摘要:

Althoughdoctors are increasingly evaluated on the basis of return-to-work (RTW)outcomes, the effect of doctor–patient communication about the workplaceand RTW after an occupational injury has received little research attention.The effect of patient-reported doctor communication on duration of disabilitywas examined retrospectively in a 3-year cohort of 325 claimants with alost-time low back injury. Although doctor proactive communication wasassociated with a greater likelihood of RTW during the acute phase (<30days of disability), this effect disappeared when injury and workloadcharacteristics were taken into account. A positive RTW recommendation wasassociated with about a 60% higher RTW rate during the subacute/chronic phase(>30 days of disability) only. Prospective studies are needed to confirmthis effect. The impact of physician communication on RTW is largelyconfounded by injury and workplacefactors.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Recentdiscoveries in molecular biology and genetics have made it possible forenvironmental health researchers to examine how genetic characteristics affectresponse to environmental exposures. Understanding such gene–environmentinteractions offers exciting possibilities for the prevention and control ofenvironmentally induced diseases. Despite these potential benefits, thecollection and analysis of genetic information in environmental healthresearch presents many of the same ethical, legal, and social (ELSI)challenges found in other types of genetic research. In this article, wedescribe a number of ELSI challenges in environmental genomic research and theopportunities and responsibilities that accompany thisresearch.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Thepurpose of this study was to investigate the association between health risksand workers’ compensation (WC) costs. The 4-year study used Health RiskAppraisal data and focused on 1996-to-1999 WC costs among XeroxCorporation’s long-term employees. High WC costs were related toindividual health risks, especially Health Age Index (a measure ofcontrollable risks), smoking, poor physical health, physical inactivity, andlife dissatisfaction. WC costs increased with increasing health risk status(low-risk to medium-risk to high-risk). Low-risk employees had the lowestcosts. In this population, 85% of WC costs could be attributed to excess risks(medium- or high-risk) or non-participation. Among those with claims, asavings of $1238 per person per year was associated with Health Risk Appraisalparticipation. Addressing WC costs by focusing on employee health statusprovides an important additional strategy for health promotionprograms.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Agricultureis one of the most hazardous occupations in the United States. We examined thework-related injury rate and risk factors among 290 Iowa male principal farmoperators using a population-based, prospective study. Baseline data werecollected between 1991 and 1994, and injury events were surveyed in the fallof 1995. Cumulative incidence of farmwork-related injury during the previousyear was 10.5%. We found that depressive symptoms (odds ratio, 3.22; 95%confidence interval, 1.04 to 9.99) and the number of hours working withanimals (odds ratio, 2.14; 95% confidence interval, 1.04 to 4.44) wereassociated with the incidence of farmwork-relatedinjuries.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Thiscase-control study examined occupational sunlight exposure and death fromnon-Hodgkin lymphoma (NHL) and NHL subtypes among 188 cases and 1880 controlsselected from a cohort of 138,905 male electric utility workers. Exposure wasclassified according to work history linked to indices of cumulative sunlightexposure. Odds ratios and 95% confidence intervals were derived fromconditional logistic regression models and were conditioned on the matchingfactors birth year and ethnicity. Mortality from NHL andintermediate/high-grade lymphomas was not related to cumulative sunlightexposure, with odds ratios around the null. For low-grade lymphomas, adose-response gradient was observed for exposure in the past 12 to 21 years,but this result seemed to be sensitive to cut points for categorization ofcumulative exposure. These data do not provide evidence for an associationbetween occupational sunlight exposure and mortality from NHL or NHLsubtypes.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Emergencymedical system (EMS) workers frequently use sharp devices in injury-pronecircumstances that involve limited visibility, confined spaces, rapidly movingvehicles, and uncooperative victims. This study examined the efficacy of anautomatic self-retracting lancet in reducing needlestick injuries and relateddirect and indirect costs. Subjects were 477 active-duty EMS workers.Counseling, laboratory testing (hepatitis B and C, hepatic function enzymes,and human immunodeficiency virus), antiviral prophylaxis, and immunizationswere provided according to US Public Health Service guidelines. Baseline andbiennial laboratory testing for hepatitis B and C and liver function enzymeswere conducted. After the introduction of a spring-loaded automatic-retractingtype glucometer lancet device, needlestick injuries decreased from 16 per 954EMS worker-years to 2 per 477 EMS worker-years. The annualized cost oftreatment declined from $8276 to $2068. The change to a self-retracting devicedecreased the number of needlestick injuries and was cost-effective with aminimal increase in device cost (annualized $366 peryear).

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Toidentify risk factors for persistent morbidity, we conducted a prospectivestudy of individuals involved in hazardous materials incidents reported to theWashington Poison Center. Between December 1997 and October 1999, 202 subjectsin 87 incidents were surveyed by telephone. Medical symptoms persisting for aminimum of 8 days after the incident were reported in 51 (25%) subjects, and18 (9%) left work or school for more than 2 days because of the exposure.Medical intervention was reported in 46 (58%) of 79 subjects for whom medicalrecords were available, and objective abnormalities were found in 57 (72%).Multiple logistic regression analysis indicated that subjects with dermalexposures, three or more alcoholic drinks per week, and previous use ofpsychiatric medications were more likely to report persistent symptoms.Divorced, widowed, or separated subjects, asthmatic subjects, and those havinginitial dermal symptoms were more likely to miss work or school for more than2 days. Of patients evaluated at a health care facility, subjects withpreexisting hypertension were more likely to receive medical treatment or haveobjective medical findings, whereas those with inhalation exposures and thosedecontaminated at the scene were less likely to be treated or haveabnormalities. In our study, both incident and individual factors werepredictive of adverse health effects, and these findings should be consideredin planning the care of patients involved in hazardous materialsincidents.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID