摘要:

Learning ObjectivesRecall past findings associating sperm parameters with occupational exposure to chemicals or work-related psychological distressUnderstand in what occupational, health, and demographic respects workers with male factor infertility differ from those seen for female infertility.Note which if any aspects of occupational stress were associated with male infertility in this study.Identify any clinical implications of these findings.The purpose of this work was to investigate the influence of working conditions, occupational exposures to potential reproductive toxic agents, and psychological stress on male fertility. The study population consisted of 202 consecutive male patients attending a fertility clinic. Of those, 106 patients had attended the clinic because of a male infertility problem (case group), 66 patients had attended the clinic because of a female infertility problem (control group), and 30 patients had a combined infertility problem (male and female). Male infertility was associated with working in industry and construction as compared with other occupations (78.6% vs 58.3%,P= 0.044). Industry and construction workers were of lower educational level than the other workers (mean: 12.1 vs 13.4 years,P= 0.021). These patients also tended to smoke more than the other workers (OR = 2.53, 95% CI = 1.08 to 5.98), more often worked in shifts (OR = 3.12, 95% CI = 1.19 to 8.13), reported physical exertion in work (OR = 3.35, 95% CI = 1.44 to 7.80), and were more exposed to noise and welding (OR = 3.84, 95% CI = 1.63 to 9.14, OR = 4.40, 95% CI = 1.11 to 1.76, respectively). Male infertility (case group) was found to be statistically related to higher marks in all four measures of burnout as compared with the controls. The largest difference was obtained in the measure of cognitive weariness (mean:2.9vs 2.1,P< 0.001). In a multiple logistic regression analysis, industry and construction jobs (adjusted OR = 2.2, 95% CI 1.2 to 2.7) and cognitive weariness (adjusted OR = 1.8, 95% CI = 1.03 to 4.6) were found to be independent risk factors for male infertility problems. Male infertility was independently associated with industry and construction jobs as well as job burnout.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Learning ObjectivesIdentify recent trends in workers’ compensation (WC) cases and the use of managed care in this setting.Describe the cost control and health care management measures introduced in an attempt to control WC expenses.Distinguish between the changes in WC costs growing out of changes in health care management and those effected by cost control measures.The effect of both a cost control and health care management initiative (HCMI) on Workers’ Compensation costs at a self-insured University Hospital was assessed. Seven cohorts of injured workers were studied. Cost control measures started in 1993 included early return to work and injury prevention programs, internal administration of legal cases, and utilization of modified duty assignments. The health care management initiative fully in place in 1997 included aggressive case management and preferred provider panel utilization. Workers’ Compensation indemnity costs and lost workdays incurred by each cohort were compared. A 41 to 59% reduction in indemnity payments and 46 to 67% reduction in lost time cases were realized after the health care management initiative was fully in place. During this time, accepted claims were reduced by 10 to 15%. The quality of the provider panel, as measured by academic credentials, experience and board certification, did not change. Cost control measures, without comprehensive case management, did not decrease these parameters significantly. The health care management initiative realized reductions in lost time cases and Workers’ Compensation indemnity costs.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Learning ObjectivesIdentify characteristic patterns of ambulatory medical care provided to patients with work-related conditions.Explain how individuals who make medical visits for work-related conditions differ from other patients demographically and in the type of health care setting in which they are seen.Contrast the type of medical care and services received by patients seen for work-related and non-work-related reasons.Recall strategies prompted by the findings of this survey that could improve the outcome in patients who seek medical care for work-related disorders.Data from the 1997 and 1998 National Ambulatory Medical Care Surveys were analyzed to describe nationally representative patterns of office-based ambulatory medical care for work-related injuries and illnesses. Key dimensions of care included patient demographics, diagnoses, utilization of services, provider and payer information, and characteristics of the clinical setting in which care was delivered. Multivariate analyses revealed that compared to visits for nonwork related conditions, ambulatory care visits for work-related conditions are more likely to involve x-rays, injury prevention counseling, and physiotherapy. Surgical procedures, mental health counseling, prescription drug medication, and the taking of blood pressure were found to be relatively less common. Additionally, authorization for care was required considerably more often at visits for work-related conditions, and the provider for patients with work-related conditions was less likely to be the patient’s regular primary care physician.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A repeated measures short-term prospective study was performed in boilermakers to determine occupational polycyclic aromatic hydrocarbon (PAH) exposure using the biomarker, 1-hydroxypyrene (1-OHP). Two work sites were studied; an apprentice school (metal fume exposure) and a boiler overhaul (residual oil fly ash [ROFA] and metal fume exposure). Pre- and postshift urine samples (n= 241; 41 male subjects) were analyzed for cotinine and 1-OHP. Descriptive statistics and generalized estimating equations were calculated. At the apprentice school cross-shift 1-OHP levels did not significantly differ. At the overhaul 1-OHP levels increased during the week in smokers and nonsmokers; in nonsmokers the 1-OHP level increased significantly postshift compared to preshift. In conclusion this study suggests that boilermakers exposed to occupational particulates are exposed to PAH. The urinary 1-OHP level may be a useful biomarker of PAH exposure in boilermakers exposed to ROFA, particularly in nonsmokers.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The purpose of this study was to combine absences, short-term disability, and workers’ compensation into a sum of the cost of time away from work (TAW) and compare it with health risk status and individual health risks of 6220 hourly workers at Steelcase Inc. The study used 3 years (1998 to 2000) of TAW and health risk appraisal data. Higher TAW costs were associated with illness days, drug/medication use, the individual’s lower perception of physical health, job dissatisfaction, high stress, life dissatisfaction, and physical inactivity. More high-risk individuals (80.6%) had a TAW occurrence than medium- (72.8%) and low-risk (61.1%) individuals. High-risk individuals had higher TAW costs than medium- and low-risk individuals. Of the total TAW costs, 36.2% was attributed to the excess risks of the medium- and high-risk individuals or nonparticipants compared with low-risk participants. If TAW costs follow risk reduction, a potential annual savings of $1.7 million could be achieved.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The work environment of cotton mill rooms of modern textile plants is characterized by noise pollution. We have taped and reproduced this noisy environment to study its effects on experimentally exposed rats. Because we have previously documented that chronic noise causes alterations in the respiratory epithelium, we have focused our investigation on the morphology of the tracheal lining. Wistar rats were exposed to the textile-type noise from 1 up to 7 months, with an average 40 hours weekly exposure of the animals. The rats were sacrificed monthly and the tracheas were studied by scanning electron microscopy (SEM) to quantify the areas of the airway lining that were covered by ciliated, serous or other cells of the epithelium. We found that noise exposure of the rats caused a significant loss of tracheal ciliated cells; an increased density of serous cells on the epithelium balanced this change. This modification of the rat trachea was already established after 1 month of noise treatment of the animals; it did not change significantly throughout the 7-month course of the herein investigation. Loss of ciliated cells was more intense in areas of the tracheal epithelium located between the regions of cartilage rings. We conclude that the ciliated cell is an elective target for damage caused on the respiratory epithelium by the workplace noise occurring in cotton mill rooms. This modification of the respiratory epithelium is likely to impair clearance of the airways since this function depends on the activity of ciliated cells.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Although laboratory animal allergy (LAA) is a significant occupational hazard among workers exposed to laboratory animals, few studies have evaluated long-term risks to workers who remain in the workplace. This short-term focus has obscured the evaluation of subsequent animal allergies (secondary LAA). We analyzed surveillance data from a 10-year LAA prevention program to estimate incidence rates of primary and secondary LAA and to evaluate the effectiveness of the prevention program in reducing the development of primary LAA. The 10-year incidence rates of primary and secondary LAA were 1.34 (95% CI, 0.78–1.90) and 11 (95% CI, 7.4–14.6) cases per 100 person-years, respectively. The annual incidence of primary LAA was reduced from 3.6% to 0 in the first 5 years and did not rise above 1.2% over the remaining years, whereas the incidence of secondary LAA was greater than 8% in most years. These findings suggest that programs effective at preventing primary LAA may need to be evaluated for their effectiveness at protecting against further risk.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Few studies have assessed respiratory symptoms and dust exposure levels in small-scale wood industry workers in Africa. We interviewed 546 workers exposed to wood dust and 565 control subjects using a respiratory health questionnaire. Inhalable dust measurements were collected for 106 workers. The dust exposure was high, and job title-based geometric mean exposure levels ranged from 2.9 to 22.8 mg/m3. Prevalence of respiratory symptoms in the previous 12 months was significantly higher in the exposed group compared with the nonexposed office workers. Allergy and sensitivity symptoms were reported regularly in the exposed group with Odds ratios and 95% confidence intervals (CIs) varying from 2.4 (95% CI = 1.8–3.1) for low-and 2.7 (1.8–4.0) for high-exposure groups compared with controls. We conclude that working in the small-scale wood industry in Tanzania is associated with an increased prevalence of respiratory symptoms.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

In 1996 the US construction industry comprised 5.4% of the annual US employment but accounted for 7.8% of nonfatal occupational injuries and illnesses and 9.7% of cases involving at least a day away from work. Information in the published literature on the disability arising from construction injuries is limited. The construction claims experience (n= 35,790) of a large workers’ compensation insurer with national coverage was examined. The leading types and sources of disabling occupational morbidity in 1996 in the US construction industry were identified. Disability duration was calculated from indemnity payments data using previously published methods. The average disability duration for an injured construction worker was 46 days with a median of 0 days. The most frequently occurring conditions were low back pain (14.8%), foreign body eye injuries (8.5%), and finger lacerations (4.8%). Back pain also accounted for the greatest percentage of construction claim costs (21.3%) and disability days (25.5%). However, the conditions with the longest disability durations were sudden-onset injuries, including fractures of the ankle (median = 55 days), foot (42 days), and wrist (38 days). Same-level and elevated falls were the principal exposures for fractures of the wrist and ankle, whereas elevated falls and struck by incidents accounted for the majority of foot fractures. Manual materials handling activities were most often associated with low back pain disability. The results suggest that these most disabling injuries can be addressed by increasing primary prevention resources in slips and falls and exposures related to injuries of sudden-onset as well as in reducing manual materials handling and other exposures associated with more gradual-onset injuries.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID