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Ogasawara A, Nagata T, Odagami K, Nagata M, Adi NP, Mori K. Relationship between diabetes treatment status and occupational accidents. J Diabetes Investig 2024. [PMID: 38517117 DOI: 10.1111/jdi.14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/17/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
AIMS To evaluate the relationship between diabetes treatment status and occupational accidents. METHODS A cross-sectional study was conducted using an online questionnaire survey completed in March 2022 among workers aged 20 years or older. The questionnaire included questions about diabetes treatment status and occupational accidents. The association between the treatment status of diabetes and occupational accidents was examined using a logistic regression analysis. RESULTS The study included 25,756 participants with no diabetes, 1,364 participants receiving diabetes treatment, 177 participants who had interrupted diabetes treatment, and 396 participants who needed diabetes treatment but had not seen a doctor. Compared with those with diabetes treatment, the odds ratio of occupational accidents among participants without diabetes was 0.40 (95% CI: 0.32-0.49), the odds ratio among participants with interrupted diabetes treatment was 4.15 (95% CI: 2.86-6.01), and the odds ratio among participants who needed diabetes treatment but had not seen a doctor was 1.25 (95% CI: 0.89-1.77). CONCLUSIONS This study showed that diabetes treatment status was related to occupational accidents, and it may be important for workers with diabetes to be supported to balance their diabetes management and their work commitments.
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Affiliation(s)
- Ayana Ogasawara
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kiminori Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masako Nagata
- Department of Occupational Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Nuri Purwito Adi
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Sears JM, Rundell SD, Fulton-Kehoe D, Hogg-Johnson S, Franklin GM. Using the Functional Comorbidity Index with administrative workers' compensation data: Utility, validity, and caveats. Am J Ind Med 2024; 67:99-109. [PMID: 37982343 PMCID: PMC10824282 DOI: 10.1002/ajim.23550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Chronic health conditions impact worker outcomes but are challenging to measure using administrative workers' compensation (WC) data. The Functional Comorbidity Index (FCI) was developed to predict functional outcomes in community-based adult populations, but has not been validated for WC settings. We assessed a WC-based FCI (additive index of 18 conditions) for identifying chronic conditions and predicting work outcomes. METHODS WC data were linked to a prospective survey in Ohio (N = 512) and Washington (N = 2,839). Workers were interviewed 6 weeks and 6 months after work-related injury. Observed prevalence and concordance were calculated; survey data provided the reference standard for WC data. Predictive validity and utility for control of confounding were assessed using 6-month work-related outcomes. RESULTS The WC-based FCI had high specificity but low sensitivity and was weakly associated with work-related outcomes. The survey-based FCI suggested more comorbidity in the Ohio sample (Ohio mean = 1.38; Washington mean = 1.14), whereas the WC-based FCI suggested more comorbidity in the Washington sample (Ohio mean = 0.10; Washington mean = 0.33). In the confounding assessment, adding the survey-based FCI to the base model moved the state effect estimates slightly toward null (<1% change). However, substituting the WC-based FCI moved the estimate away from null (8.95% change). CONCLUSIONS The WC-based FCI may be useful for identifying specific subsets of workers with chronic conditions, but less useful for chronic condition prevalence. Using the WC-based FCI cross-state appeared to introduce substantial confounding. We strongly advise caution-including state-specific analyses with a reliable reference standard-before using a WC-based FCI in studies involving multiple states.
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Affiliation(s)
- Jeanne M. Sears
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention and Research Center, Seattle, WA, USA
| | - Sean D. Rundell
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
- The Clinical Learning, Evidence And Research (CLEAR) Center for Musculoskeletal Disorders; University of Washington, Seattle, WA, USA
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Sheilah Hogg-Johnson
- Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Gary M. Franklin
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
- Washington State Department of Labor and Industries, Tumwater, WA, USA
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Su SY, Li YW, Wen FH, Yao CY, Wang JY. Associations among Health Status, Occupation, and Occupational Injuries or Diseases: A Multi-Level Analysis. Diagnostics (Basel) 2023; 13:diagnostics13030381. [PMID: 36766485 PMCID: PMC9914676 DOI: 10.3390/diagnostics13030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The present study used a hierarchical generalized linear model to explore the effects of physical and mental health and occupational categories on occupational injuries and diseases. METHODS The data were obtained from the Registry for Beneficiaries of the 2002-2013 National Health Insurance Research Database. The benefit categories involved adults with occupational injuries and diseases. Six major occupational categories and 28 subcategories were used. The main analysis methods were binary logistic regression (BLR) and hierarchical generalized linear model (HGLM). RESULTS After adjustment for relevant factors, the three major occupation subcategories most likely to develop occupational injuries and diseases were Subcategory 12 "employees with fixed employers" of Category 1 "civil servants, employees in public or private schools, laborers, and self-employed workers"; Subcategory 2 "employees in private organizations" of Category 1; and "sangha and religionists" of Category 6 "other citizens." Conditions such as mental disorders and obesity increased the risk of occupational injuries and diseases. CONCLUSION A portion of the occupational categories had a higher risk of occupational injuries and diseases. Physical and mental health issues were significantly correlated with occupational injuries and diseases. To the authors' knowledge, this is the first study to use HGLM to analyze differences in occupational categories in Taiwan.
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Affiliation(s)
- Shu-Yuan Su
- Public Health, China Medical University, Taichung 406040, Taiwan
| | - Yu-Wen Li
- Department of Human Resource, Wu Feng Cheng Ching Hospital, Taichung 412031, Taiwan
| | - Fur-Hsing Wen
- School of Business, Soochow University, Taipei 100006, Taiwan
| | - Chi-Yu Yao
- Department of Psychiatry, An Nan Hospital, Tainan City 709204, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
- Correspondence: ; Tel.: +886-4-22053366 (ext. 6313)
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The Potential for Total Worker Health® Approaches in State and Territorial Health Departments : A National Mixed-Methods Study. J Occup Environ Med 2023; 65:53-59. [PMID: 35959901 DOI: 10.1097/jom.0000000000002674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To document the extent to which state and territorial health departments (SHDs) integrate their occupational safety and health (OSH) and workplace health promotion (WHP) activities consistent with a Total Worker Health (TWH) approach. METHODS Nationally representative survey of OSH and WHP practitioners at 56 SHDs followed by in-depth interviews. RESULTS Despite reporting limited awareness of the TWH initiative and TWH resources, most respondents (57% OSH, 64% WHP) reported collaboration between OSH and WHP staff in their departments. Collaborations were described in-depth. Barriers to OSH-WHP collaborations included resource insufficiencies, organizational structure in the SHD, and conflicting practices. Facilitators included knowledge of TWH approaches, proximity to TWH Centers of Excellence, proximity between OSH/WHP programs, and leadership initiative. Motivations for collaboration were enumerated. CONCLUSIONS Strategies for building TWH capacity and activity among SHDs are discussed.
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Yassin AH, Spector JT, Mease L, Shumate A, Hill R, Lincoln JE, Baker MG. Workplace Determinants of Depression, Anxiety, and Stress in U.S. Mariners during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416628. [PMID: 36554506 PMCID: PMC9779278 DOI: 10.3390/ijerph192416628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 05/07/2023]
Abstract
United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward.
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Affiliation(s)
- Ahmad H. Yassin
- Department of Environmental & Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA
- Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA
| | - June T. Spector
- Department of Environmental & Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA
| | - Luke Mease
- Department of Environmental & Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA
- Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA 98431, USA
| | - Alice Shumate
- Western States Division, National Institute for Occupational Safety and Health, Spokane, WA 99207, USA
| | - Ryan Hill
- Western States Division, National Institute for Occupational Safety and Health, Spokane, WA 99207, USA
- Office of the Director, National Institute for Occupational Safety and Health, Washington, DC 20201, USA
| | - Jennifer E. Lincoln
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Marissa G. Baker
- Department of Environmental & Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA
- Correspondence: ; Tel.: +1-206-616-4709
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Kaur H, Scholl JC, Owens-Gary M. Depression and Diabetes in Workers Across the Life Span: Addressing the Health of America's Workforce-Behavioral Risk Factor Surveillance System, 2014-2018. Diabetes Spectr 2022; 35:198-206. [PMID: 35668882 PMCID: PMC9160556 DOI: 10.2337/ds21-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Diabetes affects nearly 12.2% of U.S. adults. Comorbid depressive symptoms among U.S. workers with diabetes are associated with increased unemployment and reduced work performance. This study examined the age-group-specific prevalence of depression among U.S. workers with self-reported diabetes and identified factors associated with depression. METHODS Data from the 2014-2018 Behavioral Risk Factor Surveillance System were used to examine the prevalence of depression among adult workers with diabetes in the United States. Relationships between depression prevalence and diabetes and demographic, physical, and behavioral risk factors were examined through bivariate and multivariable analyses. Age was categorized into four groups: 18-34, 35-54, 55-64, and ≥65 years. RESULTS The overall prevalence of self-reported depression among U.S. workers with diabetes was 17.4-30% higher than among those without diabetes. Workers with diabetes aged 18-34 years had the highest depression prevalence (28.7%) compared with other age-groups. Female workers with diabetes were significantly more likely than male workers to report depression in all age-groups. Young adult workers with diabetes who had another chronic disease were nearly three times more likely to report depression than those without another chronic condition. There were no overlapping patterns of prevalence of diabetes and depression by state. CONCLUSION Workers with diabetes are at an increased risk of depression, which can affect their overall health and productivity. These findings indicate that, among those with diabetes, young adult workers and women are most likely to have depression. Employee wellness programs may address the specific needs of individuals with diabetes and depression.
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Affiliation(s)
- Harpriya Kaur
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
- Corresponding author: Harpriya Kaur,
| | - Juliann C. Scholl
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Michelle Owens-Gary
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Relationship between fatigue severity scale and occupational injury in Korean workers. Ann Occup Environ Med 2021; 33:e15. [PMID: 34754476 PMCID: PMC8203839 DOI: 10.35371/aoem.2021.33.e15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study is to investigate the relationship between fatigue and occupational injury. Methods This study was conducted at a university hospital in 2014 and 2015. In 2014, the fatigue severity scale (FSS) was used to evaluate workers' fatigue levels. Later, when the same workers were examined in 2015, a questionnaire survey was conducted to determine whether they had experienced absences or treatment for work-related accidents. The χ2 test was used to analyse the relationship between demographic characteristics, fatigue levels, and occupational injuries. After controlling for confounders, a logistic regression analysis was performed to calculate the odds ratios (ORs). Results In 2014, 19,218 workers were screened during health examination and their fatigue level were evaluated using FSS questionnaires. in 2015, workers' occupational injury was evaluated. In result, men in the moderate- and high-fatigue groups, after adjusting for age, smoking and drinking habits, chronic diseases, and occupational factors such as size of company industrial classification and type of work (shift or non-shift), adjusted ORs for hospital treatment due to occupational injury were 1.76 (95% confidence interval [CI]: 1.39–2.24) and 2.61 (95% CI:1.68–4.06), respectively. Among men in the medium- and high-fatigue groups, the adjusted ORs for absence due to occupational injury were 2.06 (95% CI: 1.52–2.80) and 3.65 (95% CI: 2.20–6.05), respectively. No significant association was observed between fatigue and occupational injury in women. Conclusions Male workers with high fatigue levels have a higher risk of experiencing work injuries. This study suggests that active intervention be considered to prevent injuries in workers with high scores on workplace fatigue evaluation scales.
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Abstract
Exposure to major trauma can have significant consequences for workers’ mental health, but common trauma may also result in poor mental health outcomes. This cross-sectional study retrospectively investigated the occurrence of common physical or psychological workplace trauma in 901 health, social service, and trading company workers and studied these experiences in relation to occupational stress, anxiety, and depression. Stress was measured with the effort/reward imbalance (ERI) model while anxiety and depression were evaluated with the Goldberg Anxiety and Depression Scale (GADS). Healthcare workers reported a high frequency of trauma and significantly higher levels of stress, anxiety, and depression than other workers. Even in the entire population of workers of the various professional categories, verbal violence (harassment and threats), traffic accidents, home injuries, and family bereavement were significantly associated with high levels of stress, anxiety, and depression. Major trauma survivors are known to be at increased risk of mental disorders and require support in the workplace, however, even minor repeated emotional trauma and injuries can affect mental health. During mandatory health surveillance, the occupational physician should systematically collect information on minor trauma and mental health outcomes when assessing the occupational fitness of the workers assigned to him.
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Houle M, Lessard A, Marineau-Bélanger É, Lardon A, Marchand AA, Descarreaux M, Abboud J. Factors associated with headache and neck pain among telecommuters - a five days follow-up. BMC Public Health 2021; 21:1086. [PMID: 34090415 PMCID: PMC8179834 DOI: 10.1186/s12889-021-11144-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current sanitary crisis brought on by the COVID-19 recently forced a large proportion of workers to adopt telecommuting with limited time to plan transition. Given that several work-related risk factors are associated with headache and neck pain, it seems important to determine those associated with headache and neck pain in telecommuters. The main objective of this study was to identify which telecommuting and individual associated factors are related with headache and neck pain occurrence in telecommuters over a five days follow-up. The second objective was to evaluate the impact of wearing a headset on headache and neck pain intensity in telecommuters. METHODS One hundred and sixty-two participants in telecommuting situation were recruited. Baseline assessment included sociodemographic data, headache and neck pain-related disability (6-item Headache Impact Test (HIT-6) and Neck Bournemouth Questionnaire (NBQ)), headache and neck pain frequency and intensity as well as questions about the wearing of a headset (headset wearing, headset type and headset wearing hours). A prospective data collection of headache, neck pain and headset wearing was conducted using daily e-mail over a 5-day follow-up. A stepwise multivariate regression model was performed to determine associated factors of headache or neck pain occurrence during the follow-up. A t-test was conducted to assess the impact of headset wearing on headache and neck pain intensity during the follow-up. RESULTS Regarding headache, the stepwise multivariate regression model showed that the HIT-6 score was associated with future headache occurrence in telecommuters (OR (95% CI) = 1.094 (1.042-1.148); R2 = 0.094; p < 0.001). For neck pain, the stepwise multivariate regression showed that the NBQ score was related to future neck pain occurrence in telecommuters (OR (95% CI) = 1.182 (1.102-1.269); R2 = 0.182; p < 0.001). T-test showed no difference between participants that wore a headset and participant that did not wore a headset on mean headache (p = 0.94) and neck pain (p = 0.56) intensity during the five days follow-up. CONCLUSION Although several work-related risk factors are associated with headache and neck pain in workers, telecommuting did not present the same risks. Working set-up did not have a significant impact on headache and neck pain as headache-related disability was the only associated factor of future headache episodes and neck-pain related disability was the only associated factor of future neck pain episodes. Also, wearing a headset had no impact on headache and neck pain in telecommuters.
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Affiliation(s)
- Mariève Houle
- Department of Anatomy, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada.
| | - Arianne Lessard
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Émile Marineau-Bélanger
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, 24, Blvd Paul Vaillant-Couturier, 94200, Ivry sur Seine, France
| | - Andrée-Anne Marchand
- Department of Chiropractic, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G8Z 4M3, Canada
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Biswas A, Begum M, Van Eerd D, Smith PM, Gignac MAM. Organizational Perspectives on How to Successfully Integrate Health Promotion Activities into Occupational Health and Safety. J Occup Environ Med 2021; 63:270-284. [PMID: 33769396 DOI: 10.1097/jom.0000000000002087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is increasing recognition of the value of integrating efforts to promote worker health with existing occupational health and safety activities. This paper aimed to identify facilitators, barriers and recommendations for implementing integrated worker health approaches. METHODS Thirteen stakeholders from different job sectors participated in a workshop that targeted key issues underlying integrated worker health approaches in their own and other organizations. Included were participants from human resources, occupational health and safety, government, and unions. Thematic analysis and an online ranking exercise identified recommendation priorities and contributed to a conceptual framework. RESULTS Participants highlighted the importance of planning phases in addition to implementation and evaluation. Themes highlighted organizational priorities, leadership buy-in, external pressures, training, program promotion and evaluation metrics. CONCLUSIONS Findings provide practical directions for integrating worker health promotion and safety and implementation steps.
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Affiliation(s)
- Aviroop Biswas
- Institute for Work & Health, Toronto, Ontario, Canada (Dr Biswas, Begum, Van Eerd, Smith, Gignac); Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Biswas, Smith, Gignac); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Smith)
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Strollo F, Furia A, Verde P, Bellia A, Grussu M, Mambro A, Petrelli MD, Gentile S. Technological innovation of Continuous Glucose Monitoring (CGM) as a tool for commercial aviation pilots with insulin-treated diabetes and stakeholders/regulators: A new chance to improve the directives? Diabetes Res Clin Pract 2021; 172:108638. [PMID: 33358969 DOI: 10.1016/j.diabres.2020.108638] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022]
Abstract
Civil aviation pilots who develop insulin-treated diabetes and want to renew a Commercial Pilot License (CPL) represent a medical, social and regulatory problem. This depends on justified concerns about hypoglycemia, the most threatening event for people who carry out jobs requiring a high level of concentration and reliability. This negatively affects social and working aspects of pilots' lives, who have a high profile and a high-cost professional qualification. It could be possible now to revise this attitude thanks to the availability of Continuous Glucose Monitoring (CGM) devices. CGM clearly showed to prevent hypoglycemic events in insulin-treated diabetic patients by allowing strict monitoring and trend prediction of glucose levels. By systematizing available data on such devices and present regulations in CPL issuance worldwide, our review can be used as handy tool for a fruitful discussion among the scientific community, national and international civil aviation regulators, stakeholders and pilots, aimed at evaluating the evidence-based opportunity to revise CPL issuance criteria for insulin-treated diabetic pilots. For the above-mentioned reasons, there are, among the regulatory administrations of Civil Aviation around the globe, several different approaches and limitations set for the subjects with insulin-treated diabetes who want to obtain, or renew, a CPL.
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Affiliation(s)
- F Strollo
- AMD (Associazione Medici Diabetologi), ESAM (European Society of Aerospace Medicine) and IRCCS San Raffaele Pisana, Rome, Italy.
| | - A Furia
- ENAC (Italian National Civil Aviation Authority), Aeromedical Section, Rome, Italy
| | - P Verde
- AIMAS (Italian Association of AeroSpace Medicine) and IAF (Italian Air Force), Experimental Flight Center, Aerospace Medicine Department, Pratica di Mare, Rome, Italy
| | - A Bellia
- SID (Società Italiana di Diabetologia), Department of Systems Medicine, Rome University, "Tor Vergata", Italy
| | - M Grussu
- ANIAD (Italian National Association of Athletes with Diabetes), Oristano, Italy
| | - A Mambro
- AIMAS (Italian Association of AeroSpace Medicine), Anesthesiology and Resuscitation Unit, Alesini CTO Hospital, Rome, Italy
| | - M D Petrelli
- SID (Società Italiana di Diabetologia), Clinic of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | - S Gentile
- Associazione Medici Diabetologi), Campania University "Luigi Vanvitelli", Naples, Italy, and Nefrocenter Research & Nyx Start-UP, Naples, Italy
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Gerasimaviciute V, Bültmann U, Diamond PM, Tullar JM, Delclos GL, de Porras DGR, Amick BC. Reciprocal associations between depression, anxiety and work-related injury. Inj Prev 2020; 26:529-535. [PMID: 31685530 PMCID: PMC8856579 DOI: 10.1136/injuryprev-2019-043403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/11/2019] [Accepted: 10/16/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the reciprocal longitudinal associations between depression or anxiety with work-related injury (WRI) at a large employer in the southwestern United States. METHOD Three administrative datasets (2011-2013) were merged: employee eligibility, medical and prescription claims, and workers' compensation claims. The sample contained 69 066 active employees. Depression and anxiety were defined as episodes of medical visits care (ie, claims) with corresponding ICD-9-CM codes. For an individual's consecutive claims, a new case of depression or anxiety was defined if more than 8 weeks have passed since the prior episode. The presence of a workers' compensation injury claim was used to identify WRI. Three-wave (health plan years 2011 or T1, 2012 or T2, and 2013 or T3) autoregressive cross-lagged models were used to estimate whether depression or anxiety predicted WRI, also if WRI predicted depression or anxiety in the following year(s). RESULTS Depression predicted injury from T1 to T2 (β=0.127, p<0.001) and from T2 to T3 (β=0.092, p=0.001). Injury predicted depression from T1 to T3 (β=0.418, p<0.001). Effects of anxiety on WRI were small and inconsistent, from T1 to T2 (β=0.013, p=0.622) and from T2 to T3 (β=-0.043, p=0.031). T1 injury had a protective effect on T3 anxiety (β=-0.273, p<0.001). CONCLUSIONS We found evidence of reciprocal effects for depression with WRI after adjustment for prior injuries and depression. The evidence for the relationship between anxiety and WRI is less clear. WRI prevention and management programmes should incorporate depression prevention and management.
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Affiliation(s)
- Vaiva Gerasimaviciute
- The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pamela M Diamond
- The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
| | - Jessica M Tullar
- The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
| | - George L Delclos
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States
| | - Benjamin C Amick
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, United States,Institute for Work and Health, Toronto, Ontario, Canada
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13
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Campo G, Cegolon L, De Merich D, Fedeli U, Pellicci M, Heymann WC, Pavanello S, Guglielmi A, Mastrangelo G. The Italian National Surveillance System for Occupational Injuries: Conceptual Framework and Fatal Outcomes, 2002-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207631. [PMID: 33092014 PMCID: PMC7589703 DOI: 10.3390/ijerph17207631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
Background: A national database of work-related injuries has been established in Italy since 2002, collecting information on the injured person, his/her work tasks, the workplace and the risk factors contributing to incident dynamics, according to a model called Infor.Mo. Methods: A descriptive study of occupational fatal injuries, excluding work-related fatal traffic injuries, that occurred in Italy from 2002 to 2016 (15 years) was performed. Results: Among 4874 victims involved, all were males, mainly >51 years of age (43.2%), predominantly self-employed (27.8%) or workers with non-standard contracts (25%). About 18.4% and 17.3% of fatal events occurred in micro-enterprises belonging to, respectively, construction and agriculture. A wide range of nationalities (59 countries in addition to Italy) was identified. Overall, 18.9% of work-related fatal injuries were due to some form of hazardous energy—mechanical, thermal, electrical or chemical—that was normally present in the workplace. Workers’ falls from height (33.5%), heavy loads falling on workers from height (16.7%) and vehicles exiting their route and overturning (15.9%) were the events causing the greatest proportion of occupational fatal injuries in the present study (from 2002 to 2016) and in the initial pilot phase, focused on years 2002–2004, with a similar distribution of fatal events between the two time periods. The activity of the injured person made up 43.3% of 9386 risk factors identified in 4874 fatalities. Less common risk factors were related to work equipment (20.2%), work environment (14.9%), third–party activity (9.8%), personal protective equipment/clothing (8.0%) and materials (3.7%). The activity of the injured person remained the most relevant contributing factor even when the incident was caused by two or more risk factors. Discussion: Occupational fatal injuries occurred mainly in small size firms (up to nine employees) in hazardous workplaces. Small companies, which account for 68% (2888/4249) of all firms in the present study, generally have fewer resources to remain current with the continuously evolving health and safety at work regulations; moreover, these firms tend to be less compliant with health and safety at work regulations since they are less likely to be inspected by occupational vigilance services. Perspectives: An approach being introduced in Italy relies on the use of economic incentives to promote safe and healthy workplaces. The comparison of pre-intervention and post-intervention rates of work-related injuries by means of interrupted time series analyses could detect whether the intervention will have an effect significantly greater than the underlying secular trend.
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Affiliation(s)
- Giuseppe Campo
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for the Insurance of Work Related Injuries (INAIL), 00144 Rome, Italy; (G.C.); (D.D.M.); (M.P.); (A.G.)
| | - Luca Cegolon
- Public Health Department, Local Health Unit N.2 “Marca Trevigiana”, 31100 Treviso, Italy
- Institute for Maternal & Child Health, IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
- Correspondence:
| | - Diego De Merich
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for the Insurance of Work Related Injuries (INAIL), 00144 Rome, Italy; (G.C.); (D.D.M.); (M.P.); (A.G.)
| | - Ugo Fedeli
- Azienda Zero, Epidemiological Service, 35100 Padua, Veneto Region, Italy;
| | - Mauro Pellicci
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for the Insurance of Work Related Injuries (INAIL), 00144 Rome, Italy; (G.C.); (D.D.M.); (M.P.); (A.G.)
| | - William C. Heymann
- Florida Department of Health, Sarasota County Health Department, Sarasota, FL 34237, USA;
- Department of Clinical Sciences Florida, College of Medicine, State University, Sarasota, FL 34243, USA
| | - Sofia Pavanello
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, Padua University, 35128 Padua, Italy; (S.P.); (G.M.)
| | - Armando Guglielmi
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for the Insurance of Work Related Injuries (INAIL), 00144 Rome, Italy; (G.C.); (D.D.M.); (M.P.); (A.G.)
| | - Giuseppe Mastrangelo
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, Padua University, 35128 Padua, Italy; (S.P.); (G.M.)
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14
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Pre-Existing and New-Onset Depression and Anxiety Among Workers With Injury or Illness Work Leaves. J Occup Environ Med 2020; 62:e567-e572. [PMID: 32769787 PMCID: PMC7537737 DOI: 10.1097/jom.0000000000001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To examine the influence of depression and/or anxiety on work leaves and the impact of work leaves on experiencing a new-onset depression and/or anxiety disorder.
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15
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Elser H, Neophytou AM, Tribett E, Galusha D, Modrek S, Noth EM, Meausoone V, Eisen EA, Cantley LF, Cullen MR. Cohort Profile: The American Manufacturing Cohort (AMC) study. Int J Epidemiol 2020; 48:1412-1422j. [PMID: 31220278 DOI: 10.1093/ije/dyz059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Holly Elser
- Division of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.,Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Erika Tribett
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Deron Galusha
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, College of Business, San Francisco, CA, USA
| | - Elizabeth M Noth
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Valerie Meausoone
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Linda F Cantley
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark R Cullen
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
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16
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Abstract
PURPOSE OF REVIEW The effects of hypoglycemia can result in injury, including at work. Our goal was to review the recent medical literature regarding hypoglycemia and occupational injuries and provide guidance to clinicians asked to render opinions regarding fitness for work duties in individuals with diabetes. RECENT FINDINGS Recent studies contain conflicting conclusions regarding the occupational risks posed by workers with diabetes. However, the US Federal Motor Carrier Safety Administration concluded there was sufficient evidence to change the rule that previously disqualified commercial drivers with insulin-treated diabetes. Blanket employment policies that disqualify workers with diabetes are unnecessary in many occupational fields. In assessing occupational risks and fitness for duty in workers with diabetes, it is important to perform an individualized assessment of the worker and consider the risk factors for hypoglycemia, information from the treating clinician, essential functions of the job, and, if needed, availability of reasonable accommodations.
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Affiliation(s)
- Robert M Gerbo
- Department of Occupational and Environmental Sciences, Section of Occupational Medicine, West Virginia University School of Public Health, 3860 Health Sciences Center, Morgantown, WV, 26506-9145, USA.
| | - Chuan Fang Jin
- Department of Occupational and Environmental Sciences, Section of Occupational Medicine, West Virginia University School of Public Health, 3860 Health Sciences Center, Morgantown, WV, 26506-9145, USA
| | - Karen Clark
- Department of Medicine, Section of General Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
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17
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van Doorn D, Richardson N, Osborne A, Blake C. The impact of a workplace cardiovascular health screening programme 'Farmers Have Hearts' on health behaviour change among Irish farmers. Work 2019; 63:113-123. [PMID: 31127749 DOI: 10.3233/wor-192912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Irish farmers are a high-risk group for cardiovascular disease (CVD) which imposes not only a risk to their health but has more far-reaching implications for occupational health and safety. OBJECTIVE This study assessed the impact of a workplace health screening and health behaviour change programme among a sub-group of male Irish farmers. METHODS Data were collected from male livestock farmers (n = 310) who attended health screenings at livestock marts. Participating farmers also received lifestyle advice to prompt health behaviour change. Health behaviour change was tracked by two phone questionnaires at Week 1 (n = 224) and Week 12 (n = 172). All data were entered into SPSS v22 and analysed using chi-square and regression techniques. RESULTS At Week 12, 48% reported having changed at least one health behaviour. The majority of farmers were referred to their GP and by Week 12, 32% had acted on this advice. Participants most in need of health behaviour change based on adverse health screening results were, paradoxically, the least likely to contemplate or engage in health behaviour change. CONCLUSIONS Findings demonstrate that whilst workplace health screenings can be a catalyst for behaviour change for some farmers, more follow-up supports are needed to encourage sustainable behaviour change.
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Affiliation(s)
- Diana van Doorn
- National Centre for Men's Health, Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
| | - Noel Richardson
- National Centre for Men's Health, Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
| | - Aoife Osborne
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
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18
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Sedani A, Stover D, Coyle B, Wani RJ. Assessing Workplace Health and Safety Strategies, Trends, and Barriers through a Statewide Worksite Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142475. [PMID: 31336749 PMCID: PMC6678341 DOI: 10.3390/ijerph16142475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 11/16/2022]
Abstract
Chronic diseases have added to the economic burden of the U.S. healthcare system. Most Americans spend most of their waking time at work, thereby, presenting employers with an opportunity to protect and promote health. The purpose of this study was to assess the implementation of workplace health governance and safety strategies among worksites in the State of Nebraska, over time and by industry sector using a randomized survey. Weighted percentages were compared by year, industry sector, and worksite size. Over the three study periods, 4784 responses were collected from worksite representatives. Adoption of workplace health governance and planning strategies increased over time and significantly varied across industry sector groups. Organizational safety policies varied by industry sector and were more commonly reported than workplace health governance and planning strategies. Time constraints were the most common barrier among worksites of all sizes, and stress was reported as the leading employee health issue that negatively impacts business. Results suggest that opportunities exist to integrate workplace health and safety initiatives, especially in blue-collar industry sectors and small businesses.
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Affiliation(s)
- Ami Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Derry Stover
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA.
| | - Brian Coyle
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA
| | - Rajvi J Wani
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA
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19
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Eisenberg ML, Galusha D, Kennedy WA, Cullen MR. The Relationship between Neonatal Circumcision, Urinary Tract Infection, and Health. World J Mens Health 2018; 36:176-182. [PMID: 29623700 PMCID: PMC6119846 DOI: 10.5534/wjmh.180006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 01/22/2018] [Accepted: 01/28/2018] [Indexed: 12/18/2022] Open
Abstract
The risk-benefit profile of neonatal circumcision is not clear. Most studies have focused on urinary tract infections but other health sequelae have not been evaluated. While evidence supports benefits of circumcision, a lack of randomized trials has been cited as a weakness. National guidelines provide mixed recommendations regarding neonatal circumcision. We review the weight of evidence and utilize current statistical methodology on observational data to examine the risks and benefits of neonatal circumcision.
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Affiliation(s)
- Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
| | - Deron Galusha
- Statistician, Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT, USA
| | - William A Kennedy
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Mark R Cullen
- Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA, USA
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20
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Altassan KA, Sakr CJ, Galusha D, Slade MD, Tessier-Sherman B, Cantley LF. Risk of Injury by Unionization: Survival Analysis of a Large Industrial Cohort. J Occup Environ Med 2018; 60:827-831. [PMID: 29727399 PMCID: PMC6131027 DOI: 10.1097/jom.0000000000001347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the effect of union status on injury risk among a large industrial cohort. METHODS The cohort included hourly employees at 19 US plants between 2000 and 2007. Plants were classified by union status, and injuries were classified by severity. Cox-proportional hazard shared frailty model was used to determine time to first reportable injury. RESULTS A total of 26,462 workers were included: 18,955 (72%) unionized and 7507 (28%) non-unionized. Union workers incurred 3194 injuries (16.9%) compared with 618 injuries for non-union workers (8.2%). After adjusting for multiple covariates, union workers had a 51% higher risk of reportable injury. CONCLUSIONS Our results provide evidence for higher risk of reportable injuries in union workers; explanations for this increased risk remain unclear.
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Affiliation(s)
- Khaled Abdulrahman Altassan
- Department of Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut
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21
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Diagnosed Chronic Health Conditions Among Injured Workers With Permanent Impairments and the General Population. J Occup Environ Med 2018; 59:486-496. [PMID: 28486345 DOI: 10.1097/jom.0000000000000998] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To profile chronic health conditions of an injured worker sample before and after workplace injury and compare injured workers to a matched community sample. METHODS Logistic regression analyses compared risk of certain chronic health conditions for permanently disabled injured workers in the pre- and post-injury periods to comparator subsamples from the Canadian Community Health Surveys 2003 and 2009/2010. RESULTS There were notable health differences between the injured worker and comparator samples for the post-injury period. Injured men and women were more likely to report arthritis, hypertension, ulcers, depression, and back problems than the comparator sample. Injured women were also more likely to report migraine headaches and asthma. CONCLUSIONS The observed differences suggest that permanently impaired injured workers experience more rapidly accelerated health declines than other aging workers, and this outcome is gendered.
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22
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Leibler JH, Janulewicz PA, Perry MJ. Prevalence of serious psychological distress among slaughterhouse workers at a United States beef packing plant. Work 2018; 57:105-109. [PMID: 28506017 DOI: 10.3233/wor-172543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workers in the animal slaughter and processing industry in the United States experience high rates of occupational injury as well as stressful work conditions, yet mental health in this workforce remains largely unstudied. OBJECTIVE To assess prevalence of serious psychological distress (SPD) in a sample of industrial US slaughterhouse workers. PARTICIPANTS Workers at an industrial beef packing plant in Nebraska, United States (n = 137). METHODS We interviewed workers using the Kessler-6, a well-validated measure of non-specific anxiety disorders, to assess SPD. We compared SPD prevalence with national estimates from 2009 CDC's Behavioral Risk Factor Surveillance Study. RESULTS Prevalence of SPD among workers was 4.4%, compared to United States population-wide prevalence of 3.6%. Prevalence of mild and moderate psychological distress among these workers (14.6%) was also higher than national estimates. Recent occupational injury, work area and job activities were not associated with elevated prevalence of SPD. Non-Hispanic white workers experienced elevated prevalence of SPD compared to Hispanic or Latino workers (prevalence odds ratio: 6.4; CI: 1.3, 30.5; p = 0.012). CONCLUSION Workers at a US industrial slaughterhouse experienced higher prevalence of SPD compared to United States population-wide estimates, but occupational risk factors for this outcome were not identified.
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Affiliation(s)
- Jessica H Leibler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Patricia A Janulewicz
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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23
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Jovanović J, Šarac I, Đinđić N, Jovanović S. THE INFLUENCE OF WORKING CONDITIONS, HEALTH STATUS AND CHARACTERISTICS OF WORKERS ON THE OCCURRENCE OF WORKPLACE INJURIES. ACTA MEDICA MEDIANAE 2017. [DOI: 10.5633/amm.2017.0403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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24
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Smyth W, Lindsay D, Brennan D, Lindsay D. Medical and allied health staff self-reported long-term conditions. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2017. [DOI: 10.1108/ijwhm-07-2017-0050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to describe the self-reported long-term conditions of medical officers and allied health staff working in a regional public health service in northern Australia and how these conditions are managed.
Design/methodology/approach
A cross-sectional survey design was used. The sample was all medical officers and allied health staff employed in mid-2015.
Findings
Of the 365 respondents, 217 (59.5 per cent) reported having at least one long-term condition. There was a statistically significant association between professional group and the number of long-term conditions reported, χ2=10.24, p<0.05. A greater proportion of medical officers (n=29, 43.9 per cent) reported having only one long-term condition compared with allied health staff (n=36, 24.5 per cent). The top four categories of conditions were respiratory, musculoskeletal, mental health and episodic and paroxysmal, although the patterns varied amongst the professional groups, and across age groups. Respondents usually managed their main long-term conditions with personal strategies, rarely using workplace strategies.
Research limitations/implications
Although somewhat low, the response rate of 32 per cent was similar to previous surveys in this health service. Since this survey, the health service has implemented a broad Health and Wellness Programme to support their qualified workforce. Future evaluations of this programme will be undertaken, including whether the programme has assisted health professionals to manage their long-term conditions.
Practical implications
There is an urgent need for targeted, workplace-based health promotion strategies to support staff with long-term conditions. Such strategies would complement self-management approaches, and also provide an important recruitment and retention initiative.
Originality/value
This study adds empirical evidence regarding the long-term conditions among health professionals and their self-management strategies. Little is known about the long-term conditions among the various health professional groups and the findings thus make an important contribution to the existing literature.
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Kouvonen A, Kivimäki M, Pentti J, Aalto V, Oksanen T, Virtanen M, Vahtera J. Diabetes and risk of occupational injury: a cohort study. Diabet Med 2017; 34:1629-1636. [PMID: 28703867 DOI: 10.1111/dme.13423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/18/2022]
Abstract
AIMS To investigate if diabetes is associated with a higher risk of occupational (workplace or commuting) injury. METHODS Medication data from the Finnish Prescription Register were used to identify diabetes cases in 2004 in a large employee cohort (the Finnish Public Sector study). These data were linked to injury records obtained from the Federation of Accident Insurance Institutions. A total of 1020 diabetes cases (median age 52 years, range 20 to 65 years; 66% women) and their 5234 age- and sex-matched controls were followed up until 2011. Sex-stratified Cox proportional hazards models, adjusting for age, occupational status, obesity and health behaviours, were applied. Because of the small number of men in the cohort, injury types and locations were only examined among women. RESULTS During the median follow-up of 6.7 years, 25% of the participants with diabetes (n=252) and 20% of those without (n=1051) experienced an occupational injury. The association between diabetes and injury was stronger in women than men (P=0.048). Diabetes was associated with a higher risk of workplace (hazard ratio 1.37, 95% CI 1.11 to 1.69) and commuting (hazard ratio 1.36, 95% CI 1.03 to 1.79) injury in women. With regard to different injury types and locations, diabetes was associated with bone fractures, dislocations, sprains and strains, and injuries to upper and lower extremities. In men, there was an association between insulin-treated diabetes and commuting injury (hazard ratio 3.14, 95% CI 1.52 to 6.49). CONCLUSIONS Diabetes was associated with workplace and commuting injuries in women. Men with insulin-treated diabetes had a higher risk of commuting injuries.
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Affiliation(s)
- A Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Administrative Data Research Centre - Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK
- SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
| | - M Kivimäki
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - V Aalto
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - T Oksanen
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - M Virtanen
- Finnish Institute of Occupational Health, Turku and Helsinki, Finland
| | - J Vahtera
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland
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van Doorn D, Richardson N, Osborne A. Farmers Have Hearts: The Prevalence of Risk Factors for Cardiovascular Disease Among a Subgroup of Irish Livestock Farmers. J Agromedicine 2017; 22:264-274. [DOI: 10.1080/1059924x.2017.1318728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Diana van Doorn
- Department of Science and Health, National Centre for Men’s Health, Institute of Technology Carlow, Carlow, Ireland
| | - Noel Richardson
- Department of Science and Health, National Centre for Men’s Health, Institute of Technology Carlow, Carlow, Ireland
| | - Aoife Osborne
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
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Li AK, Nowrouzi-Kia B. Impact of Diabetes Mellitus on Occupational Health Outcomes in Canada. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:96-108. [PMID: 28432371 PMCID: PMC6679613 DOI: 10.15171/ijoem.2017.992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/13/2017] [Indexed: 11/23/2022]
Abstract
Background: Research suggests that diabetes mellitus (DM) has a negative impact on employment and workplace injury, but there is little data within the Canadian context. Objective: To determine if DM has an impact on various occupational health outcomes using the Canadian Community Health Survey (CCHS). Methods: CCHS data between 2001 and 2014 were used to assess the relationships between DM and various occupational health outcomes. The final sample size for the 14-year study period was 505 606, which represented 159 432 239 employed Canadians aged 15–75 years during this period. Results: We found significant associations between people with diabetes and their type of occupation (business, finance, administration: 2009, p=0.002; 2010, p=0.002; trades, transportation, equipment: 2008, p=0.025; 2011, p=0.002; primary industry, processing, manufacturing, utility: 2013, p=0.018), reasons for missing work (looking for work: 2001, p=0.024; school or education: 2003, p=0.04; family responsibilities: 2014, p=0.015; other reasons: 2001, p<0.001; 2003, p<0.001; 2010, p=0.015), the number of work days missed (2010, 3 days, p=0.033; 4 days, p=0.038; 11 days, p<0.001; 24 days, p<0.001), and workrelated injuries (traveling to and from work: 2014, p=0.003; working at a job or business: 2009, p=0.021; 2014, p=0.001). Conclusion: DM is associated with various occupational health outcomes, including workrelated injury, work loss productivity, and occupation type. This allows stakeholders to assess the impact of DM on health outcomes in workplace.
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Affiliation(s)
- Anson Kc Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M6, Canada
| | - Behdin Nowrouzi-Kia
- School of Rural and Northern Health, Centre for Research in Occupational Safety and Health, Laurentian University, 935 Ramsey Lake Rd, Sudbury, Ontario, P3E 2C6, Canada.
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28
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Marcum JL, Chin B, Anderson NJ, Bonauto DK. Self-Reported Work-Related Injury or Illness - Washington, 2011-2014. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:302-306. [PMID: 28333911 PMCID: PMC5657884 DOI: 10.15585/mmwr.mm6611a6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Porru S, Calza S, Arici C. Prevention of occupational injuries: Evidence for effective good practices in foundries. JOURNAL OF SAFETY RESEARCH 2017; 60:53-69. [PMID: 28160815 DOI: 10.1016/j.jsr.2016.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 09/21/2016] [Accepted: 11/29/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Occupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. METHOD The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based=IR, frequency/hours-based=FR, severity=SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. RESULTS 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (-26% IR, -15% FR, -18% SR) in ferrous foundries and of SR (-4%) in non-ferrous foundries. A significant (p=0.021) 'step-effect' was shown for IR in ferrous foundries, independent of secular trends (p<0.001). Sector-specific benchmarks for all injury rates were developed separately for ferrous and non-ferrous foundries. CONCLUSIONS Strengths of the study were: ITS design, according to standardized quality criteria (i.e., at least three data points before and three data points after intervention; clearly defined intervention point); pragmatic approach, with good external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large.
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Affiliation(s)
- Stefano Porru
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy; University Research Center 'Integrated Models for Prevention and Protection in Environmental and Occupational Health' (MISTRAL), University of Brescia, Brescia, Italy.
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Section of Medical Statistics, University of Brescia, Brescia, Italy
| | - Cecilia Arici
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Section of Public Health and Human Sciences, University of Brescia, Brescia, Italy; University Research Center 'Integrated Models for Prevention and Protection in Environmental and Occupational Health' (MISTRAL), University of Brescia, Brescia, Italy
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Lu W, Benson R, Glaser K, Platts LG, Corna LM, Worts D, McDonough P, Di Gessa G, Price D, Sacker A. Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing. J Epidemiol Community Health 2016; 71:439-445. [PMID: 27913614 PMCID: PMC5484034 DOI: 10.1136/jech-2016-207887] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/11/2016] [Accepted: 11/03/2016] [Indexed: 01/10/2023]
Abstract
Background Given the acceleration of population ageing and policy changes to extend working lives, evidence is needed on the ability of older adults to work for longer. To understand more about the health impacts of work, this study examined the relationship between employment histories before retirement and trajectories of frailty thereafter. Methods The sample comprised 2765 women and 1621 men from the English Longitudinal Study of Ageing. We used gendered typologies of life-time employment and a frailty index (FI). Multilevel growth curve models were used to predict frailty trajectories by employment histories. Results Women who had a short break for family care, then did part-time work till 59 years had a lower FI after 60 years than those who undertook full-time work until 59 years. Women who were largely family carers or non-employed throughout adulthood, had higher levels of frailty at 60 years but experienced a slower decline with age. Men who worked full-time but early exited at either 49 or 60 years had a higher FI at 65 years than those who worked full-time up to 65 years. Interaction between employment histories and age indicated that men in full-time work who experienced an early exit at 49 tended to report slower declines. Conclusions For women, experiencing distinct periods throughout the lifecourse of either work or family care may be advantageous for lessening frailty risk in later life. For men, leaving paid employment before 65 years seems to be beneficial for decelerating increases in frailty thereafter. Continuous full-time work until retirement age conferred no long-term health benefits.
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Affiliation(s)
- Wentian Lu
- ESRC International Centre for Lifecourse Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Rebecca Benson
- Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Karen Glaser
- Department of Global Health & Social Medicine, Institute of Gerontology, School of Social Science and Public Policy, King's College London, London, UK
| | - Loretta G Platts
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Laurie M Corna
- Department of Global Health & Social Medicine, Institute of Gerontology, School of Social Science and Public Policy, King's College London, London, UK
| | - Diana Worts
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peggy McDonough
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Giorgio Di Gessa
- Department of Social Policy, The London School of Economics and Political Science, London, UK
| | - Debora Price
- Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK
| | - Amanda Sacker
- ESRC International Centre for Lifecourse Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
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Brahem A, Selmi I, Boughattas W, Gaddour A, Maoua M, Kalboussi H, El Maalel O, Chatti S, Debbabi F, Mrizak N. Impact du diabète sur l’activité professionnelle : résultats d’une enquête réalisée dans un centre hospitalier à Sousse, Tunisie. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gender Differences in the Longitudinal Association between Work-Related Injury and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111077. [PMID: 27827844 PMCID: PMC5129287 DOI: 10.3390/ijerph13111077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/19/2016] [Accepted: 10/28/2016] [Indexed: 01/22/2023]
Abstract
Little is known about gender differences in the association between occupational injury and depression. We investigated the bidirectional association and gender differences between work-related injury and depression using the same cohort in the US Medical Expenditure Panel Survey (MEPS). In Analysis 1, the association of occupational injury and subsequent depression was investigated from 35,155 employees without depression. Analysis 2 included 32,355 participants without previous injury and examined the association of depression and work-related injury. The multivariable-adjusted odds ratio was estimated using a discrete time-proportional odds model. Male workers who had experienced workplace injury were more vulnerable to post-injury depression than non-injured male workers (OR = 2.35, 95% CI: 1.52, 3.65). Female workers with depression were more prone to get injured at the workplace than the non-depressed female workers (OR = 1.44, 95% CI: 1.07, 1.96). These results did not hold in the reverse direction for both genders. Workers compensation benefit was positively associated with the risk of post-injury depression among males, whereas anti-depressant medication and duration of depression were related to workplace injury among females. Gender differences in the direction and associated factors of the relationship between occupational injury and depression highlight the need for gender-specific intervention to the vicious cycle of workplace injury and depression.
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Schwatka NV, Atherly A, Dally MJ, Fang H, vS Brockbank C, Tenney L, Goetzel RZ, Jinnett K, Witter R, Reynolds S, McMillen J, Newman LS. Health risk factors as predictors of workers' compensation claim occurrence and cost. Occup Environ Med 2016; 74:14-23. [PMID: 27530688 PMCID: PMC5241501 DOI: 10.1136/oemed-2015-103334] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 07/11/2016] [Accepted: 07/24/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The objective of this study was to examine the predictive relationships between employee health risk factors (HRFs) and workers' compensation (WC) claim occurrence and costs. METHODS Logistic regression and generalised linear models were used to estimate the predictive association between HRFs and claim occurrence and cost among a cohort of 16 926 employees from 314 large, medium and small businesses across multiple industries. First, unadjusted (HRFs only) models were estimated, and second, adjusted (HRFs plus demographic and work organisation variables) were estimated. RESULTS Unadjusted models demonstrated that several HRFs were predictive of WC claim occurrence and cost. After adjusting for demographic and work organisation differences between employees, many of the relationships previously established did not achieve statistical significance. Stress was the only HRF to display a consistent relationship with claim occurrence, though the type of stress mattered. Stress at work was marginally predictive of a higher odds of incurring a WC claim (p<0.10). Stress at home and stress over finances were predictive of higher and lower costs of claims, respectively (p<0.05). CONCLUSIONS The unadjusted model results indicate that HRFs are predictive of future WC claims. However, the disparate findings between unadjusted and adjusted models indicate that future research is needed to examine the multilevel relationship between employee demographics, organisational factors, HRFs and WC claims.
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Affiliation(s)
- Natalie V Schwatka
- Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
| | - Adam Atherly
- Department of Health Systems, Management & Policy, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Miranda J Dally
- Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China
| | | | - Liliana Tenney
- Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
| | - Ron Z Goetzel
- Johns Hopkins University Bloomberg School of Public Health, Institute for Health and Productivity Studies, and Truven Health Analytics, Bethesda, Maryland, USA
| | | | - Roxana Witter
- Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
| | - Stephen Reynolds
- Department of Environmental and Radiological Health Sciences, School of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | | | - Lee S Newman
- Department of Environmental and Occupational Health, Center for Health, Work, and Environment and Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA.,Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA
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Occupational Exposure to PM2.5 and Incidence of Ischemic Heart Disease: Longitudinal Targeted Minimum Loss-based Estimation. Epidemiology 2016; 26:806-14. [PMID: 26079662 PMCID: PMC4741411 DOI: 10.1097/ede.0000000000000329] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We investigated the incidence of ischemic heart disease (IHD) in relation to accumulated exposure to particulate matter (PM) in a cohort of aluminum workers. We adjusted for time varying confounding characteristic of the healthy worker survivor effect, using a recently introduced method for the estimation of causal target parameters. METHODS Applying longitudinal targeted minimum loss-based estimation, we estimated the difference in marginal cumulative risk of IHD in the cohort comparing counterfactual outcomes if always exposed above to always exposed below a PM2.5 exposure cut-off. Analyses were stratified by sub-cohort employed in either smelters or fabrication facilities. We selected two exposure cut-offs a priori, at the median and 10th percentile in each sub-cohort. RESULTS In smelters, the estimated IHD risk difference after 15 years of accumulating PM2.5 exposure during follow-up was 2.9% (0.6%, 5.1%) using the 10th percentile cut-off of 0.10 mg/m. For fabrication workers, the difference was 2.5% (0.8%, 4.1%) at the 10th percentile of 0.06 mg/m. Using the median exposure cut-off, results were similar in direction but smaller in size. We present marginal incidence curves describing the cumulative risk of IHD over the course of follow-up for each sub-cohort under each intervention regimen. CONCLUSIONS The accumulation of exposure to PM2.5 appears to result in higher risks of IHD in both aluminum smelter and fabrication workers. This represents the first longitudinal application of targeted minimum loss-based estimation, a method for generating doubly robust semi-parametric efficient substitution estimators of causal parameters, in the fields of occupational and environmental epidemiology.
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Hamad R, Modrek S, Cullen MR. The Effects of Job Insecurity on Health Care Utilization: Findings from a Panel of U.S. Workers. Health Serv Res 2016; 51:1052-73. [PMID: 26416343 PMCID: PMC4874827 DOI: 10.1111/1475-6773.12393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the impacts of job insecurity during the recession of 2007-2009 on health care utilization among a panel of U.S. employees. DATA SOURCES/STUDY SETTING Linked administrative and claims datasets on a panel of continuously employed, continuously insured individuals at a large multisite manufacturing firm that experienced widespread layoffs (N = 9,486). STUDY DESIGN We employed segmented regressions to examine temporal discontinuities in utilization during 2006-2012. To assess the effects of job insecurity, we compared individuals at high- and low-layoff plants. Because the dataset includes multiple observations for each individual, we included individual-level fixed effects. PRINCIPAL FINDINGS We found discontinuous increases in outpatient (3.5 visits/month/10,000 individuals, p = .002) and emergency (0.4 visits/month/10,000 individuals, p = .05) utilization in the panel of all employees. Compared with individuals at low-layoff plants, individuals at high-layoff plants decreased outpatient utilization (-4.0 visits/month/10,000 individuals, p = .008), suggesting foregone preventive care, with a marginally significant increase in emergency utilization (0.4 visits/month/10,000 individuals, p = .08). CONCLUSIONS These results suggest changes in health care utilization and potentially adverse impacts on employee health in response to job insecurity during the latest recession. This study contributes to our understanding of the impacts of economic crises on the health of the U.S. working population.
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Affiliation(s)
- Rita Hamad
- Division of General Medical DisciplinesDepartment of MedicineStanford UniversityPalo AltoCA
| | - Sepideh Modrek
- Division of General Medical DisciplinesDepartment of MedicineStanford UniversityPalo AltoCA
| | - Mark R. Cullen
- Division of General Medical DisciplinesDepartment of MedicineStanford UniversityStanfordCA
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36
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Kouvonen A, Vahtera J, Pentti J, Korhonen MJ, Oksanen T, Salo P, Virtanen M, Kivimäki M. Antidepressant use and work-related injuries. Psychol Med 2016; 46:1391-1399. [PMID: 26804130 DOI: 10.1017/s0033291715002925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adverse effects of antidepressants are most common at the beginning of the treatment, but possible also later. We examined the association between antidepressant use and work-related injuries taking into account the duration of antidepressant use. METHOD Antidepressant use and work-related injuries between 2000 and 2011 were measured among 66 238 employees (mean age 43.8 years, 80% female) using linkage to national records (the Finnish Public Sector study). We analysed data using time-dependent modelling with individuals as their own controls (self-controlled case-series design). RESULTS In 2238 individuals who had used antidepressants and had a work-related injury during a mean follow-up of 7.8 years, no increase in the risk of injury was observed in the beginning of antidepressant treatment. However, an increased injury risk was seen after 3 months of treatment (rate ratio, compared with no recent antidepressant use, 1.27, 95% confidence interval 1.10-1.48). This was also the case among those who had used only selective serotonin reuptake inhibitors (n = 714; rate ratio 1.41, 95% confidence interval 1.08-1.83). CONCLUSIONS Antidepressant use was not associated with an increased risk of work-related injury at the beginning of treatment. Post-hoc analyses of antidepressant trials are needed to determine whether long-term use of antidepressants increases the risk of work-related injury.
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Affiliation(s)
- A Kouvonen
- Department of Social Research,University of Helsinki,Helsinki,Finland
| | - J Vahtera
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
| | - J Pentti
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
| | - M J Korhonen
- Department of Pharmacology, Drug Development and Therapeutics,University of Turku,Turku,Finland
| | - T Oksanen
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
| | - P Salo
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
| | - M Virtanen
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
| | - M Kivimäki
- Finnish Institute of Occupational Health,Turku and Helsinki,Finland
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Alali H, Abdel Wahab M, Van Hecke T, Braeckman L. Work accident victims: a comparison between non-standard and standard workers in Belgium. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2016; 22:99-106. [PMID: 27092408 DOI: 10.1080/10773525.2016.1168588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The fast growth of non-standard employment in developed countries highlights the importance of studying the influence of contract type on worker's safety and health. OBJECTIVE The main purpose of our study is to investigate whether non-standard workers are more injured than standard workers or not. Additionally, other risk factors for occupational accidents are investigated. METHODS Data from the Belgian surveys on work ability in 2009 and 2011 are used. During their annual occupational health examination, workers were asked to fill in a self-administered questionnaire. In total, 1886 complete responses are collected and analyzed using logistic regression. RESULTS Temporary workers did not have higher injury rates than permanent workers [OR 0.5, 95% confidence interval 0.2-1.2]. Low-educated, less-experienced workers and those exposed to dangerous conditions are more frequent victims of occupational accidents. CONCLUSION The present data do not support the hypothesis that non-standard workers have more injuries than standard workers. Our results about occupational accidents derived from a non-representative sample of the Belgian workforce and cannot be generalized due to the heterogeneity in job organization and labor regulations between countries. Further research is needed to extend our findings and to seek other factors that may be associated with work accidents.
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Affiliation(s)
- Hanan Alali
- a Faculty of Engineering and Architecture , Ghent University , Gent , Belgium
| | - Magd Abdel Wahab
- a Faculty of Engineering and Architecture , Ghent University , Gent , Belgium
| | - Tanja Van Hecke
- b Department of Industrial Technology and Construction , Ghent University , Ghent , Belgium
| | - Lutgart Braeckman
- c Department of Public Health, Faculty of Medicine and Health Sciences , Ghent University , Gent , Belgium
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Lander L, Sorock GS, Smith LM, Stentz TL, Kim SS, Mittleman MA, Perry MJ. Is depression a risk factor for meatpacking injuries? Work 2016; 53:307-11. [DOI: 10.3233/wor-152147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lina Lander
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Lynette M. Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Terry L. Stentz
- College of Engineering, University of Nebraska–Lincoln, Lincoln, NE, USA
- Department of Environmental, Agricultural, and Occupational Health Sciences, College of Public Health, University of Nebraska Medical Center-Omaha, NE, USA
| | - Seung-Sup Kim
- Department of Environmental and Occupational Health, The George Washington University, Washington, DC, USA
| | - Murray A. Mittleman
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Melissa J. Perry
- Department of Environmental and Occupational Health, The George Washington University, Washington, DC, USA
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Rommel A, Varnaccia G, Lahmann N, Kottner J, Kroll LE. Occupational Injuries in Germany: Population-Wide National Survey Data Emphasize the Importance of Work-Related Factors. PLoS One 2016; 11:e0148798. [PMID: 26859560 PMCID: PMC4747528 DOI: 10.1371/journal.pone.0148798] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/22/2016] [Indexed: 12/12/2022] Open
Abstract
Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18-70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4-3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7-1.2; men: 4.3%; 95% CI 3.7-5.0). In the fully adjusted model, male gender (OR 3.16) and age 18-29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons.
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Affiliation(s)
- Alexander Rommel
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Gianni Varnaccia
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Nils Lahmann
- Charité-Universitätsmedizin Berlin, Institute of Health Sciences Education and Nursing, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Lars Eric Kroll
- Robert Koch Institute, Epidemiology and Health Monitoring, General-Pape-Str. 62-66, 12101, Berlin, Germany
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Virtanen M, Ervasti J, Mittendorfer-Rutz E, Tinghög P, Lallukka T, Kjeldgård L, Pentti J, Alexanderson K. Trends of diagnosis-specific work disability after newly diagnosed diabetes: a 4-year nationwide prospective cohort study. Diabetes Care 2015; 38:1883-90. [PMID: 26251407 DOI: 10.2337/dc15-0247] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/13/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability. RESEARCH DESIGN AND METHODS The register data of diabetes medication and in- and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007‒2010) were obtained from the Swedish Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056). RESULTS The most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for confounding factors 18.8‒19.8 compensated days/year), musculoskeletal diseases (12.1‒12.8 days/year), circulatory diseases (5.9‒6.5 days/year), diseases of the nervous system (1.8‒2.0 days/year), and injuries (1.0‒1.2 days/year). The disparity in mental disorders first widened and then narrowed, while the difference in other major diagnostic categories was stable over 4 years. The highest rate (45.3 days/year) was found among people who had diabetes, lived alone, and were disabled from work owing to mental disorders. CONCLUSIONS The increased risk of work disability among those with diabetes is largely attributed to comorbid mental, musculoskeletal, and circulatory diseases. It is important to monitor comorbid conditions and take account of socioeconomic disadvantage.
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Affiliation(s)
- Marianna Virtanen
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Petter Tinghög
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Hamad R, Modrek S, Kubo J, Goldstein BA, Cullen MR. Using "big data" to capture overall health status: properties and predictive value of a claims-based health risk score. PLoS One 2015; 10:e0126054. [PMID: 25951622 PMCID: PMC4423900 DOI: 10.1371/journal.pone.0126054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 03/28/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Investigators across many fields often struggle with how best to capture an individual's overall health status, with options including both subjective and objective measures. With the increasing availability of "big data," researchers can now take advantage of novel metrics of health status. These predictive algorithms were initially developed to forecast and manage expenditures, yet they represent an underutilized tool that could contribute significantly to health research. In this paper, we describe the properties and possible applications of one such "health risk score," the DxCG Intelligence tool. METHODS We link claims and administrative datasets on a cohort of U.S. workers during the period 1996-2011 (N = 14,161). We examine the risk score's association with incident diagnoses of five disease conditions, and we link employee data with the National Death Index to characterize its relationship with mortality. We review prior studies documenting the risk score's association with other health and non-health outcomes, including healthcare utilization, early retirement, and occupational injury. RESULTS AND CONCLUSIONS We find that the risk score is associated with outcomes across a variety of health and non-health domains. These examples demonstrate the broad applicability of this tool in multiple fields of research and illustrate its utility as a measure of overall health status for epidemiologists and other health researchers.
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Affiliation(s)
- Rita Hamad
- General Medical Disciplines, Stanford University, Palo Alto, California, United States of America
| | - Sepideh Modrek
- General Medical Disciplines, Stanford University, Palo Alto, California, United States of America
| | - Jessica Kubo
- Quantitative Sciences Unit, Stanford University, Palo Alto, California, United States of America
| | - Benjamin A. Goldstein
- Quantitative Sciences Unit, Stanford University, Palo Alto, California, United States of America
| | - Mark R. Cullen
- General Medical Disciplines, Stanford University, Palo Alto, California, United States of America
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Neophytou AM, Costello S, Brown DM, Picciotto S, Noth EM, Hammond SK, Cullen MR, Eisen EA. Marginal structural models in occupational epidemiology: application in a study of ischemic heart disease incidence and PM2.5 in the US aluminum industry. Am J Epidemiol 2014; 180:608-15. [PMID: 25125691 DOI: 10.1093/aje/kwu175] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Marginal structural models (MSMs) and inverse probability weighting can be used to estimate risk in a cohort of active workers if there is a time-varying confounder (e.g., health status) affected by prior exposure-a feature of the healthy worker survivor effect. We applied Cox MSMs in a study of incident ischemic heart disease and exposure to particulate matter with aerodynamic diameter of 2.5 μm or less (PM2.5) in a cohort of 12,949 actively employed aluminum workers in the United States. The cohort was stratified by work process into workers in smelting facilities, herein referred to as "smelters" and workers in fabrication facilities, herein referred to as "fabricators." The outcome was assessed by using medical claims data from 1998 to 2012. A composite risk score based on insurance claims was treated as a time-varying measure of health status. Binary PM2.5 exposure was defined by the 10th-percentile cutoff for each work process. Health status was associated with past exposure and predicted the outcome and subsequent exposure in smelters but not in fabricators. In smelters, the Cox MSM hazard ratio comparing those always exposed above the cutoff with those always exposed below the cutoff was 1.98 (95% confidence interval: 1.18, 3.32). In fabricators, the hazard ratio from a traditional Cox model was 1.34 (95% confidence interval: 0.98, 1.83). Results suggest that occupational PM2.5 exposure increases the risk of incident ischemic heart disease in workers in both aluminum smelting and fabrication facilities.
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Cander S, Gul OO, Gul CB, Keles SB, Yavas S, Ersoy C. The Impact of Patient Education on Anthropometric, Lipidemic, and Glycemic Parameters Among Patients With Poorly Controlled Type II Diabetes Mellitus: A 3-Month Prospective Single-Center Turkish Study. Workplace Health Saf 2014; 62:500-7. [PMID: 25199169 DOI: 10.3928/21650799-20140826-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 07/25/2014] [Indexed: 11/20/2022]
Abstract
This study evaluated the impact of patient education on adherence to a diabetes care plan (e.g., anthropometric, lipidemic, and glycemic parameters) among adults with type II diabetes mellitus without adequate glycemic control. A total of 61 ambulatory adults with type II diabetes mellitus (mean age: 53.6 ± 8.2 years, 70.5% female) were evaluated for anthropometrics, duration of diabetes mellitus, type of anti-diabetic treatment, blood biochemistry, and glycemic parameters in this 3-month prospective observational single-center study. During the course of the study, participants demonstrated a significant decrease in body weight and fat percentage and HbA1c (p < .001 for each). None of the factors evaluated was a significant determinant for glycemic parameters. These findings revealed that adults with type II diabetes mellitus who received education on adherence to routine self-monitoring of blood glucose, standard diabetic diet, and an exercise program delivered by certified diabetes educators had better glycemic control and significant decrease in body weight and fat percentage over a 3-month monitoring period.
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Tessier-Sherman B, Cantley LF, Galusha D, Slade MD, Taiwo OA, Cullen MR. Occupational injury risk by sex in a manufacturing cohort. Occup Environ Med 2014; 71:605-10. [PMID: 24924313 PMCID: PMC4145414 DOI: 10.1136/oemed-2014-102083] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/25/2014] [Accepted: 05/25/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study expands previous research comparing injury risk for women and men in a cohort of 24,000 US aluminium manufacturing workers in 15 facilities from 2001 to 2010. METHODS We compared injury rates (all injury, first aid, medical treatment, restricted work and lost work time) by sex and by job and sex. Using a mixed effect modelling approach, we calculated ORs and 95% CIs adjusting for age, job tenure, ethnicity and year as fixed effects and person, job and plant as random effects. Additionally, we modelled the data stratified by plant type to examine potential differences in injury risk between smelter (generally recognised as more hazardous) and fabrication production environments. RESULTS Risk of injury was higher for women in four out of the five injury outcomes: all injuries combined (OR: 1.58, CI 1.48 to 1.67), injuries requiring first aid (OR: 1.61, CI 1.54 to 1.70), injuries requiring medical treatment (OR: 1.18, CI 1.03 to 1.36) and injuries requiring restricted work (OR: 1.65, CI 1.46 to 1.87). No difference in the risk of lost time injury by sex was found in this cohort. Analyses stratified by plant type showed similarly elevated injury risk for women, although the risk estimates were higher in smelters than fabrication plants. CONCLUSIONS To our knowledge, this is the largest single-firm study examining injury risk by sex with sufficient data to appropriately adjust for job. We show a consistently higher injury risk for women compared with men in the smelting and fabrication environments.
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Affiliation(s)
- Baylah Tessier-Sherman
- Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Linda F Cantley
- Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Deron Galusha
- Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Martin D Slade
- Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Oyebode A Taiwo
- Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mark R Cullen
- Department of General Internal Medicine, Stanford University School of Medicine, Stanford, California, USA
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Palmer KT, D'Angelo S, Harris EC, Linaker C, Coggon D. Epilepsy, diabetes mellitus and accidental injury at work. Occup Med (Lond) 2014; 64:448-53. [PMID: 24964785 DOI: 10.1093/occmed/kqu079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To assess the contribution of epilepsy and diabetes to occupational injury. METHODS The Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations and treatments. Using this, we conducted a population-based case-control study, identifying patients aged 16-64 years, who had consulted over two decades for workplace injury, plus matched controls. By conditional logistic regression, we assessed risks for diabetes and epilepsy overall, several diabetic complications and indices of poor control, occurrence of status epilepticus and treatment with hypoglycaemic and anti-epileptic agents. RESULTS We identified 1348 injury cases and 6652 matched controls. A total of 160 subjects (2%) had previous epilepsy, including 29 injury cases, whereas 199 (2.5%) had diabetes, including 77 with eye involvement and 52 with a record of poor control. Odds ratios (ORs) for occupational injury were close to unity, both in those with epilepsy (1.07) and diabetes (0.98) and in those prescribed anti-epileptic or hypoglycaemic treatments in the previous year (0.87-1.16). We found no evidence of any injury arising directly from a seizure and no one had consulted about their epilepsy within 100 days before their injury consultation. Two cases and six controls had suffered status epilepticus (OR versus never had epilepsy 1.61). Risks were somewhat higher for certain diabetic complications (OR 1.44), although lower among those with eye involvement (OR 0.70) or poor diabetic control (OR 0.50). No associations were statistically significant. CONCLUSIONS No evidence was found that diabetes or epilepsy are important contributors to workplace injury in Britain.
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Affiliation(s)
- K T Palmer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
| | - S D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E C Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - C Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - D Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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