Thesis (M.S.)--University of Michigan, 1991.

Thesis (Ph. D.)--Ohio State University, 1991. / Vita. Includes bibliographical references (leaves 317-337).

Thesis, PlanB (M.S.)--University of Wisconsin--Stout, 2006. / Includes bibliographical references.

Thesis (M.Eng.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 208-213.

Thesis (M.S.)--University of Michigan, 1991.

Lawrence S. Bacow. / Includes index. / Bibliography: p. [150]-154.

After the notorious outbreak and discovery of Legionella bacteria in 1976, the waterborne pathogen was added to the list of disease-causing agents associated with the built environment. Legionella pneumophila was discovered when it was identified as the agent that caused 34 deaths and an outbreak of pneumonia-like symptoms in several attendees of the 1976 American Legion Convention held in Philadelphia (OSHA, 2017). Recently published data from the year 2015 reported more than 6,000 Legionnaires’ cases identified in the United States (CDC, 2016). This is a concerning number given that one in every ten infected persons will die of the disease. It is believed that case numbers are likely under-reported, given that Legionnaires’ disease is very difficult to diagnose. Legionella species live naturally in bodies of water, including lakes and rivers. Legionnaires’ disease has been associated with the introduction of Legionella into manmade water systems. The presence of Legionella has been reported in cooling towers, domestic hot-water systems, humidifiers, decorative fountains, grocery spray misters, spas, whirlpools, and dental water lines, among other systems housing stagnant water (CDC, OSHA, 2017). From an occupational exposure standpoint, cooling towers are considered the most concerning source of Legionella pneumophila exposures, based on data from previous cases (Principe et al., 2017). The purpose of this research was to measure the effectiveness of biocide substitution and maintenance management in evaporative condensers. Such condensers were previously identified as having high counts of Legionella pneumophila in the water and/or on surfaces. The study sites were in the states of Florida and Georgia. Initial water testing for Legionella was carried out between July and August of 2016. Results from 2016 showed high counts of colony forming units (CFU) per millimeter (mL) at baseline assessment. An intervention of biocide substitution and enhanced management planning was recommended to lower or eliminate L. pneumophila from the water basins of the evaporative condensers. Follow-up results of water sampling conducted between July and August 2017 showed reduction of CFU counts after the intervention plan had been implemented for an entire year.

The HIV/AIDS pandemic has had a devastating effect in the world, as it is now rated as the world’s greatest killer since its appearance in the mid 1980s. A UNICEF Report (2005) states that sub Saharan Africa is the hardest hit with countries like Botswana, Zimbabwe, South Africa, Namibia and Mozambique having an average of one in every five adults being infected. Sub Saharan Africa has less than 3 percent of the world’s population but it has an estimated 65 percent of the world’s population living with HIV/AIDS as it has 26 million of the 40 million infected people worldwide. In May 2003 the Government of Zimbabwe declared HIV/AIDS a national emergency a move that seems to have yielded results as the HIV prevalence rate has come down from 26.1 percent to 18.6 percent in 2005 and further to 15.6 percent in 2007. The Ministry of Health and Child Welfare (2004) states that if the prevalence had continued at 26.1 percent, about two thirds of today’s 15- year-olds would die from this disease. The deterioration of the political, social and economic situation since 1999 and the withdrawal of donor development support due to policy differences require concerted efforts from all parties concerned, now, rather than later. More commitment must be shown by private and public sector organisations to active participation in the establishing of effective workplace programmes, to assist employees, for the pandemic has placed a heavy strain on the health delivery system, as AIDS patients occupy between 50 percent to 70 percent of all hospital beds. Furthermore, the pandemic is killing the youth at the prime of their working careers so the pandemic, while being a health problem also has a negative macro-economic impact which may lead to a developmental crisis. A study was conducted of six organisations, using two questionnaires, one for management and one for non-management level employees. The study investigates whether the organisations had HIV/AIDS programmes and whether such programmes were effective. The findings were that all six organisations had HIV/AIDS programmes in place. However, some of the programmes were not effective because the employees did not know of their existence. Furthermore, it was found that management initiated awareness programmes and made condoms available but the employees were not changing their risky behaviour.

The present study analyzed the health benefits data of employees in a southwestern United States manufacturing plant. The data consisted of the prevalence rates of headaches, muscle injuries, upper respiratory complaints, and colds/flu for baseline (1985) and intervention levels (1986-1988) for five high-risk jobs. The prevalence rates of headaches and muscle injuries decreased significantly (p < .001) from baseline levels for all five job groups. Comparisons with a nontreatment group revealed significant decreases (p < .05) for three of the five job groups. The findings support the efficacy of the ergonomic interventions. A health surveillance system is recommended for early detection and prevention of cumulative trauma disorders.

Introduction The prevalence of work-related musculoskeletal disorders is very common. The main objective of the study was to identify any association between the severity of musculoskeletal symptoms and treatment choice by workers in automobile manufacturing plants. Methods A cross-sectional study of 1017 production workers in six automobile manufacturing plants was performed. The study included the structured interviews to determine symptoms, preexisting personal risk factors, treatment choices (health care provider or no treatment sought), job strain, and job satisfaction. Nordic style questionnaire for symptoms, Karasek’s Demand Control Model and three job satisfaction questions were used to assign symptom severity, job strain, and job satisfaction, respectively. The case definition was that the person sought treatment from plant clinic or personal health care provider. The independent variables were symptom severity (2 levels), job strain (2 levels), job satisfaction (3 levels). The logistic analysis was used for data analysis. Results The Whole Body symptoms severity score was taken as the highest symptoms severity for any body region. Those with High symptoms were more likely to seek treatment than those with Low symptoms, OR=2.3 (1.23-4.27, 95%CI). There was no effect associated with job strain and job satisfaction. Those with osteoarthritis, neurological disorders and hypertension sought more treatment, OR= 3.32 (1.55-7.11, 95%CI), OR=30.5 (5.37-173, 95%CI) and OR=2.97 (1.19-7.44, 95%CI). Sex was significant, where women were more likely to seek treatment than men, OR=2.3 (1.33-3.07, 95%CI). There were no significant findings for BMI, diabetes, rheumatologic disorder, thyroid problems, and smoking. Conclusion The study found an association between the severity of the symptoms for a musculoskeletal disorder and the decision to seek treatment from a health care provider (either plant clinic or private provider). Participants with osteoarthritis, neurological disease and hypertension were also more likely to seek treatment more than those without the conditions. Women were more likely to seek treatment than men.