Occupational Health Prevention Research Articles

Inequalities and the Impact of Job Insecurity on Health Indicators in the Spanish Workforce

In a context of high job insecurity resulting from social deregulation policies, this research aims to study health and substance abuse inequalities in the workplace from a gender perspective. To this end, a transversal study was carried out based on microdata from the National Health Survey in Spain—2017, selecting the active population and calculating the prevalence of the state of health and consumption, according to socio-occupational factors (work relationship, social occupational class, time and type of working day). Odds ratios adjusted by socio-demographic variables and their 90% confidence intervals were estimated by means of binary logistic regressions stratified by sex. The results obtained showed two differentiated patterns of health and consumption. On the one hand, unemployed people and those from more vulnerable social classes showed a higher prevalence of both chronic depression and anxiety and of hypnosedative and tobacco use. On the other hand, the better positioned social classes reported greater work stress and alcohol consumption. In addition, while unemployment affected men’s health more intensely, women were more affected by the type of working day. The study can be used to design sustainable preventive occupational health policies, which should at least aim at improving the quantity and quality of employment.

Distribution feature of newly diagnosed pneumoconiosis in Guangyuan City, 2007-2017

Objective: To investigate the distribution feature of newly diagnosed pneumoconiosis in Guangyuan City from 2007 to 2017 and provide scientific evidence for the prevention and control of pneumoconiosis. Methods: In May 2019, the data of newly diagnosed pneumoconiosis in Guangyuan City during January 2007 to December 2017 were collected from Chinese Information System for Disease Control and Prevention-Occupation Disease and Occupation Health Information Monitoring System. The database was built by Excel 2010. The distribution of period, disease type, region, sex, age, working age, work type and industry were analyzed by SPSS 17.0 software. Results: Totally 3920 new cases of pneumoconiosis were reported in Guangyuan City from 2007 to 2017, 2850 cases (72.70%) were in stage Ⅰ, 724 cases (18.47%) were in stage Ⅱ, and 346 cases (8.83%) were in stage Ⅲ. The main type of pneumoconiosis was coal worker＇s pneumoconiosis (2544 cases, 64.90%, ) , second was silicosis (1313 cases, 33.49%) . The newly diagnosed pneumoconiosis were mainly distributed in Lizhou area (1855 cases, 47.32%) , Wangcang county (1392 cases, 35.51%) and Cangxi county (509 cases, 12.98%) . The patients were mainly males (3910 cases, 99.74%) , the ratio of males to females was 391∶1. The average diagnostic age was (57.56±17.58) years, the average working age was (13.68±10.81) years. The main types of work were coal miner (1748 cases, 44.59%) , roadheader (1354 cases, 34.54%) and drill man (487 cases, 12.42%) . The industry distribution was mainly mining (2930 cases, 74.74%) . The distribution of enterprise sizes were mainly small and medium-sized (1341 cases, 34.21%) and micro-sized (999 cases, 25.48%) enterprises. Conclusion: The situation of prevention and control of pneumoconiosis in Guangyuan City is still severe and the newly diagnosed cases are dominated by coal worker＇s pneumoconiosis, mainly concentrated in mining. There are more cases in Lizhou area and Wangcang county. Strengthening the prevention and control of dust hazards in high-risk areas and high-risk groups is the focus of occupational health prevention and control in Guangyuan City.

The role of physical exercise as a personal resource against job stress

Purpose. The prevention of burnout symptoms is an essential goal in occupational health promotion. Physical exercise provides health-promotion benefits. This study aimed to verify physical exercise and its planned preparation as additional predictors of employees’ burnout symptoms next to job demands and resources. We used the job demands–resources model as a theoretical framework. Method. In this longitudinal online study, 342 employees completed two questionnaires at an interval of 4 weeks. Results. Moderation and moderated mediation analyses confirmed vigorous physical exercise as a relevant personal resource, revealing that it buffers the detrimental effects of job demands on burnout symptoms. Planning strategies strongly predicted physical exercise and supported the debilitating effects of job resources on burnout symptoms. Especially in employees with medium levels of job stress, coping planning supported the enactment of vigorous physical exercise. Physical exercise did not mediate the association between job demands, job resources and burnout symptoms. Conclusions. This study enriches our knowledge about occupational health prevention. It points to a pressing topic for the near future, i.e., how work conditions (e.g., job stress) and leisure time (e.g., physical exercise) can be successfully combined to keep individuals’ job stress to a minimum and to prevent burnout symptoms.

Workplace Violence in Healthcare: A Single-Center Study on Causes, Consequences and Prevention Strategies.

Workplace violence is one of the main risk factors in the professional world. Healthcare workers are at higher risk whencompared to other sectors. Our study aimed to characterize physical and verbal violence in a public hospital and to define occupationalhealth prevention and surveillance strategies. Single center observational cross-sectional study, carried amongst healthcare workers in a public hospital inLisbon. A qualitative survey was carried out through six in-depth interviews. A quantitative survey was carried through questionnairesdelivered to 32 workers. A significance level of 5% was accepted in the assessment of statistical differences. The Mann-Whitney testand the Fisher's exact test were used to calculate p values. The main results are: (1) 41 violence incidents were reported in the quantitative phase; (2) 5/21 [23.81%] victims notifiedthe incident to the occupational health department; (3) 18/21 [85.71%] victims reported a permanent state of hypervigilance; (4) 22/28[78.57%] participants self-reported poor or no familiarity with internal reporting procedures; (5) 24/28 [85.71%] participants believed itis possible to minimize workplace violence. Workplace violence is favored by unrestricted access to working areas, absence of security guards and police officersor scarce intervention. The low notification rate contributes to organizational lack of action. The state of hypervigilance reported in ourstudy reflects the negative effects of threatening occupational stressors on mental health. Our results show that workplace violence is a relevant risk factor that significantly impacts workers' health in a noxiousmanner, deserving a tailored occupational health approach whose priority areas and strategies have been determined.

Procurement and implementation processes for Occupational Health Services in Sweden.

Employers are required to get expert advice whenever needed to ensure a safe work environment. Providers of Occupational Health Services (OHS) could be such experts, but their services are usually used to provide health-related support to individuals, not preventive Occupational Health and Safety Management (OHSM) or other group-focused interventions. To investigate how contracts with OHS providers in Sweden are established and implemented. Written OHS contracts were reviewed, and follow-up interviews were conducted with Human Resource (HR) managers, management, safety representatives, and OHS professionals in seven organizations. Generally, the HR departments drew up the contracts with the OHS providers. The contracts were not integrated with the companies' occupational health and safety management. Managers lacked knowledge on how to utilize services offered by their OHS provider. Terms and conditions of contracts were found to be inconsistent with services actually utilized. The procurement and implementation process promotes reactive rather than preventive interventions. Employers should include managers and safety representatives in procurement- and implementation processes and define relevant and measurable goals regarding the collaboration.

Sickness Absence and Hospitalization among Workers on Board Norwegian Fishing Vessels

ABSTRACTBackground: All over the world, commercial fishing is known to be a hazardous occupation. Although several causal analyses of occupational accidents have been published in recent years, knowledge of the prevalence of sick leave, diagnosis and hospitalization among workers on board Norwegian fishing vessels is still sparse.Objective: The objective of this study is to provide new knowledge about the prevalence of doctor-certified sick leave among Norwegian fishers compared to an age- and gender-matched control population. A comparison of diagnoses and hospitalizations between these groups is also presented.Methods: A sample of fishers (n = 25,971) was selected by Statistics Norway (SSB), based on occupation as fishers in 2008–2013. An age- and gender-matched control population (n = 77,913) was also selected. Outpatient consultation and hospitalization data were received from the Norwegian Patient Registry (NPR).Results: Fishers have significantly lower rates of sick leave than the general working population as a whole, but a significantly higher rate sick leave than an age- and gender-matched control population. The most common cause of sick leave in both fishers and controls was musculoskeletal problems. Fishers had a higher number of hospital stays than the control group; the stays were more often unscheduled and lasted longer than those of the control group.Conclusion: The results emphasize the continued need for preventive occupational health strategies in the fishing industry.

Endangering one’s health to improve performance?

Background: Companies are increasingly applying both goal- and performance-oriented leadership practices. For employees, such indirect control practices make higher self-regulatory demands: They become responsible for their work outcomes and have to bear the consequences of failure just like the self-employed. The current study focuses on the concept of “self-endangering work behaviors” as representing a possible negative effect of indirect control and a possible mediator between work demands and negative outcomes. Method: An online survey was conducted with 607 employees, who reported to work in an indirect control setting. It assessed extension of working hours, intensification of working hours, sickness presenteeism, and faking as possible self-endangering work behaviors together with exhaustion as a subjective well-being measure. The lavaan package was used to test the mediation hypothesis with a structural equation model. Results: Results supported the assumption that self-endangering work behaviors might partly explain the association between work demands and exhaustion. A mediation effect was found for extension of working hours, intensification of working hours, and for faking. However, sickness presenteeism delivered no statistically significant mediation effect in the association between work demands and exhaustion. Discussion: As a mechanism for coping with high work demands, the new concept of self-endangering work behaviors offers one possible explanation for the negative association between high work demands and both subjective well-being and health. The concept needs to be addressed in occupational health prevention initiatives. Such interventions should balance the negative and positive effects of indirect control and take self-endangering work behavior into account.

Fostering functioning of workers: A new challenge for prevention in occupational health.

Given large changes in working conditions and society, occupational health care has to prioritize its efforts towards fostering health and functioning of workers and as such promote work participation. This requires that more emphasis is given on the application of biopsychological models in the care of workers. Although a biopsychological approach is often mentioned as essential part of occupational health care, it's application is often hampered in practice, by practical barriers and lack of practical knowledge. This is illustrated by a study that uncovered facilitating and hindering factors in the implementation process of a preventive strategy, proven effective in reducing the risk of long term sickness absence. To facilitate the use of biopsychological models in occupational health care, it is shown that setting up a training curriculum is possible, based on the International Classification of Functioning, Disability and Health (ICF) grafted on available training in evidence based practice skills is possible. Furthermore, there is a need for elaboration of the personal factors relevant for workers and the relevant work-related environmental factors to support practical application of ICF in occupational health care. A paradigm shift in occupational health care can facilitate widespread implementation of the biopsychosocial approach in occupational health and may stimulate occupational health professionals to further integrate this approach in their dailypractice.

Nudging for Prevention in Occupational Health and Safety in South Africa Using Fiscal Policies.

Currently, in some countries occupational health and safety policy and practice have a bias toward secondary prevention and workers' compensation rather than primary prevention. Particularly, in emerging economies, research has not adequately contributed to effective interventions and improvements in workers' health. This article, using South Africa as a case study, describes a methodology for identifying candidate fiscal policy interventions and describes the policy interventions selected for occupational health and safety. It is argued that fiscal policies are well placed to deal with complex intersectoral health problems and to focus efforts on primary prevention. A major challenge is the lack of empirical evidence to support the effectiveness of fiscal policies in improving workers' health. A second challenge is the underprioritization of occupational health and safety partly due to the relatively small burden of disease attributed to occupational exposures. Both challenges can and should be overcome by (i) conducting policy-relevant research to fill the empirical gaps and (ii) reconceptualizing, both for policy and research purposes, the role of work as a determinant of population health. Fiscal policies to prevent exposure to hazards at work have face validity and are thus appealing, not as a replacement for other efforts to improve health, but as part of a comprehensive effort toward prevention.

중대재해발생률 및 진도관리모델을 고려한 공사진척도별 적정 안전보건관리비 산정기법

중대재해발생률 및 진도관리모델을 고려한 공사진척도별 적정 안전보건관리비 산정기법

Managing preventive occupational health and safety activities in Danish enterprises during a period of financial crisis

The onset of the financial crisis in 2008 has put pressure on enterprises that in turn have downsized and reorganized. Research has shown that economic recession has an effect on psychological and behavioral health that is attributed to working environment problems. The objective of this study is to unravel whether the onset of a general economic recession has had an impact on companies’ and public institutions’ preventive occupational health and safety activities. Hypotheses of the role of pro-cyclical and countercyclical effects are presented. This study is based on a survey of enterprise preventive occupational health safety activities. The baseline for the survey was established, in 2006 before the onset of the recession, with a follow up in 2011. Findings are discussed that support both the pro-cyclical and the countercyclical hypotheses. It is concluded that there is a need for a special focus on the management of preventive workplace health and safety activities in enterprises during a period of economic recession.

Study on intervention of bloodborne pathogen exposure in a general hospital

Objective: To improve the awareness of bloodborne pathogen exposure protection knowledge, reduce the contact incidence (including sharp injuries, contacting with the broken skin and mucous mem-brane contact) , and increase the self-report incidence of bloodborne pathogen exposure in the healthcare work-ers of the investigated hospital after the intervention. To summarize effective prevention and intervention mea-sures of occupational exposure to bloodborne pathogen. Methods: The project was on the basis of previous inves-tigations in a general hospital, after comparing the personnel structure and departments distribution of 727 HC-Ws before the intervention and 614 HCWs after the intervention, we selected several departments in which the healthcare workers with a higher risk of occupational exposure to bloodborne pathogens. We promoted the hospi-tal to set up occupational health prevention and control system, improved related files, supplemented by knowl-edge training, discussion and field guidance, such a comprehensive intervention in the hospital. After the inter-vention, we conducted an cross-sectional investigation, and compared the rate of protection knowledge aware-ness, self-reporting rate after exposure, occupational exposure to bloodborne pathogens (including sharp inju-ries, contacting with the broken skin and mucous membrane contact) incidence before and after the intervention. Results: Before and after the intervention, the total score of the investigated population of 14 knowledge points that we focused on in training showed a significant difference (P<0.05) , total contact incidence of bloodborne pathogen exposure reduced from 81.57 persons/100 persons per year to 43.81 persons/100 persons per year, the RR of bloodborne pathogen exposure in the former investigation was 1.86 times of that in the latter investigation, the self-reported incidence increased form 2.06 persons/100persons per year to 9.45 persons/100 persons per year, self-reporting rate after exposure increased form 0.47% to 9.65%. Conclusion: The interventions signifi-cantly improved the awareness of bloodborne pathogen exposure protection knowledge, effectively reduced the contact incidence of bloodborne pathogen exposure, and increased the self-reported incidence in the healthcare workers of the investigated hospital.

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.

TB in healthcare workers in the UK: a cohort analysis 2009–2013

ObjectivesTo describe the burden of TB in healthcare workers (HCWs) in the UK and determine whether HCWs are at increased risk of TB due to occupational exposure.MethodsRetrospective cohort analysis of...

The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

Sustainability and prevention in occupational health and safety

Over the past decade, encouraging trends have been observed in many parts of the world showing a decrease in the annual number of occupational injury claims, while occupational diseases have been shown to be on the rise and can now be considered as the main cause of death at work. While preventive actions to mitigate the risks have been shown to be effective in many situations, one must acknowledge the fact that isolated actions that are taken in reaction to a hazardous situation may not always be the most efficient to prevent its recurrence. It appears that preventive actions that are taken within the workplace need to rely on much broader perspectives to ensure that their effects will be most susceptible to be permanent or long-lasting in providing a healthier and safer environment for the workers. In today’s world, the concept of sustainability is attracting considerable attention as many governments have integrated it in their economic development strategies. According to the World Health Organization (WHO), sustainable development is defined as a strategy to “meet the needs of the present world population without causing adverse effect on health and on the environment, and without depleting or endangering the global resource base, hence without compromising the ability of future generations to meet their needs”. Sustainable development relies on several principles for framing its actions, many of which can clearly be applied to occupational health and safety. These principles include the necessity for attention to be given to the health and quality of life of people, to the prevention of known risks and to the application of precaution when there is uncertainty with regard to the risks. It may thus be considered that occupational health and safety (OHS) and prevention of injuries and diseases are issues of concern with regard to sustainability. The question that now arises is how can sustainable prevention in occupational health and safety realistically be achieved? While not being exclusive, it is believed that three avenues are worth considering: 1) integration of health and safety during the design stage of equipment and buildings; 2) incorporation of occupational health and safety concerns within the organization’s business or management plan; and 3) creation of a health and safety prevention culture through training and job knowledge transmission.

How to Define the Content of a Job-Specific Worker's Health Surveillance for Hospital Physicians?

BackgroundA job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content.MethodsBased on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications.ResultsInformation from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness.ConclusionThe process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.

Work-related accidents among the Iranian population: a time series analysis, 2000-2011.

Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world. To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011. In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box-Jenkins modeling to develop a time series model of the total number of accidents. There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)12 consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE). The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.

Awareness and Utilization of Welders' Personal Protective Eye Devices and Associated Factors: Findings and Lessons From a Nigerian Population.

This study assessed commercial welders' awareness and utilization of personal protective eye devices (PPEDs), and their associations, in Enugu, Nigeria, between January and March, 2011. The participants included 343 males, age 33.9 years±10.0 SD years. The participants reported high awareness of welding-associated ocular hazards (99.4%) and PPEDs (75.2%-98.3%), but low PPED possession and utilization rates. Cost and "presumed lack of utility" were the leading barriers to PPED possession; non-utilization was mainly attributed to "user inconvenience" and "presumed lack of protective benefit." PPED utilization was significantly associated with lower educational status (p=.030) and electric welding (p<.0001). The underlying causes are amenable to preventive occupational eye health education, enhanced ergonomics and affordability of PPEDs, and legislative enforcement of their use.

Preventive occupational health interventions in the meat processing industry in upper-middle and high-income countries: a systematic review on their effectiveness.

To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes. A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they reported on an intervention among employees in the meat processing industry and with outcomes related to work or health. Studies were assessed on risk of bias, and data were synthesized by type of intervention. A total of 13 articles reporting on two randomized controlled trials and nine non-randomized intervention studies were retrieved. Studies were categorized into three topics: ergonomics programs, skin protection, and Q fever vaccination. All studies had high risk of bias. Based on four studies, there was limited evidence for workplace health and safety programs showing reductions in musculoskeletal injury severity, reduction of lost work days, and reduction of costs and claims for several musculoskeletal disorders. There was limited evidence for added rest breaks resulting in improved productivity at the end of a workday and in reductions of perceived discomfort in various body regions at the end of the workday. One study on skin protection showed reductions of eczema prevalence, although evidence was moderate. Based on four studies, there was high-quality evidence for strong effectiveness of Q fever vaccination. This review presents evidence for the effectiveness of a variety of workplace interventions. There was limited evidence for effectiveness of ergonomic interventions, moderate evidence of a skin protection intervention, and strong evidence for Q fever vaccination.