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American Journal of Industrial Medicine
Gender, precarious work, and chronic diseases in South Korea
Il-Ho Kim, Young-Ho Khang, Carles Muntaner, Heeran Chun, Sung-Il Cho Thu, 14 Aug 2008 10:42:00 -0000
In view of the growing number of nonstandard workers in South Korea, this study examined whether nonstandard workers reported poorer health compared to standard workers and assessed whether there were gender differences in the association between employment status and chronic health outcomes.Data were taken from a representative-weighted sample of 1,563 men and 1,045 women aged 20-64, from the 2001 National Health and Nutrition Examination Survey. Nonstandard employment included part-time work, temporary work, and day labor. Self-rated health and self-reported chronic disease conditions were used as health measures.Nonstandard employment was significantly associated with higher risk of self-rated health and chronic conditions after adjusting for socioeconomic position (education, occupational class, and income) and health behaviors (cigarette smoking, alcohol consumption, regular exercise, and health examinations). However, the pattern in the relation between nonstandard work and specific health problems greatly differed by gender. Among men, nonstandard work arrangements were significantly associated with musculoskeletal disorders (OR 1.97, 95% CI 1.24-3.19) and liver disease (OR 2.83, 95% CI 1.27-6.32). Among women, nonstandard employment was related to mental disorders (OR 3.25, 95% CI 1.40-7.56).The findings clearly indicate the need for further study of the observed associations, particularly prospective and analytical studies. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Prevention of traumatic nail gun injuries in apprentice carpenters: Use of population-based measures to monitor intervention effectiveness
Hester J. Lipscomb, James Nolan, Dennis Patterson, John M. Dement Thu, 14 Aug 2008 09:26:00 -0000
Nail guns are responsible for a significant injury burden in residential construction. Risk, based on hours of work, is particularly high among apprentice carpenters due in part to more frequent exposure to tool use.Nail gun injuries were evaluated over 3 years among carpenters enrolled in two apprenticeship programs in the Midwest (2.3 million residential work hours observed) following initiation of training and a voluntary ANSI standard change calling for safer sequential triggers on framing nailers. Injury rates, based on hours of tool use, were calculated yearly. Rates and adjusted rate ratios were calculated with Poisson regression. Attributable risk percent (AR%) and population attributable risk (PAR%) were calculated yearly for modifiable independent risk factors for injury including lack of training in tool use and type of trigger mechanism on tools being used.As apprentices received training and safer trigger mechanisms became more widespread, injury rates decreased significantly (31%). While school training and hands-on mentoring were both important, injury rates were lowest among apprentices who received both. Although injury rates changed over the observation period, the relative risk comparing trigger mechanisms did not; contact trip triggers consistently carried a twofold risk.Although training and safer trigger use both increased, because of the relative prevalence of training and trigger exposures in this population, the engineering solution consistently had the potential to make more difference in population risk. Our findings demonstrate the utility of observational methods including measures of population-based risk in monitoring intervention effectiveness and making recommendations that lead to injury reduction. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Acute pesticide poisoning among agricultural workers in the United States, 1998-2005
Geoffrey M. Calvert, Jennifer Karnik, Louise Mehler, John Beckman, Barbara Morrissey, Jennifer Sievert, Rosanna Barrett, Michelle Lackovic, Laura Mabee, Abby Schwartz, Yvette Mitchell, Stephanie Moraga-McHaley Tue, 29 Jul 2008 10:11:00 -0000
Approximately 75% of pesticide usage in the United States occurs in agriculture. As such, agricultural workers are at greater risk of pesticide exposure than non-agricultural workers. However, the magnitude, characteristics and trend of acute pesticide poisoning among agricultural workers are unknown.We identified acute pesticide poisoning cases in agricultural workers between the ages of 15 and 64 years that occurred from 1998 to 2005. The California Department of Pesticide Regulation and the SENSOR-Pesticides program provided the cases. Acute occupational pesticide poisoning incidence rates (IR) for those employed in agriculture were calculated, as were incidence rate ratios (IRR) among agricultural workers relative to non-agricultural workers.Of the 3,271 cases included in the analysis, 2,334 (71%) were employed as farmworkers. The remaining cases were employed as processing/packing plant workers (12%), farmers (3%), and other miscellaneous agricultural workers (19%). The majority of cases had low severity illness (N = 2,848, 87%), while 402 (12%) were of medium severity and 20 (0.6%) were of high severity. One case was fatal. Rates of illness among various agricultural worker categories were highly variable but all, except farmers, showed risk for agricultural workers greater than risk for non-agricultural workers by an order of magnitude or more. Also, the rate among female agricultural workers was almost twofold higher compared to males.The findings from this study suggest that acute pesticide poisoning in the agricultural industry continues to be an important problem. These findings reinforce the need for heightened efforts to better protect farmworkers from pesticide exposure. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Interpretation of the "positive" methacholine challenge
David J. Hewitt Wed, 13 Aug 2008 14:06:00 -0000
A methacholine challenge may be used in confirming the diagnosis of asthma, occupational asthma, or reactive airways dysfunction syndrome (RADS) through identification of bronchial hyperreactivity (BHR). While sensitivity of the test in diagnosing clinically significant asthma is excellent, specificity of the test is poor. Since there are many conditions which have been associated with BHR, a positive test must be interpreted cautiously.This paper reviews potential causes of a positive methacholine challenge other than asthma or RADS which have been reported in the medical literature.Factors which may be associated with a positive methacholine test include test methodology, normal variation of BHR in the general population, and numerous medical conditions.In cases of inhalation exposure evaluations, alternative explanations must be considered when determining whether a causal association exists between the exposure and a positive methacholine test result. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
Shift-work and suicide ideation among police officers
John M. Violanti, Luenda E. Charles, Tara A. Hartley, Anna Mnatsakanova, Michael E. Andrew, Desta Fekedulegn, Bryan Vila, Cecil M. Burchfiel Thu, 14 Aug 2008 09:26:00 -0000
This cross-sectional study assessed the association of shift work with suicide ideation among police officers.Shift work was based on daily payroll records over 5 years (41 women, 70 men). Standardized psychological measures were employed. ANOVA and Poisson regression were used to evaluate associations.Among policewomen with increased depressive symptoms, prevalence of suicide ideation increased by 116% for every 10-unit increase in percentage of hours worked on day shift (prevalence ratio (PR) = 2.16; 95% confidence interval (CI) = 1.22-3.71). Among policemen with higher (but not lower) posttraumatic stress disorder (PTSD) symptoms, prevalence of suicide ideation increased by 13% with every 10-unit increase in the percentage of hours worked on afternoon shift (PR = 1.13; 95% CI = 1.00-1.22).Prevalence of suicide ideation significantly increased among policewomen with higher depressive symptoms and increasing day shift hours, and among policemen with higher PTSD symptoms with increasing afternoon shift hours. Am. J. Ind. Med. Published 2008 Wiley-Liss, Inc.
Occupational asthma caused by sculptured nails containing methacrylates
Riitta Sauni, Paula Kauppi, Kristiina Alanko, Maj-Len Henriks-Eckerman, Matti Tuppurainen, Timo Hannu Wed, 13 Aug 2008 14:05:00 -0000
In recent decades, the use of artificial nails including methacrylates (MAs) has increased. This study presents the first two clinical cases of occupational asthma (OA) caused by sculptured nails containing MAs.In both cases, OA was diagnosed on the basis of a work simulation test combined with the patient's history of occupational exposure and respiratory symptoms.Both patients developed work-related respiratory symptoms 4-5 years before the current examinations. Previously, the first patient (a 30-year-old female) was diagnosed as having allergic contact dermatitis (ACD) to MAs; the second patient (a 27-year-old female) had no skin symptoms. In both cases, a dual asthmatic reaction was observed in the bronchial provocation test, in which the patients simulated their work using their own products including MAs.Sculptured nails containing MAs can induce OA in nail technicians. Products not containing MAs should be used to prevent OA and ACD. If MAs are used, they should be handled with appropriate safety measures. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
International Archives of Occupational and Environmental Health
Working conditions in call-centers, the impact on employee health: a transversal study. Part II
Fri, 15 Aug 2008 06:42:46 -0000
Abstract Purpose The present study sought to assess the impact of telephone call center employees’ working conditions on health by identifying at-risk employment situations. Methods A transversal study was performed in companies followed by 47 occupational physicians taking part (working conditions have been previously described). A self-administered medical questionnaire was used to collect data on absence due to sick leave, hearing and visual problems, musculoskeletal disorders, psychotropic drug use, etc. An analog-scale self-assessment of health status and a general health questionnaire (GHQ-12) were used. Personal or familial events that might underlie health problems and affect GHQ-12 results were quantified and taken into account in a logistic regression. Results A total of 2,130 call-handlers were included. Workers who had availed sick leave during the previous 12 months were 60%. The most frequent musculoskeletal complaints over the previous 12-month period concerned the cervical region (59%). During the same period, 77.3% of subjects experienced visual fatigue, 50% reported auditory fatigue signs and 47% vocal disturbance or fatigue. According to the Likert scale, 39.4% of workers had showed psychological distress. Almost 24% of the workers had used psychoactive medication during the previous 12 months. A significant association was found between psychological distress and the frequency of musculoskeletal disorders. Psychological distress and musculoskeletal disorders were significantly greater in workers with Job Strain and Iso Strain. After taking non-occupational factors into account, some occupational factors were found to increase the risk of psychological distress (Likert >12): imposed full-time schedule, being unable to simultaneously meet both quality and quantity requirements, situations of tension with clients, negative comments from superiors, and lack of recognition from superiors. Conclusions This survey of over 2,000 call center employees highlighted the high frequency of psychological distress in this population and the health impact of working conditions. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0351-zAuthors Barbara Charbotel, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite FranceSophie Croidieu, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite FranceMichel Vohito, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceAnne-Céline Guerin, UMRESTTE Institut National de Recherche sur les Transports et leur Sécurité 25, avenue François Mitterrand 69675 Bron Cedex FranceLiliane Renaud, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceJoelle Jaussaud, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceChristian Bourboul, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceIsabelle Imbard, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceDominique Ardiet, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceAlain Bergeret, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite France Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Outpatient rehabilitation of workers with musculoskeletal disorders using structured workplace description
Mon, 11 Aug 2008 13:27:29 -0000
Abstract Objectives In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists. Methods Sick leave days reduction and return-to-work-ratios were analysed for 79 male blue collar workers with musculoskeletal disease, who voluntarily participated in an outpatient rehabilitation treatment between 2002 and 2005. During rehabilitation therapy standardized workplace descriptions were given to the therapists and individual return-to-work (rtw) schemes were implemented. Therapy lasted from 3 to 4 weeks followed by workplace reintegration. Off-work-time was calculated from 0 to 6 years before and 0 to 3 years after rehabilitation from insurance and industrial medical reports. Results A total of 97% of the patients returned to their original job at the workplace, usually directly after the rehabilitation. Average sick leave days per year were reduced from 48.8 ± 32.8 days before to 34.2 ± 37.3 days after the rehabilitation. The therapy interrupted an increase in sick leave days over the years stabilizing absence at a low level for at least 2 years. Duration of illness related work absence was the only significant predictor for sick leave reduction (P < 0.05). Other common risk factors for musculoskeletal diseases like smoking or body mass index did not significantly influence the therapeutic effect. Conclusions Our results support evidence that information exchange for workplace description and rehabilitation therapist may help to reduce sick leave days and achieve very high rtw-ratio. However it is important to observe the effects of this shared information for longer intervals. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0346-9Authors Stephan W. Weiler, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck GermanyKay Peter Foeh, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyAnke van Mark, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck GermanyRene Touissant, Medica Hospital Leipzig Department for Orthopaedics Leipzig GermanyNina Sonntag, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyAnnette Gaessler, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyJohannes Schulze, Johann Wolfgang Goethe-University Frankfurt/Main Office of the Dean, Faculty of Medicine 60590 Frankfurt/Main GermanyRichard Kessel, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
High blood lead levels in recreational indoor-shooters
Fri, 25 Jul 2008 07:00:00 -0000
Abstract Introduction Recreational shooting in indoor firing ranges is very popular in Germany. Lead-containing ammunition is still in use. Therefore we checked the blood lead levels (BLL) from 129 subjects doing several types of shooting disciplines. Methods In total, BLLs of 129 shooters (nine female) from 11 different shooting ranges with a mean age of 49 years were measured. The blood samples were taken after the volunteers had given written informed consent. Determination of lead was carried out by graphite furnace atomic absorption (GF-AAS) under strict internal and external quality control schemes. Results While individuals shooting only with airguns (n = 20) showed a median BLL of 33 μg/l (range 18–127 μg/l), those who were also users of .22 lr weapons (n = 15) turned out to have a median of 87 μg/l (range 14–172 μg/l). Shooters of .22 lr and large calibre handguns (9 mm or larger) (n = 51) had median 107 μg/l (range 27–375 μg/l) and those only using large calibre handguns (n = 32) had median 100 μg/l (range 28–326 μg/l). The IPSC-group (n = 11) had the highest median with 192 μg/l (range 32–521 μg/l). Conclusion Our results show clearly that many shooters have high blood levels; some of them are still exceeding threshold limit values (TLVs) for lead exposed workers. Especially for younger women there is a high potential risk if they become pregnant. So there is a clear need for improving the situation whether by use of lead-free ammunition or by better ventilation systems. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s00420-008-0348-7Authors Matthias Demmeler, University Munich Institute for Occupational, Social and Environmental Medicine Munich GermanyDennis Nowak, University Munich Institute for Occupational, Social and Environmental Medicine Munich GermanyRudolf Schierl, University Munich Institute for Occupational, Social and Environmental Medicine Munich Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Cancer mortality and oil production in the Amazon Region of Ecuador, 1990–2005
Thu, 24 Jul 2008 08:57:31 -0000
Abstract Objectives To compare cancer mortality rates in Amazon cantons (counties) with and without long-term oil exploration and extraction activities. Methods Mortality (1990 through 2005) and population census (1990 and 2001) data for cantons in the provinces of the northern Amazon Region (Napo, Orellana, Sucumbios, and Pastaza), as well as the province with the capital city of Quito (Pichincha province) were obtained from the National Statistical Office of Ecuador, Instituto Nacional del Estadistica y Censos (INEC). Age- and sex-adjusted mortality rate ratios (RR) and 95% confidence intervals (CI) were estimated to evaluate total and cause-specific mortality in the study regions. Results Among Amazon cantons with long-term oil extraction, activities there was no evidence of increased rates of death from all causes (RR = 0.98; 95% CI = 0.95–1.01) or from overall cancer (RR = 0.82; 95% CI = 0.73–0.92), and relative risk estimates were also lower for most individual site-specific cancer deaths. Mortality rates in the Amazon provinces overall were significantly lower than those observed in Pichincha for all causes (RR = 0.82; 95% CI = 0.81–0.83), overall cancer (RR = 0.46; 95% CI = 0.43–0.49), and for all site-specific cancers. Conclusions In regions with incomplete cancer registration, mortality data are one of the few sources of information for epidemiologic assessments. However, epidemiologic assessments in this region of Ecuador are limited by underreporting, exposure and disease misclassification, and study design limitations. Recognizing these limitations, our analyses of national mortality data of the Amazon Region in Ecuador does not provide evidence for an excess cancer risk in regions of the Amazon with long-term oil production. These findings were not consistent or supportive of earlier studies in this region that suggested increased cancer risks. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0345-xAuthors Michael A. Kelsh, Exponent Health Sciences Menlo Park CA USALibby Morimoto, Exponent Health Sciences Menlo Park CA USAEdmund Lau, Exponent Health Sciences Menlo Park CA USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Outdoor work and skin cancer incidence: a registry-based study in Bavaria
Wed, 23 Jul 2008 05:52:51 -0000
Abstract Objective To analyse the association between occupational ultraviolet (UV) light exposure and skin cancer (basal cell carcinoma, BCC; squamous cell carcinoma, SCC; cutaneous malignant melanoma, CMM) based on data from the Bavarian population-based cancer registry. Methods The population-based cancer registry of Bavaria (Germany) provided data on incident cases of BCC, SCC, and CMM, respectively, during the period 2001 until 2005. Eleven Bavarian districts with complete skin cancer registration were included in this analysis based on 2,156,336 person years. Cases were assigned to “indoor”, “mixed indoor/outdoor”, and “outdoor” exposure categories according to their job title. We computed age-specific and age-adjusted incidence rates of BCC (n = 1,641), SCC (n = 499), and CMM (n = 454) by work type, and the relative risk (RR) of skin cancer occurrence for “outdoor” and “mixed indoor/outdoor” workers, respectively, compared to “indoor” workers. Results The risk of BCC was substantially elevated in male (RR, 2.9; 95% CI, 2.2–3.9) and female (RR, 2.7; 95% CI, 1.8–4.1) outdoor workers compared to male and female indoor workers, respectively. We also found an elevated risk of similar magnitude for SCC in male (RR, 2.5; 95% CI, 1.4–4.7) and female (RR, 3.6; 95% CI, 1.6–8.1) outdoor workers compared to male and female indoor workers, respectively. CMM risk was not significantly associated with outdoor work. Conclusion Our study confirms previous reports on the increased risk of BCC and SCC in outdoor workers compared to indoor workers. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0342-0Authors M. Radespiel-Tröger, Registration office Population-based Cancer Registry Bavaria Östl. Stadtmauerstr. 30a 91054 Erlangen GermanyM. Meyer, Registration office Population-based Cancer Registry Bavaria Östl. Stadtmauerstr. 30a 91054 Erlangen GermanyA. Pfahlberg, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyB. Lausen, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyW. Uter, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyO. Gefeller, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Job stress and depressive symptoms among Korean employees: the effects of culture on work
Sat, 12 Jul 2008 07:52:40 -0000
Abstract Objective This study was conducted to investigate the association between depressive symptoms and job stress, as measured by the KOSS, among Korean employees in small- and medium-sized enterprises, and examined which components of stress are involved in the risk for depression among males and females. Methods Data were collected from a work-stress survey of full-time employees of small- and medium-sized enterprises in Incheon, South Korea. A total of 3,013 participants were included in the analysis. Job stress was measured using 24 items (7 sub-scales) of the short form of Korean occupational stress scale (KOSS-SF), and depressive symptoms were evaluated using Center for epidemiologic studies depression scale (CES-D). Results After adjustment for confounding variables, most of subscales of job stress contributed to an increased risk of depressive symptoms, and job insecurity (male; OR = 2.02, 95%CI: 1.61–2.40, female; OR = 1.95, 95%CI: 1.42–2.70) and occupational climate (male; OR = 1.84, 95%CI: 1.49–2.28, female; OR = 1.78, 95%CI: 1.30–2.49) showed strong associations in both male and female. Other subscales revealed different effects for males and females; for males, job demands (OR = 1.68, 95%CI: 1.43–2.20), inadequate social support (OR = 1.55, 95%CI: 1.23–1.94), and lack of rewards (OR = 1.88, 95%CI: 1.48–2.37) were associated with depressive symptoms, whereas for females, organizational injustice (OR = 1.62, 95%CI: 1.14–2.30) was associated with depressive symptoms. Conclusion These results indicate that job stress may play a significant role in increasing the risk of depressive symptoms, and that further preventive efforts and research are needed to reduce job stress and address health problems caused by job stress among Korean employees. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0347-8Authors Shin-Goo Park, Inha University Hospital Department of Occupational and Environmental Medicine Incheon Republic of KoreaKyoung-Bok Min, Ajou University School of Medicine Department of Occupational and Environmental Medicine Suwon Republic of KoreaSei-Jin Chang, Wonju College of Medicine, Yonsei University Department of Preventive Medicine and Institute of Occupational Medicine Seoul Republic of KoreaHwan-Cheol Kim, Inha University Hospital Department of Occupational and Environmental Medicine Incheon Republic of KoreaJin-Young Min, Seoul National University Institute of Health and Environment Chongno-gu Yongeun-dong 28 Seoul 110-799 Republic of Korea Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Occupational Therapy International
Retracted: Development of an education programme for caregivers of people aging with multiple sclerosis
Marcia Finlayson, Jennifer Dahl Garcia, Katharine L. Preissner Tue, 05 Feb 2008 03:48:00 -0000
The article from Occupational Therapy International, Development of an Education Program for Caregivers of People Aging with Multiple Sclerosis (DOI: 10.1002/OTI.245) by Marcia Finlayson, Jennifer Garcia and Katharine Preissner, published online on 5 February 2008 in Wiley InterScience (www.interscience.wiley.com), has been retracted by John Wiley & Sons, Ltd. The retraction has been agreed due to dual publication of this article. Copyright ? 2008 John Wiley & Sons, Ltd.
Occupational Medicine - current issue
OCCUPATIONAL MEDICINE CALENDAR
Fri, 01 Aug 2008 00:00:00 -0000
In this issue of Occupational Medicine
Hobson, J. Fri, 01 Aug 2008 00:00:00 -0000
We can eliminate occupational cancer from chemicals
Cherrie, J. W. Fri, 01 Aug 2008 00:00:00 -0000
PubMed: 0355-3140
Sick leaves in four factories-do characteristics of employees and work conditions explain differences in sickness absence between workplaces?
Virtanen P, Siukola A, Luukkaala T, Savinainen M, Arola H, Nygård CH, Kivimäki M, Helenius H, Vahtera J Related Articles Sick leaves in four factories-do characteristics of employees and work conditions explain differences in sickness absence between workplaces? Scand J Work Environ Health. 2008 May 22; Authors: Virtanen P, Siukola A, Luukkaala T, Savinainen M, Arola H, Nygård CH, Kivimäki M, Helenius H, Vahtera J OBJECTIVES: The study explored whether differences in sickness absence between four factories of a food industry company were explained by common determinants of sickness absence, such as employee health, sociodemographic characteristics, and physical and psychosocial work conditions. METHODS: Survey responses of 582 employees were linked to the records of short-term (1-3 days) and long-term (>3days) absence, as well as to records of absences due to musculoskeletal diagnoses. Multilevel models were applied in assessing the between-factory absence differences. RESULTS: Compared with the levels in the factory with the lowest sickness absence, in one factory the levels of short-term [rate ratio (RR) 1.72], long-term (RR 1.96), and musculoskeletal (rate ratio 2.93) absence were significantly higher. Another factory also had higher levels of long-term and musculoskeletal absence (RR 2.17 and 2.52, respectively). Adjustment for the background factors explained 35% of the difference in short-term absence, 3-9% of the differences in long-term absence, and 18-12% of the differences in musculoskeletal absence, but the between-factory differences were still highly significant. CONCLUSIONS: This study showed large differences in sickness absence between factories that were only partly explained by common determinants. Moreover, economic factors and formal control were unlikely explanatory factors, as the study was conducted within a single company. These results justify further research on local absence practices and cultures, including those of health service organizations and professionals. PMID: 18604460 [PubMed - as supplied by publisher]
Annals of Occupational Hygiene - current issue
Measurement Uncertainty
Bartley, D., Liden, G. Wed, 06 Aug 2008 00:00:00 -0000
The reporting of measurement uncertainty has recently undergone a major harmonization whereby characteristics of a measurement method obtained during establishment and application are combined componentwise. For example, the sometimes-pesky systematic error is included. A bias component of uncertainty can be often easily established as the uncertainty in the bias. However, beyond simply arriving at a value for uncertainty, meaning to this uncertainty if needed can sometimes be developed in terms of prediction confidence in uncertainty-based intervals covering what is to be measured. To this end, a link between concepts of accuracy and uncertainty is established through a simple yet accurate approximation to a random variable known as the non-central Student's t-distribution. Without a measureless and perpetual uncertainty, the drama of human life would be destroyed. Winston Churchill
Application of a Pilot Control Banding Tool for Risk Level Assessment and Control of Nanoparticle Exposures
Paik, S. Y., Zalk, D. M., Swuste, P. Wed, 06 Aug 2008 00:00:00 -0000
Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or ‘CB Nanotool’ that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.
'Stoffenmanager', a Web-Based Control Banding Tool Using an Exposure Process Model
Marquart, H., Heussen, H., Le Feber, M., Noy, D., Tielemans, E., Schinkel, J., West, J., Van Der Schaaf, D. Wed, 06 Aug 2008 00:00:00 -0000
In the scope of a Dutch programme to reinforce the working conditions policy on hazardous substances, an internet-based tool was developed to help small- and medium-sized companies to handle hazardous substances with more care. The heart of this tool, called the Stoffenmanager, is a risk banding scheme. It combines a hazard banding scheme similar to that of COSHH Essentials and an exposure banding scheme based on an exposure model originally presented by Cherrie et al. (1996) and further developed by Cherrie and Schneider (1999). The exposure model has been modified to allow non-expert users to understand and use the model. Exposure scores are calculated based on categorization of determinants of emission, transmission and immission. These exposure scores are assigned to exposure bands. The comparison of exposure bands and hazard bands leads to a risk band or priority band. Following the evaluation of the priority of tasks done with products, generic exposure control measures can be evaluated for their possibility to lower the risks. Relevant control measures can be put into an action plan and into workplace instruction cards. The tool has several other functionalities regarding registration and storage of products. The exposure model in the Stoffenmanager leads to exposure scores. These have been compared with measured exposure levels. The exposure scores correlated well with measured exposure levels. The development of the Stoffenmanager has facilitated a whole range of further developments of useful tools for small- and medium-sized enterprises.
Stoffenmanager Exposure Model: Development of a Quantitative Algorithm
Tielemans, E., Noy, D., Schinkel, J., Heussen, H., Van Der Schaaf, D., West, J., Fransman, W. Wed, 06 Aug 2008 00:00:00 -0000
In The Netherlands, the web-based tool called ‘Stoffenmanager’ was initially developed to assist small- and medium-sized enterprises to prioritize and control risks of handling chemical products in their workplaces. The aim of the present study was to explore the accuracy of the Stoffenmanager exposure algorithm. This was done by comparing its semi-quantitative exposure rankings for specific substances with exposure measurements collected from several occupational settings to derive a quantitative exposure algorithm. Exposure data were collected using two strategies. First, we conducted seven surveys specifically for validation of the Stoffenmanager. Second, existing occupational exposure data sets were collected from various sources. This resulted in 378 and 320 measurements for solid and liquid scenarios, respectively. The Spearman correlation coefficients between Stoffenmanager scores and exposure measurements appeared to be good for handling solids (rs = 0.80, N = 378, P < 0.0001) and liquid scenarios (rs = 0.83, N = 320, P < 0.0001). However, the correlation for liquid scenarios appeared to be lower when calculated separately for sets of volatile substances with a vapour pressure >10 Pa (rs = 0.56, N = 104, P < 0.0001) and non-volatile substances with a vapour pressure ≤10 Pa (rs = 0.53, N = 216, P < 0.0001). The mixed-effect regression models with natural log-transformed Stoffenmanager scores as independent parameter explained a substantial part of the total exposure variability (52% for solid scenarios and 76% for liquid scenarios). Notwithstanding the good correlation, the data show substantial variability in exposure measurements given a certain Stoffenmanager score. The overall performance increases our confidence in the use of the Stoffenmanager as a generic tool for risk assessment. The mixed-effect regression models presented in this paper may be used for assessment of so-called reasonable worst case exposures. This evaluation is considered as an ongoing process and when more good quality data become available, the analyses described in this paper will be expanded. Based on these analyses, the algorithm will be refined in the near future.
Asbestos Fibre Concentrations in the Lungs of Brake Workers: Another Look
Finkelstein, M. M. Wed, 06 Aug 2008 00:00:00 -0000
Objective: To reanalyse data on the lung content of asbestos fibres among brake mechanics. Methods: I re-analysed data published by Butnor, Roggli and colleagues on the lung content of chrysotile and tremolite asbestos fibres among brake mechanics and controls. Statistics of the distributions were estimated by maximum likelihood to accommodate observations below the detection limit. Mean concentrations were compared by the t-test, bootstrap resampling and interval-censored survival methods. Results: The mean concentrations of fibres were higher among the brake workers than the controls. The concentration of tremolite fibres was higher than the concentration of chrysotile, a pattern similar to that observed among Quebec chrysotile miners and millers. Conclusions: Re-analysis of published data does not support the interpretation that, in automotive brake repair workers with malignant mesothelioma, asbestos content is within the normal range. The alternative interpretation that brake mechanics have a greater than background burden of asbestos fibres, attributable to occupational exposure to dusts from friction products manufactured from Canadian chrysotile, appears more credible. This asbestos burden might be associated with an increased risk of asbestos-associated cancers.
Exposure to Chrysotile Asbestos Associated with Unpacking and Repacking Boxes of Automobile Brake Pads and Shoes
Madl, A. K., Scott, L. L., Murbach, D. M., Fehling, K. A., Finley, B. L., Paustenbach, D. J. Wed, 06 Aug 2008 00:00:00 -0000
Industrial hygiene surveys and epidemiologic studies of auto mechanics have shown that these workers are not at an increased risk of asbestos-related disease; however, concerns continue to be raised regarding asbestos exposure from asbestos-containing brakes. Handling new asbestos-containing brake components has recently been suggested as a potential source of asbestos exposure. A simulation study involving the unpacking and repacking of 105 boxes of brakes (for vehicles ca. 1946–80), including 62 boxes of brake pads and 43 boxes of brake shoes, was conducted to examine how this activity might contribute to both short-term and 8-h time-weighted average exposures to asbestos. Breathing zone samples on the lapel of a volunteer worker (n = 80) and area samples at bystander (e.g., 1.5 m from worker) (n = 56), remote area (n = 26) and ambient (n = 10) locations collected during the unpacking and repacking of boxes of asbestos-containing brakes were analyzed by phase contrast microscopy and transmission electron microscopy. Exposure to airborne asbestos was characterized for a variety of parameters including the number of boxes handled, brake type (i.e. pads versus shoes) and the distance from the activity (i.e. worker, bystander and remote area). This study also evaluated the fiber size and morphology distribution according to the International Organization for Standardization analytical method for asbestos. It was observed that (i) airborne asbestos concentrations increased with the number of boxes unpacked and repacked, (ii) handling boxes of brake pads resulted in higher worker asbestos exposures compared to handling boxes of brake shoes, (iii) cleanup and clothes-handling tasks produced less airborne asbestos than handling boxes of brakes and (iv) fiber size and morphology analysis showed that while the majority of fibers were free (e.g. not associated with a cluster or matrix), <30% were respirable and even fewer were of the size range (>20 µm length) considered to pose the greatest risk of asbestos-related disease. It was found that average airborne chrysotile concentrations (30 min) ranged from 0.086 to 0.368 and 0.021 to 0.126 f cc–1 for a worker unpacking and repacking 4–20 boxes of brake pads and 4–20 boxes of brake shoes, respectively. Additionally, average airborne asbestos exposures (30 min) at bystander locations ranged from 0.004 to 0.035 and 0.002 to 0.011 f cc–1 when 4–20 boxes of brake pads and 4–20 boxes of brake shoes were handled, respectively. These data show that a worker handling a relatively large number of boxes of brakes over short periods of time will not be exposed to airborne asbestos in excess of its historical or current short-term occupational exposure limits.
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Gender, precarious work, and chronic diseases in South Korea
Il-Ho Kim, Young-Ho Khang, Carles Muntaner, Heeran Chun, Sung-Il Cho Thu, 14 Aug 2008 10:42:00 -0000
In view of the growing number of nonstandard workers in South Korea, this study examined whether nonstandard workers reported poorer health compared to standard workers and assessed whether there were gender differences in the association between employment status and chronic health outcomes.Data were taken from a representative-weighted sample of 1,563 men and 1,045 women aged 20-64, from the 2001 National Health and Nutrition Examination Survey. Nonstandard employment included part-time work, temporary work, and day labor. Self-rated health and self-reported chronic disease conditions were used as health measures.Nonstandard employment was significantly associated with higher risk of self-rated health and chronic conditions after adjusting for socioeconomic position (education, occupational class, and income) and health behaviors (cigarette smoking, alcohol consumption, regular exercise, and health examinations). However, the pattern in the relation between nonstandard work and specific health problems greatly differed by gender. Among men, nonstandard work arrangements were significantly associated with musculoskeletal disorders (OR 1.97, 95% CI 1.24-3.19) and liver disease (OR 2.83, 95% CI 1.27-6.32). Among women, nonstandard employment was related to mental disorders (OR 3.25, 95% CI 1.40-7.56).The findings clearly indicate the need for further study of the observed associations, particularly prospective and analytical studies. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Prevention of traumatic nail gun injuries in apprentice carpenters: Use of population-based measures to monitor intervention effectiveness
Hester J. Lipscomb, James Nolan, Dennis Patterson, John M. Dement Thu, 14 Aug 2008 09:26:00 -0000
Nail guns are responsible for a significant injury burden in residential construction. Risk, based on hours of work, is particularly high among apprentice carpenters due in part to more frequent exposure to tool use.Nail gun injuries were evaluated over 3 years among carpenters enrolled in two apprenticeship programs in the Midwest (2.3 million residential work hours observed) following initiation of training and a voluntary ANSI standard change calling for safer sequential triggers on framing nailers. Injury rates, based on hours of tool use, were calculated yearly. Rates and adjusted rate ratios were calculated with Poisson regression. Attributable risk percent (AR%) and population attributable risk (PAR%) were calculated yearly for modifiable independent risk factors for injury including lack of training in tool use and type of trigger mechanism on tools being used.As apprentices received training and safer trigger mechanisms became more widespread, injury rates decreased significantly (31%). While school training and hands-on mentoring were both important, injury rates were lowest among apprentices who received both. Although injury rates changed over the observation period, the relative risk comparing trigger mechanisms did not; contact trip triggers consistently carried a twofold risk.Although training and safer trigger use both increased, because of the relative prevalence of training and trigger exposures in this population, the engineering solution consistently had the potential to make more difference in population risk. Our findings demonstrate the utility of observational methods including measures of population-based risk in monitoring intervention effectiveness and making recommendations that lead to injury reduction. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Acute pesticide poisoning among agricultural workers in the United States, 1998-2005
Geoffrey M. Calvert, Jennifer Karnik, Louise Mehler, John Beckman, Barbara Morrissey, Jennifer Sievert, Rosanna Barrett, Michelle Lackovic, Laura Mabee, Abby Schwartz, Yvette Mitchell, Stephanie Moraga-McHaley Tue, 29 Jul 2008 10:11:00 -0000
Approximately 75% of pesticide usage in the United States occurs in agriculture. As such, agricultural workers are at greater risk of pesticide exposure than non-agricultural workers. However, the magnitude, characteristics and trend of acute pesticide poisoning among agricultural workers are unknown.We identified acute pesticide poisoning cases in agricultural workers between the ages of 15 and 64 years that occurred from 1998 to 2005. The California Department of Pesticide Regulation and the SENSOR-Pesticides program provided the cases. Acute occupational pesticide poisoning incidence rates (IR) for those employed in agriculture were calculated, as were incidence rate ratios (IRR) among agricultural workers relative to non-agricultural workers.Of the 3,271 cases included in the analysis, 2,334 (71%) were employed as farmworkers. The remaining cases were employed as processing/packing plant workers (12%), farmers (3%), and other miscellaneous agricultural workers (19%). The majority of cases had low severity illness (N = 2,848, 87%), while 402 (12%) were of medium severity and 20 (0.6%) were of high severity. One case was fatal. Rates of illness among various agricultural worker categories were highly variable but all, except farmers, showed risk for agricultural workers greater than risk for non-agricultural workers by an order of magnitude or more. Also, the rate among female agricultural workers was almost twofold higher compared to males.The findings from this study suggest that acute pesticide poisoning in the agricultural industry continues to be an important problem. These findings reinforce the need for heightened efforts to better protect farmworkers from pesticide exposure. Am. J. Ind. Med. 2008. © 2008 Wiley-Liss, Inc.
Interpretation of the "positive" methacholine challenge
David J. Hewitt Wed, 13 Aug 2008 14:06:00 -0000
A methacholine challenge may be used in confirming the diagnosis of asthma, occupational asthma, or reactive airways dysfunction syndrome (RADS) through identification of bronchial hyperreactivity (BHR). While sensitivity of the test in diagnosing clinically significant asthma is excellent, specificity of the test is poor. Since there are many conditions which have been associated with BHR, a positive test must be interpreted cautiously.This paper reviews potential causes of a positive methacholine challenge other than asthma or RADS which have been reported in the medical literature.Factors which may be associated with a positive methacholine test include test methodology, normal variation of BHR in the general population, and numerous medical conditions.In cases of inhalation exposure evaluations, alternative explanations must be considered when determining whether a causal association exists between the exposure and a positive methacholine test result. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
Shift-work and suicide ideation among police officers
John M. Violanti, Luenda E. Charles, Tara A. Hartley, Anna Mnatsakanova, Michael E. Andrew, Desta Fekedulegn, Bryan Vila, Cecil M. Burchfiel Thu, 14 Aug 2008 09:26:00 -0000
This cross-sectional study assessed the association of shift work with suicide ideation among police officers.Shift work was based on daily payroll records over 5 years (41 women, 70 men). Standardized psychological measures were employed. ANOVA and Poisson regression were used to evaluate associations.Among policewomen with increased depressive symptoms, prevalence of suicide ideation increased by 116% for every 10-unit increase in percentage of hours worked on day shift (prevalence ratio (PR) = 2.16; 95% confidence interval (CI) = 1.22-3.71). Among policemen with higher (but not lower) posttraumatic stress disorder (PTSD) symptoms, prevalence of suicide ideation increased by 13% with every 10-unit increase in the percentage of hours worked on afternoon shift (PR = 1.13; 95% CI = 1.00-1.22).Prevalence of suicide ideation significantly increased among policewomen with higher depressive symptoms and increasing day shift hours, and among policemen with higher PTSD symptoms with increasing afternoon shift hours. Am. J. Ind. Med. Published 2008 Wiley-Liss, Inc.
Occupational asthma caused by sculptured nails containing methacrylates
Riitta Sauni, Paula Kauppi, Kristiina Alanko, Maj-Len Henriks-Eckerman, Matti Tuppurainen, Timo Hannu Wed, 13 Aug 2008 14:05:00 -0000
In recent decades, the use of artificial nails including methacrylates (MAs) has increased. This study presents the first two clinical cases of occupational asthma (OA) caused by sculptured nails containing MAs.In both cases, OA was diagnosed on the basis of a work simulation test combined with the patient's history of occupational exposure and respiratory symptoms.Both patients developed work-related respiratory symptoms 4-5 years before the current examinations. Previously, the first patient (a 30-year-old female) was diagnosed as having allergic contact dermatitis (ACD) to MAs; the second patient (a 27-year-old female) had no skin symptoms. In both cases, a dual asthmatic reaction was observed in the bronchial provocation test, in which the patients simulated their work using their own products including MAs.Sculptured nails containing MAs can induce OA in nail technicians. Products not containing MAs should be used to prevent OA and ACD. If MAs are used, they should be handled with appropriate safety measures. Am. J. Ind. Med. © 2008 Wiley-Liss, Inc.
International Archives of Occupational and Environmental Health
Working conditions in call-centers, the impact on employee health: a transversal study. Part II
Fri, 15 Aug 2008 06:42:46 -0000
Abstract Purpose The present study sought to assess the impact of telephone call center employees’ working conditions on health by identifying at-risk employment situations. Methods A transversal study was performed in companies followed by 47 occupational physicians taking part (working conditions have been previously described). A self-administered medical questionnaire was used to collect data on absence due to sick leave, hearing and visual problems, musculoskeletal disorders, psychotropic drug use, etc. An analog-scale self-assessment of health status and a general health questionnaire (GHQ-12) were used. Personal or familial events that might underlie health problems and affect GHQ-12 results were quantified and taken into account in a logistic regression. Results A total of 2,130 call-handlers were included. Workers who had availed sick leave during the previous 12 months were 60%. The most frequent musculoskeletal complaints over the previous 12-month period concerned the cervical region (59%). During the same period, 77.3% of subjects experienced visual fatigue, 50% reported auditory fatigue signs and 47% vocal disturbance or fatigue. According to the Likert scale, 39.4% of workers had showed psychological distress. Almost 24% of the workers had used psychoactive medication during the previous 12 months. A significant association was found between psychological distress and the frequency of musculoskeletal disorders. Psychological distress and musculoskeletal disorders were significantly greater in workers with Job Strain and Iso Strain. After taking non-occupational factors into account, some occupational factors were found to increase the risk of psychological distress (Likert >12): imposed full-time schedule, being unable to simultaneously meet both quality and quantity requirements, situations of tension with clients, negative comments from superiors, and lack of recognition from superiors. Conclusions This survey of over 2,000 call center employees highlighted the high frequency of psychological distress in this population and the health impact of working conditions. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0351-zAuthors Barbara Charbotel, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite FranceSophie Croidieu, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite FranceMichel Vohito, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceAnne-Céline Guerin, UMRESTTE Institut National de Recherche sur les Transports et leur Sécurité 25, avenue François Mitterrand 69675 Bron Cedex FranceLiliane Renaud, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceJoelle Jaussaud, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceChristian Bourboul, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceIsabelle Imbard, A.s.t Grand Lyon 13, rue Emile Decorps 69627 Villeubanne Cedex FranceDominique Ardiet, Agemetra 23, Avenue des Saules, La Saulaie 69600 Oullins FranceAlain Bergeret, Centre Hospitalier Lyon Sud Hospices Civils de Lyon, Service des maladies professionnelles 69495 Pierre Bénite France Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Outpatient rehabilitation of workers with musculoskeletal disorders using structured workplace description
Mon, 11 Aug 2008 13:27:29 -0000
Abstract Objectives In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists. Methods Sick leave days reduction and return-to-work-ratios were analysed for 79 male blue collar workers with musculoskeletal disease, who voluntarily participated in an outpatient rehabilitation treatment between 2002 and 2005. During rehabilitation therapy standardized workplace descriptions were given to the therapists and individual return-to-work (rtw) schemes were implemented. Therapy lasted from 3 to 4 weeks followed by workplace reintegration. Off-work-time was calculated from 0 to 6 years before and 0 to 3 years after rehabilitation from insurance and industrial medical reports. Results A total of 97% of the patients returned to their original job at the workplace, usually directly after the rehabilitation. Average sick leave days per year were reduced from 48.8 ± 32.8 days before to 34.2 ± 37.3 days after the rehabilitation. The therapy interrupted an increase in sick leave days over the years stabilizing absence at a low level for at least 2 years. Duration of illness related work absence was the only significant predictor for sick leave reduction (P < 0.05). Other common risk factors for musculoskeletal diseases like smoking or body mass index did not significantly influence the therapeutic effect. Conclusions Our results support evidence that information exchange for workplace description and rehabilitation therapist may help to reduce sick leave days and achieve very high rtw-ratio. However it is important to observe the effects of this shared information for longer intervals. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0346-9Authors Stephan W. Weiler, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck GermanyKay Peter Foeh, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyAnke van Mark, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck GermanyRene Touissant, Medica Hospital Leipzig Department for Orthopaedics Leipzig GermanyNina Sonntag, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyAnnette Gaessler, Medical Services Hamburg NDAM Airbus Deutschland GmbH Hamburg GermanyJohannes Schulze, Johann Wolfgang Goethe-University Frankfurt/Main Office of the Dean, Faculty of Medicine 60590 Frankfurt/Main GermanyRichard Kessel, University of Luebeck Institute of Occupational Medicine Ratzeburger Allee 160 23538 Luebeck Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
High blood lead levels in recreational indoor-shooters
Fri, 25 Jul 2008 07:00:00 -0000
Abstract Introduction Recreational shooting in indoor firing ranges is very popular in Germany. Lead-containing ammunition is still in use. Therefore we checked the blood lead levels (BLL) from 129 subjects doing several types of shooting disciplines. Methods In total, BLLs of 129 shooters (nine female) from 11 different shooting ranges with a mean age of 49 years were measured. The blood samples were taken after the volunteers had given written informed consent. Determination of lead was carried out by graphite furnace atomic absorption (GF-AAS) under strict internal and external quality control schemes. Results While individuals shooting only with airguns (n = 20) showed a median BLL of 33 μg/l (range 18–127 μg/l), those who were also users of .22 lr weapons (n = 15) turned out to have a median of 87 μg/l (range 14–172 μg/l). Shooters of .22 lr and large calibre handguns (9 mm or larger) (n = 51) had median 107 μg/l (range 27–375 μg/l) and those only using large calibre handguns (n = 32) had median 100 μg/l (range 28–326 μg/l). The IPSC-group (n = 11) had the highest median with 192 μg/l (range 32–521 μg/l). Conclusion Our results show clearly that many shooters have high blood levels; some of them are still exceeding threshold limit values (TLVs) for lead exposed workers. Especially for younger women there is a high potential risk if they become pregnant. So there is a clear need for improving the situation whether by use of lead-free ammunition or by better ventilation systems. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s00420-008-0348-7Authors Matthias Demmeler, University Munich Institute for Occupational, Social and Environmental Medicine Munich GermanyDennis Nowak, University Munich Institute for Occupational, Social and Environmental Medicine Munich GermanyRudolf Schierl, University Munich Institute for Occupational, Social and Environmental Medicine Munich Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Cancer mortality and oil production in the Amazon Region of Ecuador, 1990–2005
Thu, 24 Jul 2008 08:57:31 -0000
Abstract Objectives To compare cancer mortality rates in Amazon cantons (counties) with and without long-term oil exploration and extraction activities. Methods Mortality (1990 through 2005) and population census (1990 and 2001) data for cantons in the provinces of the northern Amazon Region (Napo, Orellana, Sucumbios, and Pastaza), as well as the province with the capital city of Quito (Pichincha province) were obtained from the National Statistical Office of Ecuador, Instituto Nacional del Estadistica y Censos (INEC). Age- and sex-adjusted mortality rate ratios (RR) and 95% confidence intervals (CI) were estimated to evaluate total and cause-specific mortality in the study regions. Results Among Amazon cantons with long-term oil extraction, activities there was no evidence of increased rates of death from all causes (RR = 0.98; 95% CI = 0.95–1.01) or from overall cancer (RR = 0.82; 95% CI = 0.73–0.92), and relative risk estimates were also lower for most individual site-specific cancer deaths. Mortality rates in the Amazon provinces overall were significantly lower than those observed in Pichincha for all causes (RR = 0.82; 95% CI = 0.81–0.83), overall cancer (RR = 0.46; 95% CI = 0.43–0.49), and for all site-specific cancers. Conclusions In regions with incomplete cancer registration, mortality data are one of the few sources of information for epidemiologic assessments. However, epidemiologic assessments in this region of Ecuador are limited by underreporting, exposure and disease misclassification, and study design limitations. Recognizing these limitations, our analyses of national mortality data of the Amazon Region in Ecuador does not provide evidence for an excess cancer risk in regions of the Amazon with long-term oil production. These findings were not consistent or supportive of earlier studies in this region that suggested increased cancer risks. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0345-xAuthors Michael A. Kelsh, Exponent Health Sciences Menlo Park CA USALibby Morimoto, Exponent Health Sciences Menlo Park CA USAEdmund Lau, Exponent Health Sciences Menlo Park CA USA Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Outdoor work and skin cancer incidence: a registry-based study in Bavaria
Wed, 23 Jul 2008 05:52:51 -0000
Abstract Objective To analyse the association between occupational ultraviolet (UV) light exposure and skin cancer (basal cell carcinoma, BCC; squamous cell carcinoma, SCC; cutaneous malignant melanoma, CMM) based on data from the Bavarian population-based cancer registry. Methods The population-based cancer registry of Bavaria (Germany) provided data on incident cases of BCC, SCC, and CMM, respectively, during the period 2001 until 2005. Eleven Bavarian districts with complete skin cancer registration were included in this analysis based on 2,156,336 person years. Cases were assigned to “indoor”, “mixed indoor/outdoor”, and “outdoor” exposure categories according to their job title. We computed age-specific and age-adjusted incidence rates of BCC (n = 1,641), SCC (n = 499), and CMM (n = 454) by work type, and the relative risk (RR) of skin cancer occurrence for “outdoor” and “mixed indoor/outdoor” workers, respectively, compared to “indoor” workers. Results The risk of BCC was substantially elevated in male (RR, 2.9; 95% CI, 2.2–3.9) and female (RR, 2.7; 95% CI, 1.8–4.1) outdoor workers compared to male and female indoor workers, respectively. We also found an elevated risk of similar magnitude for SCC in male (RR, 2.5; 95% CI, 1.4–4.7) and female (RR, 3.6; 95% CI, 1.6–8.1) outdoor workers compared to male and female indoor workers, respectively. CMM risk was not significantly associated with outdoor work. Conclusion Our study confirms previous reports on the increased risk of BCC and SCC in outdoor workers compared to indoor workers. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0342-0Authors M. Radespiel-Tröger, Registration office Population-based Cancer Registry Bavaria Östl. Stadtmauerstr. 30a 91054 Erlangen GermanyM. Meyer, Registration office Population-based Cancer Registry Bavaria Östl. Stadtmauerstr. 30a 91054 Erlangen GermanyA. Pfahlberg, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyB. Lausen, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyW. Uter, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen GermanyO. Gefeller, Friedrich-Alexander-University Erlangen-Nuremberg Department of Medical Informatics, Biometry, and Epidemiology Waldstr. 6 91054 Erlangen Germany Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Job stress and depressive symptoms among Korean employees: the effects of culture on work
Sat, 12 Jul 2008 07:52:40 -0000
Abstract Objective This study was conducted to investigate the association between depressive symptoms and job stress, as measured by the KOSS, among Korean employees in small- and medium-sized enterprises, and examined which components of stress are involved in the risk for depression among males and females. Methods Data were collected from a work-stress survey of full-time employees of small- and medium-sized enterprises in Incheon, South Korea. A total of 3,013 participants were included in the analysis. Job stress was measured using 24 items (7 sub-scales) of the short form of Korean occupational stress scale (KOSS-SF), and depressive symptoms were evaluated using Center for epidemiologic studies depression scale (CES-D). Results After adjustment for confounding variables, most of subscales of job stress contributed to an increased risk of depressive symptoms, and job insecurity (male; OR = 2.02, 95%CI: 1.61–2.40, female; OR = 1.95, 95%CI: 1.42–2.70) and occupational climate (male; OR = 1.84, 95%CI: 1.49–2.28, female; OR = 1.78, 95%CI: 1.30–2.49) showed strong associations in both male and female. Other subscales revealed different effects for males and females; for males, job demands (OR = 1.68, 95%CI: 1.43–2.20), inadequate social support (OR = 1.55, 95%CI: 1.23–1.94), and lack of rewards (OR = 1.88, 95%CI: 1.48–2.37) were associated with depressive symptoms, whereas for females, organizational injustice (OR = 1.62, 95%CI: 1.14–2.30) was associated with depressive symptoms. Conclusion These results indicate that job stress may play a significant role in increasing the risk of depressive symptoms, and that further preventive efforts and research are needed to reduce job stress and address health problems caused by job stress among Korean employees. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00420-008-0347-8Authors Shin-Goo Park, Inha University Hospital Department of Occupational and Environmental Medicine Incheon Republic of KoreaKyoung-Bok Min, Ajou University School of Medicine Department of Occupational and Environmental Medicine Suwon Republic of KoreaSei-Jin Chang, Wonju College of Medicine, Yonsei University Department of Preventive Medicine and Institute of Occupational Medicine Seoul Republic of KoreaHwan-Cheol Kim, Inha University Hospital Department of Occupational and Environmental Medicine Incheon Republic of KoreaJin-Young Min, Seoul National University Institute of Health and Environment Chongno-gu Yongeun-dong 28 Seoul 110-799 Republic of Korea Journal International Archives of Occupational and Environmental HealthOnline ISSN 1432-1246Print ISSN 0340-0131
Occupational Therapy International
Retracted: Development of an education programme for caregivers of people aging with multiple sclerosis
Marcia Finlayson, Jennifer Dahl Garcia, Katharine L. Preissner Tue, 05 Feb 2008 03:48:00 -0000
The article from Occupational Therapy International, Development of an Education Program for Caregivers of People Aging with Multiple Sclerosis (DOI: 10.1002/OTI.245) by Marcia Finlayson, Jennifer Garcia and Katharine Preissner, published online on 5 February 2008 in Wiley InterScience (www.interscience.wiley.com), has been retracted by John Wiley & Sons, Ltd. The retraction has been agreed due to dual publication of this article. Copyright ? 2008 John Wiley & Sons, Ltd.
Occupational Medicine - current issue
OCCUPATIONAL MEDICINE CALENDAR
Fri, 01 Aug 2008 00:00:00 -0000
In this issue of Occupational Medicine
Hobson, J. Fri, 01 Aug 2008 00:00:00 -0000
We can eliminate occupational cancer from chemicals
Cherrie, J. W. Fri, 01 Aug 2008 00:00:00 -0000
PubMed: 0355-3140
Sick leaves in four factories-do characteristics of employees and work conditions explain differences in sickness absence between workplaces?
Virtanen P, Siukola A, Luukkaala T, Savinainen M, Arola H, Nygård CH, Kivimäki M, Helenius H, Vahtera J Related Articles Sick leaves in four factories-do characteristics of employees and work conditions explain differences in sickness absence between workplaces? Scand J Work Environ Health. 2008 May 22; Authors: Virtanen P, Siukola A, Luukkaala T, Savinainen M, Arola H, Nygård CH, Kivimäki M, Helenius H, Vahtera J OBJECTIVES: The study explored whether differences in sickness absence between four factories of a food industry company were explained by common determinants of sickness absence, such as employee health, sociodemographic characteristics, and physical and psychosocial work conditions. METHODS: Survey responses of 582 employees were linked to the records of short-term (1-3 days) and long-term (>3days) absence, as well as to records of absences due to musculoskeletal diagnoses. Multilevel models were applied in assessing the between-factory absence differences. RESULTS: Compared with the levels in the factory with the lowest sickness absence, in one factory the levels of short-term [rate ratio (RR) 1.72], long-term (RR 1.96), and musculoskeletal (rate ratio 2.93) absence were significantly higher. Another factory also had higher levels of long-term and musculoskeletal absence (RR 2.17 and 2.52, respectively). Adjustment for the background factors explained 35% of the difference in short-term absence, 3-9% of the differences in long-term absence, and 18-12% of the differences in musculoskeletal absence, but the between-factory differences were still highly significant. CONCLUSIONS: This study showed large differences in sickness absence between factories that were only partly explained by common determinants. Moreover, economic factors and formal control were unlikely explanatory factors, as the study was conducted within a single company. These results justify further research on local absence practices and cultures, including those of health service organizations and professionals. PMID: 18604460 [PubMed - as supplied by publisher]
Annals of Occupational Hygiene - current issue
Measurement Uncertainty
Bartley, D., Liden, G. Wed, 06 Aug 2008 00:00:00 -0000
The reporting of measurement uncertainty has recently undergone a major harmonization whereby characteristics of a measurement method obtained during establishment and application are combined componentwise. For example, the sometimes-pesky systematic error is included. A bias component of uncertainty can be often easily established as the uncertainty in the bias. However, beyond simply arriving at a value for uncertainty, meaning to this uncertainty if needed can sometimes be developed in terms of prediction confidence in uncertainty-based intervals covering what is to be measured. To this end, a link between concepts of accuracy and uncertainty is established through a simple yet accurate approximation to a random variable known as the non-central Student's t-distribution. Without a measureless and perpetual uncertainty, the drama of human life would be destroyed. Winston Churchill
Application of a Pilot Control Banding Tool for Risk Level Assessment and Control of Nanoparticle Exposures
Paik, S. Y., Zalk, D. M., Swuste, P. Wed, 06 Aug 2008 00:00:00 -0000
Control banding (CB) strategies offer simplified solutions for controlling worker exposures to constituents that are found in the workplace in the absence of firm toxicological and exposure data. These strategies may be particularly useful in nanotechnology applications, considering the overwhelming level of uncertainty over what nanomaterials and nanotechnologies present as potential work-related health risks, what about these materials might lead to adverse toxicological activity, how risk related to these might be assessed and how to manage these issues in the absence of this information. This study introduces a pilot CB tool or ‘CB Nanotool’ that was developed specifically for characterizing the health aspects of working with engineered nanoparticles and determining the level of risk and associated controls for five ongoing nanotechnology-related operations being conducted at two Department of Energy research laboratories. Based on the application of the CB Nanotool, four of the five operations evaluated in this study were found to have implemented controls consistent with what was recommended by the CB Nanotool, with one operation even exceeding the required controls for that activity. The one remaining operation was determined to require an upgrade in controls. By developing this dynamic CB Nanotool within the realm of the scientific information available, this application of CB appears to be a useful approach for assessing the risk of nanomaterial operations, providing recommendations for appropriate engineering controls and facilitating the allocation of resources to the activities that most need them.
'Stoffenmanager', a Web-Based Control Banding Tool Using an Exposure Process Model
Marquart, H., Heussen, H., Le Feber, M., Noy, D., Tielemans, E., Schinkel, J., West, J., Van Der Schaaf, D. Wed, 06 Aug 2008 00:00:00 -0000
In the scope of a Dutch programme to reinforce the working conditions policy on hazardous substances, an internet-based tool was developed to help small- and medium-sized companies to handle hazardous substances with more care. The heart of this tool, called the Stoffenmanager, is a risk banding scheme. It combines a hazard banding scheme similar to that of COSHH Essentials and an exposure banding scheme based on an exposure model originally presented by Cherrie et al. (1996) and further developed by Cherrie and Schneider (1999). The exposure model has been modified to allow non-expert users to understand and use the model. Exposure scores are calculated based on categorization of determinants of emission, transmission and immission. These exposure scores are assigned to exposure bands. The comparison of exposure bands and hazard bands leads to a risk band or priority band. Following the evaluation of the priority of tasks done with products, generic exposure control measures can be evaluated for their possibility to lower the risks. Relevant control measures can be put into an action plan and into workplace instruction cards. The tool has several other functionalities regarding registration and storage of products. The exposure model in the Stoffenmanager leads to exposure scores. These have been compared with measured exposure levels. The exposure scores correlated well with measured exposure levels. The development of the Stoffenmanager has facilitated a whole range of further developments of useful tools for small- and medium-sized enterprises.
Stoffenmanager Exposure Model: Development of a Quantitative Algorithm
Tielemans, E., Noy, D., Schinkel, J., Heussen, H., Van Der Schaaf, D., West, J., Fransman, W. Wed, 06 Aug 2008 00:00:00 -0000
In The Netherlands, the web-based tool called ‘Stoffenmanager’ was initially developed to assist small- and medium-sized enterprises to prioritize and control risks of handling chemical products in their workplaces. The aim of the present study was to explore the accuracy of the Stoffenmanager exposure algorithm. This was done by comparing its semi-quantitative exposure rankings for specific substances with exposure measurements collected from several occupational settings to derive a quantitative exposure algorithm. Exposure data were collected using two strategies. First, we conducted seven surveys specifically for validation of the Stoffenmanager. Second, existing occupational exposure data sets were collected from various sources. This resulted in 378 and 320 measurements for solid and liquid scenarios, respectively. The Spearman correlation coefficients between Stoffenmanager scores and exposure measurements appeared to be good for handling solids (rs = 0.80, N = 378, P < 0.0001) and liquid scenarios (rs = 0.83, N = 320, P < 0.0001). However, the correlation for liquid scenarios appeared to be lower when calculated separately for sets of volatile substances with a vapour pressure >10 Pa (rs = 0.56, N = 104, P < 0.0001) and non-volatile substances with a vapour pressure ≤10 Pa (rs = 0.53, N = 216, P < 0.0001). The mixed-effect regression models with natural log-transformed Stoffenmanager scores as independent parameter explained a substantial part of the total exposure variability (52% for solid scenarios and 76% for liquid scenarios). Notwithstanding the good correlation, the data show substantial variability in exposure measurements given a certain Stoffenmanager score. The overall performance increases our confidence in the use of the Stoffenmanager as a generic tool for risk assessment. The mixed-effect regression models presented in this paper may be used for assessment of so-called reasonable worst case exposures. This evaluation is considered as an ongoing process and when more good quality data become available, the analyses described in this paper will be expanded. Based on these analyses, the algorithm will be refined in the near future.
Asbestos Fibre Concentrations in the Lungs of Brake Workers: Another Look
Finkelstein, M. M. Wed, 06 Aug 2008 00:00:00 -0000
Objective: To reanalyse data on the lung content of asbestos fibres among brake mechanics. Methods: I re-analysed data published by Butnor, Roggli and colleagues on the lung content of chrysotile and tremolite asbestos fibres among brake mechanics and controls. Statistics of the distributions were estimated by maximum likelihood to accommodate observations below the detection limit. Mean concentrations were compared by the t-test, bootstrap resampling and interval-censored survival methods. Results: The mean concentrations of fibres were higher among the brake workers than the controls. The concentration of tremolite fibres was higher than the concentration of chrysotile, a pattern similar to that observed among Quebec chrysotile miners and millers. Conclusions: Re-analysis of published data does not support the interpretation that, in automotive brake repair workers with malignant mesothelioma, asbestos content is within the normal range. The alternative interpretation that brake mechanics have a greater than background burden of asbestos fibres, attributable to occupational exposure to dusts from friction products manufactured from Canadian chrysotile, appears more credible. This asbestos burden might be associated with an increased risk of asbestos-associated cancers.
Exposure to Chrysotile Asbestos Associated with Unpacking and Repacking Boxes of Automobile Brake Pads and Shoes
Madl, A. K., Scott, L. L., Murbach, D. M., Fehling, K. A., Finley, B. L., Paustenbach, D. J. Wed, 06 Aug 2008 00:00:00 -0000
Industrial hygiene surveys and epidemiologic studies of auto mechanics have shown that these workers are not at an increased risk of asbestos-related disease; however, concerns continue to be raised regarding asbestos exposure from asbestos-containing brakes. Handling new asbestos-containing brake components has recently been suggested as a potential source of asbestos exposure. A simulation study involving the unpacking and repacking of 105 boxes of brakes (for vehicles ca. 1946–80), including 62 boxes of brake pads and 43 boxes of brake shoes, was conducted to examine how this activity might contribute to both short-term and 8-h time-weighted average exposures to asbestos. Breathing zone samples on the lapel of a volunteer worker (n = 80) and area samples at bystander (e.g., 1.5 m from worker) (n = 56), remote area (n = 26) and ambient (n = 10) locations collected during the unpacking and repacking of boxes of asbestos-containing brakes were analyzed by phase contrast microscopy and transmission electron microscopy. Exposure to airborne asbestos was characterized for a variety of parameters including the number of boxes handled, brake type (i.e. pads versus shoes) and the distance from the activity (i.e. worker, bystander and remote area). This study also evaluated the fiber size and morphology distribution according to the International Organization for Standardization analytical method for asbestos. It was observed that (i) airborne asbestos concentrations increased with the number of boxes unpacked and repacked, (ii) handling boxes of brake pads resulted in higher worker asbestos exposures compared to handling boxes of brake shoes, (iii) cleanup and clothes-handling tasks produced less airborne asbestos than handling boxes of brakes and (iv) fiber size and morphology analysis showed that while the majority of fibers were free (e.g. not associated with a cluster or matrix), <30% were respirable and even fewer were of the size range (>20 µm length) considered to pose the greatest risk of asbestos-related disease. It was found that average airborne chrysotile concentrations (30 min) ranged from 0.086 to 0.368 and 0.021 to 0.126 f cc–1 for a worker unpacking and repacking 4–20 boxes of brake pads and 4–20 boxes of brake shoes, respectively. Additionally, average airborne asbestos exposures (30 min) at bystander locations ranged from 0.004 to 0.035 and 0.002 to 0.011 f cc–1 when 4–20 boxes of brake pads and 4–20 boxes of brake shoes were handled, respectively. These data show that a worker handling a relatively large number of boxes of brakes over short periods of time will not be exposed to airborne asbestos in excess of its historical or current short-term occupational exposure limits.
Sites:
American Occupational Therapy Foundation: Through the use of fiscal and human resources, AOTF expands and refines the body of knowledge of occupational therapy and promotes understanding of the value of occupation in the interest of the public good.AMPS (UK) Ltd.: UK site for Assessment of Motor and Process Skills standardised assessment framework. Includes training listings and support network.
AMPS Project International (Assessment of Motor and Process Skills): Promoting a standardised assessment with details of the assessment and resources.
British Institute for Occupation and Health: occupationUK is a virtual institute which gathers together individuals committed to the occupational nature of humans. It has no physical presence and is not a constituent part of any institution. It has no membership restrictions and will welcome any individual who is committed to its aims and ...
Canadian Occupational Therapy Foundation: Health Match BC provides doctor and registered nurse recruitment services for medical career opportunities in British Columbia, Canada on behalf of hospitals and health care employers. www.healthmatchbc.org
CJ Education and Consulting, LLC: CJ Education and Consulting, LLC - Splints for Hands and Upper Extremity. P.O. Box 3930 Woodbridge, CT 06525 (203)393-2446
Exploring Hand Therapy: ExploringhandTherapy.Com - Hand Therapy Excellence in education, online courses, free newsletter, CEU's, and Contact Hours, authors of the Purple Book
Functional Therapy Activities: CD-ROM software for occupational and physical therapists in rehabilitation, with 200 functional therapy ideas for various disabilities, including treatment planning for ADL and vocational rehab.
International Clinical Educators: Continuing education home study DVD & Video programs (CEUs), plus Workshops with Jan Davis for Physical Therapists and Occupational Therapists. Functional treatment and NDT training to improve the quality of care for stroke survivors.
International Journal of Therapy and Rehabilitation: Monthly interdisciplinary therapy journal.
Kawa (River) Model Research Project: The Kawa Model Research Project homepage, 川モデル研究プロジェクトのホームページ。日本の作業療法モデルである川モデルの説明をします。
Model of Human Occupation Clearinghouse: Library of materials and resources on the Model of Human Occupation, with news, research updates and references.
Mouse testing and training: Mouse testing and training tools specifically for adaptive mouse users or young children learning to use a mouse. Printable report and links to downloadable training applications.
National Board for Certification in Occupational Therapy: The National Board for Certification in Occupational Therapy, Inc. (NBCOT) is a not-for-profit credentialing agency that provides certification for the occupational therapy profession. NBCOT serves the public interest by developing, administering, and continually reviewing a certification process...
Occupational Therapy Resources: Resources and links relevant to OT in schools.
OT Now: Occupational Therapy Now is dedicated to the sharing and interchange of ideas and concepts related to occupation and to occupational therapy. OTnow consists of an OT e-mail list, OT bulletin board OT news letter and OT resources
OT Seeker: OTseeker is a database that contains abstracts of systematic reviews and randomised controlled trials relevant to occupational therapy. Trials have been critically appraised and rated to assist you to evaluate their validity and interpretability. These ratings will help you to judge the qua...
OTDBASE: OTDBASE is a OT literature search service covering journals from around the world. Take the opportunity to explore OTDBASE and discover how a OT Journal database can assist you in your practice and research projects and papers.
OTdirect: Occupational Therapy Resources for Occupational Therapists in the UK
Sensory Integration International: A non-profit, tax-exempt corporation concerned with the impact of sensory integrative problems on people's lives.
Therapy Network Seminars: Therapy Network Seminars provides upper extremity continuing education courses for occupational & physical therapists, athletic trainers and other allied health professionals.
Therapy Weekly: Therapy Weekly is the only independent weekly newspaper for the UKs physiotherapists, occupational therapists and speech and language therapists. Search through hundreds of therapy jobs online, find careers information, read the latest therapy news and information on continuing professional de...
This directory is based on the Open Directory and may have been modified