the study. The sample was randomly divided into an experimental group, which received a motor-cognitive coordination training, and a control group, which received a relaxation and mobility training. Both groups met for 15-minute sessions three times a week for eight weeks. Before and after the intervention, working memory, attention, information-processing capacity, divergent thinking, and mood were measured. In addition, acute effects regarding attention and mood were tested. The results showed that the motor-cognitive coordination break improves working memory and divergent thinking after eight weeks of intervention, whereas neither the mood nor the information processing speed improved more for the experimental group compared to the control group. The results on the acute increase in attention performance failed to reach significance. The new approach of this study was not only the derivation and development of targeted exercises, but also their testing and evaluation in the field of application. Motor-cognitive coordination exercise in the workplace might play an important role in both occupational health management and personnel development, especially for companies that are under highly competitive and innovative pressure.

Literature review to integrate information to assist workers to select masks even at workplaces without occupational health personnel.

BackgroundWith the COVID‐19 pandemic, the idea of universal mask wearing to prevent infecting others when one becomes infected has prevailed among people. In general, any workplace is not exempt and workers are required to wear a mask while working at the sites.ObjectivesThis study aims to integrate information to assist workers to select effective protectors for the prevention of droplet infection even at workplaces without occupational health personnel.MethodsA total of 94 studies were included in this study: 91 studies were identified in MEDLINE, which was used for the literature search, and an additional three studies were identified from other information sources. The studies were checked to eliminate duplication and narrowed down to 31 based on the titles and abstracts. The contents of the 31 studies were read through and then 19 studies were extracted for careful reading.Results and ConclusionsRegarding the protectors used at workplaces, it was suggested that (1) workers continue to use respiratory protectors as needed at sites where respiratory protectors such as an N95 respirator had to be used even before the spread of COVID‐19 and (2) wear surgical masks, multi‐layer cloth masks, or hybrid fabric masks made of several types of fabrics that are recommended in terms of preventing dissemination of droplets and protecting against inhalation of droplets, selected according to the working conditions, taking account of air permeability, breathability, and durability.

Risk Assessment Method Fostering Occupational Safety and Health Personnel in the Concrete-related Field

Risk Assessment Method Fostering Occupational Safety and Health Personnel in the Concrete-related Field

Covid-19

Much has been said in the popular press about the world-wide COrnaVIrus Disease 2019 (COVID-19) pandemic. Some of this information is accurate, some is exaggerated. In some cases vital information has not been presented, while other information is simply wrong. As business activity resumes in the U.S. and other countries, occupational health and safety personnel will have to make some extremely difficult decisions. Those decisions will have to be based on a thorough understanding of the scientific facts and not fear, partial information or distortions. So, what are the facts? What is a coronavirus? How does it work? How did it get that name? Where did it come from? How does it spread? Is there any way to stop it? Do masks work? What about social distancing, hand sanitizers and hand washing? What do the coronavirus statistics mean? Can a vaccine be made? Does post-infection therapy work, and is it safe? Does vitamin C and zinc do anything, or is it just a hoax? These are some of the questions that will be addressed in this article.

System and human resources for occupational health in the republic of the Philippines: Management of occupational health activities at overseas workplaces for Japanese enterprises

This study aimed to consider the appropriate occupational health system for Japanese enterprises in the Philippines based on information on the regulations and development of specialists. We collected information using an information-gathering checklist. Along with literature and internet surveys, we conducted interviews by visiting local business sites, central government agencies in charge of medical and health issues, and educational institutions with specialized occupational physician training curricula. Occupational health administration in the Philippines is managed by the Department of Labor and Employment, which issues the Occupational Safety and Health Standards that specify the legal requirements for occupational health. A new law(Republic Act 11058),enacted in 2018 to strengthen the Occupational Safety and Health Standards, has newly established a penalty provision in case of violations. Professional personnel responsible for occupational health are grouped as safety officers and occupational health personnel, including occupational physicians and occupational nurses; training is conducted at the Occupational Safety and Health Center of the Department of Labor and Employment and educational institutions. The basic medical insurance system and the workers' compensation system are operated by the Philippine Health Insurance Corporation and Social Security Committee, respectively, both of which are government agencies. We confirmed that occupational health activities in the Philippines are based on government regulations, namely, the Occupational Safety and Health Standards. In addition, the enactment of a new law calls for strict compliance with corporate occupational health activities. To manage proper occupational health activities at overseas workplaces, Japanese corporations should clarify corporate-wide policies and support local employers in complying with regulations and utilizing highly specialized personnel.

Frequency of Exposure to Secondhand Smoke Outside the Home Is Associated with a Lower FEV1/FVC in Male Workers Regardless of Smoking Status.

Decreased respiratory function associated with aging leads to the onset of chronic obstructive pulmonary disease (COPD) and increased risk of death in the elderly. Prevention of a decline in respiratory function from a young age is important. This study aimed to clarify the factors that affect decreased forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), an index of obstructive respiratory disorder caused by airway obstruction, by considering the influence of body composition and lifestyle. We recruited 262 employed adult men and determined their lifestyle-related factors, including smoking status, past or current secondhand smoke (SHS) exposure, exposure to SHS outside the home, and physical activity (PA). Body composition and respiratory function were also measured. The data were then compared with those of non-smokers using logistic regression analysis, adjusting for age. We also investigated factors influencing FEV1/FVC using multiple regression analysis, adjusting for age, height, smoking status, and lifestyle. Current smokers and heavy smokers exhibited significantly lower amounts of PA and had a higher body fat%, visceral fat area, prevalence of cohabitation with smokers, and frequency of SHS exposure outside the home, and FEV1/FVC was significantly lower in heavy smokers. A multiple regression analysis revealed that FEV1/FVC was associated only with the frequency of SHS exposure outside the home. It is important for occupational health personnel of a company to advise both non-smokers and smokers to avoid SHS to prevent chronic obstructive pulmonary disease onset. This needs to be coupled with encouragement to quit smoking, especially for heavy smokers.

Managing Research Animal Specimens and Laboratory Safety.

The procedures necessary to perform testing in a veterinary diagnostic laboratory have inherent associated risks to personnel in regard to exposure to infectious agents. In research institutions animals can be experimentally infected, acquire naturally occurring infections and can also be exposed to other hazards such as toxic chemicals or radiologic entities. A critical component of the use of animals in a research environment is the collaboration between the responsible researcher and the veterinary diagnostic laboratory with the institutional health and safety professionals to ensure that the proper engineering controls, personal protective equipment, laboratory procedures and training are in place for personnel working with the animals or their specimens. Unlike the typical researcher, the veterinary diagnostic laboratory generally has to be equipped to safely process and work with a wide range of potential hazards where the communication of pertinent information from the researcher to the diagnostic laboratory regarding the identity of the potential hazard is paramount. Diagnostic laboratory design, safety equipment, personal protective equipment, laboratory procedures, occupational health program and personnel training must be sufficient to address hazards based on a risk assessment performed in conjunction with safety professionals. This article will summarize safety considerations with the various areas of concern in the operation of a diagnostic laboratory for research animal specimens.

Work-Related Upper Limb Symptoms in Hand-Intensive Health Care Occupations: A Cross-Sectional Study With a Health and Safety Perspective.

Research with physical therapists reveals high rates of work-related musculoskeletal injuries, especially low back pain, with early career onset. Less focus has been given to upper limb disorders (ULDs) in these professionals, who frequently perform repetitive arm/hand and precision finger motions during work. The objective was to estimate prevalence of body-site-specific upper limb (UL) symptoms and diagnosed ULDs in Irish chartered physical therapists, physiotherapists, and athletic therapists, with adjustment for leisure time injury, and document first onset of specific UL symptoms. The design was a cross-sectional survey (N=347) using random sampling (physiotherapists in private practice), proportionate cluster sampling (hospital-based physiotherapists), and all-population sampling (physical therapists and athletic therapists). The methods used were a postal questionnaire with annual, current, and incapacitating UL symptoms (neck, shoulders, elbows, wrists, fingers, thumbs) (Nordic Questionnaire); symptom onset; diagnosed UL disorders; and sociodemographics; prevalence with 95% CIs, and adjusted prevalence (general linear modeling). Adjusted annual prevalence of UL symptoms in at least 1 body site was 78.1% (95% CI = 71.4-82.2), and of incapacitating symptoms was 21.0% (95% CI = 16.4-27.0). Shoulder (53.2%, 95% CI = 47.9-58.7), neck (49.4%, 95% CI = 44.2-55.0), and thumbs (46.1%, 95% CI = 40.7-51.5) were mostly affected. Hospital-based therapists had a significantly higher prevalence of incapacitating symptoms compared with others (35.7% vs 23.3%). Respondents totaling 28.2% had at least 1 lifetime diagnosis of ULD, most commonly shoulder tendonitis (12.5%, 95% CI = 8.4-15.3) and overuse syndrome (11.8%, 95% CI = 8.4-15.3). First onset was mostly after 5 years working as a therapist; however, this differed by anatomical site. A cross-sectional study design limited interpretation of symptoms as work-related causes. The high prevalence of ULD and symptoms warrants attention from occupational health and safety personnel. Training in injury prevention and risk assessment should be provided during education and as part of continuing education.

Emerging Occupational Health Needs at a Semiconductor Factory Following the 2016 Kumamoto Earthquakes: Evaluation of Effectiveness and Necessary Improvements of List of Postdisaster Occupational Health Needs.

We sought to share our experiences with occupational health efforts at a manufacturing site after a large earthquake event, and to evaluate the effectiveness of our "List of Occupational Health Needs Following Disasters" (Needs List). We implemented occupational health efforts following the 2016 Kumamoto earthquakes in Japan, with reference to the Needs List and a related manual, and analyzed the needs that arose. The instruments used enabled occupational health personnel to predict what needs would arise and facilitate their countermeasures. Among such needs that arose, 87.7% were in the Needs List, but seven undocumented needs were also observed. We confirmed that the Needs List could predict as many occupational health needs as we had expected at the disaster, though it is necessary to improve them by reflecting on our experiences.

Work, organisational practices, and margin of manoeuver during work reintegration

Background: Many individuals of working age experience cardiovascular disease and are disabled from work as a result. The majority of research in cardiac work disability has focused on individual biological and psychological factors influencing work disability despite evidence of the importance of social context in work disability. In this article, the focus is on work and organisational features influencing the leeway (margin of manoeuvre) workers are afforded during work reintegration.Methods: A qualitative method was used. A large auto manufacturing plant was selected owing to work, organisational, and worker characteristics. Workplace context was assessed through site visits and meetings with stakeholders including occupational health, human resources and union personnel and a review of collective agreement provisions relating to seniority, benefits and accommodation. Worker experience was assessed using a series of in-depth interviews with workers (n = 12) returning to work at the plant following disabling cardiac illness. Data was analysed using qualitative content analysis.Results: Workers demonstrated variable levels of adjustment to the workplace that could be related to production expectations and work design. Policies and practices around electronic rate monitoring, seniority and accommodation, and disability management practices affected the buffer available to workers to adjust to the workplace.Conclusions: Work qualities and organisational resources establish a margin of manoeuver for work reintegration efforts. Practitioners need to inform themselves of the constraints on work accommodation imposed by work organisation and collective agreements. Organisations and labour need to reconsider policies and practices that creates unequal accommodation conditions for disabled workers.Implications for rehabilitationMargin of manoeuvre offers a framework for evaluating and structuring work reintegration programmes.Assessing initial conditions for productivity expectations, context and ways and means to support work reintegration can be integrated with worker perceptions of work ability and possibilities for adaptation to structure and then monitor work reintegration programmes. Margin of manoeuvre can be used to evaluate sustainability of work at the end of rehabilitation.Cause-based workers’ compensation schemes, collective agreement provisions, and organisational approaches to non-compensable disability create two tiers of disabled workers and make certain workers more vulnerable to occupational disability.

Development of the Career Anchors Scale among Occupational Health Nurses in Japan

This study aimed to develop the Career Anchors Scale among Occupational Health Nurses (CASOHN) and evaluate its reliability and validity. Scale items were developed through a qualitative inductive analysis of interview data, and items were revised following an examination of content validity by experts and occupational health nurses (OHNs), resulting in a provisional scale of 41 items. A total of 745 OHNs (response rate 45.2%) affiliated with the Japan Society for Occupational Health participated in the self-administered questionnaire survey. Two items were deleted based on item-total correlations. Factor analysis was then conducted on the remaining 39 items to examine construct validity. An exploratory factor analysis with a main factor method and promax rotation resulted in the extraction of six factors. The variance contribution ratios of the six factors were 37.45, 7.01, 5.86, 4.95, 4.16, and 3.19%. The cumulative contribution ratio was 62.62%. The factors were named as follows: Demonstrating expertise and considering position in work (Factor 1); Management skills for effective work (Factor 2); Supporting health improvement in groups and organizations (Factor 3); Providing employee-focused support (Factor 4); Collaborating with occupational health team members and personnel (Factor 5); and Compatibility of work and private life (Factor 6). The confidence coefficient determined by the split-half method was 0.85. Cronbach's alpha coefficient for the overall scale was 0.95, whereas those of the six subscales were 0.88, 0.90, 0.91, 0.80, 0.85, and 0.79, respectively. CASOHN was found to be valid and reliable for measuring career anchors among OHNs in Japan.

Disclosure of Type 1 diabetes at work among Finnish workers.

To determine which self-management factors and psychosocial work factors were associated with disclosing diabetes to colleagues, line managers and occupational health personnel among workers with Type 1 diabetes. A total of 767 working-aged respondents with Type 1 diabetes completed a Finnish cross-sectional survey named 'People with Type 1 Diabetes in Worklife'. Factor analysis was carried out, followed by logistic regressions to estimate the associations between self-management factors, psychosocial work factors and the likelihood of disclosure separately to colleagues, line managers and occupational health personnel. The models were adjusted for sociodemographic, diabetes-related and work-related variables. A total of 52% of the respondents had disclosed their diabetes to their colleagues, 45% to occupational health personnel and 28% to their line manager. Receiving social support and having good psychosocial work ability were significantly associated with disclosure to colleagues, line managers and occupational health personnel. Relations at work were associated with disclosure to colleagues and the line manager. Furthermore, opportunity to self-manage diabetes at work was associated with disclosure to colleagues. Line managers and colleagues have a remarkable role to play in providing workplace support to workers with Type 1 diabetes. Disclosure of Type 1 diabetes should be encouraged as line managers can provide workers with the right support, implement work adaptations and facilitate job retention. As only half of respondents disclosed their Type 1 diabetes at work, further research is required into the reasons for and consequences of not disclosing a diagnosis.

Prediction tools for sickness absenteeism

Purpose – Bradford formula (index) or factor (BF) was originally designed for use as part of the overall investigation and management of absenteeism. Work ability index (WAI) is an instrument that has been used to evaluate work ability. The purpose of this paper is to evaluate retrospectively, the properties of the WAI, the BF and their combination – the sickness absence probability factor – in predicting future sickness absence. Design/methodology/approach – Data on sickness absences of shipyard employees for the period 2002-2006 were utilized for the calculation of the relevant BFs. The Greek version of the WAI questionnaire was also used. The sickness absence probability factor was calculated by summing up the scores of the two other tools, after transforming them into categorical variables. Findings – Increased BF values are positively and strongly correlated to increased sickness absenteeism levels in the following years (p&lt;0.001), especially for the immediate following years. WAI score is also strongly negatively correlated to absence. The combination of BF and WAI acted even better. Originality/value – The use of tools, like the BF and the suggested sickness probability factor, should be considered by occupational health personnel in order to act proactively on sickness absenteeism, since they were found to be related to future absenteeism. Actions should follow health and safety rules and ethics and should be undertaken by competent health personnel.

Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences.

The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs. The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided. The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted. Cooperation between human resources workers' compensation personnel, safety and occupational health personnel is a must for successful management of the WC program. Information and data sharing are critical for root cause and injury prevention, case management, and cost containment efforts. Enhancing efforts in these areas will save an estimated $100 million through cost avoidance efforts.