The Prevalence of Chronic Diseases Among Current and Ex-Miners in the United States

Reducing Work-Related Stress Through Soft-Skills Training Intervention in the Mining Industry

OBJECTIVE

The aim of the study was to verify if soft-skills training is an effective intervention in reducing work-related stress among miners, that is, people who run the risk of losing health and/or life due to unpredictable natural forces or human error at work.

BACKGROUND

The motivation for the intervention was based on Job Demands-Resources model where soft skills are job resources that help individuals to cope with or prevent high demands of the environment. The needed skills as well as work demands were first investigated and then a custom training was developed. The rationale for introducing soft-skills training into the work environment can be seen as compatible with the Human Capital Model (HCM) which is designed to stimulate positive organizational behaviour by providing an effective approach to ensure employees' adequate coping with work-related stress.

METHOD

96 volunteer employees were assigned to intervention (n = 48) and comparison (n = 48) groups. 16-hour tailored training covered tasks and simulation games related to communication, teambuilding, self-management and conflict resolution skills. Job Content Questionnaire, Occupational Stress Indicator (modified to fit the mining environment) and General Health Questionnaire were used in the study. A MANOVA with effect-size measures was conducted.

RESULTS

Results revealed a significant increase in decision latitude and social support for the trainees. A substantial decrease in stress was also observed, along with a significant decrease in general health problems. There were no such changes in the comparison group.

CONCLUSIONS

A soft-skills training, including communication, teamwork, self-motivation and conflict-resolution skills, helped participants to cope better with the stressful environment and improved their mental health. These effects lasted three months later.

APPLICATION

The intervention improved miners' psychosocial health and the strategies of coping with stress, which increased safety and health in the company. Investigating the effectiveness of such interventions included in the general Human Capital Model, as it was done in the study, might be a step forward towards building an interdisciplinary approach for health and safety and human resources.

Occupational Safety and Health of Women in Mining

The mining industry plays a critical role in the U.S. economy, with active mines in every state producing materials such as those used to construct houses and roads, make medicines, and manufacture cars and electronics. Throughout its history, mining has been a male-dominated industry. Recent estimates indicate that between 10% and 17% of miners are women. Previous occupational safety and health (OSH) research has focused primarily on the male experience. In more recent years, the mining industry has engaged in efforts to increase workforce diversity through the recruitment and retention of women miners. To meet the needs of a diverse workforce, it is critically important to identify OSH concerns that are unique to populations that have been understudied and to develop work-related policies and practices that improve their work experiences and health outcomes. The purpose of this article is to describe the specific OSH challenges women as miners face and to discuss how the National Institute for Occupational Safety and Health's (NIOSH) Mining Program is situated to address these challenges through its Mining Program Strategic Plan.

Estimating mortality from coal workers' pneumoconiosis among Medicare beneficiaries with pneumoconiosis using binary regressions for spatially sparse data

Background

Coal workers' pneumoconiosis (CWP) is an occupational lung disease due to inhalation of coal dust. We estimated mortality from CWP and other pneumoconioses among Medicare beneficiaries.

Methods

We used the 5% Medicare Limited Claims Data Set, 2011–2014, to identify patients diagnosed with ICD‐9‐CM 500 (CWP) through 505 (Asbestosis, Pneumoconiosis due to other silica or silicates, Pneumoconiosis due to other inorganic dust, Pneumonopathy due to inhalation of other dust, and Pneumoconiosis, unspecified) codes. We applied binary regression models with spatial random effects to determine the association between CWP and mortality. Our inferences are based on Bayesian spatial hierarchical models, and model fitting was performed using Integrated Nested Laplace Approximation (INLA) algorithm in R/RStudio software.

Results

The median age of the sample was 76 years. In a sample of 8531 Medicare beneficiaries, 2568 died. Medicare beneficiaries with CWP had 25% higher odds of death (adjusted OR: 1.25, 95% CI: 1.07, 1.46) than those with other types of pneumoconiosis. The number of comorbid conditions elevated the odds of death by 10% (adjusted OR: 1.10, 95% CI: 1.09, 1.10).

Conclusion

CWP increases the likelihood of death among Medicare beneficiaries. Healthcare professionals should make concerted efforts to monitor patients with CWP to prevent premature mortality.

Characteristics of trauma patients that leave against medical advice: An eight-year survey analysis using the National Hospital Ambulatory Medical Care Survey, 2009-2016

BACKGROUND

Leaving against medical advice (AMA) is associated with increased readmission rates, fragmented patient care, and healthcare litigation. Understanding the factors associated with trauma patients leaving AMA from acute care settings will help guide better communication with trauma patients and improve patient satisfaction. This study aims to assess the sociodemographic and in-hospital care characteristics of trauma patients that leave AMA from acute care centers across the U.S.

METHODS

We pooled and analyzed eight years of data (2009-2016) from the National Hospital Ambulatory Medical Care Survey. The outcome variable was whether the patient left AMA or not. The main predictors were the triage class, weekend presentation, health insurance status, the presence of chronic diseases, and the receipt of therapeutic and diagnostic procedures. The sociodemographic characteristics -age, sex, and race/ethnicity, were measured as potential confounders in the developed model. We performed logistic regression and reported the unadjusted and adjusted odds of leaving AMA as well as the 95% confidence intervals.

RESULTS

The weighted percent of the trauma patient population that left AMA was 1.8%. The odds of leaving AMA decreased with advancing age, and increased among non-Hispanic Blacks, compared with non-Hispanic Whites. After adjusting for age, race, and gender, the odds of leaving AMA increased among patients that lacked health insurance (AOR: 1.86; 95% CI: 1.51-2.31), and had diagnostic procedures (AOR: 2.79; 95% CI: 2.32-3.36). The odds of leaving AMA reduced among trauma patients who were classified as emergent (AOR: 0.70; 95% CI: 0.50-0.98) and had therapeutic procedures (AOR: 0.39; 95% CI: 0.32-0.47).

CONCLUSION

Predicting trauma patients with increased odds of leaving AMA will inform intentional communication that may reduce leaving AMA rates and improve care.

Mortality among workers employed in the mining industry in the United States: A 29-year analysis of the National Health Interview Survey-Linked Mortality File, 1986-2014

BACKGROUND

Working in the mining industry increases the risk of chronic diseases and mortality. We investigated overall and cause-specific mortality rates among workers employed in the mining sector in the United States.

METHODS

We pooled 29 years of National Health Interview Survey (NHIS) public-use data from 1986 to 2014, with mortality follow-up until 31 December 2015. We grouped respondents into the mining and nonmining sectors based on the responses given at the time of the NHIS interview. We compared the overall and cause-specific mortality rates using standardized mortality ratios (SMR) and 95% confidence interval (CI) adjusted for the competing cause of death.

RESULTS

From 1986 to 2014, an estimated 14 million deaths were recorded among subjects eligible for mortality follow-up. Of these, an estimated 50,000 deaths occurred among those working in the mining sector. A significantly higher overall mortality (SMR = 1.26, 95% CI: 1.17-1.36), and mortality from heart diseases (adjusted SMR = 1.56, 95% CI: 1.31-1.83), cancer (adjusted SMR = 1.30, 95% CI: 1.14-1.48) and unintentional injuries (adjusted SMR = 1.41, 95%CI: 1.03-1.85) were observed among those employed in the mining sector. When the analyses were restricted to men, only the SMRs for heart disease and cancer remained statistically significant. No elevated SMR for deaths from chronic lower respiratory disease was observed in the study.

CONCLUSION

Workers employed in the mining sector have a significantly increased total death rate and death rates from heart disease, cancer, and unintentional injuries.