Background: Chronic neck pain is a problem that may be prevented and treated by physical activity. Little is known about effective interventions to increase physical activity in workers with neck pain. Objective: To evaluate the effects of an intervention aimed at increasing physical activity among workers with chronic neck pain. Design: A 10-week randomized controlled study in a population of 35 (intervention n= 19, control n= 16) workers. Physical activity was assessed using a tri-axial accelerometer pre and post the intervention. Outcomes: Daily steps, metabolic equivalent, proportions of time spent sitting/lying, standing and walking, and sit-to stand transitions. Linear mixed model was used to analyze the intervention effect (group × time) adjusted for the baseline value for each outcome. Results: There was no significant intervention effect on steps, metabolic equivalent, walking or sit-to stand transitions. There were significant intervention effects on decreased time spent sitting/lying (p=0.010) and increased standing (p=0.017).   Conclusion: No differences between intervention and control groups were found in parameters of total physical activity. However sedentary time decreased substantially in intervention group and was replaced by standing time. Larger studies using objective assessments of physical activity and sedentary behavior, investigating the effects of changes in PA and sedentary behavior on pain and health outcomes, in a working population with chronic neck pain are recommended. / Bakgrund: Kronisk nacksmärta är ett problem som kan vara möjligt att förebygga och behandla med fysisk aktivitet. Det finns begränsad kunskap om effektiva interventioner för att öka fysisk aktivitet hos arbetstagare med nacksmärta. Syfte: Att utvärdera effekten av en intervention riktad mot att öka fysisk aktivitet hos en grupp arbetstagare med kronisk nacksmärta. Design: En 10 veckors randomiserad kontrollerad studie i en population av arbetstagare med kronisk nacksmärta, n= 35 (interventionsgrupp n=19, kontrollgrupp n= 16). Fysisk aktivitet mättes med triaxiell accelerometer före och efter interventionen.  Utfallsmått: Antal steg per dag, metabolisk ekvivalent, förändringar i proportionerna mellan tid i sittande/liggande, stående och gående och antal uppresningar från sittande till stående. Resultat: Det fanns ingen signifikant interventionseffekt avseende steg, metabolisk ekvivalent, tid i gående eller antal uppresningar från sittande. Tid i sittande/liggande minskade signifikant (p=0,010) och tid i stående ökade, också signifikant (p=0,017).  Slutsats: Det fanns ingen skillnad mellan grupperna i total fysisk aktivitet. Däremot minskade tiden i sittande/liggande markant och ersattes av tid i stående. Större studier med objektiva mätningar av fysisk aktivitet och stillasittande beteende som också undersöker effekter av förändringar i fysisk aktivitet på smärta och hälsovariabler bland arbetstagare med kronisk nacksmärta rekommenderas. / STIMUL

Medical certification of workers for respirator use is an important activity of occupational medicine health professionals. Spirometry is a diagnostic tool to evaluate respiratory distress/insufficiency that may affect respirator use. In this study, we analyzed the pulmonary function data of 337 workers from different occupations which required medical evaluation to wear a respirator. The American Thoracic Society and National Fire Protection Association criteria were used to evaluate employees. Of 337 workers who were cleared for respiratory use on the basis of medical questionnaires for respirator compliance, 14 (4.15%) failed to pass respirator compliance on the basis of NFPA criteria and 5 (1.48%) failed to pass respirator compliance criteria on the basis of ATS criteria. We compared the use of different Spirometric equations to evaluate these criteria and we found the Crapo equation cleared more workers for respirator use as compared to the Knudson and NHANES III equations. We also measured repeated Forced Expiratory Volume in 1st Second (FEV1) and Forced Vital Capacity (FVC) and compared the results longitudinally over time. Age was the only significant factor affecting the reduction in the lung function in longitudinal analysis. Longitudinal spirometry results suggested that workers were protected while using a respirator in the workplace, but age is the significant factor in reducing their lung function. As some workers were able to qualify for respirator use based on questionnaire alone but failed respirator clearance subsequent to pulmonary function testing, it is recommended that spirometry be used to evaluate clearance for all workers who will use a respirator in the workplace. As well, using different Spirometric equations can affect the outcome on passing or failing clearance for respirator use, and this should be considered in a respiratory medical certification program.

The long-term goal of this research is to reduce the number of deaths by suicide. Suicide is the leading cause of violent death in the United States, and is currently the 10th most common cause of death across all age groups. Suicide prevention efforts have historically been focused on youth/young adults, and the elderly, with less attention on programming for individuals in the working years. Our intention is to generally broaden the understanding of suicide, depression and the workplace, with the hope of improving interventions for this underserved population. The research activities outlined below were conducted under the auspices of a larger quasi-experiment at the University of Iowa. We first sought to assess the experiences of professional, nonclinical staff identifying and responding to apparently mental health problems in the workplace. We looked at the impact of two exposures on engagement with individuals in crisis: self-reported contact (the number of students or coworkers a participant interacted with each week), and participation in any suicide prevention training/programming over the previous five years. High contact with students was generally associated with a greater capacity for recognizing and responding to depression and potential suicidality. In contrast, the association between high contact with employees and recognition and response was insignificant for four of the six recognition and response behaviors. Participation in any form of suicide prevention training or programming in the previous five years was highly associated with recognizing and responding to depressed or suicidal coworkers and students. Next, we considered the impact of a personal prior experience with suicide and prior suicide prevention training/programming on four constructs: preparedness to respond to someone in crisis, familiarity with appropriate resources, gatekeeper self-efficacy, and gatekeeper reluctance. Suicide prevention training/programming was significantly associated with higher perception of three constructs: preparedness, familiarity, and self-efficacy. There was no statistical difference in reluctance between previously training participants and participants who had not previously taken suicide prevention training or programming. Individuals who had a personal prior experience with suicide were less reluctant to engage, although the results were not significant. There was an association between individuals who had a personal prior experience with suicide and suicide prevention training/programming, suggesting that individuals with a personal connection to suicide might be more likely to enroll in suicide prevention programming. Finally, we examined how a suicide prevention training programming impacted the perception of safety culture in the workplace. On the 10 item safety scale, there was a significant difference between the means scores reported by the intervention and control group on 7 of the 10 questions. Individuals who participated in QPR gatekeeper training reported a higher sum safety culture score than individuals who did not participate in the training; the overall model was statistically significant. This project shows that suicide prevention training/programming of any kind in the workplace can have a persistent, positive training impact on employees by informing and empowering them to act. It suggests that individuals with a personal prior experience with suicide may be more likely to take suicide prevention training, and may be less reluctant to engage with someone in crisis. It also demonstrates that suicide prevention training may have a positive impact on other workplace psychosocial factors, and deserves prioritization in workplace wellness programming.

Thesis advisor: Sean Clarke / In the popular press and in the public imagination there has been much interest in the concept of generational differences—the idea that one’s experiences might vary as a function of the timing of one’s birth and other key life events relative to historical markers or periods. While research findings on generational differences in the workplace, including occupational health, have been limited and inconsistent, nurse administrators have noted important occupational health differences in work-related experiences of the nurses they supervise. This secondary analysis of cross-sectional data on 1,146 direct care staff registered nurses in non-administrative roles enrolled in the Boston Hospital Workers Health Study (BHWHS) in 2014 examined the relationships between being a member of one of three generationally-defined age groups (Baby Boomers, Generation X and Millennials) and indicators of three major categories of health. Physical (measured by body mass index, pain presence and severity, absences and limitations related to pain, and occupational injury), psychological (measured by psychological distress), and overall work-related (measured by work limitations) health variables were analyzed using regression modeling controlling for individual and work-related characteristics. Overall, this sample of nurses from two major teaching hospitals in a single city, which was relatively homogeneous in terms of gender, race, and ethnicity, reported generally good health and serious symptoms or limitations were rare. With a few notable exceptions, poor physical health was more common in older age groups and psychological symptoms were worse in the younger age groups in this cohort. However, the findings should be interpreted cautiously and may reflect a number of selection and survivor biases. Further research is needed to replicate these findings before drawing broader conclusions about age or generation as influences on nurse occupational health. As the empirical literature stands, it appears that energy would best be focused on nurturing a culture of health, emphasizing risk factors for various health problems, across all age groups, rather than in tailoring health promotion efforts for nurses by age or generation. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Introduction: A task-associated analysis of ammonia and particulate matter concentrations was conducted on swine farms in breeding and gestation barns. The purpose of this study was to determine if specific tasks performed by workers increase concentrations of ammonia and particulate matter exposure. Methods: An exploratory, descriptive design was used to determine if swine confinement workers have increased ammonia and particulate matter exposure when performing assigned tasks in breeding and gestation barns. A convenience sample of 8 workers volunteered from among all breeding and gestation workers (n=24). Data collection occurred in the morning at each of the 8 farms and continued until tasks were completed (~4 hrs). Analysis of covariance (ANCOVA) was computed to determine if the type of task or type of barn was related to workers' exposure to ammonia or particulate matter. Results: Ammonia levels were below the sensitivity of the instrument (<0.1) except on 1 morning when the ammonia concentration was recorded at 8 ppm. However, concentrations above 0.1 ppm lasted for less than 5 minutes. Consequently, this variable was not included in the analysis. Correlation analysis was used to answer the 1st research question. The results suggested a statistically significant decrease in particulate matter as the number of operating fans increased. Analysis of covariance (ANCOVA) was used to answer the last 2 research questions. The results suggested a significant interactive effect between the type of confinement barn and the type of tasks workers were performing. The barn types differed by the number of exhaust fans and the type of animal waste disposal system. Conclusions: Occupational health nurses can use study results to implement interventions to minimize worker exposures. These results indicate that understanding the relationship between building design and type of work tasks along with the importance of proper ventilation may minimize worker exposure to harmful particulate matter in SCBs during the summer months.

More than 100 million American workers, 7 million workplaces, and 945,000 hazardous chemical products are covered under the Hazard Communication Standard (HCS), regulated by the Occupational Safety and Health Administration. There were a total of 1,183,500 recordable non-fatal illnesses and injuries in private industry workplaces in 2006 resulting in days away from work. Of these, 19,480 were due to chemicals and chemical products. In addition, there were a total of 5,703 work-related fatalities in 2006. In 191 of these, chemicals and chemical products were listed as the primary source of injury and as the secondary source of injury in 104 cases. The economic impact of both fatal and non-fatal occupational injuries amounted to $164.7 billion in 2006. OSHA established the HCS in order to ensure that workers are informed of the hazardous chemicals with which they work, yet OSHA admits that many adults may have difficulty reading material that communicates hazards. Violations of OSHA's HCS were the third most cited violation in 2007. Since only 12 percent of the adults surveyed in the United States demonstrated Proficient health literacy, the state of affairs poses a serious problem for hazard communication, which nurses and nurse practitioners are often responsible for conveying. Health tasks that require Proficient health literacy include "drawing abstract inferences, comparing or contrasting multiple pieces of information within complex texts or documents, or applying abstract or complicated information from texts or documents". Donabedian's Structure-Process-Outcome framework served as the conceptual basis for this study. Twelve research studies (nine journal articles and three doctoral dissertations) published between 1993 and 2003 were reviewed. None of these studies measured the participants' literacy level. The purpose of this single administration, cross-sectional study was to examine literacy levels as a hypothesized predictor of test scores of employees presenting to the Lakeside Occupational Medical Center, Downtown Clinic, for a physical examination, immunization, drug screening, or follow-up appointment. MSDS test scores served as the dependent variable and were measured by an investigator-made test consisting of seven passages, taken from seven separate MSDSs for sodium hypochlorite, each from a different manufacturer. Sodium hypochlorite is commonly utilized in numerous industries including the janitorial, pulp, paper, textile, dairy, and water-cooling industries and is known to cause work-related health effects such as asthma and irritation of the eyes and throat. Each passage was followed by five multiple choice questions. Literacy levels were measured utilizing the Short Test of Functional Health Literacy in Adults (STOFHLA). The readability level of the written material was measured utilizing the Simplified Measure of Gobbledygook (SMOG) and the Flesch-Kincaid Grade Level (FKGL). The characteristics of age, highest grade level completed, native language, and job category were measured by a demographic sheet. The results indicate that there was a significant positive correlation between the total STOFHLA scores and the total scores on the MSDS test. Therefore, hypothesis number 1 was supported. Findings on the readability level of the examples of the MSDSs to the participant's overall MSDS score were inconclusive. However, the format of the MSDS, specifically the number of lines/sentence and the number of words that are 3 syllables or more, may influence comprehension. Therefore, written hazard communication material should be written in short sentences and use words less than 3 syllables. This way the likelihood of the material being understood by the worker will be increased. Further research aimed at understanding exactly how reading grade level and sentence structure impacts comprehension of hazardous materials information is needed.

This research aim to develop a framework to evaluate critically the effectiveness of health and safety strategies in supply chains in the UK was achieved through a range of objectives which included a review of literature on health and safety management in supply chains and small and medium-sized enterprises, an explanation of the effect of poor health and safety performance on organisations and analysis of factors that inspire health and safety management in organisations. Other objectives are the analysis of health and safety improvement strategies, an establishment of a basis for the development of a framework, the establishment of the perception and attitude to supply chain health and safety management, and the development of a conceptual framework based on ideal and best practices as well as theory that may be used to evaluate critically health and safety strategies in supply chains in the UK. The study adopted a triangulated research approach which used a questionnaire survey to ascertain the views of respondents on some health and safety issues. These views were combined with observations of a case study organisation to underpin the basis for the framework. It was established that the reliance on regulatory measures as means of improving health and safety standards in organisations is no longer advisable. An alternative and best strategy is the use of the influences inherent in supply chain relationships. There were noticeable improvements in the relationship of the case study organisation with its suppliers, and in the general awareness of supply chain health and safety management, when the framework that was developed was tried in their supply chain.

<p>The Essential Drugs Programme (EDP) is one of the tools developed to achieve the objectives of the South African National Drug Policy. Occupational health (OH) services are largely in the private sector and usually provide an element of Primary Health Care in addition to Occupational Hygiene, Medicine and Nursing. The aim of this study was to determine the challenges of implementing the Essential Drugs Programme into Occupatinal Health settings in the Port Elizabeth and East London areas. A descriptive cross-sectional study was carried out. Respondents cited the evidence-based approach to management of clients as a motivating factor for adopting the EDP in Occupational Health clinics.</p>

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Occupational skin diseases is one of the most commonest occupational disease groups accounting for about a fifth of all occupational diseases in the UK. Current guidance from the HSE for skin health surveillance is the skin inspection by a responsible person in the workplace. The use of teledermatology can be attractive to reliably conduct skin surveillance in the workplace, and a tool box to take reproducible standardised photographs from the hands of workers in the workplace was developed. Aim of this thesis was to assess diagnostic accuracy and validity of this toolkit with visual inspection as criterion standard for the presence of minor or major hand dermatitis and by scoring the hands and photographs with the validated Hand Eczema Severity Index. Workers from four different occupations were recruited over a 7 month period and 332 workers were assessed on a repeatedly basis producing 1212 assessments. Skin hydration and transepidermal water loss was measured and a symptoms questionnaire was completed by every participant. A high prevalence of skin problems was found in our study: 70% of the participants presented at least once over the study period with minor or major skin symptoms. A high intrarater reliability compared to the visual assessment was shown for the teledermatologic assessment with an agreement of 88%, kappa of 0.79, and a positive likelihood ratio of 7.4 and negative likelihood ratio of 0.07; about 5% of participants with normal skin were over-diagnosed compared to the visual inspection. The interrater reliability was low. The biophysical parameter did not distinguish between normal and affected skin. The tool kit has shown to produce reliable and standardised high quality photographs, the assessment of the photographs showed a very good intrarater agreement to the criterion standard. The toolkit would allow regular skin surveillance with minimal interruption in the workplace and with reliable results from the assessment.