Pre-employment Medical Examinations Research Articles

Evaluation of occupational health literacy of health workers in Adana, Türkiye

Objective: The importance of occupational health and safety (OHS) and related health literacy is increasing. The aim of this study was to evaluate the occupational health literacy status of healthcare workers in Adana (Turkey). Method: The population of the study consists of health workers in Adana province (N=18,660). Between April 29 and June 13, four researchers visited the workplaces of health workers and asked them to answer online survey questions through the WhatsApp application in face-to-face meetings. The study was completed with 179 individuals determined using non-probability sampling method. The analyses were performed using the SPSS 22 software. The Kolmogorov-Smirnov, t-test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test were used in the analyses. A significance level of p < 0.05 was considered statistically significant. Results: The study included 179 healthcare workers with an average age of 32.36±7.97 years. Pre-employment medical examinations and periodic examinations were reported to have been performed in 65.9% and 50.3%, respectively. The "Occupational Health Literacy Scale" that was administered to the participants with a resulting avarage score was 80.30±11.68. Participants who underwent workplace periodic examinations had higher scores in Factor 1 and Factor 4 compared to those who did not undergo any periodic examination. Conclusion: Participants who underwent periodic examinations and those who were informed about health risks had higher occupational health literacy. It is recommended that health workers be informed about health risks in the institutions they work, periodic examinations are carried out regularly, OHS trainings are planned, and these trainings are repeated periodically.

Health risk classification patterns among Filipino seafarers. Analysis from a pre-employment clinic in the Philippines: a 5-year review.

Seafaring is a demanding profession that exposes individuals to unique health risks and challenges. This study investigates risk classification patterns among seafarers who underwent physical and medical examination at the Nordic Medical Clinic, a pre-employment clinic in the Philippines. The analysis involved data obtained from medical records, including demographic information, diagnoses, medical risk classification, corresponding management, and occupational details. medical risk classification, based on guidelines from the Philippine Department of Labour and Employment, categorised fit to work seafarers into risk class A, B, or C. Descriptive statistics and statistical tests, with a significance level set at p < 0.05, were utilised for data analysis using R Studio (version 4.2.3). The study population consisted of 11,831 seafarers seen at the Nordic Medical Clinic between 2018 and 2022. The results revealed a significant proportion of seafarers falling into higher risk classifications, with risk class C being the most prevalent at 48.16%. Pre-employment medical examinations (PEME) to fit to work duration demonstrated a significant association with risk classification, revealing that lower-risk classes had shorter fit-to-work times compared to higher-risk classes. Moreover, risk classification exhibited uneven distribution across specific demographic and occupational characteristics, with older seafarers, males, married individuals, and those in higher-ranking positions having a higher proportion of risk class C. Our findings highlight the need for comprehensive and customised pre-boarding medical screening standards for seafarers based on factors such as their specific role, vessel type, voyage, contract length, and work location. Moreover, health implementation of health promotion and preventive strategies that are based on the specific occupational and demographic needs of the seafarers are needed.

Profile of Dermatological Disorders among Construction Workers: A Cross-Sectional Study

Background: The construction industry is a growing industry worldwide, including India, employing a large population. Construction workers perform a variety of work including mixing concrete and carrying heavy objects. Occupational contact dermatitis is a significant occupational dermatosis, cement being the most important agent and is an occupational hazard. Objective: The objective of this study was to estimate the prevalence of occupational skin diseases among construction workers. Materials and Methods: This cross-sectional study was conducted in Manipal, Karnataka, among 300 construction workers. A detailed inquiry was made on demographic parameters such as age, sex, nature of work, duration of the job, chemicals exposed to, symptoms, and use of protective devices. They were examined to note the symptoms, clinical pattern, and distribution of lesions. Results: The majority of the workers belonged to the age group between 20 and 29 years. The common skin disorders noticed were callosities (17.33%), traumatic injuries (10%), dermatophyte infections (8.33%), and dermatitis (5.7%) along with few other dermatoses encountered due to increased exposure to heat and due to increased wet work in workers who did not wear protective devices. Conclusions: There is a lack of preemployment and periodic medical examinations for construction workers. Common dermatoses seen among the construction workers were mainly due to the lack of preventive measures. Hence, it is important to raise health awareness to recognize early signs and symptoms of various dermatoses and educate regarding the use of personal protective equipment.

A Comparative study in Qatargas Medical Department: The impact of effective fitness to work on the reduction of Offshore Medical Evacuations

Background: A significant number of offshore operations are carried out by Qatargas (QG) employees and contractors in multiple offshore locations, hence, people acutely ill require costly and risky Medical Evacuation (Medevac) undertaken by helicopter or boat.1 This study aims to evaluate the impact of offshore fitness to work on reducing the number of preventable medevacs in QG compared to other oil and gas offshore organizations. Methods: This is a retrospective review of medevac data (2018-2020) in Qatargas offshore locations concerning the total yearly population. Employees’ records, human resource data, and medical screening data were used as a dominator for the population. It included analysis of pre-employment medical examination, periodic medical examination, medical screening programs, occupational vaccination, and fitness to return to work programs. Results: During the 3 years, 10 medevacs occurred for a total of 13,376 workers, resulting in a rate of 0.74 medevac cases per 1000 workers (Figure 1). This rate is remarkable compared to similar studies in other oil and gas offshore industries (4.97/10002; 4/10003). In addition, we have evaluated retrospectively the medical records of the medevac cases to identify those due to a medical reason (not injuries/trauma). Among the 6 medical cases, 1 worker had a pre-existing medical condition. Another finding was that the average age of the 3 medical medevac cases due to suspicious chest pain was 57 years old. All medevacs were male workers, mostly because of illnesses (60%) rather than trauma (40%) (Figure 2). Conclusion: This study provides a new benchmark medevac rate (0.74/1000). A robust fitness to work in an offshore program with the adequate implementation of other preventative measures (e.g., vaccination) is effective in reducing the number of preventable medical medevacs from offshore remote locations and hence, reducing the cost of both medevacs and lost working hours.

Work-related Respiratory Symptoms and Associated Factors among Cement Factory Workers in Rupandehi District, Nepal

Background Cement factory workers are exposed to cement dust at workplace. It leads to a greater prevalence of chronic respiratory signs and symptoms.&#x0D; Objective To identify the prevalence of Work-related respiratory symptoms, its association with various risk factors, and to assess the outcomes like hospitalization and sickness absenteeism.&#x0D; Method Cross-sectional study was conducted in the Argakhanchi Cement factory among 190 workers with minimum work experience of 1 year. Census method was used for data collection. To assess the respiratory symptoms, sputum samples were collected; smears prepared by pick and smear method, and later stained by Leishman and pap stain. Smears devoid of alveolar macrophages were considered unsatisfactory for evaluation.&#x0D; Result The mean age of respondents with standard deviation was 35.56±11.45 years. The prevalence of Work-related respiratory symptoms was 31.6%. Age, no. of years worked, working in the raw materials department, burner and clinker department, cleaning department and wearing mask were the significant risk factors. On cytological analysis of the sputum sample, mild inflammatory cell noticed in 71.6%, moderate inflammation in 23.7%, and dense inflammation in 4.2%. Fungal spores were seen in 3.7%, fungal pseudohyphae in 0.5%, and bacterial colonies in 27% of the sputum samples. Out of 190 participants, 8(4.2%) of them had to be hospitalized and 17(8.9%) were on sick leave due to respiratory symptoms.&#x0D; Conclusion Pre-employment and periodic medical examination, frequent work shift, training on occupational health and safety, use of appropriate personnel protective equipment is recommended to reduce respiratory symptoms.

Telemedicine for Pre-Employment Medical Examinations and Follow-Up Visits on Board Ships: A Narrative Review on the Feasibility.

Background: Telemedicine has already been applied to various medical specialties for diagnosis, treatment, and follow-up visits for the general population. Telemedicine has also proven effective by providing advice, diagnosis, and treatment to seafarers during emergency medical events onboard ships. However, it has not yet been applied for pre-employment medical examinations and follow-up visits on board ships. Objective: This review aimed to assess the possibility of using telemedicine during periodic visits between one pre-employment medical examination and others on board ships, and to recommend necessary medical examination tests with screening intervals for seafarers. Methods: Various databases including PubMed, EMBASE, Scopus, CINAHL, and Cochrane Library were explored using different keywords, titles, and abstracts. Studies published between 1999 and 2019, in English, in peer-reviewed journal articles, and that are conference proceedings were considered. Finally, the studies included in this review were chosen on the basis of the eligibility criteria. Results: Out of a total of 168 studies, 85 studies were kept for further analysis after removing the duplicates. A further independent screening based on the inclusion and exclusion criteria resulted in the withdrawal of 51 studies that were not further considered for our analysis. Finally, 32 studies were left, which were critically reviewed. Out of 32 accepted studies, 10 studies demonstrated the effectiveness of the electrocardiogram (ECG) in monitoring and managing remote patients with heart failure, early diagnosis, and postoperative screening. In 15 studies, telespirometry was found to be effective in diagnosing and ruling out diseases, detecting lung abnormalities, and managing patients with chronic obstructive pulmonary disease (COPD) and asthma. Seven studies reported that telenephrology was effective, precise, accurate, and usable by non-medical personnel and that it reduced sample analysis times and procedures in laboratories. Conclusion: using new technologies such as high-speed internet, video conferencing, and digital examination, personnel are able to make the necessary tests and perform virtual medical examination on board ships with necessary training.

Predictors of uptake of cervical cancer screening among nurses in Ogbomoso, Nigeria

Background/Aims More than one million women are currently living with cervical cancer. Approximately 311 000 deaths were attributed to the disease in 2018, with the majority occurring in low- and middle-income countries, like Nigeria. Cervical cancer screening has been consistently shown to be effective in reducing the occurrence of new cases of cervical cancer and mortality related to the disease. This study aimed to determine the predictors of cervical cancer screening among nurses in Ogbomoso, Oyo State. Methods This was a descriptive cross-sectional study, which used a structured pretested questionnaire to collect data from 230 nurses randomly selected from two settings in Ogbomoso, Nigeria. Data were analysed using descriptive statistics, Chi-Square and logistic regression. Results All participants had heard of cervical cancer and its screening measures. More than half of the respondents (68.7%) had never submitted for screening. The respondents reported factors such as lack of facilities (77.0%), financial status (76.5%), lack of awareness (75.7%), inconvenient screening time (75.7%) and level of education (71.7%) as influencers of use of cervical cancer screening. Logistic regression analysis showed marital status was significantly related to cervical cancer screening usage (P=0.047). Conclusions Good knowledge of nurses on cervical cancer screening does not translate to uptake of screening services. It is recommended that cervical and other cancer screening services should be included in the pre-employment medical examination of nurses to compel usage of screening services.

Mental health problems and suicide in the younger generation - implications for prevention in the Navy and merchant fleet.

Psychologists and psychiatrists worldwide are expressing concerns regarding the growing prevalence of mental health problems and the incidence of suicide in young adults. The reasons are seen in the extremely high tempo of social changes, information pressure, and values evolution in the younger generations, which are exposed to growing inequalities, loneliness and lack of social support. Poverty, social isolation, consumerism, hedonism, and unrealistic expectations of the future generate in the vulnerable part of the young adults inevitable frustrations, which give way to depression, anxiety, addictions, and suicide. This creates additional risks for the situation on board ships, both military and merchant, and requires greater efforts during pre-admission selection and in the course of the service or voyages. Suicides in the Navy are better registered than in the cargo fleet and are lower than in the same age and gender groups from the general population, and usually lower than in other types of forces. Data on suicides in the civilian maritime sector are less conclusive, but suggest it as a growing problem, especially considering stress on board. Recent studies revealed quite a lot of mental health problems in the merchant fleet crews, including depression, anxiety, and suicidal thoughts. Among the reasons such factor as "flag of convenience" strategy that implies lower standards, recruiting of the less trained and lower-paid workforce, multinational and multilanguage rotating crews, higher workload and stress and insufficient level of the pre-employment medical examination are mentioned. Recent trends in the mental health of the youth demand higher awareness both in the military ships and in the merchant fleet. We consider that more education and training aimed at mental health problems identification and stress-resilience promotion are needed both for the military and civilian staff on board. Better education of the whole personnel and "healthy ship" approach (better recognition of the crew members' needs, attention to mental health problems, nutrition, physical activity, etc.) may be applied both for the Navy and merchant fleet.

Awareness, Prevalence and Factors Associated with Respiratory Morbidities Among Selected Petrol Pump Workers in Bengaluru City?

Introduction:Petrol pump workers are exposed to fumes emanated during petrol filling and vehicular exhaust thus falling prey to several respiratory diseases.Objectives:To assess the awareness and prevalence of respiratory morbidities among petrol pump workers of selected petrol pumps in Bangalore.Methodology:This cross-sectional study was conducted among 158 petrol pump workers from 11 selected pumps in Bengaluru. Following IEC approval, the baseline socio-demographic data, knowledge regarding respiratory morbidities and current morbidity pattern were ascertained. Medical examination and Peak Expiratory Flow rate (PEFR) was estimated.Results:The 158 workers were all male, mostly between 18-27 years (65.19%) and high school educated (49.37%). Knowledge regarding respiratory morbidities was 56%, while prevalence of respiratory morbidity was 61%. Those workers who had completed their higher education (>10th standard), earning monthly income (>Rs. 5000) had better knowledge regarding respiratory morbidities.Recommendation:Pre-employment and regular medical examination including lung function tests and promotion of use of PPEs to be implemented.

The patient with epilepsy and medicolegal aspects: a view for the neurologist.

Patients with epilepsy face innumerable obstacles in daily life, related to work, permission to drive and interpersonal relationships, which require medical guidance. This paper reports a literature review based on scientific articles and civil and traffic system, as a way to resolve doubts about medical obligations in the patient's permission to drive and work. An employment agreement requires the contractor to guarantee safety conditions as well as requiring the patient, at the pre-employment medical examination, to let the physician know previous medical conditions, including epilepsy. More than 90% of patients with epilepsy omit this information during the application assessment, thus being subject to imputation of ideological falsehood crime as disposied on article 299 of Brazilian Penal Code. Medical confidentiality breaches may only occur in specific situations. In Brazil, the authorization and driver's license renewal is governed by the Brazilian Traffic Code (Federal Law n° 9503/1997). For patient evaluations, two groups are considered: those on antiepileptic medication and those on medication withdrawal. A favorable report from the attending physician is also required, in both categories. Seizures that occur exclusively during sleep, and focal aware events or prolonged aura are not differentiated from other seizure types disposed in the traffic law. It is the responsibility of the attending physician to analyze each patient individually to resolve conflicts between public safety and the individual patient's independence. A frank and honest doctor-patient relationship is essential for the patient to understand the public and individual consequences of epileptic seizures and to feel comfortable seeking medical help.

Weight gain in public hospital workers: a retrospective cohort study.

This study assessed changes in the nutrition profile of public hospital workers over a period of three decades and the association between nutritional status and occupational factors. A retrospective cohort study was conducted with staff taken on in 1980, 1990, and 2000 still working in the hospital in 2013. The following data was obtained from staff records: sociodemographic characteristics; and body weight and height, recorded during pre-employment and periodic medical examinations. The latter was used to calculate body mass index (BMI).The final sample consisted of 386 workers (76.4% women and 88.1% white) with a mean age of 29.3 ± 7.3 years. Mean body weight and BMI at admission were highest in the 2000 cohort (W = 66.3 ± 12.5kg; BMI = 21.3 ± 2.5 kg/m2), compared to 1980 (W = 56.7 ± 10.2 kg; BMI = 21.3 ± 2.5 kg/m2)and 1990 (W = 62.2 ± 11.5 kg; BMI = 22.9 ± 3.3 kg/m2) cohorts. Variation in weight and BMI between the pre-employment examination and final periodic examination was highest in the 2000 cohort. When stratified by sex, this difference in variation was observed only in men. No association was found between variation in body weight and BMI and work shift and occupation. The increase in weight and BMI reflects the nutritional transition in Brazil, underscoring the need for nutritional surveillance and the implementation of health education programs directed at staff.

Food Handling Practices among Food Handlers of Eating Establishments in the Government Hospitals, Mandalay City, Myanmar

Background: Hospital environment is a favourable condition for growing of pathogens. Unhygienic practices of food handlers and contaminated food may be the cause of foodborne diseases, resulting in much comorbidity and longer hospital stay of the affected persons.&#x0D; Aims: To study socio-demographic characteristics, working characteristics and food handling practices among food handlers of eating establishments in the government hospitals, Mandalay city, Myanmar.&#x0D; Study Design: Cross-sectional descriptive study.&#x0D; Place and Duration of Study: One hundred and eleven eligible food handlers from government hospitals in Mandalay city, Myanmar between May 2018 and August 2018.&#x0D; Methodology: Face to face interviews with all eligible food handlers were carried out with pretested questionnaire. Observational checklist was used for current situation of food handlers.&#x0D; Results: The majority of employees were female and full-time food handlers. No pre-employment and periodic medical examinations of food handlers were done. More than half (54.05%) of total food handlers had unsatisfactory on food handling practices. Food handling practices status was influenced by duration of working in the current jobs (P=.001).&#x0D; Conclusion: There was high status of unhygienic food handling practices of the food handlers working in the eating establishments of the government hospitals, Mandalay city, Myanmar.

Pre-employment medical examinations - what is the issue?

Pre-employment medical examinations - what is the issue?

Decision aid for the use of additional tests during the pre-employment medical examination (PEME) of seafarers.

No laboratory tests and imaging techniques are recommended for routine use in the ILO/IMO Guidelines on the Pre-Employment Medical Examination (PEME) of Seafarers that form the basis for statutory certification. However, they are widely used as components of the PEME protocols developed by insurers, employers and national maritime authorities in an attempt to predict and reduce the risks from illness whilst working at sea. This may be justified on scientific, safety, economic or professional grounds. We propose a rational approach for deciding if and when tests can be justified for routine use in assessing a seafarer's fitness for work at sea. This is based on well-established methods for determining the validity of screening tests in public health as well as the seafarer demographics. We do not address the well-established use of similar tests where illness is suspected but only when they are used for routine PEME screening of all seafarers.

Standards for quality assurance of pre-employment medical examinations of seafarers: the IMHA Quality experience.

Standards to assess the quality of doctors and clinics performing pre-employment medical examinations (PEMEs) were developed for International Maritime Health Association (IMHA) Quality, a not for profit organisation, created to provide an ethically sound and professional accepted accreditation system that would benefit seafarers having PEMEs and employers, insurers and national maritime authorities seeking valid assessments of seafarers' fitness for duty. These standards followed a format widely used in other healthcare settings, where assessment of clinical performance is desirable. Uptake of these standards by doctors and clinics was not as expected, as they did not see sufficient business benefits coming from accreditation to justify the costs. This was, at least in part, because there was some antagonism to a professionally based accreditation system from commercial interest groups such as insurers, while national maritime authorities did not come forward to use the system as a recommendation or requirement for approval of doctors. The IMHA Quality accreditation system has now been closed and for this reason we are making the standards publicly available. Those who helped to develop them hope that doctors and clinics will now use them as a means of improving the quality of their practice when performing PEME.

The evidence base for seafarer pre-employment medical examinations (PEMEs).

The evidence base for seafarer pre-employment medical examinations (PEMEs).

Mandatory Pre-Employment Medical Examination—The Practice and the Law: Is It Justifiable?

“An employee shall not in respect of any person seeking employment, or of persons already in his employment; discriminate against the person on grounds of gender, race, colour, ethnic origin, creed, social or economic status, disability or politics” (Section 14(e) of the Labour Act 651). The aim of this study is to evaluate the process of pre-employment medical report examinations, the law and the practice—in some public institutions in Kumasi. This study was conducted in two major public institutions in the Kumasi metropolis. The identities of respondents will remain confidential so as to maintain anonymity. Three groups of respondents were used in the study (Group 1: Employees who were employed within the past 5 years. Group 2: Eight medical doctors who have been mandated to conduct and write medical reports of prospective employees. Group 3: Ten senior human resource staff members of the two aforementioned public institutions). Each group was asked specific questions related to the process of medical examinations and the laws of employment. Responses were analyzed and reported descriptively using SPSSII. All respondents from Group 1 were asked to submit to a medical examination commencing work. Sixty-five (65%) percent of respondents in Group 2 indicated that they were unaware of the job description of a prospective employee at the time of examination. All members in Group 3 indicated that the medical examination results of applicants are kept on their personal files, which are accessible to other human resource personnel. Based on the above section of the Labour Act of 2003, it is our assertion that there is no legal basis for the mandatory request of medical examination reports of prospective employees. Again, the medical reports do not always take into consideration the job description of the prospective employee. Therefore, reliance on a medical report to determine the fitness of a prospective employee for a particular job is not based on fair evaluation and thus not justifiable for the institutions studied.

Routine chest radiograph in pre-employment medical examination for healthcare workers: Time for a review of the protocol.

Pre-employment medical examination (PEME) sought to evaluate the ability of workers to work without risk to their own or others' health and safety. This is important especially in a hospital environment where the patients may be at risk in case of employees harbouring infectious lung conditions or as a result of occupational exposure. Although not all healthcare workers are at risk or pose risk, they are expected to undergo chest X-ray (CXR) as part of PEME. The aim of this study is to determine the number of prospective employees with abnormal findings on routine CXR, describe their characteristics and reassess the value of CXR in PEME. This was a retrospective study of all the staffs employed into the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, from January 2004 to December 2013. Of the 633 personnel employed during this period, medical records of 416 staffs were available for analysis. Data extracted included age, gender, and CXR report. Descriptive statistics was used for analysis and presentation. The mean age of the prospective employees was 26.6 years ± 5 with a range of 20-49 years. Three hundred and ninety-six (95.2%) employees had normal CXR report while 20 (4.8%) had abnormal CXR. The only abnormality reported was cardiomegaly which was found in 66% of those aged ≥41 years. Cardiomegaly was significantly associated with increasing age (P = 0.003). Routine CXR as part of PEME for prospective employees into this healthcare institution is no longer necessary. It is suggested that its routine use should be limited to older job seekers.

JOB STRESS AMONG POLICE OFFICERS IN MANSOURA CITY, EGYPT

Introduction: Police officers experience frequent and ongoing stressors in their work.Exposure to violence, suffering, and death is inherent to their profession. Aim of work: To describe the level of job stress, risk factors, and coping strategies adopted to reduce it in police officers in Mansoura city, Egypt. Materials and methods: Police officers completed a self-administered questionnaire covering the socioeconomic and occupational data, occupational stress index scale and coping inventory for stressful situations. Results: A high average total Occupational Stress Index (OSI) score (133.7)was found with role overload having the highest subscale mean (20.9). The significant factors associated with level of stress were rank of officers, nature and sector of work, shift work, smoking and other habits. Coping strategies to overcome stress were mainly task-oriented. Conclusion: Pre-employment and periodic medical examination and psychological assessment of officers is required together with implementation of stress management program and counseling. Further large scale multicenter research is recommended.

Do Danish Maritime Doctors Value Continuous Education Initiatives?

Aims and objectives: Seagoing employees must undergo medical examinations every second year. Even though International Organisations issued guidelines for these pre-employment medical examinations there is a lack of an internationally accepted continuous training programme for the maritime doctors who perform these examinations. The aim of this survey was to examine the Danish maritime doctors perceived training needs as part of a planned comprehensive maritime occupational health prevention programme. Methods: A questionnaire based on international standards was distributed to all the maritime doctors (110) electronically in May 2017. The completed questionnaires were 46.4%. STATA was used for the statistical analysis of the data and correlations among the self-rated needs as dependent variables and the doctors characteristics were performed with Fisher exact test, with significance level at α=0.05%. Results: The maritime doctors considered very important to receive training in “Fitness evaluation and medical examinations guidelines” (76.47%) followed by “Rules and regulations within maritime medicine” (68.63%) and “Working conditions and health risks on board” (62.75%). The number of examinations influenced their preference with those with more than 20 patients to express a more pressing need for training. Age, gender and years of practice did not have any influence in their self-rated needs. Furthermore, they pointed out flexible ways of training including distance learning and the establishment of a webpage by the respective Authorities as one stop-shop. Conclusion: Maritime doctors are in favour of continuous education and training. The survey may help the respective Authorities to organise such short courses on targeted topics in the country.