Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation

BACKGROUND

Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings.

METHOD

We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare.

RESULTS

Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases.

DISCUSSION

Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.

Assessing Mental Healthcare Worker Experiences of Workplace Fairness and Organizational Value: A National Survey of Peer-Support Specialists

BACKGROUND

Peer-support specialists-individuals with diagnosed mental illnesses who provide support services to other adults with diagnosed mental health issues-often feel stigmatized and undervalued at work, leading to negative personal- and job-related outcomes. Given their important link to positive service user outcomes, this study assessed how peer-support specialists perceive fairness and feel valued in the workplace.

METHODS

Peer-support specialists (N = 274) were recruited online from peer-support specialist listservs, social media groups, and patient-run organizations to take a cross-sectional survey that included a 14-item scale on how workplace fairness relates to job satisfaction and four questions on how valued they felt by administrators, clinicians, the people they serve, and fellow peer-support specialists. Descriptive and bivariate statistics were used to assess total scores and differences by gender and race.

FINDINGS

Ranging in age from 20 to 77 years and identifying predominantly as White (81.0%) and female (62.9%), respondents noted that fair practices in the workplace would increase their job satisfaction, with no significant differences observed by gender or race. Most peer-support specialists felt valued by the people they serve (97.1%) and fellow peer-support specialists (92.7%). However, fewer reported feeling valued by administrators (64.6%) and clinicians (60.6%).

CONCLUSIONS/APPLICATION TO PRACTICE

Peer-support specialists value fairness at the workplace and feel undervalued by some staff. This study highlights peer-support specialists' important role in behavioral health services and suggests that healthcare professionals, including occupational health specialists, are important stakeholders in creating fairer workplaces and increasing peer-support specialists' sense of being valued, leading to improved personal and organizational outcomes.

The One Health Framework

Six of every 10 infectious diseases in people are zoonotic. The One Health approach is vital to global efforts to prevent and respond to these diseases.

Silicosis

Occupational exposures to dust with elevated levels of respirable crystalline silica in artificial stone increase workers' risk for silicosis.

The Occupational Health of Nurses in the Economic Community of West African States: A Review of the Literature

Nurses provide the majority of health care in sub-Saharan Africa, which has high rates of Hepatitis B Virus (HBV) and human immunodeficiency virus (HIV). This systematic review used PRISMA methodology to synthesize the literature published between January 2008 and December 2018 examining the occupational health of nurses practicing in the Economic Community of West African States (ECOWAS). The United States' National Institute for Occupational Safety and Health's Hierarchy of Controls is used to frame the findings. This research was mostly conducted in Nigeria and Ghana and focused on administrative controls. Nurses practicing in ECOWAS are at high risk of acquiring a bloodborne illness due to inadequate engineering and administrative controls, as well as limited access to personal protective equipment (PPE). These findings indicate interventions to improve these controls would likely lower the occupational risks faced by nurses practicing in ECOWAS. Research in more countries in ECOWAS would likely find differences in occupational health practices in Nigeria and Ghana, which are relatively wealthy, and other countries in the region. This literature showed nurses practicing in ECOWAS did not have adequate protection from biological hazards. Regional health groups, such as the West African Health Organization, should commit to improving occupational health practice. Needle recapping and double gloving must be discontinued, and PPE must be made more widely available in ECOWAS. Occupational health professionals in the region should advocate for better distribution of PPE and consider offering trainings on these behaviors.

Health Promotion in Volunteer Firefighters: Assessing Knowledge of Risk for Developing Cardiovascular Disease

Cardiac events are strongly associated with line of duty deaths among firefighters. Among a convenience sample (N = 14) of volunteer firefighters, a questionnaire assessed their knowledge of cardiovascular disease before and after cardiovascular health training using evidence-based guidelines. The questionnaire explored their pattern of physical activity, awareness of their lipid levels, body mass index, as well as signs and symptoms of cardiovascular disease. Thereafter, an educational health program was conducted. Firefighters demonstrated an increase in knowledge post training, in that they were able to identify cardiovascular risk factors and personal determinants of cardiovascular disease. Occupational health providers are encouraged to educate firefighters about the seriousness of cardiovascular disease, and to implement measures to promote better lifestyle behaviors.

Health Literacy Level of Casting Factory Workers and Its Relationship With Occupational Health and Safety Training

Health literacy (HL) is a stronger predictor of an individual's health status than income, employment status, education level, and race or ethnicity. Lower levels of HL may contribute to low uptake or less adherence to occupational health and safety (OHS) training. This study was conducted among casting factory workers who received OHS training routinely. Data on sociodemographic characteristics, OHS training, and scores of the Health Literacy Survey-European Union (HLS-EU) were collected. Of the 282 of the 600 (47%) workers surveyed, 13.5% had inadequate, 47.5% problematic, 30.9% sufficient, and 8.2% excellent HL scores. There were no statistically significant differences between workers with limited and proficient HL with respect to age group or educational level. Workers with limited HL were less satisfied with OHS training content and were less likely to identify one-on-one health and safety training sessions as training. Limited HL is a universal problem both in the general and working populations, and it may be restricting the workers understanding of OHS training. Occupational health nurses should be aware of the detrimental effects of limited HL and modify their OHS training where needed for purposes of increasing the successful adoption of safe work practices.

Leptospirosis

Leptospirosis is a leading zoonotic disease for morbidity and mortality in humans globally. Occupational health nurses should teach workers and the public about leptospirosis and the importance of disrupting the infection source through rodent control, animal vaccination, and flood prevention.

Physical Activity and Psychological Well-Being in Older University Office Workers: Survey Findings

Prolonged sitting time has been reported among university workers which can have adverse health effects. The aim of this study was to examine the sitting time, physical activity, and psychological well-being reported by older university office workers. An online self-reported survey was distributed to all office workers 55 years and older at one university in Australia. Sixty-six office workers were recruited. They reported an average sitting time of 7.5 hours per day on weekdays. In all, 72.7% of the sample reported both moderate and high physical activity levels. A high percentage of the office workers reported depression (25.8%) and anxiety (12.1%). Lower education levels were significantly related to higher perceived stress and more depressive symptomatology ( p = .03 and .02, respectively). Significant associations were found between stress, depression, and anxiety ( p < .001) among this group of workers.

The American Association of Occupational Health Nurses: Seventy-Five Years of Education, Practice, and Research

For the past 75 years, the American Association of Industrial Nurses, and later the American Association of Occupational Health Nurses, has advocated for occupational and environmental health nurses by supporting quality undergraduate and graduate education in the specialty and certification through the American Board of Occupational Health Nurses, Inc., and providing funding for and dissemination of occupational health nursing research as well as by developing occupational health nursing practice standards, competencies, and code of ethics.

Global Tuberculosis

Tuberculosis (TB) infections remain a common but deadly disease. TB control in health care and correctional settings presents numerous public health challenges for occupational and correctional health nurses.

How the Non-Work Environment Can Affect Worker and Family Health

Occupational health nurses are familiar with environmental exposures workers encounter in their workplaces. However, employees are only "on-the-job" about one third of each workday, with a multitude of potential exposures in other environments that can affect their health. This article addresses some of the major exposures employees encounter outside the workplace-air, water, and soil pollution, and hazardous wastes-including a discussion of several well-known national and international environmental incidents. The major sources of these pollutants and how they contaminate the environment were investigated. Finally, risk assessment and communication along with effective strategies for educating employees and the community are presented.

An Update on Travel Vaccines and Issues in Travel and International Medicine

The fields of travel and international medicine are rapidly changing and growing. The role of occupational and travel health nurses is expanding and should be a focus for the future. At the American Association of Occupational Health Nurses Annual meeting on March 24, 2015, in Boston, five presentations were included in the session, An Update on Travel Vaccines and Issues in Travel and International Medicine. This article summarizes three of the presentations and includes a portion of the information generated by the Centers for Disease Control and Prevention (CDC) included in the fourth presentation. The first section focuses on the Essential Elements of Travel Medicine Programs including the pre-travel care assessment, trip research and risk identification, medication intervention review, non-pharmaceutical and prevention strategies, and post-travel care. The next section is an overview of key issues for business travelers. The growth in the number of international business travelers and unique aspects of business travel are emphasized in a comprehensive travel health program. This section also includes a discussion of expatriates and their special risks identified in recent literature (e.g., an assessment of the significant costs of health events and productivity losses by both business travelers and expatriates). The final section offers a specific example of a vaccine-preventable disease, namely, Japanese encephalitis (JE) virus, and needed changes in JE vaccine recommendations.

Zika Virus

Zika virus (ZIKV) infections are the latest global public health emergency. Occupational health nurses can protect society by educating workers, women of childbearing age, and others traveling in ZIKV-infected areas about prevention strategies.

Reducing Occupational Risk to Ambulatory Caregivers

In recent years, safe patient handling in the health care industry has been addressed by various stakeholders, but much work remains to reduce health care worker injuries, and improve safety and care quality for patients. Recently, safe patient handling in ambulatory care settings has gained attention. As health care delivery evolves, demands on ambulatory care will increase and more dependent patients will visit ambulatory care clinics. Typically, ambulatory care clinics are not equipped with appropriate safe patient handling equipment. Examination tables, standard in ambulatory care clinics, currently have fixed height and are not easily accessible. This study investigated the benefits of introducing new height-adjustable examination tables to an ambulatory care setting. The results of this study indicate that by using height-adjustable examination tables, work-related musculoskeletal disorder (WMSD) risk for caregivers can be significantly reduced.

Impact of Work Environments and Occupational Hazards on Smoking Intensity in Korean Workers

The purpose of this study was to investigate the influence of work environments and occupational hazards on smoking intensity by occupation type in Korean workers. This study used the data from the Fourth Korea National Health and Nutrition Examination Survey in 2009. The sample of this study included 3,769 adults who were aged 18 years or older and had an occupation of office work, sales, or manufacturing. After controlling for sociodemographic characteristics, the generalized linear models revealed that office workers and the sales force who had smoking co-workers at the workplace were more likely to smoke than those who did not. A dirty workplace and exposure to occupational noise were significant factors increasing the smoking intensity for manufacturers. A smoking cessation program considering physical work environments and co-workers' support should be developed for Korean workers.

Ebola Update

The Ebola virus disease first appeared in 1976 in the Sudan and the Democratic Republic of Congo. The most recent outbreak occurred in West Africa in March 2014 and quickly spread in surrounding countries. Ebola spreads through direct contact with the body fluids of an infected individual. The incubation period for Ebola is 2 to 21 days. Individuals are infectious when symptomatic. Identifying individuals at high risk for Ebola in the United States includes early recognition of symptoms and a history of travel to an Ebola-affected area. Multiple diagnostic tests exist and should include a complete blood count and a comprehensive metabolic profile. Standard, contact, and droplet precautions are advised when taking care of patients with Ebola. Appropriate personal protective equipment as recommended by the Centers for Disease Control and Prevention should be worn. No vaccine or antiviral drug has been approved, but vaccine trials are under way. Occupational health nurses play a key role in educating employees about this disease.

Polio: another cause for global concern?

Polio was declared an international public health emergency in May 2014. International travel and migration raises the threat for widespread outbreak. Promoting and protecting worker's health requires increased vigilance over international public health concerns.

Chikungunya Virus

A mosquito-borne viral disease that is creating increased concern globally is Chikungunya virus (CHIKV). Occupational and environmental health nurses should educate workers about this emerging viral infection.