Shift work, health, the working time regulations and health assessments.
(49/2403)
Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value. (+info)
What is the risk associated with being a qualified military parachutist?
(50/2403)
Military parachuting has been recognized as a hazardous activity since it was first introduced in World War II. Other risks associated with military service include actual war-fighting, training with weapons and explosives, operating with armoured vehicles or deployment to climatic extremes. These other hazards should be considered in any assessment of the additional risk associated with military parachuting. The aim of this study was to identify the risk attributable to parachuting amongst US Army enlisted soldiers. This study identified a cohort of infantry soldiers who served between 1990-94. They were separated by receipt of parachute hazardous duty pay. There was a total of 329,794 person-years (PY) available for study of which 18% were in the exposed group. The rate of hospitalization was very similar in both groups [123.9 per 1,000 PYs for the exposed group, 127 in the non-exposed group: relative risk (RR) = 0.98, 95% confidence interval (CI) = 0.96-1.00). The exposed group was 1.49 times (CI = 1.42-1.57) more likely to be admitted as a result of an injury as compared with the non-exposed group. Military parachuting was 20 times (CI = 16.6-24.3) more likely to be the cause of an injury. This study has shown that receipt of hazardous duty pay for military parachuting can be used as a marker in identifying significant additional risks to the health of infantry soldiers associated with military parachuting. This was reflected in an increased incidence of admission for acute injury and musculoskeletal trauma (particularly a trauma pattern associated with parachuting) as a result of military parachuting. Other risks, which are associated with parachute pay, are admission for the effects of heat, battle injury and helicopter accidents. (+info)
Health surveillance in milling, baking and other food manufacturing operations--five years' experience.
(51/2403)
The objective of this study was to describe the incidence of allergic respiratory disease and its outcome in terms of symptoms and jobs, across different flour-using industries. It uses the findings of a health surveillance programme in a large food organization over a five-year period. The population under surveillance consisted of 3,450 employees with exposure to ingredient dusts, of whom 400 were in flour milling, 1,650 in bread baking, 550 in cake baking and 850 in other flour-using operations. A total of 66 employees with either asthma or rhinitis symptoms attributable to sensitization to allergens in the workplace were identified. The majority of these (48/66) had become symptomatic prior to the commencement of the health surveillance programme in 1993. The incidence rates (per million employees per year) for those who developed symptoms between 1993 and 1997 were 550 for flour milling, 1,940 for bread baking, 0 for cake baking and 235 for other flour-using operations. The agent believed to be responsible for symptoms was most commonly grain dust in flour millers and fungal amylase in bread bakers. Wheat flour appeared to have a weaker sensitizing potential than these other two substances. In terms of outcome, at follow-up 18% of symptomatically sensitized employees had left the company. Two of the ex-employees retired through ill health due to occupational asthma. Of those still in employment, 63% described an improvement in symptoms, 32% were unchanged and 4% were worse than when first diagnosed. Over half the cases still in employment were continuing to work in the same job as at the time of diagnosis. (+info)
Is atopy and smoking important in the workplace?
(52/2403)
The relationship between the respiratory system and the environment involves a complex dynamic interaction of genetic susceptibility, host defence and toxicity. The chance of an individual developing a respiratory disease is dependent on genetic susceptibility and subsequent hereditary risk factors, life-style risk factors and the amount and nature of the exposure that may be encountered in the working environment. Atopic status is an important pre-existing risk that a worker may bring to the workplace (occupational asthma/rhinitis to high molecular weight agents). Smoking is an avoidable additional risk for certain occupational diseases (occupational asthma/bronchitis/cancer) while it can be protective in other circumstances (allergic alvcolitis). More controversially, smoking in some workers may put at increased risk the health of colleagues (passive smoking). This article attempts to clarify the issues surrounding the interaction of atopy, smoking and the workplace. (+info)
Labor Day and the war on workers.
(53/2403)
We celebrate Labor Day every year with barbecues and picnics, rarely remembering that the holiday was born in the midst of tremendous labor struggles to improve working conditions. In the last century, 16-hour workdays and 6- and 7-day workweeks led to terribly high injury rates in the nation's mines and mills. Thousands upon thousands of workers died, caught in the grinding machinery of our growing industries. Today, despite improvements, thousands of workers still die in what has been described as a form of war on the American workforce. This commentary reminds us of the historical toll in lives and limbs that workers have paid to provide us with our modern prosperity. It also reminds us that the continuing toll is far too high and that workers who died and continue to die in order to produce our wealth deserve to be remembered and honored on this national holiday. (+info)
Audit of immunization policy and practice of health care workers within National Health Service Trusts in England and Wales.
(54/2403)
The purpose of this study was to identify the variation in occupational health immunization policies and practice within NHS Trusts throughout England and Wales. Questionnaires were sent to 440 NHS Trusts and 279 were returned (a response rate of 63%). The results were compared with current Department of Health Guidelines. They highlighted the fact that NHS Trusts do not adopt a consistent approach to immunization practice and that these policies often do not reflect Department of Health Guidance. Of those responding, 249 (89%) stated that they would like additional guidance on immunization practice within the NHS workplace. The production of updated, evidence-based guidelines for immunization practice, may help to ensure that a more consistent approach is taken throughout the NHS. This would benefit both the Trusts and their employees who at present may be confused by being given different advice when moving between Trusts. (+info)
Ethical requirements for occupational health research--compliance arrangements for a single company in relation to a recent major nuclear industry study.
(55/2403)
The media coverage given to occupational health studies in the field of ionizing radiation has, on occasion, been the cause of very real distress to radiation workers and their families. In response to this situation the Chief Medical Officers of the major UK nuclear companies developed an ethical policy for future involvement in research, based on the duty of care which researchers owe to a key customer of such studies: the worker. The policy consists of four principal elements: medical confidentiality; worker information; worker consent and the guarantee of the availability to the workers of pre-publication knowledge of the results. The policy issued in 1991/92 has achieved growing acceptance among researchers and medical journals, though the medical officers involved have been aware of some scepticism, particularly in relation to the practicalities of the dissemination of pre-publication information. The Record Linkage Study published in November 1997 marked a major piece of research work involving data from 120,000 radiation workers that had been carried out since the development of the policy. This paper reports on the successful compliance arrangements to meet the ethical requirements of that study within a single UK nuclear company, and is published to demonstrate that with commitment from researchers, the journal and occupational health staff such ethical requirements, and particularly the need for pre-publication information can be met in full. (+info)
A review of the healthy worker effect in occupational epidemiology.
(56/2403)
This review article aims to anatomize sources of the healthy worker effect (HWE) and to summarize advantages and limitations of several approaches frequently proposed to eliminate the HWE. Although the HWE is frequently addressed in the context of selection bias, our review suggests that the selection of occupational cohorts with advantageous health status would preferably be addressed as a source of confounding biases. The authors also conclude that the exclusion of unhealthy workers at employment and the study of active workers are the two main sources of HWE, and that the use of the general population as a comparison group in occupational epidemiology should be avoided if possible. The authors encourage investigators to make distinctions between the underlying factors related to the use of the general population as the comparison group in occupational epidemiology. (+info)