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Permanent Occupational Medicine Job in Not Disclosed Texas with Locum Medical Group
Locum Medical has a client in the Houston, Texas area that needs Occupational Medicine coverage to start ASAP until a permanent candidate is found. Clinic hours are Monday-Friday from 9 a.m.-6 p.m. There
Permanent Occupational Medicine Job in Bakersfield California with California Physician Opportunities
BL-1103 Central Valley Occupational Med/Urgent Care Clinic Bakersfield is located near many California activities both in summer and winter. Great weather, all the amenities and convenience
Permanent Occupational Medicine Job in Dearborn, MI needs FM provider for Clinic Michigan with Enterprise Medical Services
Clinic in Dearborn, MI is seeking an Occupational Medicine provider to do Family Medicine in Clinic. Currently there are 60 Occupational Medicine providers and only one is doing Family Medicine. Work

Journal of Occupational and Environmental Medicine - Current Table Of Contents

RE: Who Cares About Paperwork?
Page: 1093DOI: 10.1097/JOM.0b013e3181883d72Authors: Clarke, William R. MD, JD, MTMH, MA
Author's Response.
Page: 1093DOI: 10.1097/JOM.0b013e31818bc454Authors: Brink, LuAnn L. PhD
The Association of Diabetes With Job Absenteeism Costs Among Obese and Morbidly Obese Workers.
Page: 1094DOI: 10.1097/JOM.0b013e31818837e0Authors: Brautbar, Nachman MD

American Journal of Industrial Medicine

A risk-neutral default for chemical risk management
Sven Ove Hansson, Christina Rudén Thu, 28 Aug 2008 10:42:00 -0000
In many risk management decisions concerning industrial chemicals, including decisions on classification and labeling, lack of toxicity data is interpreted as (or has the same implications as) absence of toxicity. In other words, if the toxicity of a chemical is unknown, it is treated as having no or low toxicity. This practice is difficult to defend from a decision-theoretical point of view. We apply standard decision theory to toxicity data and investigate an alternative approach in which substances with unknown properties are treated as if they had the average toxicity among tested substances in the group to which they belong. An index of acute toxicity is proposed and then used to define a risk-neutral hazard default that can be applied to industrial chemicals for which no specific information on acute toxicity is available. It is proposed that such a risk-neutral approach is preferable to the current practice of treating substances with unknown acute toxicity in the same manner as substances that can reasonably be assumed to have no such harmful properties. The risk-neutral approach could be generalized to other toxicological endpoints. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
The impact of hearing conservation programs on incidence of noise-Induced hearing loss in Canadian workers
Hugh Davies, Steve Marion, Kay Teschke Mon, 25 Aug 2008 08:51:00 -0000
Noise exposure remains one of the most ubiquitous of occupational hazards. Hearing conservation program legislation and the programs themselves were designed to lower risk of resulting occupational noise-induced hearing loss, but there has been no broad-based effort to assess the effectiveness of this policy.The incidence of a 10-dB standard threshold shift was examined in a group of Canadian lumber mill workers, using annual audiogram series obtained from the Workers' Compensation Board of British Columbia for the period 1979-1996 and using Cox proportional hazard models.Mean cumulative noise exposure was 98.1 dB-years. The audiograms from 22,376 individuals, among whom there were 2,839 threshold shifts of 10 dB or greater (i.e., a "standard threshold shift"), were retained in multivariable analyses. After adjusting for potential confounders, continuous use of hearing protection, and initial hearing tests later in the study period, the risk for standard threshold shift was reduced by 30%. Risk increased sixfold, however, in those with the highest noise exposure.Hearing conservation programs may be effective in reducing overall incidence of hearing loss. In the absence of noise control at source, however, highly exposed workers remain at unnecessary risk. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Occupational allergy and asthma among salt water fish processing workers
Mohamed F. Jeebhay, Thomas G. Robins, Mary E. Miller, Eric Bateman, Marius Smuts, Roslynn Baatjies, Andreas L. Lopata Fri, 22 Aug 2008 08:18:00 -0000
Fish processing is a common economic activity in Southern Africa. The aim of this study was to determine the prevalence and host determinants of allergic symptoms, allergic sensitization, bronchial hyper-responsiveness and asthma among workers processing saltwater fish.A cross-sectional study was conducted on 594 currently employed workers in two processing plants involved in pilchard canning and fishmeal processing. A modified European Community Respiratory Health Survey (ECRHS) questionnaire was used. Skin prick tests (SPT) used extracts of common airborne allergens, fresh fish (pilchard, anchovy, maasbanker, mackerel, red eye) and fishmeal. Spirometry and methacholine challenge tests (MCTs; tidal breathing method) used ATS guidelines.Work-related ocular-nasal symptoms (26%) were more common than asthma symptoms (16%). The prevalence of atopy was 36%, while 7% were sensitized to fish species and 26% had NSBH (PC20 [le] 8 mg/ml or [ge]12% increase in FEV1 post-bronchodilator). The prevalence of probable occupational asthma was 1.8% and fish allergic rhino-conjunctivitis 2.6%. Women were more likely to report work-related asthma symptoms (OR = 1.94) and have NSBH (OR = 3.09), while men were more likely to be sensitized to fish (OR = 2.06) and have airway obstruction (OR = 4.17). Atopy (OR = 3.16) and current smoking (OR = 2.37), but not habitual seafood consumption were associated with sensitization to fish.Based on comparison with previous published studies, the prevalence of occupational asthma to salt water fish is lower than due to shellfish. The gendered distribution of work and exposures in fish processing operations together with atopy and cigarette smoking are important determinants of occupational allergy and asthma. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Acute pesticide poisoning among agricultural workers in the United States, 1998-2005
Geoffrey M. Calvert, Jennifer Karnik, Louise Mehler, John Beckman, Barbara Morrissey, Jennifer Sievert, Rosanna Barrett, Michelle Lackovic, Laura Mabee, Abby Schwartz, Yvette Mitchell, Stephanie Moraga-McHaley Tue, 29 Jul 2008 10:11:00 -0000
Approximately 75% of pesticide usage in the United States occurs in agriculture. As such, agricultural workers are at greater risk of pesticide exposure than non-agricultural workers. However, the magnitude, characteristics and trend of acute pesticide poisoning among agricultural workers are unknown.We identified acute pesticide poisoning cases in agricultural workers between the ages of 15 and 64 years that occurred from 1998 to 2005. The California Department of Pesticide Regulation and the SENSOR-Pesticides program provided the cases. Acute occupational pesticide poisoning incidence rates (IR) for those employed in agriculture were calculated, as were incidence rate ratios (IRR) among agricultural workers relative to non-agricultural workers.Of the 3,271 cases included in the analysis, 2,334 (71%) were employed as farmworkers. The remaining cases were employed as processing/packing plant workers (12%), farmers (3%), and other miscellaneous agricultural workers (19%). The majority of cases had low severity illness (N = 2,848, 87%), while 402 (12%) were of medium severity and 20 (0.6%) were of high severity. One case was fatal. Rates of illness among various agricultural worker categories were highly variable but all, except farmers, showed risk for agricultural workers greater than risk for non-agricultural workers by an order of magnitude or more. Also, the rate among female agricultural workers was almost twofold higher compared to males.The findings from this study suggest that acute pesticide poisoning in the agricultural industry continues to be an important problem. These findings reinforce the need for heightened efforts to better protect farmworkers from pesticide exposure. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Occupational asthma caused by sculptured nails containing methacrylates
Riitta Sauni, Paula Kauppi, Kristiina Alanko, Maj-Len Henriks-Eckerman, Matti Tuppurainen, Timo Hannu Wed, 13 Aug 2008 14:05:00 -0000
In recent decades, the use of artificial nails including methacrylates (MAs) has increased. This study presents the first two clinical cases of occupational asthma (OA) caused by sculptured nails containing MAs.In both cases, OA was diagnosed on the basis of a work simulation test combined with the patient's history of occupational exposure and respiratory symptoms.Both patients developed work-related respiratory symptoms 4-5 years before the current examinations. Previously, the first patient (a 30-year-old female) was diagnosed as having allergic contact dermatitis (ACD) to MAs; the second patient (a 27-year-old female) had no skin symptoms. In both cases, a dual asthmatic reaction was observed in the bronchial provocation test, in which the patients simulated their work using their own products including MAs.Sculptured nails containing MAs can induce OA in nail technicians. Products not containing MAs should be used to prevent OA and ACD. If MAs are used, they should be handled with appropriate safety measures. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
Genetic Polymorphisms of IL-1A, IL-1B, IL-1RN, NFKB1, FAS, and FASL, and Risk of Silicosis in a Chinese Occupational Population
Fen Wu, Zhaolin Xia, Yabin Qu, Yunxia Tang, Duozhi Cao, Pin Sun, David C. Christiani Tue, 29 Jul 2008 10:03:00 -0000
To test whether polymorphisms in IL-1, NF-KB, FAS, and FASL genes are associated with risk of silicosis.A case-control study was conducted with 183 silicosis patients and 111 silica-exposed miners who were frequency-matched by age, dust exposure duration, work location, and type of work. Genotype analysis was performed on genomic DNA, using a PCR-RFLP assay.Individuals carrying the NFKB1 ins/del genotype had a decreased risk of silicosis (adjusted OR = 0.57, 95% CI = 0.32-0.998, P = 0.049) compared with subjects carrying the ins/ins genotype and individuals with the FAS-1377AA homozygote had a decreased risk of silicosis compared with those with the -1377GG genotype (adjusted OR = 0.42, 95% CI = 0.19-0.93, P = 0.03). The analysis of haplotypes of polymorphisms in FAS showed that there was a 2.71-fold (OR = 2.71, 95% CI = 1.22-6.03, P = 0.011) increased risk of silicosis for subjects with alleles of FAS-1377G and FAS-670G, compared with those carrying alleles of FAS-1377G and FAS-670A.Although the polymorphisms at NFKB1, FAS-1377, and extended haplotype FAS-1377G/-670G may play a role in the development of silicosis in the Chinese population, our findings should be verified by larger studies with >1 case/control ratio. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.

International Archives of Occupational and Environmental Health

Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders
Thu, 09 Oct 2008 09:09:31 -0000
Abstract Objective  To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). Method  A post-test only design was used in the context of disability claims. Twenty-eight IPs participated in the study. Claimants with MSD formed the patient population. For each IP, the first claimant who agreed to participate was included in the study, and underwent FCE in addition to the regular disability claim assessment. Firstly, the IP performed the statutory disability claim assessment. Secondly, the FCE assessment took place. Finally, a self-formulated questionnaire was presented to the IPs after they viewed the FCE report. IPs were asked whether they perceived FCE information to be of complementary value to their judgment of the claimant’s physical work ability investigated. We considered FCE information to be of complementary value if more than 66% of the IPs indicated as such. IPs were also asked whether FCE information led them to change their initial judgment about the claimant’s physical work ability, and whether they felt this information made them more confident about their ultimate judgement. Finally, they were asked whether they planned to include FCE information in future disability claims and for what type of claimants. Differences between IPs who did or did not experience complementary value were explored. Results  Of the 28, 19 (nearly 68%) IPs considered FCE information to be of complementary value for their assessment of claimants with MSD. Half of the IPs stated that FCE information reinforced their judgment. All but four IPs changed their assessment after reading the FCE report. Sixteen IPs intended to involve FCE information in future disability claim assessments. There were no observed differences between the IPs who did or did not consider the FCE information to be of complementary value. Conclusion  FCE information was found to have complementary value at present and in the future according to most IPs in the assessment of the physical work ability of claimants with MSD. Half of the IPs felt that this information reinforces their judgment in this context. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0361-xAuthors Haije Wind, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsVincent Gouttebarge, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsP. Paul F. M. Kuijer, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsJudith K. Sluiter, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The NetherlandsMonique H. W. Frings-Dresen, Academic Medical Center, University of Amsterdam Coronel Institute of Occupational Health P.O. Box 22700 1100 DE Amsterdam The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Paternal and maternal exposure to welding fumes and metal dusts or fumes and adverse pregnancy outcomes
Mon, 29 Sep 2008 20:19:06 -0000
Abstract Objective  We assessed whether paternal exposure prior to conception and maternal exposure during pregnancy to welding fumes (WF) and metal dusts or fumes (MD/F) independently and jointly increases the risk of preterm delivery, low birth weight, and small-for-gestational age. Methods  The study population was selected from The Finnish Prenatal Environment and Health Study of 2,568 newborns (response rate 94%) and included 1,670 women who worked during pregnancy of which 68 were exposed either to WF and/or MD/F. Results  The risk of SGA was related to maternal exposure to WF only (adjusted OR = 1.78; 95% CI 0.53–5.99), MD/F only (adjusted OR = 1.77; 95% CI 0.38–8.35) and both exposures (2.92; 1.26–6.78). The corresponding effect estimates for preterm delivery were 2.66 (0.32–22.08), 5.64 (1.14–27.81) and for birth weight below 3,000 g 3.79 (1.09–13.19), 1.85 (0.56–6.14) and 1.70 (0.70–4.15), respectively. There was some suggestive, inconsistent evidence that the risk of preterm delivery and SGA is related to paternal exposure to WF. Conclusions  The present results provide evidence that maternal exposure to WF or MD/F combination during pregnancy may reduce fetal growth and suggestive evidence that paternal exposure to WF may increase the risk of preterm delivery and small-for-gestational age. The small number of exposed women and the lack of data for exposure concentrations suggest the need for further study to verify our findings. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0349-6Authors Reginald Quansah, University of Birmingham Institute of Occupational and Environmental Medicine Edgbaston Birmingham B15 2TT UKJouni J. K. Jaakkola, University of Birmingham Institute of Occupational and Environmental Medicine Edgbaston Birmingham B15 2TT UK Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)
Tue, 23 Sep 2008 10:15:02 -0000
Abstract Objectives  To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant. Methods  A spatial case–control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993–2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface. Results  Significant MM odds ratio of 5.29 (95 CI: 1.18–23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls. Conclusion  Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0358-5Authors Marina Musti, University of Bari, National Register of Mesothelioma, Regional Operative Centre (C.O.R.) Department of Internal Medicine and Public Medicine, Section of Occupational Medicine “Ramazzini” Apulia ItalyAlessio Pollice, University of Bari Department of Statistical Sciences “Carlo Cecchi” Bari ItalyDomenica Cavone, University of Bari, National Register of Mesothelioma, Regional Operative Centre (C.O.R.) Department of Internal Medicine and Public Medicine, Section of Occupational Medicine “Ramazzini” Apulia ItalySilvano Dragonieri, University of Bari Respiratory Diseases, Department of Clinical Methodology and Medical-Surgical Technologies Bari ItalyMassimo Bilancia, University of Bari Department of Statistical Sciences “Carlo Cecchi” Bari Italy Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Sickness absence and return to work rates in women with breast cancer
Tue, 16 Sep 2008 08:20:49 -0000
Abstract Purpose  Most women are diagnosed with breast cancer when they are of working age. How long are breast cancer patients absent? How many of them return to work? Methods  ArboNed Occupational Health Services documents sickness absence data of 1 million workers of whom 40% were women. Between 2001 and 2005, 2,259 women had 2,361 episodes of sickness absence due to breast cancer. These absence episodes were followed for 2 years using Kaplan–Meier analysis. Results  The mean ± standard error of mean duration of absence due to breast cancer was 349 ± 5 days. Thirty-seven percent of absences lasted longer than one year and 12% of absences lasted longer than 2 years particularly in women aged 25–34 years. Conclusions  The mean duration of sickness absence due to breast cancer was nearly a year, but most women returned to work. The results of the study can be used as a reference for return to work of women following breast cancer. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s00420-008-0359-4Authors Corné A. M. Roelen, University Medical Center Groningen, University of Groningen Department of Health Sciences PO Box 196 9700 AD Groningen The NetherlandsPetra C. Koopmans, University Medical Center Groningen, University of Groningen Department of Health Sciences PO Box 196 9700 AD Groningen The NetherlandsJan H. de Graaf, ArboNed Corporate Accounts PO Box 158 8000 AD Zwolle The NetherlandsFulya Balak, ArboNed Corporate Accounts PO Box 158 8000 AD Zwolle The NetherlandsJohan W. Groothoff, University Medical Center Groningen, University of Groningen Department of Health Sciences PO Box 196 9700 AD Groningen The Netherlands Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Vibration-induced white finger syndrome and carpal tunnel syndrome among Finnish metal workers
Wed, 10 Sep 2008 08:31:54 -0000
Abstract Objective  Officially 10–26 cases of vibration-induced white fingers (VWF) have been reported annually in Finland. It has been suggested that the numbers are underestimated. The purpose of the present study was to estimate the cumulative exposure to hand–arm vibration (HAV) and the prevalence of clinically diagnosed cases of VWF and carpal tunnel syndrome (CTS) in a population of Finnish metal workers and to determine the symptoms and clinical tests that would best predict the diagnosis. Methods  A questionnaire on vibration exposure at the workplace and symptoms of the upper extremities was sent to a sample (n = 530) of members of the local Metalworkers Union. Those who reported finger blanching, numbness or tingling of the fingers or symptoms of CTS were invited to take part in clinical examinations. Their cumulative lifelong exposure to HAV was evaluated. Those whose symptoms referred to VWF or CTS were given a cold provocation test with the measurement of finger systolic blood pressure and electroneuromyography of the upper arms. Results  Altogether 285 metal workers (54%) responded to the questionnaire, and 24 new cases of VWF (8.4%) and 12 cases of CTS (4.2%) were diagnosed. In the group of VWF patients, seven workers had both VWF and CTS. All of the workers diagnosed as having VWF also had numbness or tingling in their fingers. Consequently, questions concerning numbness and tingling, a two-point discrimination test, Phalen’s test, and Tinell’s test had a high predicting value for VWF. The exposure time of the VWF cases did not differ significantly from that of the study group as whole, but the cumulative exposure index was significantly higher. Conclusion  The results suggest that VWF is underdiagnosed in Finland. In screening for the health effects of HAV, sensorineural symptoms of hands should be carefully inquired about and examined in patients complaining of white fingers. More education on the recognition and evaluation of HAV exposure and its health effects is needed. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0357-6Authors Riitta Sauni, Finnish Institute of Occupational Health P.O. Box 486 33101 Tampere FinlandRauno Pääkkönen, Finnish Institute of Occupational Health P.O. Box 486 33101 Tampere FinlandPauliina Virtema, Finnish Institute of Occupational Health P.O. Box 486 33101 Tampere FinlandVille Jäntti, Tampere University Hospital Department of Clinical Neurophysiology Tampere FinlandMika Kähönen, Tampere University Hospital Department of Clinical Physiology Tampere FinlandEsko Toppila, Finnish Institute of Occupational Health Helsinki FinlandIlmari Pyykkö, Tampere University Hospital Department of Otorhinolaryngology Tampere FinlandJukka Uitti, Finnish Institute of Occupational Health P.O. Box 486 33101 Tampere Finland Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Occupational styrene exposure and hearing loss: a cohort study with repeated measurements
Tue, 02 Sep 2008 06:10:41 -0000
Abstract Objective  Associations between occupational styrene exposure and impairment of hearing function were investigated, guided by three questions: are there hearing losses concerning high frequency and standard audiometric test? Are there dose–response relationships and measurable thresholds of effects? Are there signs of reversibility of possible effects if the workers are examined during times of improvement from their work? Methods  A group of workers from a boat building plant, some of whom were laminators, were examined in subgroups of current low (n = 99, mean mandelic acid MA + phenylglyoxylic acid PGA = 51 mg/g creatinine), medium (n = 118, mean 229 mg/g creat.) and high (n = 31, mean 970 mg/g creat.) exposure to styrene. In addition, subgroups chronically exposed to high-long (n = 17) and low-short (n = 34) styrene levels were analysed. The examinations were carried out during normal work days and during the company holidays. Hearing thresholds and transient evoked otoacoustic emissions (TEOAE) were measured. Statistics included multiple co-variance analyses with repeated measures, linear regressions, and logistic regressions. Results  The analyses of all participants demonstrated no clear exposure effects. Particularly no sufficient proof of dose–response relationship measured against parameters of current exposure (MA + PGA, styrene/blood) and of chronic exposure (cumulative and average life time exposure resp.) was found. The analyses of groups exposed to high levels show elevated thresholds at frequencies up to 1,500 Hz among the subgroup exposed to high styrene levels (e.g. 40–50 ppm as average) for a longer period of time (e.g. more than 10 years). These participants also demonstrated signs of “improvement” at frequencies above 2,000 Hz during work holidays, when they were not exposed to styrene. A significantly elevated odds ratio for cases of hearing loss (more than 25 dB (A) in one ear, 3,000–6,000 Hz) was found among the group exposed to high levels (above 30 ppm as average) for a longer period of time (more than 10–26 years). The measurements of TEOAE did not exhibit significant results related to exposure. Conclusion  This study found, that chronic and intensive styrene exposure increases the hearing thresholds. At levels of about 30–50 ppm as an average inhaled styrene per work day over a period of about 15 years with higher exposure levels above 50 ppm in the past, an elevated risk for impaired hearing thresholds can be expected. The formerly published results on ototoxic effects below 20 ppm could not be confirmed. With few exceptions (at frequencies of 1,000 and 1,500 Hz) no dose–response relationship between threshold and exposure data was found. Improvements of hearing thresholds during work- and exposure-free period are possible. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0355-8Authors Gerhard Triebig, University Hospital of Heidelberg Institute and Outpatient Clinic for Occupational and Social Medicine Voßstraße 2 69115 Heidelberg GermanyThomas Bruckner, University of Heidelberg Department of Biometry in Medicine Heidelberg GermanyAndreas Seeber, University of Dortmund Institute of Occupational Physiology Dortmund Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131

Occupational Therapy International

Effectiveness of a peer-support community in addiction recovery: participation as intervention
Rosemary A Boisvert, Linda M Martin, Maria Grosek, Anna June Clarie Thu, 09 Oct 2008 04:11:00 -0000
The main purpose of the study was to determine whether a peer-support community programme would reduce relapse rates among clients recovering from substance addictions and homelessness and result in increased perceived community affiliation, supportive behaviours, self-determination and quality of life.Mixed methods were utilized including semi-structured interviews, participant observation and a pretest/post-test to evaluate changes on the quality of life rating, the Medical Outcomes Study-Social Support Survey, and the Volitional Questionnaire. Data from the prior year's permanent supportive housing programme were used for comparison of relapse rates.Significant reduction of risk of relapse was found in clients who participated in the programme. Significant differences were found on three subscales of the Medical Outcomes Study-Social Support Survey. Improvement that did not reach statistical significance was seen on the quality of life rating. Qualitative evidence supported improvements in perceived community affiliation and supportive behaviours.Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions and homelessness. Limitations include a small sample size and lack of a randomized control group. Copyright © 2008 John Wiley & Sons, Ltd.
The application of client-centred occupational therapy for Korean children with developmental disabilities
Dae Hyuk Kang, Eun Young Yoo, Bo In Chung, Min Ye Jung, Ki Yeon Chang, Hye Seon Jeon Fri, 26 Sep 2008 04:37:00 -0000
The aim of this paper was to investigate the effectiveness of client-centred occupational therapy using the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Eight girls and 23 boys from Korea, with developmental disabilities and from 3 to 10 years of age participated in this study. Each child participated in 20 to 24 sessions of client-centred occupational therapy. Both the COPM and the AMPS change scores demonstrated statistically significant improvement (p < 0.01) in occupational performance. Significant correlations were found between COPM - Performance and AMPS - Motor skills (rs = 0.64, p < 0.05), and COPM - Satisfaction and AMPS - Process skills (rs = 0.62, p < 0.05) in a group positive towards client-centred occupational therapy. The COPM was a valuable tool in guiding and measuring the client-centred occupational therapy for children with developmental disabilities. The small sample size of 31 children limits the generalizability of the study's results. Future research needs to use a larger and more diverse sample of children to further validate the effectiveness of client-centred occupational therapy. Copyright © 2008 John Wiley & Sons, Ltd.
Perceived stress in occupational therapy students
Teresa A. Pfeifer, Peter L. Kranz, Angela E. Scoggin Tue, 16 Sep 2008 04:30:00 -0000
The purpose of this study was to examine perceived stress of entry-level master's occupational therapy (OT) students enrolled at a Texas university. A total of 29 students including nine men and 20 women participated in the study. Questionnaires and interviews were used for data collection. The participants were interviewed during the end of the first and second year of the entry-level master's programme in OT. Questionnaires, given at the same time, contained demographic data, open-end questions and force choice questions rated on a Likert scale. The results indicated that the majority of students (66.4%) rated their current level of stress as above average or the highest in their lives. The students expressed feelings of being overwhelmed, confused regarding course expectations and wanted more hands-on experience. When responding to how they managed stress, more than half of the students in the study took an active approach by utilizing exercise. Limitations of the study include using a non-standardized questionnaire, a small number of participants, and that the participants did not represent diversity and were for the most part Hispanic. It is recommended that future research address the cultural and generational issues that may affect perceptions of stress and how students cope with stress. Copyright © 2008 John Wiley & Sons, Ltd.

Occupational Medicine - current issue

OCCUPATIONAL MEDICINE CALENDAR
Wed, 08 Oct 2008 00:00:00 -0000

In this issue of Occupational Medicine
Patel, D. Wed, 08 Oct 2008 00:00:00 -0000

Nanocommentary: Occupational and environmental health and nanotechnology--what's new?
Sng, J., Koh, D. Wed, 08 Oct 2008 00:00:00 -0000


PubMed: 0355-3140

Inflammation but no DNA (deoxyribonucleic acid) damage in mice exposed to airborne dust from a biofuel plant.
Madsen AM, Saber AT, Nordly P, Sharma AK, Wallin H, Vogel U Related Articles Inflammation but no DNA (deoxyribonucleic acid) damage in mice exposed to airborne dust from a biofuel plant. Scand J Work Environ Health. 2008 Aug;34(4):278-7 Authors: Madsen AM, Saber AT, Nordly P, Sharma AK, Wallin H, Vogel U OBJECTIVES: Particles in ambient air are associated with such health effects as lung diseases and cancer of the lung. Exposure to bioaerosols has been found to be associated with respiratory symptoms. The toxic properties of exposure to combustion and bioaerosol particles from biofuel plants have not been studied in detail. This study investigated whether exposure to dust from biofuel plants induces DNA (deoxyribonucleic acid) damage and inflammation in exposed mice. METHODS: DNA damage and inflammation were evaluated in mice exposed through the intratracheal installation of airborne dust collected at a biofuel plant at the straw storage hall and in the boiler room. The mice were given either a single dose of dust (18 or 54 microg) or four doses of 54 microg on each of four consecutive days. Control mice were exposed to a 0.9% sodium chloride solution. RESULTS: In the mice exposed to 4 x 54 microg of dust, the lung tissue mRNA (messenger ribonucleic acid) levels of interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein-2 (MIP-2) were increased more than 10-fold if the dust was from the boiler room and 30- to 60-fold if the dust came from the straw storage hall. The levels of DNA strand breaks in broncheoalveolar lavage (BAL) cells from the mice exposed to dust did not differ from those in the control samples. CONCLUSIONS: The results indicate that the instillation of dust from a biofuel plant, at doses corresponding to 2 weeks of exposure to human endotoxins, results in a strong inflammatory response without detectable DNA damage in BAL cells. The dust from the straw storage hall induced the strongest inflammatory response and had the highest concentration of most microbial components. PMID: 18820821 [PubMed - in process]
Inequalities in health, social causation and the role of occupation.
Kristensen P Related Articles Inequalities in health, social causation and the role of occupation. Scand J Work Environ Health. 2008 Aug;34(4):235-8 Authors: Kristensen P PMID: 18820820 [PubMed - in process]

Annals of Occupational Hygiene - current issue

A Framework for the Concurrent Consideration of Occupational Hazards and Obesity
Schulte, P. A., Wagner, G. R., Downes, A., Miller, D. B. Tue, 07 Oct 2008 00:00:00 -0000
Occupational hazards and obesity can lead to extensive morbidity and mortality and put great financial burden on society. Historically, occupational hazards and obesity have been addressed as separate unrelated issues, but both are public health problems and there may be public health benefits from considering them together. This paper provides a framework for the concurrent consideration of occupational hazards and obesity. The framework consists of the following elements: (i) investigate the relationship between occupational hazards and obesity, (ii) explore the impact of occupational morbidity and mortality and obesity on workplace absence, disability, productivity and healthcare costs, (iii) assess the utility of the workplace as a venue for obesity prevention programs, (iv) promote a comprehensive approach to worker health and (v) identify and address the ethical, legal and social issues. Utilizing this framework may advance the efforts to address the major societal health problems of occupational hazards and obesity.
Development and Evaluation of an Exposure Control Efficacy Library (ECEL)
Fransman, W., Schinkel, J., Meijster, T., Van Hemmen, J., Tielemans, E., Goede, H. Tue, 07 Oct 2008 00:00:00 -0000
Objectives: This paper describes the development and evaluation of an evidence database on the effectiveness of risk management measures (RMMs) to control inhalation exposure. This database is referred to as Exposure Control Efficacy Library (ECEL). Methods: A comprehensive review of scientific journals in the occupational hygiene field was undertaken. Efficacy values for RMMs in conjunction with contextual information on study design, sampling strategy and measurement type (among other parameters) were stored in an MS Access database. In total, 433 efficacy values for six RMM groups (i.e. enclosure, local exhaust ventilation, specialized ventilation, general ventilation, suppression techniques and separation of the worker) were collected from 90 peer-reviewed publications. These RMM categories were subdivided into more specific categories. Results: Estimated average efficacy values ranged from 87% for specialized ventilation to 43% for general ventilation. Substantial variation in efficacy values was observed within RMM categories based on differences in selected covariables within each study (i.e. study design, sampling strategy, measurement type and others). More contrast in efficacy values was observed when evaluating more detailed subcategories. Conclusions: It is envisaged that ECEL will contribute to exposure modelling, but should be supplemented with expert opinion, preferably in a formal expert elicitation procedure. The work presented here should be considered as a first attempt to collate and analyse RMM efficacy values and inclusion of additional (unpublished) exposure data is highly warranted.
Conceptual Model for Assessment of Inhalation Exposure: Defining Modifying Factors
Tielemans, E., Schneider, T., Goede, H., Tischer, M., Warren, N., Kromhout, H., Van Tongeren, M., Van Hemmen, J., Cherrie, J. W Tue, 07 Oct 2008 00:00:00 -0000
The present paper proposes a source–receptor model to schematically describe inhalation exposure to help understand the complex processes leading to inhalation of hazardous substances. The model considers a stepwise transfer of a contaminant from the source to the receptor. The conceptual model is constructed using three components, i.e. (i) the source, (ii) various transmission compartments and (iii) the receptor, and describes the contaminant's emission and its pattern of transport. Based on this conceptual model, a list of nine mutually independent principal modifying factors (MFs) is proposed: activity emission potential, substance emission potential, localized control, separation, segregation, dilution, worker behavior, surface contamination and respiratory protection. These MFs describe the exposure process at a high level of abstraction so that the model can be generically applicable. A list of exposure determinants underlying each of these principal MFs is proposed to describe the exposure process at a more detailed level. The presented conceptual model is developed in conjunction with an activity taxonomy as described in a separate paper. The proposed conceptual model and MFs should be seen as ‘building blocks’ for development of higher tier exposure models.
Evaluation of Peak Exposures in the Dutch Flour Processing Industry: Implications for Intervention Strategies
Meijster, T., Tielemans, E., Schinkel, J., Heederik, D. Tue, 07 Oct 2008 00:00:00 -0000
Objectives: To effectively decrease occupational exposure to flour dust and related allergens, detailed information on exposure determinants and effectiveness of control measures is essential. In this paper, we use personal real-time exposure measurements to get more insight into the relationship between specific work characteristics, including the use of control measures, and (peak) exposure to flour dust. The study has three objectives: (i) identify tasks and activities related to peak exposure, (ii) identify control measures and other important exposure determinants and (iii) assess the potential impact of these control measures on the (peak) exposure to flour dust. Methods: A data set containing 82 real-time exposure measurements in combination with information from detailed observations was used to study the association between peak exposures and different tasks, activities and other determinants such as control measures. Descriptive statistics of peak exposure on job level were generated as well as information on contribution of task-specific peak exposures to time-weighted average (TWA) exposure levels. Finally, we evaluated the efficacy of a variety of control measures on task exposure by comparing exposure levels of groups of workers with and without controls. Results: In workers included in this study, >75% of TWA exposure is directly associated with peak exposures during a limited set of well-defined tasks/activities. The impact of a single task on population TWA exposure is generally limited (<40%). Worker behavior seems an important determinant in effective exposure control for many tasks. Conclusions: Data from real-time measurements provide important detailed information with respect to exposure determinants and control measures, not obtainable from conventional measurement studies focusing at TWA exposure. This information is essential to perform prospective impact assessments of intervention strategies on the populations’ exposure distribution.
Exposure to Metalworking Fluid Aerosols and Determinants of Exposure
Lillienberg, L., Burdorf, A., Mathiasson, L., Thorneby, L. Tue, 07 Oct 2008 00:00:00 -0000
Metalworking fluid (MWF) aerosols are associated with respiratory disorders including asthma and hypersensitivity pneumonitis. The aims of this study were to describe exposure to inhalable MWF aerosols and volatile compounds in machine shops, to estimate the influence of important determinants of exposure and to compare different sampling techniques for MWF aerosols. Personal full-shift air samples of inhalable aerosol (PAS-6 sampler) and total aerosol (open-faced sampler) were collected on operators in five medium to big-sized machine shops in three companies. The filters were analysed gravimetrically and extracted by supercritical fluid extraction for MWF aerosol and triethanolamine content. In addition, personal measurements were taken for formaldehyde and volatile compounds on adsorbent samplers. Continuous dust measurements were performed with a real-time instrument (DataRAM) during 2 h periods, using 1-min average values. In total, 95 measurements of inhalable aerosol and extracted MWF aerosols on 51 operators were conducted. Within the companies, the average exposure to inhalable aerosol ranged from 0.19 to 0.25 mg m–3 with geometric standard deviations from 1.56 to 1.79. On average, the extracted fraction of MWF aerosol was 67% of the inhalable aerosol concentration. The exposure levels of triethanolamine, formaldehyde and volatile compounds were generally low. About 45% of the between-worker variance could be explained by use of compressed air, lack of complete enclosure of machines or grinding as cutting task. In 21 workers with continuous aerosol measurements, short-term peak exposures during 6% of the work time contributed to ~25% of the average concentration of inhalable MWF aerosol. Inhalable MWF aerosol concentration measured with the PAS-6 sampler was a factor 2 higher than the concentrations derived from the open-faced sampler. These findings suggest that control measures, such as full enclosure of machines and the elimination of the use of compressed air as cleaning technique, are required to reduce the exposure to MWF aerosols to levels below the expected threshold for adverse respiratory health effects.
Respiratory Exposure to Components of Water-Miscible Metalworking Fluids
Suuronen, K., Henriks-Eckerman, M.-L., Riala, R., Tuomi, T. Tue, 07 Oct 2008 00:00:00 -0000
Water-miscible metalworking fluids (MWFs) are capable of causing respiratory symptoms and diseases. Recently, much emphasis has been put on developing new methods for assessing respiratory exposure to MWF emulsions. The air concentrations of ingredients and contaminants of MWF and inhalable dust were measured in 10 metal workshops in southern Finland. Oil mist was determined by infra red spectroscopy analysis after tetrachloroethylene extraction from the filter. Aldehydes were collected on Sep-Pak chemosorbents and analysed by liquid chromatography. Volatile organic compounds (VOCs) were collected on Tenax adsorbents and analysed by gas chromatography with mass spectrometric detection after thermal desorption. Endotoxins were collected on glass fibre filter and analysed by enzyme-based spectrophotometry, and viable microbes were collected on polycarbonate filter and cultured. Inhalable dust was collected on cellulose acetate filter and quantified gravimetrically. Associations between the different exposures were calculated with Spearman’s correlations. The mean concentration of oil mist was 0.14 (range <0.010–0.60) mg m–3. The mean total concentration of aldehydes was 0.095 (0.026–0.38) mg m–3, with formaldehyde as the main aldehyde. The average total concentration of VOC was 1.9 (0.34–4.5) mg m–3 consisting mainly of high-boiling aliphatic hydrocarbons. Several potential sensitizing chemicals such as terpenes were found in small quantities. The concentration of microbial contaminants was low. All the measured air concentrations were below the Finnish occupational exposure limits. The exposure in machine shops was quantitatively dominated by volatile compounds. Additional measurements of MWF components such as aldehydes, alkanolamines and VOCs are needed to get more information on the chemical composition of workshops’ air. New air cleaning methods should be introduced, as oil mist separators are insufficient to clean the air of small molecular impurities.

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