摘要:

Questionnaire-based measures of function have been validated extensively in studies of chronic illness and work-related low back pain. These measures have only recently been developed for upper extremity disorders (UEDs), and there is little information on their utility in evaluation of injured workers. We developed the Upper Extremity Function Scale (UEFS), an eight-item, self-administered questionnaire, to measure the impacts of UEDs on function. This instrument was tested in a cohort of 108 patients with work-related UEDs and 165 patients with the carpal tunnel syndrome (CTS); both groups were enrolled in prospective follow-up studies. The UEFS demonstrated excellent psychometric properties, including good internal consistency (Cronbach's alpha > 0.83), relative absence of floor effects, and excellent convergent and discriminant validity, compared with measures of symptom severity and clinical findings. In the CTS group, the UEFS was more responsive to significant improvements over time than clinical measures such as grip and pinch strength. These data support the use of a self-reported functional scale as a measure of outcome in studies of work-related UEDs. Further investigations in working populations are needed to substantiate its utility in workers with UEDs who have not yet sought medical care.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Subject matter experts from 13 North American corporations provided detailed descriptions of the historical development and the current components and operations of their office ergonomics programs. Results were summarized across corporations and presented for the following programmatic topics: backgrounds of key people, initial awareness and preliminary needs assessment, program development, program implementation, program monitoring and evaluation, program components, education and training, workstation and job analysis, early identification of cases, case management, and alternate office environments. The subject matter experts also provided comments about the strengths of their programs, their advice to others, and lessons they learned. These observations suggested the need for an office ergonomics program, and possibly other occupational health programs, to fit into a corporation's culture and capitalize on its infrastructure. Most corporations used multidisciplinary task forces or teams to develop their programs. Communication, which included training, awareness, advertising, and feedback, was also an important issue. Flexibility and simplicity were important attributes of these programs. It is hoped that this descriptive information will be helpful to some occupational health managers interested in or concerned about managerial perspectives and skills related to the development and implementation of programs within their own corporations.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The US Public Health Service (PHS) published new recommendations for preventing HIV seroconversion in health care workers suffering needle-stick injuries. In response, health care institutions across the United States are updating their internal protocols to meet the currently accepted standard of care in this area. We found the new guidelines lacking in critical definitions necessary to clarify practical applications in specific cases. We also found the recommendations of when to use one, two, or three drugs for post-exposure prophylaxis confusing. We report our university hospital's experience with needle-stick injuries over the past year. We propose modified guidelines that more finely stratify risk categories, define clinical variables which occur in practice, and simplify the algorithm for case management. The cost of managing our cases according to the modified guidelines are compared with management costs using the PHS guidelines. Potential costs of applying the PHS guidelines in our institution ranged from $68,994-$260,544; according to our modified guidelines, costs would range from $19,199-$54,749. We also present an analysis of the number of injured health care workers who need to be treated to prevent one case of seroconversion in the various risk stratifications.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The purpose of this study was to establish a simple observation to help in distinguishing patients who are giving their maximal effort during computer-assisted grip strength measurements from those who are not. Preliminary observations had suggested that maximal effort with this grip-strength device was characterized by greater force in the radial digits than the ulnar digits and a small variability in force between individual grasps. These observations were then prospectively analyzed in the following groups: (a) 178 assembly workers tested during a routine screening at a computer manufacturing company and during pre-placement physicals; (b) 196 workers with a hand injury or cumulative trauma disorder who were seeking consultation for medical treatment: (c) 55 workers with a hand injury or cumulative trauma disorder being measured to determine their return to work status or impairment rating; and (d) 58 asymptomatic volunteers. The volunteers were instructed to perform the maximal group in the same fashion as the other groups and then to repeat the test exerting a submaximal effort they estimated to be 50% of their own maximal effort. The results of this study demonstrated that there is a highly significant association,P< 0.001, between the presence of a "total pattern" (radial over ulnar force being less than 1.0, unilateral grip variation greater than 15%, and difference between the left and right grip variation greater than 5%) and the presence of submaximal effort during grip-strength measurements.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

An historical follow-up study of 528 model makers in a German automobile company found an unusual pattern of mortality among these workers that included an increased risk of total cancer and tumors of the stomach, genitourinary organs, and the brain (Becker et al, 1992). Because of small numbers of cases and problems with the validity of causes of death, we carried out a second follow-up using data from the official mortality statistics and extending the observation period by five years. The new results did not confirm the previous observations of an increased risk of total cancer, cancer of the genitourinary organs, and tumors of the brain but confirmed indications of an increased risk of stomach cancer and suggested for the first time that there may be an increased risk of cancer of the intestine. Though the small numbers of cases did not allow statistical confirmation of these findings, they are consistent with the results of other studies recently conducted in the United States and published in this journal.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Washington's late night retail worker crime protection regulation, enforced by the state Occupational Safety and Health Administration (OSHA) program, was intended to prevent injuries by deterring violent crimes. We investigated whether the regulation was associated with businesses' violence prevention activities. We surveyed 1,516 employers at high risk of robbery, including gas stations, groceries, hotels, restaurants, and taverns, in 1995 to determine whether they had violence prevention training programs for their employees (a requirement of the standard). Awareness of the regulation was low (4.4%). Employers covered by the regulation were more likely to have programs (Odds Ratio [OR] = 1.4), as were those aware of a regulation (OR = 3.4). State OSHA plan contact (an inspection or consultation) was also associated with having a program (OR = 1.9). Despite low awareness of the standard, results suggested that regulatory efforts to protect high-risk employees were associated with employers' robbery and crime prevention activities.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID