Inaug.-diss. -- München. / Literaturverzeichnis": p. [163-172].

Despite the known health hazards associated with exposure to lead, occupational lead poisoning remains a health problem. Although a variety of public health programs have been implemented to control this exposure, knowledge of which occupational groups are at greatest risk is incomplete. This research developed and applied a lead risk model that generated estimates of lead-using industries and numbers of employees potentially exposed to lead, and then, validated the model through a lead exposure prevalence survey among construction workers. The lead risk model was developed using data from the National Occupational Exposure Survey, state lead registries, lead inspection results from the Occupational Safety and Health Administration, and other sources. The model was applied to Massachusetts County Business Patterns and Department of Employment and Training databases to produce state and county estimates of numbers of employees potentially exposed to lead, and lead-using companies, ranked by exposure risk. The sensitivity of the state lead registry was evaluated using estimates from this model. To validate the model, a prevalence survey of lead exposure was conducted among a sample of 127 western Massachusetts plumbers. Based on the model, an estimated 1% (20,825) of Massachusetts employees are potentially exposed to lead, 53% are at moderate or high risk of lead exposure, and 74% work within a 5 contiguous-county area in eastern Massachusetts. There are 3,448 lead-using facilities, representing 2% of total companies. The model also showed a high sensitivity (70%) for state regulated construction groups within the lead registry, but low sensitivities for all other construction industries. The geometric mean for blood lead and zinc protoporphyrin among plumbers in the prevalence survey were 7.0 $\mu$g/dl and 30.9 $\mu$g/dl, respectively, indicating relatively low levels of lead exposure. Current smokers, smoking at the workplace, and hand scraping metal were associated with higher lead levels, while wearing protective equipment at work was associated with lower levels. The model identified non-traditional lead-using industries, thus, potentially allowing the state to better target educational and medical intervention activities to reduce the risk of occupational lead exposure. Similar lead-reduction activities can be applied to other states that adopt the model.

Injury epidemiology, a relatively new sub-discipline of epidemiology, has continued to evolve since the ground-breaking work by Dr. William Haddon during the 1960s. The case-crossover design is a relatively new epidemiological methodology developed specifically for investigating the transient effects of a brief exposure on the onset of an acute outcome. This dissertation work provides some initial empirical data illustrating the strengths and limitations of the case-crossover design as applied within the field of occupational injury epidemiology. The review of the literature details the utility of the case-crossover study design, the currently known strengths and limitations, and confirms the under-utilization of this design to date. Examples from an on-going multi-center, interview-based, case-crossover study of acute traumatic occupational hand injuries are utilized to highlight some of the strengths and weaknesses of this new method, as applied to injury research. The application demonstrates the importance of temporal factors in determining the etiology of occupational acute traumatic hand injury. The findings point out the need to know more about the timing of high risk work tasks and transient exposures throughout the work day. These factors should be taken into consideration when developing intervention strategies for the prevention of hand injuries in the workplace. To evaluate the potential impact of information bias on the results of this study, a reliability study was also conducted. The findings from this test-retest study suggest that the frequency and duration of unusual transient workplace exposures, occurring proximal to the time of an injury, can be reliably recalled using a telephone interview.

<p>The Global War on Terror has routinely exposed military personnel to PTSD qualifying traumatic events. Scant research has included a military training and occupational context among combat Veteran populations who leave military service. This retrospective cohort study explored the influence of pre-exposure training on the relationship between combat exposure, posttraumatic stress symptoms (PTSS) and functioning impairments after discharge from military service. The results confirmed an occupational associated exposure risk for approximately 15% of the US military. Despite the combative specialty Veteran experiencing more combat in frequency and intensity, there were no differences in PTSS or functioning impairment any time after discharge or within the last thirty days between occupational cohorts. The study concluded that combative occupational training is protective against the effects of battle exposure experiences, but not post battle experiences. The study results suggest that military organizational resilience training is not effective in bolstering hardiness after discharge and transitioning into the civilian population. These findings support the creation of a military occupational mental health model for future PTSD diagnosis and treatment for combat Veteran populations.

<p> Leaders play a crucial role in mitigating organizational trauma. Perverse and toxic leaders can disrupt the operating system, including initiating such rupturing events as closing programs or budget cuts. Other times, the disruptions are external and caused by socio-political changes, competitions, and lack of public acceptance. Behavioral health organizations by the nature of their work and the position they occupy in society are at risk of receiving the traumatizing events that change the culture and the operating systems. Leaders are responsible for managing the culture of an organization and mitigating the traumatic events that can result in mediocre services and organizational peril. Transformational leaders possess a great deal of emotional intelligence and believe in their abilities to lead in difficult times. They acknowledge the trauma or traumatizing events, and labor in transforming culture as leaders, employees, and the organization transcends through the events. A Delphi study allowed 18 experts in behavioral health organizations, to share their personal and professional experiences and to arrive at a consensus about leadership roles relating to the phenomenon of organizational trauma. Consequently, the role of leaders in preventing, mitigating, and healing organizational trauma was recognized as an essential role. Last, the experts agreed that transformational leadership styles, as well as emotional intelligence, are necessary interpersonal and professional skills to consider in training and development programs for leaders. The findings were congruent with the knowledge found in the literature review which indicates a need for ongoing study and research. </p><p>

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Published also as E.R. Hayhurst's Thesis (Ph. D.)--University of Chicago, 1916, with title: Industrial health-hazards and occupational diseases in Ohio. / Prepared in conformity with House joint resolution no. 12 - Eightieth General assembly of Ohio, under the general supervision and direction of the Ohio State Board of Health ... February, 1915. Includes index.

Thesis equivalent (M.P.H.)--University of Michigan, 1947.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Include\s bibliographical references (leaves 78-87).

Dissertation (Ph.D.)--University of South Florida, 2006. / Title from PDF of title page. Document formatted into pages; contains 66 pages. Includes vita. Includes bibliographical references.