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Swart L, Claassen N, Buys T. Mapping the evidence on assessment of fitness to work at heights: a scoping review protocol. BMJ Open 2023; 13:e067847. [PMID: 37225273 DOI: 10.1136/bmjopen-2022-067847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Falls from height are a leading cause of serious injury and fatality globally. In South Africa, work at heights is regulated by occupational health and safety legislation, which places responsibility on employers to ensure their workers are fit for high-risk work. There is however no formal procedure or consensus on how fitness to work at heights should be assessed. This paper presents an a priori protocol for a scoping review that seeks to identify and map the current evidence base around the assessment of fitness to work at heights. It forms the initial phase of a PhD study aimed at developing an interdisciplinary consensus statement for assessing fitness to work at heights in the South African construction industry. METHODS AND ANALYSIS This scoping review will follow the Joanna Briggs Institute (JBI) scoping review framework and will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping reviews (PRISMA-ScR) checklist. An iterative search will be conducted in a selection of multidisciplinary databases including, Proquest Central, PubMed, Scopus, Science Direct, Web of Science, PsychINFO and Google Scholar. Thereafter, searches for grey literature will be performed in Google.com and websites of various national and international agencies, governing bodies and professional organisations with an interest in occupational health and work at heights. Where appropriate, targeted requests for clarification for further information will be undertaken with information sources. A descriptive qualitative content analysis of the results will be conducted and a level of evidence rating will be assigned to each study using the JBI approach. This will allow us to provide some commentary on the rigour of the existing evidence base. ETHICS AND DISSEMINATION Ethics approval for the PhD study was granted by the Research Ethics Committee, Faculty of Health Sciences, University of Pretoria, ethics reference number, 486/2021. Results of the scoping review will be submitted to a scientific journal for publication. TRIAL REGISTRATION NUMBER This protocol is registered on the Open Science Framework at osf.io/yd5gw.
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Affiliation(s)
- Lyndsey Swart
- Occupational Therapy, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Nicolaas Claassen
- Enviromental and Occupational Health, University of Pretoria, Pretoria, South Africa
- Occupational and Environmental Health, Edith Cowan University School of Medical and Health Sciences, Joondalup, Western Australia, Australia
| | - Tania Buys
- Occupational Therapy, University of Pretoria, Pretoria, South Africa
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Alsuwaidi AR, Al Hosani FI, Al Memari S, Narchi H, Abdel Wareth L, Kamal H, Al Ketbi M, Al Baloushi D, Elfateh A, Khudair A, Al Mazrouei S, AlHumaidan HS, Alghaithi N, Afsh K, Al Kaabi N, Altrabulsi B, Jones M, Shaban S, Sheek-Hussein M, Zoubeidi T. Seroprevalence of COVID-19 infection in the Emirate of Abu Dhabi, United Arab Emirates: a population-based cross-sectional study. Int J Epidemiol 2021; 50:1077-1090. [PMID: 33893483 PMCID: PMC8135550 DOI: 10.1093/ije/dyab077] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 01/08/2023] Open
Abstract
Background The United Arab Emirates (UAE) was the first country in the Middle East to report severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serosurveys are essential to understanding the extent of virus transmission. This cross-sectional study aims to assess the seroprevalence of SARS-CoV-2 infection in the Emirate of Abu Dhabi. Methods Between 19 July and 14 August 2020, 4487 households were selected using a random sample stratified by region and citizenship of the head of household (UAE citizen or non-citizen). A cluster sample of 40 labour camps was selected. Data on socio-demographic characteristics, risk factors and symptoms compatible with coronavirus disease 2019 (COVID-19) were collected. Each participant was first tested by Roche Elecsys® Anti-SARS-CoV-2 assay, followed, when reactive, by the LIAISON® SARS-CoV-2 S1/S2 IgG assay. Results Among 8831 individuals from households, seroprevalence was 10·4% [95% confidence intervals (CIs) 9·5–11·4], with higher seroprevalence in Abu Dhabi and Al Ain regions compared with those in Al Dhafra. In households, we found no sex difference and UAE citizens had lower seroprevalence compared with those of other nationalities. Among 4855 workers residing in labour camps, seroprevalence was 68·6% (95% CI 61·7–74·7), with higher seroprevalence among workers from Southeast Asia. In households, individuals with higher body mass indexes demonstrated higher seroprevalences than individuals with normal weight. Anosmia and ageusia were strongly associated with seropositivity. Conclusions The majority of household populations in the Emirate of Abu Dhabi remained unexposed to SARS-CoV-2. In labour camps, SARS-CoV-2 transmission was high. Effective public health measures should be maintained.
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Affiliation(s)
- Ahmed R Alsuwaidi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | - Hassib Narchi
- Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Laila Abdel Wareth
- National Reference Laboratory, Abu Dhabi, United Arab Emirates.,Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Hazem Kamal
- Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
| | - Mai Al Ketbi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Durra Al Baloushi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Abubaker Elfateh
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Ahmed Khudair
- Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates
| | | | - Hiba Saud AlHumaidan
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Noura Alghaithi
- Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Khalil Afsh
- Al Dhafra Hospitals, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Nawal Al Kaabi
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company, Abu Dhabi, United Arab Emirates
| | - Basel Altrabulsi
- National Reference Laboratory, Abu Dhabi, United Arab Emirates.,Pathology & Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Matthew Jones
- National Reference Laboratory, Abu Dhabi, United Arab Emirates
| | - Sami Shaban
- Department of Medical Education, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Taoufik Zoubeidi
- Department of Analytics in the Digital Era, College of Business and Economics, United Arab Emirates University, Al Ain, United Arab Emirates
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Can Resilience be Measured and Used to Predict Mental Health Symptomology Among First Responders Exposed to Repeated Trauma? J Occup Environ Med 2020; 61:285-292. [PMID: 30575696 DOI: 10.1097/jom.0000000000001526] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To examine whether baseline measures of resilience among active first responders predicts future mental health symptomology following trauma exposure. METHODS Multivariate linear regression examined the associations between baseline resilience and future mental health symptomatology following repeated trauma exposure. Symptomatology at 6-month follow-up was the dependent variable. RESULTS The associations between baseline resilience and future posttraumatic stress disorder (PTSD) (P = 0.02) and depression (P = 0.03) symptoms were statistically significant. Those reporting higher resilience levels had lower symptomology at 6-month follow-up. Eighty percent of first-responders who screened positive for low resilience went on to develop more PTSD symptoms. CONCLUSIONS Examining resilience may serve as a more effective means of screening, given resilience is a malleable construct which can be enhanced via targeted interventions. Higher levels of resilience may protect the long-term mental health of first-responders, particularly in regard to future PTSD.
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Remote screening of retinal and optic disc diseases using handheld nonmydriatic cameras in programmed routine occupational health checkups onsite at work centers. Graefes Arch Clin Exp Ophthalmol 2020; 259:575-583. [PMID: 32728935 PMCID: PMC7391026 DOI: 10.1007/s00417-020-04860-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate the first year outcomes of a remote screening program for detection of retinal diseases using handheld nonmydriatic cameras in occupational routine checkups performed onsite at work centers. Methods Cross-sectional, first year screening program outcomes audit. Participants were volunteers recruited from staff within work centers. Retinal fundus images were captured by technicians, and images and data were anonymized and sent securely to a remote server. A team of ophthalmologists, all retinal specialists, remotely read the images using a custom-made software and sent telematic reports of findings within 24–48 h. The main items evaluated were the detection of retinal abnormalities and the relationship between retinal findings and demographic data such as age and sex. Results A total of 19,881 workers were evaluated in 52 centers. Mean age was 41.1 years old, 43.9% men and 56.1% women. Mean duration of the test was around 2 min. Of the workers, 7.8% presented abnormalities in retinal fundus images, being the main findings choroidal nevus (2.4%), macular pigment abnormalities (1.5%), glaucomatous optic disc (1.2%), and macular signs of high myopia (1.1%). The presence of abnormalities was associated with greater age, being 5%, 7.9%, 12.6%, and 19.7% in workers less than 40 years, from 40 to 49, 50–59, and ≥ 60 years (p < 0.05), respectively. Men had more abnormalities in retinal fundus images than women (8.6 vs. 7.2; p < 0.05 RR: 1.2; CI 1092–1322). Conclusions Mass screening of retinal and optic disc abnormalities during occupational health routine checkups is a feasible, quick, and efficient tool for early detection of potential vision-threatening disease markers.
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Opie E, Brooks S, Greenberg N, Rubin GJ. The usefulness of pre-employment and pre-deployment psychological screening for disaster relief workers: a systematic review. BMC Psychiatry 2020; 20:211. [PMID: 32393208 PMCID: PMC7216600 DOI: 10.1186/s12888-020-02593-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 04/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals who conduct disaster relief work overseas are exposed to a variety of traumatic events that can cause distress and trigger psychological illnesses. Identification of which disaster relief workers may be at risk of experiencing psychological distress or mental health disorders is frequently carried out through pre-employment or pre-deployment psychological screening. The primary objective of our review was to assess the evidence for pre-employment and pre-deployment psychological screening of relief workers who work in disaster situations. We aimed to identify specific pre-employment and pre-deployment characteristics that predict impaired wellbeing of an individual following engaging in disaster-related work. METHODS A combined list of search terms was composed relating to disaster-related occupations, screening methods, psychological disorders, and study design. The databases used were PsycINFO, MEDLINE, EMBASE, and GlobalHealth. We included studies that used cross-sectional or longitudinal study designs; were published in the English language in peer-reviewed academic journals; reported on the association between pre-employment and pre-deployment features and post-deployment psychological disorders or distress; considered any occupational groups responding to a specified, discrete crisis; and used at least one validated measure of distress or disorder. We extracted data on the author; year of publication; disaster description; country of study; study design; population sample; disorder(s) outcome and the measures used; and results. RESULTS Sixty-two, high-quality studies were included in the review. Forty-one potential predictors were identified. Of these, only volunteer status and previous history of mental illness and life stressors emerged as reliable predictors of distress or disorder. CONCLUSION The results suggest that whilst it is attractive to screen for pre-employment and pre-deployment indicators of resilience, the evidence base for doing so is weak. At best, this sort of screening can only weakly suggest vulnerability and at worst may result in discrimination. Until better evidence about its usefulness becomes available, employers should exercise caution over its use.
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Affiliation(s)
- Elena Opie
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ, UK.
| | - Samantha Brooks
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
| | - Neil Greenberg
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
| | - G. James Rubin
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
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Magnavita N. Obstacles and Future Prospects: Considerations on Health Promotion Activities for Older Workers in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061096. [PMID: 29843423 PMCID: PMC6025276 DOI: 10.3390/ijerph15061096] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022]
Abstract
The ageing of workers is one of the most important issues for occupational health and safety in Europe. The ageing of the active population means that health promotion is a necessity rather than a mere option. This review considers barriers and perspectives for workplace health promotion for older workers. Lack of awareness on the part of management and inflexibility in the occupational health and safety system appear to be major barriers. To overcome these, it will be necessary to disseminate knowledge regarding the effectiveness of health promotion actions for older workers, encourage greater involvement on the part of social partners, recover resources by replacing medical consumerism and bureaucratic practices, adopt an integrated approach combining the prevention of occupational risks and the promotion of healthy lifestyles, and recognize subsidiarity and the ability of working communities to regulate themselves.
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Affiliation(s)
- Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
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McLellan RK. Work, Health, And Worker Well-Being: Roles And Opportunities For Employers. Health Aff (Millwood) 2018; 36:206-213. [PMID: 28167707 DOI: 10.1377/hlthaff.2016.1150] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Work holds the promise of supporting and promoting health. It also carries the risk of injury, illness, and death. In addition to harms posed by traditional occupational health hazards, such as physically dangerous workplaces, work contributes to health problems with multifactorial origins such as unhealthy lifestyles, psychological distress, and chronic disease. Not only does work affect health, but the obverse is true: Unhealthy workers are more frequently disabled, absent, and less productive, and they use more health care resources, compared to their healthy colleagues. The costs of poor workforce health are collectively borne by workers, employers, and society. For business as well as altruistic reasons, employers may strive to cost-effectively achieve the safest, healthiest, and most productive workforce possible. Narrowly focused health goals are giving way to a broader concept of employee well-being. This article explores the relationship between health and work, outlines opportunities for employers to make this relationship health promoting, and identifies areas needing further exploration.
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Affiliation(s)
- Robert K McLellan
- Robert K. McLellan is section chief of the Department of Occupational and Environmental Medicine at the Dartmouth-Hitchcock Medical Center, and a professor of medicine at the Geisel School of Medicine at Dartmouth, both in Lebanon, New Hampshire
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Prevalence, awareness, treatment, and control of hypertension among Chinese working population: results of a workplace-based study. ACTA ACUST UNITED AC 2018; 12:311-322.e2. [PMID: 29483001 DOI: 10.1016/j.jash.2018.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Abstract
We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18-60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%-23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%-48.8%) were aware of their condition, 20.6% (95% CI: 19.8%-21.4%) were in treatment, but only 8.5% (95% CI: 7.9%-9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71-0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07-2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.
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Marshall RE, Milligan-Saville JS, Mitchell PB, Bryant RA, Harvey SB. A systematic review of the usefulness of pre-employment and pre-duty screening in predicting mental health outcomes amongst emergency workers. Psychiatry Res 2017; 253:129-137. [PMID: 28365535 DOI: 10.1016/j.psychres.2017.03.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 03/19/2017] [Accepted: 03/23/2017] [Indexed: 02/07/2023]
Abstract
Despite a lack of proven efficacy, pre-employment or pre-duty screening, which alleges to test for vulnerability to PTSD and other mental health disorders, remains common amongst emergency services. This systematic review aimed to determine the usefulness of different factors in predicting mental disorder amongst emergency workers and to inform practice regarding screening procedures. Systematic searches were conducted in MEDLINE, PsycINFO and EMBASE to identify cohort studies linking pre-employment or pre-duty measures in first responders with later mental health outcomes. Possible predictors of poor mental health were grouped into six categories and their overall level of evidence was assessed. Twenty-one prospective cohort studies were identified. Dynamic measures including physiological responses to simulated trauma and maladaptive coping styles (e.g. negative self-appraisal) had stronger evidence as predictors of vulnerability in first responders than more traditional static factors (e.g. pre-existing psychopathology). Personality factors (e.g. trait anger) had moderate evidence for predictive power. Based on the evidence reviewed, however, we are unable to provide emergency services with specific information to enhance their current personnel selection. The results indicate that pre-duty screening protocols that include personality assessments and dynamic measures of physiological and psychological coping strategies may be able to identify some personnel at increased risk of mental health problems. However, further longitudinal research is required in order to provide meaningful guidance to employers on the overall utility of either pre-employment or pre-duty screening. In particular, research examining the sensitivity, specificity and positive predictive values of various screening measures is urgently needed.
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Affiliation(s)
- Ruth E Marshall
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josie S Milligan-Saville
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia.
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Postoffer Pre-Placement Screening for Carpal Tunnel Syndrome in Newly Hired Manufacturing Workers. J Occup Environ Med 2016; 58:1212-1216. [PMID: 27930481 DOI: 10.1097/jom.0000000000000891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We determined the predictive validity of a postoffer pre-placement (POPP) screen using nerve conduction velocity studies (NCV) to identify future cases of carpal tunnel syndrome (CTS). METHODS A cohort of 1648 newly hired manufacturing production workers underwent baseline NCS, and were followed for 5 years. RESULTS There was no association between abnormal POPP NCV results and incident CTS. Varying NCV diagnostic cut-offs did not improve predictive validity. Workers in jobs with high hand/wrist exposure showed greater risk of CTS than those in low exposed jobs (relative risk 2.82; 95% confidence interval 1.52 to 5.22). CONCLUSIONS POPP screening seems ineffective as a preventive strategy for CTS.
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Influence of Functional Capacity Evaluation on Physician's Assessment of Physical Capacity of Veterans With Chronic Pain: A Retrospective Analysis. PM R 2016; 9:652-659. [DOI: 10.1016/j.pmrj.2016.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 10/11/2016] [Accepted: 10/15/2016] [Indexed: 11/18/2022]
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Ballal SG. Occupational Rhinitis Revisited: Emphasis on the Risk Factors in Saudi Industry. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2016; 4:154-163. [PMID: 30787722 PMCID: PMC6298352 DOI: 10.4103/1658-631x.188254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) Task Force defines occupational rhinitis (OR) as "an inflammatory disease of the nose, which is characterized by intermittent or persistent symptoms (i.e., nasal congestion, sneezing, rhinorrea, itching), and/or variable nasal airflow limitation and/or hypersecretion arising out of causes and conditions attributable to a particular work environment and not to stimuli encountered outside the workplace." The objectives of this review are to highlight the causes of OR in industrial settings in Saudi Arabia in order to alert primary healthcare physicians and other healthcare providers of the importance of diagnosing and managing OR to prevent further complications and present to the General Organization for Social Insurance (GOSI) evidence of the existence of OR in Saudi industrial sector. The literature search yielded no publications from Saudi Arabia that have investigated the prevalence of OR, but it is expected to be high judging from the high prevalence of allergic rhinitis in the country. The occupational groups that are at risk of developing OR include workers in the petrochemical industry, healthcare personnel, livestock and bird breeders, bakers, farmers, housewives and other occupations all of which are present in Saudi Arabia. Clinic and industry based research within Saudi Arabia is recommended to determine the prevalence of OR and to alert healthcare providers to suspect OR in all symptomatic working adults, including housewives and domestic helpers. Use of EAACI algorithm for the diagnosis and management of this condition will help to manage the condition and prevent the deterioration and further complications. Furthermore, diagnosis using internationally recognized guidelines and the results of the suggested epidemiologic surveys may convince GOSI to recognize OR as an occupational disease.
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Affiliation(s)
- Seifeddin G. Ballal
- Department of Family and Community Medicine, College of Medicine, University of Dammam, Dammam, Saudi Arabia
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Schaafsma FG, Mahmud N, Reneman MF, Fassier J, Jungbauer FHW. Pre-employment examinations for preventing injury, disease and sick leave in workers. Cochrane Database Syst Rev 2016; 2016:CD008881. [PMID: 26755127 PMCID: PMC7163410 DOI: 10.1002/14651858.cd008881.pub2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Many employers and other stakeholders believe that health examinations of job applicants prevent occupational diseases and sickness absence. This is an update of the original Cochrane review (Mahmud 2010). OBJECTIVES To evaluate the effectiveness of pre-employment examinations of job applicants in preventing occupational injury, disease and sick leave compared to no intervention or alternative interventions. SEARCH METHODS We searched CENTRAL (the Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO and PEDro (up to 31 March 2015). We did not impose any restrictions on date, language or publication type. SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled before-after (CBA) studies, and interrupted time-series (ITS) studies of health examinations to prevent occupational diseases and injuries in job applicants in comparison to no intervention or alternative interventions. DATA COLLECTION AND ANALYSIS All five review authors independently selected studies from the updated search for inclusion. We retrieved two new studies with the updated search from 1 April 2008 to 31 March 2015, resulting in a total of eleven studies. MAIN RESULTS We included two RCTs, seven CBA studies and two ITS studies. Nine studies with 7820 participants evaluated the screening process of pre-employment examinations as a whole, and two studies with 2164 participants evaluated the measures to mitigate the risks found following the screening process. The studies were too heterogeneous for statistical pooling of results. We rated the quality of the evidence for all outcomes as very low quality. The two new CBA studies both used historical controls and both had a high risk of bias.Of those studies that evaluated the screening process, there is very low quality evidence based on one RCT that a general examination for light duty work may not reduce the risk for sick leave (mean difference (MD) -0.09, 95% confidence interval (CI) -0.47 to 0.29). For army recruits, there is very low quality evidence based on one CBA study that there is a positive effect on fitness for duty after 12 months follow-up (odds ratio (OR) 0.40, 95% CI 0.19 to 0.85).We found inconsistent evidence of an effect of job-focused pre-employment examinations on the risk of musculoskeletal injuries in comparison with general or no pre-employment examination based on one RCT with high risk of bias, and four CBA studies. There is very low quality evidence based on one ITS study that incorporation of a bronchial challenge test may decrease occupational asthma (trend change -2.6, 95% CI -3.6 to -1.5) compared to a general pre-employment examination with lung function tests.Pre-employment examinations may also result in a rejection of the applicant for the new job. In six studies, the rates of rejecting job applicants increased because of the studied examinations , on average, from 2% to 35%, but not in one study.There is very low quality evidence based on two CBA studies that risk mitigation among applicants considered not fit for work at the pre-employment examination may result in a similar risk of work-related musculoskeletal injury during follow-up compared to workers considered fit for work at the health examination. AUTHORS' CONCLUSIONS There is very low quality evidence that a general examination for light duty work may not reduce the risk for sick leave, but may have a positive effect on fitness for duty for army recruits after 12 months follow-up.There is inconsistent evidence of an effect of job-focused pre-employment examinations on the risk of musculoskeletal injuries in comparison with general or no pre-employment examination. There is very low quality evidence that incorporation of a bronchial challenge test may decrease occupational asthma compared to a general pre-employment examination with lung function tests. Pre-employment examinations may result in an increase of rejecting job applicants in six out of seven studies. Risk mitigation based on the result of pre-employment examinations may be effective in reducing an increased risk for occupational injuries based on very low quality evidence. This evidence supports the current policy to restrict pre-employment examinations to only job-specific examinations. Better quality evaluation studies on pre-employment examinations are necessary, including the evaluation of the benefits of risk mitigation, given the effect on health and on the financial situation for those employees who do not pass the pre-employment examination.
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Affiliation(s)
- Frederieke G Schaafsma
- VU University Medical Center, EMGO+ InstituteDepartment of Public and Occupational HealthVan der Boechorststraat 7 ‐ room A524Postbus 7057AmsterdamNetherlands1007 MB
| | - Norashikin Mahmud
- Universiti Teknologi MalaysiaProgram of Industrial and Organizational Psychology, Faculty of ManagementJohor Bahru CampusSkudaiJohorMalaysia81310
| | - Michiel F Reneman
- University Medical Center GroningenCenter of RehabilitationGroningenNetherlands
| | - Jean‐Baptiste Fassier
- Université Claude Bernard ‐ Lyon 1UMRESTTE ‐ UMR 9405Domaine RockefellerCedex 08LyonFrance69373
| | - Franciscus HW Jungbauer
- University Medical Hospital GroningenOccupational Health departmentHanzeplein 1GroningenNetherlands9800RB
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Pre-employment examination for low back risk in workers exposed to manual handling of loads: French guidelines. Int Arch Occup Environ Health 2015; 89:1-6. [PMID: 25739378 DOI: 10.1007/s00420-015-1040-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/24/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Low back pain (LBP) is a major cause of sickness absence and disability in the working population, and the pre-employment examination should insure that worker's state of health is compatible with the requirements of proposed job. This paper summarizes the main recommendations of the good practice guidelines of the French Society of Occupational Medicine for pre-employment examination in workers exposed to manual handling of loads apart from pre-employment test. METHODS The recommendations were developed according to the Clinical Practice Guidelines proposed by the French National Health Authority and based on a systematic search of the literature 1990-2012 in several databases. The guidelines were written and reviewed by two multidisciplinary committees. On the basis of the level of evidence in the literature, the proposed guidelines are classified as grade A, B, C or expert consensus. RESULTS The main recommendations of these guidelines are as follows: (1) medical contraindications alone should not exclude employment in a job associated with a low back risk on the basis of a history of "simple" nonspecific LBP; (2) the relevance of examining a previous history of LBP, which is the best predictor of future LBP due to the recurrent nature of LBP. CONCLUSIONS These guidelines correspond to a constant concern with prevention of occupational risk. Primarily intended for occupational physicians, they are also intended for general practitioners who carry out pre-employment examinations in many countries and are likely to be increasingly faced with this type of situation because of the combination of increasing work constraints with ageing of the workforce.
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Rothstein MA, Roberts J, Guidotti TL. LIMITING OCCUPATIONAL MEDICAL EVALUATIONS UNDER THE AMERICANS WITH DISABILITIES ACT AND THE GENETIC INFORMATION NONDISCRIMINATION ACT. AMERICAN JOURNAL OF LAW & MEDICINE 2015; 41:523-567. [PMID: 26863849 DOI: 10.1177/0098858815622190] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although medical care delivery by one's personal physician is the paradigmatic American healthcare arrangement, in the workplace setting, many Americans undergo medical evaluations to assess their fitness for duty or degree of impairment. This Article explores the complex and evolving legal status of occupational medical evaluations. Beginning with the legal and ethical frameworks of occupational medical practice, the Article then examines the effects of increasingly detailed legal regulation under the Americans with Disabilities Act and the Genetic Information Nondiscrimination Act on employees, employers, and physicians.
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Gouttebarge V, van der Molen HF, Frings-Dresen MHW, Sluiter JK. Developing a Best-Evidence Pre-employment Medical Examination: An Example from the Construction Industry. Saf Health Work 2014; 5:165-7. [PMID: 25379333 PMCID: PMC4213926 DOI: 10.1016/j.shaw.2014.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/12/2014] [Accepted: 05/15/2014] [Indexed: 02/07/2023] Open
Abstract
The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME). Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry (systematic literature search and expert meeting), specific job demands and related requirements were defined and instruments proposed. Finally, a work ability assessment was linked to the instruments' outcomes, resulting in the modular character of the developed PE-ME. Twenty-two specific job demands for all Dutch construction jobs were identified, including kneeling/squatting, working under time pressure, and exposure to hazardous substances. The next step was proposing self-report questions, screening questionnaires, clinical tests, and/or performance-based tests, leading to a work ability judgment. "Lifting/carrying" is described as an example. The new modular PE-ME enables a job-specific assessment of work ability to be made for more than 100 jobs in the Dutch construction industry.
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Affiliation(s)
- Vincent Gouttebarge
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Judith K Sluiter
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
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Zoer I, Sluiter JK, Frings-Dresen MHW. Psychological work characteristics, psychological workload and associated psychological and cognitive requirements of train drivers. ERGONOMICS 2014; 57:1473-1487. [PMID: 25033892 DOI: 10.1080/00140139.2014.938130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED This study aimed to assess the psychological work characteristics and psychological workload of train drivers and to define the psychological and cognitive requirements of their work. A systematic literature search was performed, and expert interviews were conducted. The following work demands were specific to train drivers: high emotional and mental demands, small amount of autonomy and skill discretion. No evidence of a high emotional workload, a high mental workload or short-term stress reactivity was found. In general, the drivers' fatigue complaints and recovery needs after work were comparable to that of other workers. However, severe sleepiness and high need for recovery did affect a substantial proportion of train drivers. The ability to stay aware, to anticipate, to remain attentive and to cope with fatigue are psychological and cognitive skills that are required to adequately and safely perform the train drivers' job. Including these requirements in periodic assessments of train drivers is recommended. PRACTITIONER SUMMARY A systematic literature search was performed, aimed at assessing the psychological work characteristics and psychological workload of train drivers. Based on this information and interviews with experts, a list of psychological and cognitive requirements that needed to perform the train drivers’ job adequately and safely was proposed.
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Affiliation(s)
- Ilona Zoer
- a Coronel Institute of Occupational Health, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
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Dale AM, Addison L, Lester J, Kaskutas V, Evanoff B. Weak grip strength does not predict upper extremity musculoskeletal symptoms or injuries among new workers. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:325-331. [PMID: 23857165 PMCID: PMC4725296 DOI: 10.1007/s10926-013-9460-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Grip strength is often tested during post-offer pre-placement screening for workers in hand-intensive jobs. The purpose of this study was to evaluate the association between grip strength and upper extremity symptoms, work disability, and upper extremity musculoskeletal disorders (UE MSDs) in a group of workers newly employed in both high and low hand intensive work. METHODS 1,107 recently-hired workers completed physical examinations including grip strength measurements. Repeated surveys obtained over 3 years described the presence of upper extremity symptoms, report of physician-diagnosed musculoskeletal disorders (MSDs), and job titles. Baseline measured grip values were used in analytic models as continuous and categorized values to predict upper extremity symptoms, work disability, or UE MSD diagnosis. RESULTS Twenty-six percent of males and 20 % of females had low baseline hand strength compared to normative data. Multivariate logistic regression analyses showed no consistent associations between grip strength and three health outcomes (UE symptoms, work disability, and MSDs) in this young cohort (mean age 30 years). Past MSD and work type were significant predictors of these outcomes. CONCLUSIONS Physical hand strength testing was not useful for identifying workers at risk for developing UE MSDs, and may be an inappropriate measure for post-offer job screens.
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Affiliation(s)
- Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA,
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Is an occupational examination superior to an occupational health history alone for preplacement screening in health care settings? J Occup Environ Med 2012; 54:276-9. [PMID: 22361991 DOI: 10.1097/jom.0b013e318246f1b7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine whether preplacement recommendations following an occupationally focused medical history is different from those following an occupational consultation. METHODS This was a retrospective cohort study of 172 applicants to our institution. RESULTS Following provider review of occupational history survey alone, none of the applicants had restrictions recommended. In comparison, only 163 applicants (94.7%) were recommended to be hired without restrictions following provider review of the same patient's occupational history and examination (P = 0.0078). CONCLUSION A well-designed questionnaire is useful for screening applicants for preplacement examinations and assures sufficient detail to allow for a large proportion of individuals to proceed to employment without an occupational examination. However, in this study, a small but statistically significant portion (5%) of applicants required occupational examinations for appropriate work recommendations.
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Madan I, Williams S. Is pre-employment health screening by questionnaire effective? Occup Med (Lond) 2011; 62:112-6. [PMID: 22207454 DOI: 10.1093/occmed/kqr208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Following a job offer, many employers require the chosen candidate to undergo health screening by questionnaire before the applicant commences work. Despite their widespread use, the effectiveness of such questionnaires remains uncertain. AIMS To systematically review the evidence for the effectiveness of pre-employment health questionnaires in predicting health and employment outcomes. METHODS We used a sensitive search strategy to search electronic databases from 1985 to September 2009. The search included dissertations for Membership of the UK Faculty of Occupational Medicine (MFOM). The authors independently selected abstracts and papers for critical appraisal and inclusion in the review using methods based on guidelines produced by the National Health Service Centre for Reviews and Dissemination, University of York. RESULTS Five hundred and three abstracts were identified; nine papers and two MFOM dissertations were critically appraised. Seven papers and two MFOM dissertations were included in the final review. Six studies explored pre-employment predictors of respiratory symptoms, one explored predictors of back pain in nurses, and two dissertations explored work outcomes including sickness absence and ill-health retirement. No papers addressing mental health outcomes met our inclusion criteria. Included studies either failed to identify pre-employment predictors of health and work outcomes or found very weak predictors. CONCLUSIONS Pre-employment health screening (PEHS) by questionnaire has a low predictive value in detecting future adverse health and occupational outcomes. Where PEHS takes place, the health standards required and criteria for rejection of applicants should be based on a full risk assessment of the prospective post.
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Affiliation(s)
- I Madan
- Occupational Health Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
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Chan SH, Kuok OM. A Study of Human Resources Recruitment, Selection, and Retention Issues in the Hospitality and Tourism Industry in Macau. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/15332845.2011.588579] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Franco G. Occupational health practice and exposure to nanoparticles: reconciling scientific evidence, ethical aspects, and legal requirements. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2011; 66:236-240. [PMID: 22014197 DOI: 10.1080/19338244.2010.539642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The paper aims at focusing the relationship between scientific evidence and ethical values' issues of occupational health practice according to the new Italian law 81/2008 stating that the occupational health physician (OHP) is required to act according to the Code of Ethics of the International Commission on Occupational Health. The code itself emphasizes that (i) the practice should be relevant, knowledge-based, sound, and appropriate to the occupational risks and (ii) the objectives and methods of health surveillance must be clearly defined. Because exposure to nanoparticles involves several uncertainties about health effects and may limit the effectiveness of workers' health surveillance, OHPs face a several ethical dilemmas, involving different stakeholders. The dilemmas arising from the practice should be dealt with according to the ethical principles of beneficence, autonomy, and justice in order to take a decision.
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Affiliation(s)
- Giuliano Franco
- Department of Medicine and Medical Specialties, University of Modena and Reggio Emilia, School of Medicine of Modena, Modena, Italy
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Mahmud N, Schonstein E, Schaafsma F, Lehtola MM, Fassier JB, Reneman MF, Verbeek JH. Pre-employment examinations for preventing occupational injury and disease in workers. Cochrane Database Syst Rev 2010:CD008881. [PMID: 21154401 DOI: 10.1002/14651858.cd008881] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Many employers and other stakeholders believe that health examinations of job applicants prevent occupational diseases and sickness absence. OBJECTIVES To evaluate the effectiveness of pre-employment examinations of job applicants in preventing occupational injury, disease and sickness absence compared to no intervention or alternative interventions. SEARCH STRATEGY We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO and PEDro (to December 2009) not restricted by date, language or publication type. SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled before-after studies (CBA), and interrupted time-series (ITS) of health examinations to prevent occupational diseases and injuries in job applicants. DATA COLLECTION AND ANALYSIS Four review authors (NM, ML, JV, ES) independently selected studies, extracted data, and determined study quality. The studies were too heterogeneous for statistical pooling of results. MAIN RESULTS We included two RCTs, five CBA studies and two ITS. Seven studies with 5872 participants evaluated the screening process of pre-employment examinations and two studies with 2164 participants evaluated the measures to mitigate the risks found following the screening process.Of those studies that evaluated the screening process, one study found that a general examination did not reduce sick leave (Mean Difference -0.1 95% CI -0.5 to 0.3) but another study found that a more task focused examination did (MD -36 95% CI -68.3 to -3.8). One study found that incorporation of a bronchial challenge test decreased occupational asthma (trend change -2.6 95% CI -3.6 to -1.5). Three studies that included functional capacity evaluation found contradictory effects on injury rates and number of medical visits. The rates of rejecting job applicants varied from 2% to 35%.Neither of the two studies that evaluated risk mitigation found an increased injury rate after training or work accommodations had been implemented.We rated the evidence for all outcomes as very low quality. AUTHORS' CONCLUSIONS There is very low quality evidence that pre-employment examinations that are specific to certain jobs or health problems could reduce occupational disease, injury, or sickness absence. This supports the current policy to restrict pre-employment examinations to job-specific examinations. More studies are needed that take into account the harms of rejecting job applicants.
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Affiliation(s)
- Norashikin Mahmud
- Faculty of Health Sciences, University of Sydney, Cumberland Campus C42, PO Box 170, Lidcombe, NSW, Australia, 1825
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