<p> Several lines of evidence suggest that pigs act as a reservoir of hepatitis E virus (HEV). This dissertation presents data from studies conducted from August 2010 &ndash; August 2011 in Nan, Thailand. These studies define the previously unknown burden of HEV in pig and human populations in Nan province, and evaluate the transmission of HEV among humans having direct or indirect contact with the reservoir in pig. This work begins with a literature review. The first study addressed the risks for HEV transmission between pigs in different sized farms, and possible risk factors among pigs in a cross-sectional study. This study found a 9.9% (87/879) seroprevalence of anti-HEV among pigs and 2.9% of pigs had HEV ribonucleic acid (RNA) positive fecal samples. All HEV sequences corresponded to genotype 3. Pigs raised on medium sized farms with 30-300 pigs per farm had higher anti-HEV seroprevalence than pigs raised on larger farms with over 300 pigs after controlling for other potential confounders. Better hygienic practices were used in larger farms compared with small or medium sized farms. The second study addressed the association between occupational pig exposure to HEV infection among farmers over the age of 15 and the general population without direct contact with pigs in a cross-sectional study. The overall prevalence of anti-HEV was 23.0% (118/513). There was no association between anti-HEV prevalence and direct exposure to pigs. Frequent consumption of organ meat &ge; 2 times per week was a significant risk factor for HEV seroprevalence, adjusted odds ratio (OR) 3.23, 95% confidence interval (CI) 1.15, 9.01. Serum samples from all subjects with recent symptoms compatible with hepatitis who were IgM anti-HEV positive among the farmers and 40 serum samples from the control unexposed group with the highest mean optical density (OD) value were evaluated for HEV RNA by reverse transcriptase polymerase chain reaction (RT PCR). None of the samples were HEV RNA positive. These studies establish that HEV is endemic among pig populations in Nan province. It appears that HEV infections in humans are acquired more frequently as a food-borne infection than by direct contact with pigs in this population. </p>

In spite of the vast technological progress and improvement in the standard of management systems within hazardous industries around the world, occupational health and safety incidents and fatalities continue to devastate thousands of lives each year. Throughout the last decade, significant improvement has been achieved in the reduction of health and safety incident rates across the South African petrochemical environment. However, a persistent roller-coaster fatality rate still prevails. Recent studies have shown that in order to conquer the relentless battle in realizing sustainable world-class health and safety performance, an organisation has to move beyond the traditional compliance orientated safety focus towards an interdependent safety culture in which safety is ubiquitous and embedded in the hearts of all employees. The root causes of more and more occupational health and safety incidents are no longer as a result of mechanical or systems failure, but instead originate from the attitude, values and beliefs of management and employees with regard to the significance of safety, also known as the safety culture. This has ignited a rising interest in the concept of safety culture among organisations because of the positive impact on occupational health and safety in reducing the potential for fatalities, injuries and workplace incidents. Hence the primary objective of this study is to determine the maturity of the current safety culture in the South African petrochemical environment by identifying particular culture shortfalls which could lead to hesitant progress towards the desired interdependent state. In order to reach this objective, three secondary objectives have also been set. Firstly, an understanding of the concept of organisational culture and safety culture is crucial. In simple terms, organisational culture can be described as the shared values, assumptions and beliefs in an organisation that ultimately direct employee behaviour. Organisational culture is characterised by three layers known as artefacts, espoused values and basic assumptions. These layers represent the manifestation of the organisational culture and vary in terms of outward visibility and resistance to change. Understanding and analysing these layers provide the reasons why employees behave in certain ways. Safety culture is a subset of organisational culture; in other words, it is the manifestation of the organisation?s attitude, values and commitment in regard to the importance of health and safety. Companies which have developed effective safety cultures have demonstrated unequivocal results in closing the elusive health and safety performance gap. Secondly, the fundamental components conducive of an effective safety culture were explored. These components include management and employee commitment to health and safety, accountability and involvement, communication and trust, risk awareness and compliance, competency and learning and finally recognition. Most of the components can be assigned to the artefact level or a combination of the level of artefacts and espoused values with only a small number more appropriately associated with the level of basic assumptions. The effectiveness within each of these areas ultimately dictates the nature of the safety culture and the success in preventing health and safety incidents. The focus of the last secondary objective was to determine the development stages leading to an effective safety culture known as an interdependent safety culture. Each of these stages represents the degree of maturity of the attitudes and commitment of management and employees in relation to the ongoing health and safety improvement in the organisation. The DuPont model suggests that in a reactive safety culture, safety is merely a natural instinct with no real perceived value for the individual or organisation. Moving towards a dependent safety culture, employees start to value safety but only so they do not get caught. The next stage called an independent safety culture is characterised by self preservation. In this stage, the mindset of employees changed towards an attitude of ?I do things safe so I do not get hurt?. In the final stage known as interdependent safety culture, employees embrace safety as a personal virtue not only for their own safety but also in contribution to the safety of their peers. In such a culture it is employees? desire to do things safely so that no-one gets hurt. An empirical study was conducted through a quantitative research approach in the form of a safety climate questionnaire. The target population consisted of first-line managers and non-managerial personnel within the production; maintenance; laboratory; technical, and the safety, health and environment departments in a petrochemical organisation. In light of the results emanating from the empirical study it can be concluded that an overall positive perception was observed towards the selected safety culture components indicative through the mean response scores above the neutral scale of 3. Older and more experienced employees demonstrated a more positive response to the safety compared to younger employees. However, several distinctive safety culture shortcomings were also identified. In the current safety culture, health and safety is sometimes overlooked due to productivity or cost implications. Employees tend to withhold safety related information to themselves as a culture of guilt prevails and mere compliance to safety standards is considered adequate. Solutions to health and safety problems are most of a short-term nature and do not address the root cause. It therefore provides evidence that the organisation under evaluation has not yet reached the desired safety culture maturity stage of interdependence. Although the study population is limited to a single organisation, the shortfalls identified could relate to the larger petrochemical environment and thus could explain the recent fluctuating health and safety performance. This assumption, however, can only be validated through further research within a much greater sample size inclusive of more than one organisation in the petrochemical environment. It is thus clear that the existing safety culture within the petrochemical organisation could lead to potential health and safety incidents if the shortcomings are not appropriately addressed. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2011.

Health and safety is of the utmost importance for any company or institution to be successful. There is quite a negative perception regarding the health and safety of rural hospitals and clinics. Rural hospitals are most of the time overcrowded due the large amount of patients that has no medical aid, thus increases the risk for health and safety issues. Patients sit in long queues for hours to receive medical attention and their medication and are therefore exposed to all kinds of diseases, which is a high risk for these patients’s health. The employees working in these rural areas are also exposed to life-threatening diseases on a daily basis and have a good chance of being infected. Employees leave the public sector because of these unsafe working conditions and find themselves either working in the private sector or may even immigrate to foreign countries for better and safer working conditions. During this research done, there were a few shortcomings identified for the management to improvement on and to ensure a safe working environment. There are quite a lot of negativities surrounding the patients and employees in these rural hospitals, because patients get raped by nurses, babies get stolen from maternity wards, doctors are attacked by patients and much more horrific incidents happening in these hospitals. Cultural differences are also a main concern for management, because there are a lot of different races working together in the same department and not everyone has the same beliefs and ways in doing tasks. These cultural differences may lead to clashes amongst employees and result in a negative working environment. This quantitative research was done in selected rural hospitals, due to cost and time consumption. Only 80 employees (doctors, nurses and pharmacists) participated in the research done and the research was not an in-depth research, but enough evidence was compiled to make the necessary assumptions that all is not well in the public sector. With the new National Health Insurance (NHI) to be implemented from 2012, there may a lot of changes in the rural hospitals for the better. Hospitals all over the country are being upgraded and the working conditions are being attended to by the government which may attract more health professional to rural hospitals and clinics. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2012

The occupational environment has been a fruitful source of research on causes of cancer. Analyses in studies of occupational risk factors for cancer can experience problems if an attempt is made to model large numbers of exposures, some of which may be highly correlated. Typical analyses of such studies focus on one chemical at a time, but this may not adequately deal with mutual confounding. Based on a large study in Montreal, the objective of this thesis was twofold: to assess several occupational chemicals for their etiologic role in lung cancer, and to explore the use of semi-Bayes modeling to simultaneously estimate the effects of many chemicals at a time. Methods. Data came from a multiple-cancer case-control study of exposures in the work place. The study was comprised of 857 cases of lung cancer and 2172 controls consisting of patients with other types of cancer diagnosed from 1979 to 1985. Detailed occupational histories were collected and occupational hygienists translated these into exposure histories for 231 chemicals. All chemicals were analysed with conventional modeling strategies of both single and multiple parameter models. Of the 231 chemicals, 184 were singled out for analysis in a single large semi-Bayes model, which is a variant of classical empirical Bayes. This analysis is a fairly novel method suited to estimating large numbers of parameters in the face of sparse data. For the Bayesian portion of this model, chemicals were grouped by shared chemical and physical properties, based on the belief that these shared properties would imply similar effects on the risk of lung cancer. Results. Estimates for all 231 chemicals were derived under the various modeling strategies. For most chemicals, estimates changed little across these analytic approaches, though some differences were apparent. Of the 231 chemicals assessed, 53 were earmarked as requiring further evaluation and underwent additional analyses. Discussion. While semi-Bayes models have been shown previously to offer improved estimation over conventional analyses, the gains in using semi-Bayes models in the present study were less clear. Effort put into some portions of the Bayesian modeling did not materially influence the results. A number of chemicals were earmarked as potential lung carcinogens.

This thesis explores the occupational health and safety risks facing labour hire employees (also known as temporary agency workers) in the Australian state of Victoria. Three questions are considered. First do labour hire employees face greater risk of injury and disease than direct hire employees? Second, if so, which characteristics of labour hire employment contribute to a higher rate of injury? Third, what characteristics of labour hire employment reduce the likelihood of injured employees returning to work and being rehabilitated? The first question is answered by an aggregate analysis of data drawn from all workers' compensation claim files in Victoria between 1994/5 and 2000/1 contrasting the frequency of injury for both temporary agency employees and direct hire employees. Second a unique sub sample of individual investigated claim files was then examined to test employment factors that could account for the higher frequency of injury amongst agency workers. A third data source involved a survey and focus groups of temporary agency workers. This provided supplementary data on the work experiences of labour hire employees. A number of conclusions are drawn. Labour hire employees are more likely to be injured at work than their direct hire counterparts. Factors explaining this include economic pressures, disorganisation at the host workplace, and regulatory failure for agency employees. Several of these factors are uniquely related to the triangular nature of labour hire arrangements. Once injured at work, labour hire employees are especially disadvantaged relative to direct hire employees through the reluctance of many labour hire employers to offer further employment. This reduces the capacity of labour hire workers to return to meaningful employment. Regulatory failure stemming from both employment and occupational health and safety legislation underpins the greater likelihood of agency workers being injured at work and then dispensed with by employers. Until the uniqueness of their triangular relationship with employers and hosts is recognised through appropriate regulatory intervention, their greater occupational health and safety risks will not be overcome.

Doctor of Philosophy(PhD) / Background: There is no on-going information on the number, rate or circumstances of work-related fatal injury in Australia. This thesis reports on a study aimed to identify and describe all work-related fatalities that occurred in Australia during the four-year period 1989 to 1992, in order to make a significant contribution to the effectiveness of activity designed to prevent work-related traumatic death. Methods: A broad definition of work was used, with particular focus on workers and bystanders. The study also included the injury-related deaths of volunteers, students, persons performing home duties and persons fatally injured on farms but not due to obvious farm work. The data were obtained primarily from coronial files. Files were found for 99.7% of the deaths of interest. Detailed results are presented on the work-related deaths of workers, bystanders and persons fatally injured while engaged in home duties. The results for workers are also compared with those from an earlier study of work-related fatalities in Australia, which covered the years 1982 to 1984 inclusive. Other aspects of work-related deaths are considered in detail, including the effect of employment arrangements; their coverage by occupational health and safety and compensation agencies; their handling by the coronial system; the role of External Cause codes in identifying and monitoring work-related injury deaths; and the reliability and validity of the definitions used to classify work-related injury deaths. Results: There were 2,413 persons fatally injured while working or commuting during the study period (1,787 working; 626 commuting), with a rate of death for working persons of 5.5 per 100,000 persons per year. This compared to the rate of 6.7 for working deaths during 1982 to 1984, with just under half of the decline probably due to changes in the industry distribution of the workforce. Another 802 persons were fatally injured as a result of someone else’s work activity, and 296 persons aged 15 years and over were fatally injured while undertaking active tasks in an unpaid and informal capacity in their own home or in someone else’s home. Thirty-four percent of working deaths were not covered by either occupational health and safety (OHS) or compensation agencies. A consideration of External Cause codes for the period 1979 to 1997 inclusive suggested there was a yearly decrease in the rate of workplace deaths of 2.6% per year, with less than half of this change due to industry changes in the workforce. Deaths occurring in a small number of particular circumstances were found to pose classification problems. Conclusion: Fatal work-related trauma remains an important problem for the Australian community. By understanding how and why these deaths occur, appropriate steps can be taken to prevent similar incidents recurring. It is expected that the results reported here, and other information that has arisen from the study, will make an important contribution to developing this understanding and preventing the occurrence of work- related traumatic death in Australia.

Doctor of Philosophy (PhD) / Injuries to people living and working on farms in New South Wales continue to be a significant burden on the health system, Workers’ Compensation system, agricultural industries and farming families. Strategies to reduce the number and severity of injuries suffered by farmers and people working on farms rely on accurate information. Unfortunately there is no one dataset available to describe the circumstances surrounding farm injuries and the size of this burden in Australia. Hence, a number of different data sources are required to provide a picture of farm injuries. To date, there has been very little critical examination of what value each of these datasets provides to describing farm injuries. This Thesis aimed to: • Undertake surveillance of injuries occurring to people on farms or during agricultural production in NSW using data from an Emergency Department, NSW Hospital Separations information, NSW Workers’ Compensation Claims, and ABS Deaths data. • Critically examine the utility of Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths Data for the surveillance of farm injuries in NSW. • Critically examine data classification systems used in Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths data collections to describe the breadth of farm injuries in NSW. • Define the priority areas for farm injury prevention initiatives in NSW based on the information obtained from the examination of the data from Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths. • Evaluate the effectiveness of the NSW Rollover Protective Structure (ROPS) rebate scheme and examine the utility of the data currently available in NSW to measure the performance of the program. Four datasets, Tamworth Emergency Department, Hospital Separations, Workers’ Compensation and the Australian Bureau of Statistics (ABS) Deaths data were used to provide information on the surveillance of farm injuries, describe the breadth of classifications used to describe farm injuries, and define priorities for the prevention of farm injuries. There were 384 farm-related injuries which presented to the Emergency Department at the Tamworth Base Hospital between 1 September 1997 and 31 August 1998. Emergency Department data collected in this study used the Farm Injury Optimal Dataset (FIOD) for classification, which allowed for a comprehensive picture of the circumstances surrounding the injury event. The three most common external causes of injury were related to horses, motorcycles, and animals. Commonly people were working at the time of injury. Children represented 21% of the people injured. The average number of injuries per 100 farms per annum was 34.7. An examination of hospital discharge data for NSW was undertaken for the period 1 July 1992 to 30 June 2000 where the location of the injury was a farm. Classification of cases in this dataset conformed to the International Classification of Disease (ICD) versions 9 and 10. There were 14,490 people who were injured on a farm during the study period. The three most common external causes of injury were motorcycles, animals being ridden and agricultural machinery. Children represented 17% of all farm injury cases. The rate per 1,000 farms ranged from 19 to 42 per annum. An examination of Workers’ Compensation claims for agricultural industries in NSW between 1 July 1992 and 30 June 2001 was undertaken. The ‘Type of Occurrence’ classification system was used to code the claims. There were 24,332 claims of which the majority were males (82%). The incidence of injury / disease in agriculture per annum varied from 37 per 1,000 workers to 73 per 1,000 workers. The rate per 1,000 agricultural establishments varied from 54 to 76. The average cost of a claim was $10,880 and the average time lost per claims was 9.2 weeks. There were 81 deaths and 3,158 permanent disabilities. The three most common agents were sheep / goats (5%), ferrous and non-ferrous metals (5%), crates / cartons / boxes / etc (5%). Using ABS deaths data to examine the deaths of people working and living on farms was limited to males whose occupation was recorded as ‘farmer and farm manager’ and ‘agricultural labourer and related worker’. There were 952 deaths over the period 1 January 1991 and 31 December 2000. The information provided a consistent series of cases over time. Areas where prevention should be directed included motor vehicle accidents; falls; agricultural machinery; other machinery; firearms; poisoning; and drowning. Using any one of the datasets alone to examine people injured on farms not only underestimates the number of people injured, but also misses particular types of agents involved in farm injuries. Each of the datasets used in this Thesis provides a different perspective of farm injury in NSW. By examining the information together, there are a number of areas which are consistently represented in each dataset such as falls and agricultural machinery. While no one dataset provided all the information that would be useful for the prevention of injuries, the available information does provide direction for the development of prevention strategies. The overall weakness of the information provided is that it misses a number of risk factors that contribute to farm injuries such as fatigue and training. The lack of appropriate denominator information also makes it difficult to directly compare the datasets and estimate the size of the problem. There are a number of additional coding categories that could be included in each dataset that would provide a better understanding of the different groups at risk of sustaining an injury on a farm or during agricultural work. These coding categories include activity at time of injury, admission to hospital, and occupation. An example of the use of data to determine the effectiveness of a farm injury prevention program is the ‘NSW Rollover Protective Structure (ROPS) Rebate Scheme’ evaluation. Tractor rollover deaths have been identified as an issue for prevention by Farmsafe Australia; however, such deaths were not identified in any of the datasets used in this Thesis due to coding limitations in the ABS data. In this Thesis information about the evaluation of the ‘NSW ROPS Rebate Scheme’ is presented. The scheme was successful in fitting 10,449 ROPS to tractors and the following lessons were learnt: when providing a rebate, the administration (i.e. sending the cheque) needs to be done well; advertising is important and should be co-ordinated, increase the awareness of the risk(s) the intervention is aiming to prevent and effectiveness of subsequent solution (s); the program should ensure there is an increased awareness of the outcome the intervention is aiming to prevent; if regulation is part of the program, enforcement needs to undertaken; and should address any barriers to uptake. The information provided in this Thesis highlights the substantial burden that farm injury places on the agricultural and rural sector of NSW. While there is no one data source that can describe the circumstances and the burden of farm injuries, the currently available datasets do provide an insight into the circumstances of farm injuries and the burden these injuries place on health, Workers’ Compensation, agricultural industries and farming families.

Thesis (Ph.D. in Nursing) -- University of Colorado, 2005. / Typescript. Includes bibliographical references (leaves 198-212). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (Ph. D.)--Virginia Commonwealth University, 2005. / Prepared for: Dept. of Health Administration. Bibliography: leaves 202-251. Also available online.

Since Sweden joined the European labor market there has been an increase of posted workers, primarily in the construction industry. The aim of this thesis is to study how the EU has affected the Swedish health and safety regulation in the case of posted workers in the construction industry and what room for maneuver there was on the government agency level in the application of the EU-regulations, during the period of 1994–2018. Three research questions are examined: 1) How has the number of posted workers in the construction industry changed? 2) How has the work environment for the posted workers in the construction industry developed? and 3) How has the Swedish Work Environment Authority ap-plied the work environment regulation for posted workers in the construction industry? The results show that there are major gaps in the statistics and enforcement. Most alarmingly, while the posted workers’ share of employment, according to public records, at its highest is around 2 percent, in 2018, their share (together with unregistered foreign workers) of the death accidents in 2008–2017 is much higher, at 14 percent. The EU has weakened the regulation but there have also been hindrances on the national level.