ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Managed care techniques are becoming increasingly available to manage the medical and indemnity losses associated with injuries paid for under the workers' compensation system. The authors describe 3 years' experience of identifying and abating workplace hazards and medically managing cases utilizing a preferred provider organization established solely for workers' compensation cases. In the model described, the occupational physician/nurse case-management team coordinates the entire process, from prevention of accidents to facilitated return to work. During the study period (1992 to 1995), per-capita losses were reduced by 23%, from $241 in fiscal year 1992 (the year before the managed care initiative), to $185 in fiscal year 1995. (Hereafter, each year referred to indicates that fiscal year.) In 1992, 22 lost-time cases per 1000 employees occurred, whereas the number of lost-time cases in the years 1993 to 1995 averaged 12 to 14 per 1000 employees. The rate of "medical only" cases dropped significantly from 155 per 1000 in 1992 to 96 per 1000 in 1995. The per-capita amount of monies spent on medical care decreased from $81 in 1992 to $63 in 1995. The most significant savings in medical costs related to claims associated with new occupational injuries, injuries that occurred during the fiscal year. In 1992, the per-capita loss on such cases was $23 and in 1995 it was $13, a 43% decrease. The number of temporary/total days dropped significantly from 163 per 100 employees in 1992 to 70 days in 1995. Concurrently, the per-capita loss for temporary total disability was reduced from $53 in 1992 to $26 in 1995. Per-capita administrative costs, as well as other indemnity losses (predominately permanent partial disability), decreased only slightly over the study period ($58 to $54 and $60 to $51, respectively). We feel that these results indicate that environmental-risk management and medical-care management can be integrated to produce substantial savings. It also suggests that managed-care techniques, which are becoming more available to employers, can even be applied in states that do not have managed care legislation.

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Very few studies have described the prevalence of mental disorders in the workplace by using standard diagnostic criteria. A two-stage case-control study of anxiety and depression was initiated by Electricité de France and Gaz de France, the French Nationwide Company producing electricity and gas, using the General Health Questionnaire with 12 items as a screening test and the Composite International Diagnostic Interview as a diagnostic instrument. Its aim was to point out occupational situations that promote the occurrence of anxiety and depression crises. Annual prevalence of depression was estimated at 7.6% in men (95% confidence interval [CI], 5.5 to 9.7) and at 17.9% in women (95% CI, 9.9 to 25.8), and that of anxiety at 9.6% (95% CI, 6.9 to 12.3) in men and 26.3% (95% CI, 17.2 to 35.4) in women. Workers in hazardous occupations were found to be protected from these disorders, whereas supervisory staff tended to be prone to developing them. Important changes in work or in its organization seemed to be risk factors. Extra-professional variables and occupational characteristics were included in a logistic regression model. The odds ratios corresponding to recent job changes and a supervisory position were significantly elevated (odds ratios = 1.7 and 2.4, respectively). These results suggest that some occupational events, such as major changes in work content or organization, may cause or precipitate anxiety and/or depressive disorders.

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study examined 47 office workers during a day of regular work in front of a video display unit (VDU) and a day of leisure in the same environment. The study investigated possible effects of VDU work on circulating melatonin and adrenocorticotropic hormone (ACTH) levels. Circulating melatonin levels decreased significantly during VDU work, whereas ACTH levels increased significantly. In contrast, melatonin and ACTH levels did not change significantly during a day of leisure. Mental strain during work was significantly and positively associated with circulating levels of ACTH but not melatonin. The results indicate that the VDU environment is associated with measurable changes in melatonin and ACTH levels. Mental strain might explain changes in ACTH levels, but specific factors that might contribute to changes in melatonin levels are unknown. These findings might be relevant to the recent debate about the possible influence that electromagnetic and VDU environments might have on electromagnetic sensitivity.

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Sickness and accident-insurance (sick leave) claims at an automotive stamping and assembly complex were analyzed using Poisson regression over a 4-year period to identify occupational health problems. The incidence of lower-respiratory disability (excluding asthma) was higher in painting operations (rate ratio [RR] = 2.9, 95% confidence interval [CI] = 1.2 to 6.8), and final assembly and processing areas (RR = 2.7, 95 % CI = 1.0 to 7.4) at the assembly plant, and in metal assembly (welding) areas (RR = 2.8, 95% CI = 1.4 to 5.7) at the stamping plant. Disability rates for upper-extremity musculoskeletal disorders were statistically significantly higher (RR = 3.1 to 3.8) in major assembly plant production areas, as were back disability rates (RR = 1.5). During the first 6 months of new work assignments in painting or final assembly, respiratory problem rates were four times higher than in other areas. Upper-extremity musculoskeletal rate ratios ranged from 4.4 to 5.7 for new assignments in body, hard trim, and chassis areas. Higher rates in new assignments appeared to result from assignment changes precipitated by developing health problems, or from routine assignments to new tasks, some of which conferred high risk and were tolerated for less than 6 months. Musculoskeletal disability was consistent with known ergonomic hazards and paralleled that reported on the Occupational Safety and Health Administration log. Work-related musculoskeletal and other problems can be readily identified from disability insurance claims without dependence on plant medical visits or workers' compensation records. Disability insurance appears to absorb considerable work-related medical and absence costs.

ISSN:1076-2752    

出版商:OVID    

年代:1996

数据来源: OVID