Employee Screening Research Articles

Influence of country of origin on prevalence of hepatitis B markers among employees in a small suburban hospital.

Hepatitis risk in a small suburban hospital was evaluated by laboratory screening of all hospital employees for hepatitis immunologic markers. Excluding four U.S.-born subjects who had received hepatitis vaccination, the laboratory screening revealed 21% of those tested had some hepatitis B antigen or antibody. Positive markers were found in 46% of foreign-born compared to 10% of native-born (P less than 0.001). Foreign-born participants accounted for 68% of the positive marker cases while representing only 31% of the employee population. The country of origin appeared to have a statistically significant greater importance as a determinant of hepatitis B status than occupational area in this particular hospital setting.

The low yield of routine radiographic screening of tuberculin-positive hospital employees

On the basis of limited benefit in relation to cost, mass radiographic screening for tuberculosis was challenged and abandoned in the 1970s. In the 1980s the value of such periodic screening of hospital employees with known positive tuberculin reactions was queried on the same grounds but without comparable data. We report here the results of 11 years of radiographic screening of tuberculin-positive employees of a university hospital. Although 3900 chest films were obtained at considerable cost, only one proved and six suspect cases of tuberculosis were detected, all of which were symptomatic. Even in the absence of symptoms all could have been identified by other screening criteria, five on the basis of recent tuberculin conversion and two as tuberculin-positive new employees. These data support the recent statement that periodic chest roentgenograms of hospital employees with known positive reactions to tuberculin skin testing are not justified.

A survey of hepatitis B vaccination programs for hospital employees

Hepatitis B infection is an occupational risk for certain categories of health care workers. Studies have estimated that 10% to 30% of those who are exposed to, or handle, blood frequently have serologic markers of previous hepatitis B virus (HBV) infection.le5 In 1982 an HBV vaccine became available and the Immunization Practices Advisory Committee (ACIP) recommended vaccination of highrisk individuals.6 Field trials of the vaccine have shown an 80% to 95% efficacy in preventing infection among susceptible persons; the vaccine causes no serious side effects.7* ’ Three doses are required at a total cost of approximately $100. Serologic screening, if done, and administering the vaccine are additional costs. There has been much discussion in the hospital setting regarding whether an HBV vaccination program should be instituted. A survey was designed to determine community practice in Los Angeles County hospitals regarding HBV screening and immunization of employees.

Use of GMDH to predict human dynamic strengths

This paper presents further application of the Group Method of Data Handling (GMDH), a heuristic technique. It was applied to develop non-linear polynomials to predict dynamic strengths for the knuckle to shoulder and the floor to shoulder heights. Only three anthropometric variables are needed as inputs to these models. The input variables can be measured accurately and reliably very quickly. Using these polynomials, it is possible to predict the maximum dynamic lift (MDL) of a worker and, thereby, simply employee screening and placement procedures for jobs requiring lifting. As demonstrated earlier in cases of isometric strengths, the GMDH can also be successfully used to predict dynamic strengths from body size measurements which are weakly correlated with human strengths, isometric or dynamic.

Incubation of Varicella-Zoster Virus-Reply

In Reply .—Drs Myers and Hierholzer have taken a more conservative stance than we did, both in regard to serologic screening of hospital employees and the incubation period of varicella. We have no theoretical objections to their suggestions. From a practical point of view, however, the majority of hospitals in the United States do not have ready access to either the FAMA test or ELISA. When exposure occurs, these hospitals must rely on histories of disease for infection-control decisions. Faced with personnel shortages, some hospitals may find it difficult to relieve exposed susceptible employees from patientcare duties for even short periods. We agree that hospital employees who have direct contact with pediatric or oncologic patients are excellent candidates for future varicella vaccination. This potential should encourage commercial development and distribution of appropriate serologic tests.

Cost-effectiveness of the two-step skin test for tuberculosis screening of employees in a community hospital.

To assess the frequency of the booster effect as well as the need for and the cost effectiveness of the two-step skin test for tuberculosis screening at our medical center, we conducted a pilot study from June 1980 to March 1983 with hospital and clinic employees. Six (0.4%) of 1,521 employees tested by the two-step skin test demonstrated the booster effect. The mean age of these six employees was 35 years (range, 24 to 44 yr). During the study period, 10 employees converted to a positive skin test. The booster effect would have accounted for approximately 38% (6 of 16) of those converting if the two-step testing were not performed. At our medical center, the additional cost of the two-step skin test was low and justifiable for medical and epidemiologic reasons. We suggest that each hospital review the prevalence of tuberculosis among its patient and employee populations. The need for and cost effectiveness of the two-step skin test for new hospital employees must be re-examined on the basis of these data.

Prediction of human static and dynamic strengths by modified basic GMDH algorithm

The basic group method of data handling (GMDH), with some modifications, is applied to predict human static and dynamic strengths as a function of body size. It is indicated by a comparison between GMDH models (not time-series models) and traditional regression models that GMDH improves strength prediction accuracy while using relatively fewer predictors (body size parameters). Employee screening and placement procedures for jobs requiring exertion of physical strength are simplified by this method.

Cost of hepatitis B prevention in hospital employees: post-exposure prophylaxis.

To determine the cost of post-exposure prevention of hepatitis B among hospital employees, a 12-month prospective study was conducted in six Phoenix-area hospitals. Data on reported employee accidents which involved exposure to blood and any subsequent medical attention were obtained weekly. Costs were assigned to all tests, treatments, and working time lost. For 518 potential hepatitis B exposures, the mean cost per incident was $92. Costs associated specifically with preventing hepatitis accounted for 80% of the costs. When data on these incidents were applied to a model procedure for handling potential exposures to hepatitis B, the costs increased to $109 per incident. One work-related case of clinical hepatitis B cost the hospital $13,376. A determination of total hospital costs for hepatitis B should include the direct and indirect cost of each employee case of the disease, the costs of routine serologic screening of employees, and the cost of post-exposure strategies.

Employee Rubella Screening Programs in Arizona Hospitals

One year after voluntary guidelines on rubella screening of hospital employees were issued by the Arizona Department of Health, a survey of 68 members of the Arizona Hospital Association was conducted, with an 81% response. Some form of employee rubella screening was present in only 49% of responding hospitals. Of the screening hospitals, 70% of programs had a mandatory aspect for selected employees. Administrative logistics, cost, problems encountered, and the quality and coverage of the program varied substantially among the different hospitals. Fewer than half of the screening hospitals had programs for physicians, students, or volunteers. Verbal histories of immunization or serological tests, although notoriously unreliable, were accepted by 14% of the screening hospitals. Half of the nonscreening hospitals plan to implement programs in the future. Reasons given for not establishing rubella screening programs include cost, no pediatric or obstetric service, liability issues, high turnover, and no previous case of rubella in an employee. Three hospitals (all screening) reported they had had a case of rubella in an employee. The data suggest slow partial compliance with recommendations for rubella screening in hospitals.

Employee rubella screening programs in Arizona hospitals

One year after voluntary guidelines on rubella screening of hospital employees were issued by the Arizona Department of Health, a survey of 68 members of the Arizona Hospital Association was conducted, with an 81% response. Some form of employee rubella screening was present in only 49% of responding hospitals. Of the screening hospitals, 70% of programs had a mandatory aspect for selected employees. Administrative logistics, cost, problems encountered, and the quality and coverage of the program varied substantially among the different hospitals. Fewer than half of the screening hospitals had programs for physicians, students, or volunteers. Verbal histories of immunization or serological tests, although notoriously unreliable, were accepted by 14% of the screening hospitals. Half of the nonscreening hospitals plan to implement programs in the future. Reasons given for not establishing rubella screening programs include cost, no pediatric or obstetric service, liability issues, high turnover, and no previous case of rubella in an employee. Three hospitals (all screening) reported they had had a case of rubella in an employee. The data suggest slow partial compliance with recommendations for rubella screening in hospitals. (<i>JAMA</i>1983;249:2675-2678)

An Analysis of Isometric and Isokinetic Spinal Lifting Motions

Low back pain is a condition which, at some time, affects over half of the world's population and is also the number one cause of physical limitation for persons under 45 years of age. The etiology of most low back pain largely is unknown. However, it is known that after injury the biomechanics of the back change drastically. The present study investigates the ability of normal men and women to move and exert force with the back (as is done during lifting). Twenty men and women were monitered as they attempted to exert maximal force with the back under isometric and isokinetic conditions. The back angle and velocity of movement were controlled while torque, intra-abdominal pressure and the electromyographic activity of the ten trunk muscles monitored. The relationship between isometric and isokinetic exertions was determined as well as the interactive contribution of muscle forces and abdominal pressure to spinal loading. These results suggest new manual material handling implications as well as a new method for employee screening.

Hospital Infection Control for Varicella Zoster Virus Infection

More than 500 hospital employees and 209 patients were exposed to varicella zoster virus (VZV) as a consequence of 22 uncontrolled hospital introductions that occurred over a period of 34 months. Five introductions of varicella were by hospital employees who acquired the infection outside the hospital. Successful infection control of VZV requires an accurate definition of the susceptible population and the limitation of transmission. Individuals with prior VZV infection are epidemiologically not at risk for developing clinical illness. Serologic screening of hospital employees with uncertain prior VZV history is effective in identifying those at risk of developing the infection. A prior history of intimate exposure to VZV does not imply immunity in the absence of clinical illness.

Inadequate sensitivity of tuberculin tine test for screening employee populations.

Tuberculin Tine and Mantoux skin tests were simultaneously applied to opposite arms of 1,065 medical center employees during their usual preemployment and annual health examinations for the purpose of evaluating the Tine test sensitivity. Of 829 skin tests read, 39 (5%) were positive by the Mantoux method. Tine tests were positive in 27 of the 39: a sensitivity of 69% and a false-negative rate of 31%. In view of these results, the tuberculin tine test is not sensitive enough and is not indicated for employee screening programs when finding tuberculosis infection, and not disease, is the primary goal.

British Food Journal Volume 83 Issue 1 1981

Pre‐employment medical examinations with appropriate testing are required in many industries—a basic tenet of Occupational Medicine—and it has long been a recommendation of many in community medicine and environmental health for those food handlers whose close contact with open food, aspects of its preparation, processing, sale, exposure for sale, make their personal health important and in prevention of diseases and may constitute a health hazard to food consumers. Epidemiological studies have revealed too many instances of a human source of disease, especially in milk and water, for this to be denied or under‐estimated. Food poisioning outbreaks caused by a carrier, of chronic or limited duration, enable those investigating such outbreaks to see there could be advantages in medical screening of certain employees especially in certain areas of food trades. The main problem is to decide the extent of the discipline and who should be subject to it. The fact that by far the majority of the examinations and tests will prove negative should not be seen as removing the need for the service. After all, there are a number of similar circumstances in public health. Meat inspection, for example, in which a 100% inspection of all food animals slaughtered for human food is now fully established, it is not suggested that inspections should in any way be reduced despite the fact that a number of the diseases, eg., tuberculosis, no longer occurs as it once did, which was the prime cause of meat inspection being brought into being. Other areas where routine medical examinations reveal satisfactory health with only a few isolated cases requiring attention, is the school medical service. Here, the “de‐bunkers” have had some success, but if children are not regularly examined at vulnerable age levels and especially in between where the occasion demands, there is no question that much will be missed and ill‐health progress to a chronic state.

DETECTION OF DECEPTION IN THE EMPLOYMENT CONTEXT: A REVIEW AND CRITICAL ANALYSIS

Empirical research on the validity of the polygraph, voice stress analysis, and paper and pencil instruments as mechanisms for the detection of deception is reviewed. It is noted that while these devices have their greatest use in the employment context, virtually all research has been done in an actual or simulated criminal investigation context. Three separate uses of devices for the detection of deception in the employment context are identified, namely, pre‐employment screening, periodic screening of current employees, and investigation into a specific theft. Differences between each of these uses and the criminal investigation context are identified, and issues limiting the generalizability of research findings from one context to another are raised. Among the issues are the effects of a low base rate of guilt on accuracy, the effects of making multiple judgments on overall accuracy, and the potential for racial or ethnic bias in judgments of guilt or innocence.

Cigarette smoke in enclosed public facilities.

A portable carbon monoxide detector (catalytic electrode) was used to record carbon monoxide concentrations in enclosed public facilities, including night clubs, bars, restaurants, stores, hospitals, and public transit vehicles. The highest concentrations of carbon monoxide were found in night clubs, where evening indoor readings averaged 13.4 ppm, which was 4.1 +/- 1.5 ppm higher than outdoor readings. In one poorly ventilated establishment, values ranged from 20 to 40 ppm, with substantial gradients around the room. Adequate ventilation and screening of restaurant employees for ischemic heart disease should prevent problems from cigarette-induced build-up of carbon monoxide. Unfortunately, much lower concentrations of other constituents of smoke cause symptoms and changes of pulmonary function in the nonsmoker. If carbon monoxide is used as an indicator of cigarette smoke accumulation, concentrations should not exceed ambient readings by more than 5 ppm.

Maintenance of an Eye Protection Programme

The maintenance of an Eye Protection Programme is a logical extension of the implementation and introduction of that programme. There is no real line of demarcation where one finishes and the other begins, thus It Is difficult to avoid some duplication in presenting the follow-up programme. The success of the maintainance programme will therefore be directly dependent on the way in which the implementation was introduced. In addition there will be a number of other factors which will require careful planning and the continual Involvement of competent personnel to ensure that the initial success is maintained. Provision must be made for maintaining the programme in all respects. It must be soundly based and give proper and due regard to the personal requirements of the individual employee to ensure that his co-operation Is forthcoming. This will entail adequate repair and replacement facilities; prompt attention to complaints of dissatisfaction; provision for visual screening of new employees; and in particular professional examination of employees where changing vision and prescription eye-wear Is concerned. All planning and procedures Introduced for the maintenance of an Eye Protection Programme must be directed towards the ultimate goal of eliminating eye injuries in the work environment.

RPM Correlates of Attitudes toward Delinquency: Before and after Contact with Delinquents

The co-operative and submissive roles of the RPM were related to “unfavorable” attitudes of 24 staff persons toward delinquency both before and after contact with delinquents. After contact with delinquents, the permissive role was related to “favorable” attitudes toward delinquency. Such findings indicate that the RPM might be successfully used in the screening of prospective employees who are to work with delinquents.

Rapid Determination of Lead in Urine by Ion Exchange

Abstract For routine screening of employees in the lead industry, a method for determination of urinary lead was developed in which this element is removed from urine by means of a chelating agent, eluted, and determined by a modified dithizone method. The method gives values which are about 5% below those obtained by the wet ashing technic, with a precision of ± 2.1% in the range of 2-15 µg. of lead per 50 ml. urine sample. The advantages of the method are that it requires only about 1 hr. to carry out, is convenient, and avoids the time-consuming and potentially hazardous wet ashing step.

Occupational health problems in an industrial society.

When the medical student of today begins to think about his future professional career, he is often confused by the multiplicity of choices for his life work. Until recently, little or no importance has been given to a relatively new, very broad, and challenging field. It is my purpose to explore, and to some extent define, the present developments in a new specialty and perhaps a new era in public health in a field called occupational health. Industrial medicine has grown up empirically to serve a need. Industry had first to provide medical care for its workers who received traumatic injuries on the job. This expanded subsequently into the screening of employees both before hiring and during employment to explore their physical fitness and to provide for their proper placement. During the earlier period accident and compensation insurance developed as a means of financing the treatment and care of those