Este estudo foi desenvolvido em um frigorífico de grande porte de um município do interior do Paraná, para avaliar atividades desenvolvidas dentro de câmaras frigoríficas em ambientes com temperatura de 10 ºC à -35 ºC. Os principais objetivos foram analisar o processo de trabalho em um frigorífico, com relação aos fatores condições de trabalho, danos e custos físicos, diagnosticar comparativamente todos os fatores do instrumento, os níveis de prazer e o sofrimento dos trabalhadores, bem como indicar os principais riscos inerentes às atividades executadas. Os resultados foram obtidos por meio do instrumento Inventário sobre Trabalho e Riscos de Adoecimento – ITRA, com a participação de 178 funcionários, contemplando 4 escalas de 13 fatores num total de 124 itens desse instrumento. Esses colaboradores foram classificados em diferentes grupos de acordo com a escolaridade, estado civil, tempo de serviço, turno, idade e temperatura de trabalho. Para análise estatística dos dados foi utilizado o programa Statistica program, versão 5.0 (Statsoft®). No processo de trabalho, foram identificados como principais riscos à saúde do trabalhador o trabalho em altura, o possível vazamento de gases tóxicos, o uso incorreto do ar comprimido e os choques elétricos, sendo que todos os riscos contém medidas de controle. A torção da coluna lombar, a sobrecarga nos joelhos e os riscos de prensagem, batidas e contusões foram os mais evidentes danos à saúde dos colaboradores. Para o fator condição de trabalho, todos os itens foram classificados no nível crítico, sendo que houve diferença estatisticamente significativa em alguns itens para turno de trabalho e para idade. Com relação ao custo físico, houve predominância de respostas também com classificação crítica, sendo a diferença observada em alguns dos itens para tempo de serviço, turno e temperatura de trabalho. Com referência aos danos físicos, a avaliação se mostrou heterogênea, com alguns dos itens considerados na escala grave. Diferença estatística foi observada para tempo de serviço e turno de trabalho. A temperatura não foi identificada como variável de influência negativa no processo de trabalho. Para a variável turno, os funcionários que trabalham no horário noturno apontaram piores classificações, refletindo indiretamente o desgaste emocional, mental e familiar por trabalhar num período diferenciado. A variável tempo de serviço indica de forma geral que o sofrimento vai diminuindo com o passar dos anos. Dentre os itens pesquisados, apenas 6% apresentaram classificação grave, 61%, em nível crítico ou intermediário e 33% classificação suportável. Nenhum item apresentou o resultado com doença ocupacional. A média geral dentre os 13 fatores analisados, classificou 10 em nível crítico e 3 em nível suportável ou satisfatório. / This case study was undertaken in a large freezer factory in an inland city in the state of Paraná to evaluate activities carried out in freezer rooms at ambient temperatures of between 10º C and -35º C. The main objectives were: to analyze the work processes in a freezer factory with respect to factors such as working conditions, physical injuries and physical costs; to diagnostically compare factors related to the levels of pleasure and suffering of the workers; and to indicate the key risks inherent in the activities performed. The results were obtained through the use of the ITRA (Inventory on Labor and Risk of Illness) with the participation of 178 employees. The ITRA comprises 4 scales of 13 factors totalling 124 items. These employees were classified into different groups according to level of education, marital status, length of service, shift, age and temperature at which they worked. For statistical analysis the Statistica program, version 5.0 (Statsoft ®) was used. Within the work processes, the following were identified as representing major risks to workers‟ health: working at height, the possible leak of toxic gases, misuse of compressed air and electric shocks, however contains all risk control measures. The most obvious health risks to employees were torsion of the lumbar spine, overloading of the knees and risks from being squeezed, bumped and bruised. In relation to the „working conditions‟ factor, all the items were classified at the „unsatisfactory‟ level, with statistically significant differences in some items related to type of shift and age. Regarding the „physical cost‟ factor, most responses were also rated as „unsatisfactory‟ with some differences related to length of service, working temperature and shift. With reference to the „physical injuries‟ factor, the responses were heterogeneous, with some items on the scale considered to be „severe‟. Statistical difference was observed for education, marital status, length of service and shift. Temperature was not identified as a variable with a negative influence on the work process. In terms of the „shift‟ factor, employees working on night shifts gave worse ratings, indirectly reflecting the emotional and mental stress of working at night. The „length of service‟ factor generally indicated that suffering decreased over the years. Among the items surveyed, only 6% were classified as „severe‟, 61% were „unsatisfactory‟, and 33% were „tolerable‟. No item was classified as an „occupational illness‟. The overall average of the 13 factors analyzed, ranked 10 as „unsatisfactory‟ and 3 as „tolerable‟ or satisfactory.

The construction industry is considered to be an extremely dangerous working environment, and therefore the health status of construction workers needs to be considered prior, during and on leaving the industry. Occupational hazards relative to the construction worker are well researched internationally; however few countries undertake routine medical surveillance to identify the health status of the construction worker relative to these hazards. Employers have a higher duty of care to identify workers who could be a risk at work from non-occupationally related conditions such as hypertension and diabetes mellitus. Work could exacerbate these conditions, leading to absenteeism, poor performance and eventually leaving the industry due to ill health. The dissertation explores, inter alia: the risks to which workers are exposed; the legal aspects; relevant literature regarding medical surveillance, and the use of a medical surveillance instrument used to determine the health status of 142 construction workers who consented to participate in the study. The methodological approach used in this study was a quantitative descriptive design, more specifically, using a randomised cross-sectional survey design. The instrument used to determine health status included a full medical, occupational and social history, as well as a physical examination undertaken by Occupational Health Nursing Practitioners (OHNs). Findings indicate that most construction workers believe they are healthy. However only a small percentage of construction workers did not require referral for further investigation and / or treatment.

M.Cur. / Occupational health nurses are qualified registered nurses with a post-graduate qualification in occupational health nursing as a specialised discipline, and provide the basic healthcare aspect of the occupational health programme. Their most important activity is to identify and assess the health hazard risks in the workplace. Health risk assessments are conducted by occupational health nurses to determine all the stresses, e.g. hazardous chemicals, vibration, insufficient lighting, noise exposure and thermal exposure, which may affect employees‟ health and working efficiency. The researcher conducted audits and, over a period of time, observed that 85% (n=23) of occupational health nurses in different settings conduct health risk assessments only to a certain extent. The following questions were raised: To what extent do occupational health nurses conduct health risk assessments? What are the possible reasons for them conducting the health risk assessments only to a certain extent, or not at all? What can be done to improve this? The purpose of this study was thus to explore and describe the extent to which occupational health nurses conduct health risk assessments; and the possible reasons for not conducting them or conducting them only to a certain extent. Guidelines were developed to assist occupational health nurses in conducting health risk assessments. A quantitative, descriptive design was used in this study. A sampling frame was developed from a list of all the members of the South African Society of Occupational Health Nursing Practitioners (SASOHN) in Gauteng. From the target population of occupational health nurses in Gauteng, a systematic cluster sampling method was used. A developed questionnaire was distributed by mail and e-mails, and reminders were sent by the researcher to the respondents (Burns & Grove, 2006). The researcher ensured validity and reliability throughout the study by means of theoretical review, content securing and statistical assistance (Burns & Grove, 2006). Ethical standards of the right to self-determination, right to privacy, right to confidentiality and autonomy, right to fair treatment and right to protection from discomfort and harm were adhered to. The findings revealed that the occupational health nurse is a mature, predominately female experienced practitioner who operates on behalf of a disproportionably large number of employees. Four factors influencing these nurses in conducting a health risk assessment to a certain extent were identified: competence, ignorance about the role of the occupational health nurse, workload and attitude. The researcher formulated guidelines to assist practising occupational health nurses to conduct health risk assessments.

No description available.

The goal of San Bernardino County Medical Information Resource is to develop, coordinate, and implement a centralized information and referral database that contains information about health and human services provided by public and private entities throughtout the county of San Bernardino and is accessible to the public via the Internet.

No description available.

Agro-terrorism has become a major concern since the September 11, 2001, terrorist attacks due to characteristics that create unique problems for managing the threat of an agro-terrorist attack. The costs of trucking delays alone were in the tens of millions of dollars. Over the last few years, the government has spent billions of dollars on biological surveillance and record keeping in preventing potential attacks. Several public and private initiatives are currently in use. Examples include 1) the bio-terrorism regulation of 2004 on maintenance of records; 2) establishment of food protection centers for research and teaching excellence; and 3) investments in emerging technology, such as radio frequency monitoring (RFEM) technology, with the potential to track shipments and provide real-time data that can be used to prevent agro-terrorism risks along food supply chains. This thesis addresses the costs and risk premiums associated with alternative tracking strategies, where and when along the milk supply chain these strategies will reduce the most risks, and what policy implications are associated with the most costeffective tracking strategy. To accomplish these objectives, stochastic optimization is used to determine the costs and risk premiums of alternative tracking strategies. Next, the realoptions method along with a portfolio of options, also referred to as the "tomato garden" framework, is used to determine where and when alternative intervention strategies should be implemented to reduce the most risks. Finally, policy implications are derived on the cost-risk tradeoffs, probability of attacks, and containment efforts if there is an attack by using game theory to determine the incentives needed to motivate participants in the milk supply chain to invest in security measures.

Secular trends in breast cancer incidence in younger women suggest environmental factors, like exposure to environmental chemicals, may play a role in rising incidence. One of the strongest risk factors for developing breast cancer, next to family history, is high mammographic breast density, which is defined as the proportion of fibroglandular breast tissue relative to fat as seen on a mammogram. Phthalates, a ubiquitous endocrine disrupting chemical, have the potential to interfere with endogenous hormones like estrogen and androgens. There is growing evidence from animal and epidemiologic studies indicating distinct periods of heightened susceptibility to endocrine disrupting chemicals throughout the life course, particularly during critical windows of breast development. Exposure to hormonally active environmental chemicals like phthalates may be a modifiable risk factor for breast cancer, therefore reducing or eliminating exposure could have substantial public health benefits. The overarching goal of this dissertation was to assess the relationship between exposure to phthalates during two critical windows of susceptibility, the prenatal and pregnancy periods, and its effect on breast tissue composition in adolescence and adulthood. First, a comprehensive review of epidemiologic studies summarized the body of evidence for the association between phthalate exposure and intermediate markers known to be in the causal pathway of breast cancer risk (age at breast development, menarche, and breast tissue composition). This systematic review of the literature aimed to identify potential patterns of evidence by outcome and timing of exposure. Evidence from this review suggested that phthalate exposure during the prenatal and childhood periods may play a role in altering menarche. Findings for phthalate exposure and age at breast development were inconclusive. There was a considerable lack of epidemiologic data on phthalate exposure and breast tissue composition throughout the life course. Based on one study, there is a potential association between phthalate exposure during pre-puberty and altered breast tissue density in adolescent girls. No study assessed the relationship between phthalate exposure during the prenatal or pregnancy period and subsequent breast tissue composition. Second, an examination for the association between prenatal phthalate exposure and breast tissue composition measured in adolescence (Chapter 3) and the association between phthalate exposure during pregnancy and breast tissue composition measured during or after the postpartum transient period (Chapter 4) aimed to address this major gap identified from the comprehensive review. The empirical chapters of this dissertation used data from an ongoing longitudinal birth cohort study of mothers and their children conducted by the New York City Columbia Center for Children's Environmental Health and the Breast Cancer and the Environment Research Project (CCCEH-BCERP). The CCCEH-BCERP study cohort has prospective data on nine phthalate metabolite concentrations measured during the third trimester of pregnancy and breast tissue composition measured in a subsample of mother-daughter dyads. Notably, we used novel non-invasive methods (optical breast spectroscopy) in this younger cohort of mothers and daughters to objectively measure specific components of the bulk breast composition before mammography screening age. There was significant evidence of altered breast tissue composition in both mothers and daughters. For daughters (n=127, mean age 15.2 ± 1.9 years), prenatal exposures to select low molecular weight (LMW) and high molecular weight (HMW) phthalate metabolites altered overall breast density in opposing directions, which appears to be driven by significant altered percent breast water. There was a significant association between higher prenatal levels of a LMW phthalate metabolite (monobutyl phthalate) and lower levels of overall breast density (adjusted β = -0.32; 95% CI: -0.51, -0.13) and significant association between sum of di(2-ethylhexyl) phthalate (∑DEHP), a HMW phthalate metabolite, and higher levels of overall breast density in girls (adjusted β = 0.20; 95% CI: 0.05, 0.34). For mothers (n=133, mean age 41 ± 5.3 years at follow-up), there was a significant association between two LMW phthalate metabolites and lower levels of percent breast collagen. Additionally, there was a significant inverse relationship between levels of mono-(3-carboxypropyl), a HMW phthalate metabolite, and percent total hemoglobin of the breast (adjusted β =-0.03; 95% CI: -0.06, 0.00, p=0.05). Overall, this dissertation increased our understanding of the impact that exposure to phthalates during critical windows of susceptibility may have on specific components of the breast. Reducing exposure to both HMW and LMW phthalates may have an impact in reducing breast cancer risk, particularly for girls prenatally exposed, as there was stronger evidence of higher overall breast density and percent water from exposure to select HMW phthalates. Future prospective studies should confirm these results as findings might provide an opportunity for modifying potential breast cancer risk.

京都大学 / 新制・課程博士 / 博士(工学) / 甲第23182号 / 工博第4826号 / 新制||工||1754(附属図書館) / 京都大学大学院工学研究科都市環境工学専攻 / (主査)教授 米田 稔, 教授 高野 裕久, 教授 松井 康人 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DGAM

Environmental exposure levels are often sufficiently disparate between populations such that there is little or no overlap, complicating our ability to ascertain the full dose-response curve and as such create informed regulatory policy.I reviewed the literature on methods available to address non- and partially-overlapping exposure distributions, drawing from both epidemiology as well as other relevant disciplines to describe the universe of proposed solutions. I also used the case study of maternal PCB-153 exposure and birthweight, utilizing real-world and simulated data to explore our ability to ascertain “true” dose-response curves from observational data given the limited cohort-specific exposure ranges. I investigated the importance of controlled and uncontrolled confounding as well as the impact of sample size on our ability to ascertain a “true” underlying dose-response curve. Pooling and meta-analysis were useful to increase the heterogeneity of exposure distributions despite imperfect confounding control and heterogenous confounding structures across cohorts. The analyses also serve as continued evidence of the challenges of making population-wide inferences from study samples with restricted exposure ranges as well as the danger of pooling multisite data without sufficiently accounting for heterogeneity in both exposure level and distribution of confounders. These results highlight the limitations of using both individual studies and systematic reviews of environmental chemicals, and emphasize the need for pooling and meta-analysis to widen exposure distributions that in turn permit us to accurately capture the negative effects of these environmental chemicals.