Health Surveillance Of Workers Research Articles

Mental Vitality @ Work: The effectiveness of a mental module for workers’ health surveillance for nurses and allied health professionals, comparing two approaches in a cluster-randomised controlled trial

The aim of this study was to compare two approaches for a worker's health surveillance (WHS) mental module on work functioning and work-related mental health. Nurses and allied health professionals from one organisation were cluster-randomised at ward level to e-mental health care (EMH) (N = 579) or occupational physician care (OP) (N = 591). Both groups received screening and personalised feedback on impaired work functioning and mental health. Positively screened participants received an invitation to follow a self-help EMH intervention, or for a consultation with an OP. The primary outcome was impaired work functioning. Follow-up was performed after 3 and 6 months. Linear mixed models were applied to determine differences. Non-inferiority of the EMH-care approach was demonstrated if the mean absolute improvement on work functioning in the OP-care group was ≤10 points higher than the EMH-care group. Analyses were performed on the positively screened participants (almost 80 %) (EMH N = 75; OP N = 108) and all participants (EMH N = 98; OP N = 142). Both groups improved over time regarding impaired work functioning. A considerable percentage of participants had improved relevantly at follow-up regarding work functioning (3 months: EMH 30 %, OP 46 %; 6 months: EMH 36 %, OP 41 %) compared to baseline. No statistically significant differences were found between the groups, and the difference did not exceed the pre-defined criterion for non-inferiority. The OP-care approach for a WHS mental module trended towards better performance in targeting work functioning, but our findings indicate that the EMH-care approach was non-inferior. However, the high dropout rate and low compliance to EMH interventions should be taken into account.

Mental Vitality @ Work—A Workers' Health Surveillance Mental Module for Nurses and Allied Health Care Professionals

To evaluate the process of workers' health surveillance (WHS) targeting work functioning and mental health of health care professionals, alongside a randomized controlled trial comparing two strategies. Nurses and allied health care professionals working in one hospital were invited. Process indicators were assessed using methods such as questionnaires and track-and-trace data. All participants (32%; N = 369) received screening and personalized feedback. In group 1, 41% went to a preventive consultation with their occupational physician. Protocol adherence of participating occupational physicians (n = 5) was high. They regarded the WHS mental module to be meaningful. In group 2, 16% logged into an e-mental health intervention. Most participants would appreciate a future offer of the WHS. The WHS mental module was well received and fitted in the occupational health service activities. Nevertheless, response and compliance should be improved.

Improving occupational health care for construction workers: a process evaluation

BackgroundTo evaluate the process of a job-specific workers’ health surveillance (WHS) in improving occupational health care for construction workers.MethodsFrom January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received.ResultsReach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation.ConclusionsProgramme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect to the intervention were the most prominent aspects that influenced the intervention process. The increase in the workers’ knowledge about their health status and work ability was substantial, and the workers’ satisfaction with the intervention was good. The perceived effect of the advised preventive actions on health status was sufficient.Trial registrationNetherlands Trial Register: http://NTR3012

Three-year follow up of primary health care workers trained in identification of blind and visual impaired children in Malawi

Background: Control of blindness in children is one of the priorities of VISION 2020. Early detection of children needing eye services is essential to achieve maximum visual recovery. Even though training primary (community) Health care workers (PHC) should play an important role in early identification of children, it is not known how many of these workers leave after being trained, and whether those who remain continuing identifying children in the long term. The objectives of the study were to determine the attrition of primary health workers over a 3-year period after training, and to assess their knowledge and skills on cataract in children in southern Malawi. Methods: This was a cohort study that followed primary health care workers (health surveillance assistants) over a 3-year period from 2008 to 2011 and reassessed their attrition rates, knowledge and skills on cataract in children. Results: Among the 59 HSAs that were originally trained in 2008, 54 (92%) were interviewed and were found to be still working in the health sector. Knowledge regarding cataract blindness in children remained constant over the 3-year period, however, only two HSAs had reported identifying and referring children. Conclusion: Despite attrition among primary health care workers being low, only a few actually identify cataract children in the communities after being trained. Other innovative ways are needed to identify prevalent and incident cases in Malawi, as the use of HSAs is unlikely to be successful in addressing blindness in children.

Serosurvey Against H5 and H7 Avian Influenza Viruses in Italian Poultry Workers

Highly pathogenic (HP) and low pathogenic (LP) avian influenza viruses (AIVs) belonging to H5 and H7 subtypes have been found to be associated with human infection as the result of direct transmission from infected poultry. Human infections by AIVs can cause mild or subclinical disease, and serosurveys are believed to represent an important tool to identify risk of zoonotic transmission. Therefore, we sought to examine Italian poultry workers exposed during LPAI and HPAI outbreaks with the aim of assessing serologic evidence of infection with H5 and H7 AIVs. From December 2008 to June 2010 serum samples were collected from 188 poultry workers and 379 nonexposed controls in Northern Italy. The hemagglutination inhibition (HI) assay using horse red blood cells (RBCs) and a microneutralization (MN)-enzyme-linked immunosorbent assay test were used to analyze human sera for antibodies against the following H5 and H7 LPAI viruses: A/Dk/It/4445/07(H5N2); A/Ty/It/2369/09(H5N7); A/Ty/It/218-193/ 10; A/Ck/It/3775/99(H7N1); A/Ty/It/214845/03(H7N3); and A/Dk/It/332145/09(H7N3). Since previous studies identified low antibody titer to AIVs in people exposed to infected poultry, a cutoff titer of > or = 1:10 was chosen for both serologic assays. Only HI-positive results confirmed by MN assay were considered positive for presence of specific antibodies. The Fisher exact test was used to analyze differences in seroprevalence between poultry workers and control groups, with the significance level set at P < 0.05. MN results showed a proportion of H7-seropositive poultry workers (6/188, i.e., 3.2%), significantly higher than that of controls (0/379), whereas no MN-positive result was obtained against three H5 LPAI subtypes recently identified in Italy. In conclusion, the survey indicated that assessing seroprevalence can be an important tool in risk assessment and health,surveillance of poultry workers.

Adverse effects of low occupational cadmium exposure on renal and oxidative stress biomarkers in solderers

ObjectivesRecent studies suggest adverse health effects after low exposure to cadmium (Cd). Brazing with Cd-containing solder exposes workers to Cd. The purpose of this study was to assess: (1) indicators...

A Road Map Toward a Globally Harmonized Approach for Occupational Health Surveillance and Epidemiology in Nanomaterial Workers

Few epidemiological studies have addressed the health of workers exposed to novel manufactured nanomaterials. The small current workforce will necessitate pooling international cohorts. A road map was defined for a globally harmonized framework for the careful choice of materials, exposure characterization, identification of study populations, definition of health endpoints, evaluation of appropriateness of study designs, data collection and analysis, and interpretation of the results. We propose a road map to reach global consensus on these issues. The proposed strategy should ensure that the costs of action are not disproportionate to the potential benefits and that the approach is pragmatic and practical. We should aim to go beyond the collection of health complaints, illness statistics, or even counts of deaths; the manifestation of such clear endpoints would indicate a failure of preventive measures.

El servicio de seguridad y salud en el trabajo

El artículo sostiene que, principalmente, a partir de la aprobación de la ley 29783, Ley de Seguridad y Salud en el Trabajo, se viene interiorizando la importancia de la implementación de regulaciones y medidas que refuercen o enfaticen la seguridad y salud en el trabajo. Sin embargo, se recalca que hasta que aparezca la norma reglamentaria de la ley, las empresas como los trabajadores tendrán que velar por implementar un servicio que consideren —técnicamente— idóneo a su centro de labores sin tener un referente normativo claro, puesto que, la ley no detalla la ejecución de un servicio de seguridad y salud en el trabajo. Al respecto, el documento técnico denominado «Protocolos de Exámenes Médico Ocupacionales y Guías de Diagnóstico de los Exámenes Médicos Obligatorios por Actividad», contiene una serie de regulaciones que permite integrar e implementar un servicio adecuado y apropiado de vigilancia en la salud de los trabajadores

Inconsistencies in Guidelines for Visual Health Surveillance of VDT Workers

In Europe, 25% of workers use video display terminals (VDTs). Occupational health surveillance has been considered a key element in the protection of these workers. Nevertheless, it is unclear if guidelines available for this purpose, based on EU standards and available evidence, meet currently accepted quality criteria. The aim of this study was to appraise three sets of European VDT guidelines (UK, France, Spain) in which regulatory and evidence-based approaches for visual health have been formulated and recommendations for practice made. Three independent appraisers used an adapted AGREE instrument with seven domains to appraise the guidelines. A modified nominal group technique approach was used in two consecutive phases: first, individual evaluation of the three guidelines simultaneously, and second, a face-to-face meeting of appraisers to discuss scoring. Analysis of ratings obtained in each domain and variability among appraisers was undertaken (correlation and kappa coefficients). All guidelines had low domain scores. The domain evaluated most highly was Scope and purpose, while Applicability was scored minimally. The UK guidelines had the highest overall score, and the Spanish ones had the lowest. The analysis of reliability and differences between scores in each domain showed a high level of agreement. These results suggest current guidelines used in these countries need an update. The formulation of evidence-base European guidelines on VDT could help to reduce the significant variation of national guidelines, which may have an impact on practical application.

Circuit board accident – organizational dimension hidden by prescribed safety

This study analyzes an accident in which two maintenance workers suffered severe burns while replacing a circuit breaker panel in a steel mill, following model of analysis and prevention of accidents (MAPA) developed with the objective of enlarging the perimeter of interventions and contributing to deconstruction of blame attribution practices. The study was based on materials produced by a health service team in an in-depth analysis of the accident. The analysis shows that decisions related to system modernization were taken without considering their implications in maintenance scheduling and creating conflicts of priorities and of interests between production and safety; and also reveals that the lack of a systemic perspective in safety management was its principal failure. To explain the accident as merely non-fulfillment of idealized formal safety rules feeds practices of blame attribution supported by alibi norms and inhibits possible prevention. In contrast, accident analyses undertaken in worker health surveillance services show potential to reveal origins of these events incubated in the history of the system ignored in practices guided by the traditional paradigm.

Evaluation of the national health surveillance program of workers previously exposed to asbestos in Spain (2008)

ObjectivesAlthough asbestos was banned in Spain in 2001, monitoring the health of previously-exposed workers is required. In 2002 the Ministry of Health and the autonomous regions of Spain planned a health surveillance program for workers exposed to asbestos (Programa de Vigilancia de la Salud de los Trabajadores Expuestos al Amianto [PIVISTEA]) with employers’ organizations, trade unions and scientific societies. The aim of this study was to evaluate the PIVISTEA to improve its effectiveness. MethodsA questionnaire with indicators for the year 2008 was sent to Spain's 17 autonomous regions, as well as to the autonomous cities of Ceuta and Melilla. The results were analyzed by evaluating the compliance of each program with the activities established by the PIVISTEA. ResultsIn December 2008, a total of 22,158 workers from 14 autonomous regions and 306 companies were included in the program. The program had been started in 88% of the regions but surveillance activities remained scarce in 24%. Fifty-seven percent of the autonomous regions (69% of the total number of workers) provided the information requested. Seven autonomous regions provided data on the relationship between the diseases found and asbestos exposure. Only 5% of these diseases entitled affected individuals to receive compensation for occupational diseases. ConclusionsThe health surveillance of workers previously exposed to asbestos in Spain, as well as medical-legal recognition of diseases caused by exposure at work, remain in adequate. Although the trend is positive, the effectiveness of many regional programs is limited, and inter-regional inequalities among affected workers have been detected.

Acidentes com material biológico relacionados ao trabalho: análise de uma abordagem institucional

RESUMO OBJETIVO: analisar o perfil de relatórios, instrumentos de registros e fluxos de tratamento, notificações, acompanhamentos, profilaxias e encaminhamentos devidos a acidentes causados por material perfurocortante em trabalhadores de saúde em uma instituição de saúde pública. Métodos: a coleta de dados usou um questionário semiestruturado aplicado aos profissionais responsáveis pelos registros de acidentes e avaliou os formulários utilizados em três setores da instituição de estudo. RESULTADOS: foram analisados 134 registros de acidentes biológicos. Quando comparamos os registros da instituição com os 50 registrados no mesmo período pelo banco de dados da Secretaria Municipal de Saúde do Rio de Janeiro, apenas 11 casos foram concordantes. Também identificamos falta de padronização nos formulários utilizados, fluxos diferentes e falta de registros de investigações dos casos, além de ausência de acompanhamento do desfecho dos acidentes. CONCLUSÃO: constataram-se subnotificação e discordância entre as fontes. Um formulário de registro para acidentes biológicos foi elaborado para informações de notificação e investigações, bem como criado um programa para monitorar acidentes causados por material perfurocortante, visando melhorar a vigilância de saúde dos trabalhadores da instituição.

Occupational health surveillance for the workers at high temperature in a industrial zone

为保证劳动者的权益和身心健康,为了职业健康监护监督工作的顺利开展,我们分析了苏州工业园区近3年来高温作业人员的职业健康监护资料,报道如下.一、资料与方法1.资料:苏州工业园区2008至2010年高温作业人员岗前、岗中、离岗职业健康监护资料.高温作业人员主要涉及出炉工、浇铸工、炉前工、熔炉工、机动锻工等.2.方法:根据GBZ 188-2007《职业健康监护技术规范》对2008至2010年高温作业人员进行职业健康检查,检查项目包括:(1)症状询问:重点询问心血管系统、泌尿系统及神经系统症状,如心悸、胸闷、恶心、呕吐、腹痛、反酸、上腹部疼痛、多饮、多尿、血尿、头痛、晕眩等;(2)体检:内科常规检查,重点进行心血管系统检查;(3)实验室检查:进行血常规、尿常规、血清中丙氨酸转氨酶(ALT)、心电图、血糖检测,有甲状腺亢进病史或检查有异常者进行血清中游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、促甲状腺激素(TSH)检测。

Which subgroups of fire fighters are more prone to work-related diminished health requirements?

PurposeTo determine whether certain subgroups of fire fighters are prone to work-related diminished health requirements.MethodsThe health requirements for fire-fighting were tested in a workers’ health surveillance (WHS) setting. These health requirements included psychological, physical and sense-related components as well as cardiovascular risk factors. The odds ratio (OR) and 95% confidence interval (95% CI) for the presence of the diminished health requirements were calculated for the subgroups of gender, professionalism and age.ResultsThe prevalence of diminished psychological requirements was equivalent among the subgroups, and no significant high-risk group was identified. As compared to men fire fighters, women fire fighters were more likely to have diminished physical requirements (OR 28.5; 95% CI 12.1–66.9) and less likely to have cardiovascular risk factors (OR 0.3; 0.1–0.5). As compared to volunteer fire fighters, professionals were less likely to have diminished physical requirements (OR 0.5; 0.3–0.9), but professionals had a higher prevalence of cardiovascular risk factors with an odds ratio of 1.9 (1.1–3.2). As compared to the youngest fire fighters, the oldest fire fighters were more likely to have diminished sense-related requirements (OR 7.1; 3.4–15.2); a similar comparison could be made between oldest and middle-aged fire fighters (OR 5.1; 2.5–10.5). In addition, the oldest fire fighters were more likely to have cardiovascular risk factors when compared to the youngest (OR 4.4; 1.7–11.1) and to the middle-aged fire fighters (OR 3.1; 1.2–7.9).ConclusionsSubgroups (gender, professionalism and age) of fire fighters are prone to at least one specific work-related diminished health requirement. Therefore, parts of the WHS could be applied with more attention to these high-risk groups.

A trial of a job-specific workers' health surveillance program for construction workers: study protocol

BackgroundDutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians.Methods/DesignThe ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement.DiscussionThis study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS.Trial registrationNTR3012

Feasibility and Acceptability of Workers’ Health Surveillance for Fire Fighters

ObjectivesThe objective of this study was to test the feasibility and acceptability of a new workers' health surveillance (WHS) for fire fighters in a Dutch pilot-implementation project.MethodsIn three fire departments, between November 2007 and February 2009, feasibility was tested with respect to i) worker intent to change health and behavior; ii) the quality of instructions for testing teams; iii) the planned procedure in the field; and iv) future WHS organisation. Acceptability involved i) satisfaction with WHS and ii) verification of the job-specificity of the content of two physical tests of WHS. Fire fighters were surveyed after completing WHS, three testing teams were interviewed, and the content of the two tests was studied by experts.ResultsFeasibility: nearly all of the 275 fire fighters intended to improve their health when recommended by the occupational physician. The testing teams found the instructions to be clear, and they were mostly positive about the organisation of WHS. Acceptability: the fire fighters rated WHS at eight points (out of a maximum of ten). The experts also reached a consensus about the optimal job-specific content of the future functional physical tests.ConclusionOverall, it is feasible and acceptable to implement WHS in a definitive form in the Dutch fire-fighting sector.

Reintroduction into the job market of former workers with RSI of an electronics industry in São Paulo metropolitan area, Brazil

ObjectivesThis study addresses chronic illness due to work as a factor of social and economic exclusion, analysing the process of reintegration into the labour market of workers with repetitive strain...

Feasibility of Biomarker Studies for Engineered Nanoparticles

Occupational exposure to engineered nanoparticles (NP) may pose health risks to the workers. This article is to discuss the feasibility of identifying biomarkers that are associated with NP exposure. Scientific literature on the adverse health effects of ambient ultrafine particles (UFP) and NP was reviewed to discuss the feasibility of conducting biomarker studies to identify NP-induced early biological changes. Various approaches for biomarker studies have been identified, including potential injury pathways that need to be considered and the methodologies that may be used for such studies. Although NP may have novel mechanisms of injury, much can be learned from our experience in studying UFP. Oxidative stress-related pathways can be an important consideration for identifying NP-associated biomarkers, and one of the most effective approaches for such studies may be proteome profiling. Biomarker studies will provide valuable information to identify early biological events associated with the adverse health effects of engineered nanomaterials before the manifestation of clinical outcomes. This is particularly important for the health surveillance of workers who may be at higher risk due to their occupational settings.

The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals.

BackgroundEmployees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective.MethodsThe study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group) with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in both intervention arms will be assessed, and a process evaluation will be performed.DiscussionWhen it is proven effective compared to a control group, a WHS mental module for nurses and allied health professionals could be implemented and used on a regular basis by occupational health services in hospitals to improve employees' mental health and work functioning.Trial RegistrationNTR2786

A systematic review of job-specific workers’ health surveillance activities for fire-fighting, ambulance, police and military personnel

Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs. The search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers' health surveillance. The methodological quality was checked. At least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, 'physical' (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines. Several examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying job-specific WHS in effectiveness studies.