Category Archives: Health & Safety

Long working hours as a risk factor for atrial fibrillation: a multi-cohort study

Source: Mika Kivimäki, Solja T. Nyberg, G. David Batty, Ichiro Kawachi, Markus Jokela, et al, European Heart Journal, July 13, 2017

From the abstract:
Aims:
Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (≥55 per week) and those working standard 35–40 h/week.

Methods and results:
In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991–2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI = 1.13–1.80, P = 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I2 = 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N = 2006, hazard ratio = 1.36, 95% CI = 1.05–1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association.

Conclusion:
Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

Computer-based training (CBT) intervention reduces workplace violence and harassment for homecare workers

Source: Nancy Glass, Ginger C. Hanson, W. Kent Anger, Naima Laharnar, Jacquelyn C. Campbell, Marc Weinstein and Nancy Perrin, American Journal of Industrial Medicine, Vol 60 Issue 7, July 2017
(subscription required)

From the abstract:
Background: The study examines the effectiveness of a workplace violence and harassment prevention and response program with female homecare workers in a consumer driven model of care.

Methods: Homecare workers were randomized to either; computer based training (CBT only) or computer-based training with homecare worker peer facilitation (CBT + peer). Participants completed measures on confidence, incidents of violence, and harassment, health and work outcomes at baseline, 3, 6 months post-baseline.

Results: Homecare workers reported improved confidence to prevent and respond to workplace violence and harassment and a reduction in incidents of workplace violence and harassment in both groups at 6-month follow-up. A decrease in negative health and work outcomes associated with violence and harassment were not reported in the groups.

Conclusion: CBT alone or with trained peer facilitation with homecare workers can increase confidence and reduce incidents of workplace violence and harassment in a consumer-driven model of care.

Workers Need a Bill of Rights

Source: Andrew Strom, OnLabor blog, May 24, 2017

Except for about a month in the summer of 2009 when the Democrats had 60 votes in the Senate, for the entire twenty-first century any proposal to substantially increase workers’ rights at the national level has had to be prefaced by the comment that, “of course, this is not politically feasible now.” But rather than just spending the next four years fending off misguided Republican legislation, I think it’s time to step back and focus on principles that should guide workplace legislation. Toward that end, here are some thoughts on a potential workplace bill of rights.

There might be some other rights that should be included in this list, and maybe folks have ideas about better ways to phrase the various rights. But, I think it would be helpful for the labor movement, worker advocates, and the Democratic party to start talking about this bill of rights in order to refocus our discussion about jobs. The measure of a good job, whether it is in manufacturing or the service sector, should be whether it provides these rights to workers. In addition, we should be thinking about what changes we need to see in our laws to ensure that all workers enjoy these basic rights on the job. Some of these issues can be addressed at the state level, although of course, that would mean that these rights would exist in only a handful of states. Here’s my proposed worker bill of rights – let the debate begin…..

Maternal occupational physical activity and risk for orofacial clefts

Source: A. J. Agopian, Jihye Kim, Peter H. Langlois, Laura Lee, Lawrence W. Whitehead, Elaine Symanski, Michele L. Herdt, George L. Delclos, American Journal of Industrial Medicine, Early View, May 19, 2017
(subscription required)

From the abstract:
Objectives
To perform a case-control study of maternal occupational physical activity and risk for orofacial clefts in Texas during 1999-2009.

Methods
We used logistic regression to assess 14 measures of physical activity estimated from a job exposure matrix, using the maternal occupation reported on the birth certificate, among 887 children with cleft lip with or without cleft palate (CLP), 436 children with cleft palate only (CP), and 1932 controls.

Results
After adjusting for several potential confounders, seven measures of physical activity (as a categorical and/or continuous variable) were significantly associated with CLP, CP, or both. Positive associations were seen for keeping balance, kneeling, standing, and walking/running (odds ratio 95% confidence interval range 1.0-1.9 for fourth versus first quartile). A significant positive trend was also seen for bending/twisting. Negative associations were seen for repetitive motion and sitting.

Conclusions
Maternal occupational physical activity may be related to the etiology of orofacial clefts.

Psychosocial work factors and low back pain in taxi drivers

Source: Barbara J. Burgel, Rami A. Elshatarat, American Journal of Industrial Medicine, Online First, May 19, 2017
(subscription required)

From the abstract:
Introduction
Taxi drivers are at high risk for low back pain (LBP).

Aim
Identify the association between psychosocial-work factors (Job strain, Iso-strain, effort-reward imbalance [ERI], unfairness, and mental exertion) and LBP in taxi drivers.

Methods
A cross-sectional study was done with 129 taxi drivers.

Results
Approximately 63% reported LBP in the prior 12 months. Chi square or t-test analyses identified the associations between demographic, work, health, and psychosocial work factors, and self-report of LBP in the prior 12 months. Depression, perceived physical exertion, dispatcher and manager support, unfair treatment at work, and unfair treatment due to nationality were significantly associated with LBP in bivariate analyses. Multivariate logistic regression was done to identify the predictors of LBP. High dispatcher support remained the sole significant predictor for lower prevalence of LBP (OR = 0.66, P = 0.017).

Conclusion
Greater understanding of psychosocial work factors may aid in developing interventions to prevent LBP in taxi drivers.

Evaluation of a state based syndromic surveillance system for the classification and capture of non-fatal occupational injuries and illnesses in New Jersey

Source: Marija Borjan, Margaret Lumia, American Journal of Industrial Medicine, Online First, May 23, 2017
(subscription required)

From the abstract:
Background
This preliminary study evaluates a real-time syndromic surveillance system to track occupationally-related emergency room visits throughout New Jersey.

Methods
Emergency Department (ED) chief complaint fields were evaluated from 79 of 80 hospitals in NJ in 2014, using work-related keywords and ICD-9 E-codes, to determine its ability to capture non-fatal work-related injuries. Sensitivity analysis and descriptive statistics, were used to evaluate and summarize the occupational injuries identified.

Results
Overall, 11 919 (0.3%) possible work-related ED visits were identified from all ED visits. Events with the greatest number of ED visits were slips, trips, and falls (1679, 14%). Nature of injury included cuts, lacerations (1041, 9%). The part of the body most affected was the back (1414, 12%). This work-related classifier achieved a sensitivity of 5.4%, a specificity of 99.8%, and a PPV of 2.8%.

Conclusions
This evaluation demonstrated that the syndromic surveillance reporting system can yield real-time knowledge of work-related injuries.

Implementation of a resident handling programme and low back pain in elder care workers

Source: Andreas Holtermann, Occupational & Environmental Medicine, Volume 74, Issue 6, 2016
(subscription required)

From the introduction:
Low back pain (LBP) is the most important contributor to number of years lived with a disability and a major risk factor for sickness absence and work disability. Occupational groups with physically demanding work, like healthcare workers, have particularly high prevalence of LBP, and a considerable fraction of the LBP is considered to be caused by work-related factors. Moreover, LBP is a particular barrier for sustainable employment among workers with physically demanding work. Therefore, implementation of equipment (mechanical lifts or other assistive devices) for reducing the mechanical loading of healthcare workers during manual handling of residents should theoretically be efficient for preventing LBP and sickness absence among those with LBP. However, interventions implementing equipment for reducing the mechanical loading on healthcare workers during manual handling of residents show conflicting results on LBP. This might be due to the relatively short follow-up period of previous intervention studies introducing equipment for manual handling, which may need longer time before being fully implemented in an organisation. Moreover, it can be caused by lacking repetitive measures of both the implementation of the intervention as well as the often fluctuating level of LBP. Thus, there is a research gap in the documentation of the effects on LBP

Cost-Benefit Analysis of a Support Program for Nursing Staff

Source: Dane Moran; Albert W Wu; Cheryl Connors; Meera R Chappidi; Sushama K Sreedhara; Jessica H Selter; William V Padula, Journal of Patient Safety, Published Ahead-of-Print, April 27, 2017
(subscription required)

From the abstract:
OBJECTIVES
A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit.

METHODS
A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital.

RESULTS
Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program.

CONCLUSIONS
The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET)

Source: Samuel R. Huntley, David J. Lee, William G. LeBlanc, Kristopher L. Arheart, Laura A. McClure, Lora E. Fleming and Alberto J. Caban-Martinez, American Journal of Industrial Medicine, Vol. 60 no. 6, June 2017
(subscription required)

From the abstract:
Background:
Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain.

Methods:
We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET).

Results:
Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%].

Conclusions:
Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.

The impact of body armor on physical performance of law enforcement personnel: a systematic review

Source: Colin Tomes, Robin Marc Orr, Rodney Pope, Annals of Occupational and Environmental Medicine, Vol. 29 no. 14, December 2017, First Online: May 16, 2017

From the abstract:
Background:
The law enforcement officer profession requires performance of arduous occupational tasks while carrying an external load, consisting of, at minimum, a chest rig, a communication system, weaponry, handcuffs, personal protective equipment and a torch. The aim of this systematic review of the literature was to identify and critically appraise the methodological quality of published studies that have investigated the impacts of body armour on task performance and to synthesize and report key findings from these studies to inform law enforcement organizations.

Methods:
Several literature databases (Medline, CINAHL, SPORTDiscus, EMBAS) were searched using key search words and terms to identify appropriate studies. Studies meeting the inclusion criteria were critically evaluated using the Downs and Black protocol with inter-rater agreement determined by Cohen’s Kappa.

Results:
Sixteen articles were retained for evaluation with a mean Downs and Black score of 73.2 ± 6.8% (k = 0.841). Based on the research quality and findings across the included studies, this review determined that while effects of body armour on marksmanship and physiological responses have not yet been adequately ascertained, body armour does have significant physical performance and biomechanical impacts on the wearer, including: a) increased ratings of perceived exertion and increased time to complete functional tasks, b) decreased work capability (indicated by deterioration in fitness test scores), c) decreased balance and stability, and d) increased ground reaction forces.

Conclusions:
Given the physical performance and biomechanical impacts on the wearer, body armour should be carefully selected, with consideration of the physical fitness of the wearers and the degree to which the armour systems can be ergonomically optimized for the specific population in question.