Chrysotile, tremolite and fibrogenicity.
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Recently published analyses have shown that the risks of mesothelioma and lung cancer in Quebec chrysotile miners and millers were related to estimated level of fibrous tremolite in the mines where they had worked. An analysis has therefore been made of radiographic changes in men who in 1965 were employed by companies in Thetford Mines where the same question could be examined for fibrogenicity. Of 294 men who met the necessary requirements, 129 had worked in six centrally located mines, where the tremolite content was thought to be high, 81 in 10 peripheral mines where it was thought to be low and 84 in both. The median prevalence of small parenchymal opacities (> or = 1/0) in chest radiographs read by six readers was higher among men ever than never employed in the central mines (13.6% against 7.4%), despite the fact that the mean cumulative exposure was lower in the former (430 mpcf.y vs 520 mpcf.y). After accounting by logistic regression for cigarette smoking, age, smoking-age interaction and cumulative exposure, the adjusted odds ratio for central mine employment was 2.44 (95% lower bound: 1.06). Together with other surveys of asbestos miners and millers, this study suggests that amphibole fibres, including tremolite, are more fibrogenic than chrysotile, perhaps to the same extent that they are carcinogenic, though the data available were not sufficient to address the latter question. (+info)
Violence in the emergency department: a survey of health care workers.
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BACKGROUND: Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. METHODS: A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. RESULTS: Of the 163 staff, 106 (65%) completed the survey. A total of 68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. Physical exercise, sleep and the company of family and friends were the most frequent coping strategies. INTERPRETATION: Violence in the emergency department is frequent and has a substantial effect on staff well-being and job satisfaction. (+info)
Risk assessment for heart disease and workplace ETS exposure among nonsmokers.
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In 1994 the U.S. Occupational Health and Safety Administration (OSHA) published a study of risk assessment for heart disease and lung cancer resulting from workplace exposure to environmental tobacco smoke (ETS) among nonsmokers. This assessment is currently being revised. The present article considers different possible approaches to a risk assessment for heart disease among nonsmokers resulting from workplace ETS exposure, reviews the approach taken by OSHA in 1994, and suggests some modifications to that approach. Since 1994 the literature supporting an association between ETS exposure and heart disease among never smokers (sometimes including long-term former smokers) has been strengthened by new studies, including some studies that have specifically considered workplace exposure. A number of these studies are appropriate for inclusion in a meta-analysis, whereas a few may not be due to methodological problems or problems in exposure definition. A meta-analysis of eight relative risks (either rate ratios or odds ratios) for heart disease resulting from workplace ETS exposure, based on one reasonable selection of appropriate studies, yields a combined relative risk of 1.21 (95% confidence interval [CI], 1.04-1.41). This relative risk, which is similar to that used by OSHA in 1994, yields an excess risk of death from heart disease by age 70 of 7 per 1000 (95% CI 0.001-0.013) resulting from ETS exposure in the workplace. This excess risk exceeds OSHA's usual threshold for regulation of 1 per 1000. Approximately 1,710 excess ischemic heart disease deaths per year would be expected among nonsmoking U.S. workers 35-69 years of age exposed to workplace ETS. (+info)
Summary: workshop on health risks attributable to ETS exposure in the workplace.
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This 1998 workshop was convened to address the health risks of exposure to environmental tobacco smoke (ETS) in the workplace. It was paired with a 1997 workshop on issues related to ETS exposure in work environments ((italic)1(/italic)). In the 1998 workshop, a multidisciplinary group of participants was charged with reviewing evidence on the quantitative risks to health posed by ETS and to discuss development of risk assessment methodology for the future. The overall charges for the present workshop were to consider various health outcomes and make recommendations regarding those health outcomes to be included in assessment of health risk resulting from ETS in the workplace; to consider available studies addressing these health outcomes and to evaluate the validity of data for estimating risk from occupational ETS exposure; to review and evaluate mathematical models useful for estimating the risk due to ETS exposure; to examine dose-response models and to characterize the models regarding validity and uncertainty in estimating health risk attributable to ETS exposure in the workplace. (+info)
Biological monitoring to assess exposure from use of isocyanates in motor vehicle repair.
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OBJECTIVES: To develop a method for the measurement of a metabolite of hexamethylene diisocyanate (HDI), an isocyanate, and use it to assess the exposure of sprayers employed in motor vehicle repair shops. METHODS: Urine samples were taken from sprayers wearing personal protective equipment and spraying in booths or with local exhaust ventilation, from bystanders, and from unexposed subjects. Samples were analyzed for a metabolite of HDI, hexamethylene diamine (HDA), by gas chromatography-mass spectrometry (GC-MS). RESULTS: HDA was detected in four sprayers and one bystander out of 22 workers. No HDA was detected in the urine of unexposed subjects. CONCLUSIONS: Exposure to isocyanates still occurs despite the use of personal protective equipment and the use of a booth or extracted space. Health surveillance is likely to be required to provide feedback on the adequacy of controls even if such precautions are used and to identify cases of early asthma. Biological monitoring can provide a useful additional tool to assess exposure and the adequacy of controls in this group of exposed workers. (+info)
Sources of job satisfaction and psychological distress in GPs and medical house officers.
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The psychological health and job satisfaction of 285 GPs and 89 medical house officers from Leeds was compared using standardized self-report measures. Forty-eight per cent of the GPs and 20% of the house officers scored as 'cases' of psychiatric disorder. The GPs were less satisfied with the recognition they received for their work and their hours of work, but more satisfied with their job variety and job autonomy. Further research examining the sources of work-related distress in different medical settings could help inform future organizational changes. (+info)
Audit and 'responsible care' in the chemical industry.
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Audit is an essential element of Health and Safety Management Systems. This paper examines the Chemical Industry Association's 'Responsible Care' initiative and its role in encouraging continuous improvement in the management of safety, health and the environment, within the chemical industry. The case study from Zeneca describes how the principles of audit have been incorporated into their Safety, Health and Environmental Management practices. (+info)
Problematic or practical? Professional body occupational health guidelines.
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This paper focuses upon conflict between professional and managerial values in an occupational health setting. Findings are presented which suggest that the guidelines issued by UK occupational health professional bodies (describing the duties and responsibilities of occupational health professionals), have been perceived by professionals as being impractical because they tend to focus on the theoretical role of the professional at the expense of the reality of the experienced role. The paper concludes that the problem does not actually lie with the guidelines, but with the perception of the guidelines. It is suggested that this problem can be addressed by empowering occupational health professionals to interpret and tailor the guidelines to suit their particular working environment. In addition, encouraging occupational health professionals to pro-actively market their role, will result in awareness raising amongst the managers for whom they work who often have inappropriate expectations of the occupational health professionals. (+info)