ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Learning ObjectivesExplain the general nature of work-family conflict.Relate the prevalence and work-related correlates of work-family conflict as reported in the Maastricht Cohort study.Identify the work- and family-related antecedents of work-family conflict for male and female employees.Summarize the personal consequences of work-family conflictThis study examined both risk factors for the onset of work–family conflict and consequences in terms of need for recovery and prolonged fatigue for men and women separately. Two-year follow-up data from the Maastricht Cohort Study on “Fatigue at Work” (n= 12,095) were used. At baseline, the prevalence of work–family conflict was 10.8% (9.0% in women; 11.1% in men), the cumulative incidence at 1 year follow-up was 5.1%. For men, several work-related demands, shift work, job insecurity, conflicts with coworkers or supervisor, having full responsibility for housekeeping, and having to care for a chronically ill child or other family member at home were risk factors for the onset of work–family conflict, whereas decision latitude and coworker and supervisor social support protected against work–family conflict. In women, physical demands, overtime work, commuting time to work, and having dependent children were risk factors for work–family conflict, whereas domestic help protected against work–family conflict at 1 year follow-up. Work–family conflict was further shown to be a strong risk factor for the onset of elevated need for recovery from work and fatigue.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purpose of the investigation was to determine whether genetic polymorphisms in enzymes that metabolize exogenous chemicals modulate the effects of environmental tobacco smoke (ETS) exposure on birth weight. A survey was conducted from 2000 to 2001 among 266 pregnant women who were hospitalized for delivery and on their singleton live births. We determined maternal GSTM1 and GSTT1 polymorphisms by polymerase chain reaction and measured the urinary cotinine of pregnant women at delivery by radioimmunoassay. Birth weight was found to decrease significantly with increasing concentrations of maternal urinary cotinine (P< 0.05). The interactive effect of exposure to ETS and the presence of the GSTT1 polymorphism was found to be significant by multivariate analysis (P< 0.01), whereas the interactive effect of exposure to ETS and the presence of GSTM1 polymorphism did not reach statistical significance (P= 0.21). A combination of the GSTM1-null and the GSTT1 null-genotypes was found to exacerbate the effect of maternal exposure to ETS on birth weight more than the presence of either genotype alone. Our data indicate that maternal exposure to ETS negatively affects neonatal birth weight, and the adverse effect of maternal exposure to ETS on neonatal birth weight could be modified by the maternal metabolic genotypes, GSTM1 and GSTT1.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled trial, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0, 6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days/person as compared to 197.9 (14.0) days in the reference group (P< 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2),P< .01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2–5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This work presents 10 years of experience using an Integrated Workers’ Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers’ compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers’ compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers’ psychological, as well as physical needs and where communication between all parties (eg, medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results can be obtained in an environment in which the employer pays the full cost of medical care and the claimant has free choice of medical provider at all times.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID