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

摘要:

This case-control study assessed whether office workers who report more severe levels of musculoskeletal symptoms of the upper extremities demonstrate higher levels of keyforce in comparison to controls with less severe symptoms. Office workers reporting working on computer keyboards for four hours per day were classified as cases or controls based upon a median split on a Composite Symptom Severity score (cases = 23, controls = 25). Keyboard force and keying rate were measured during a 15-minute keyboarding task. Measures of task-related discomfort, muscular fatigue, pain, upper extremity symptoms, psychological distress and force were collected at baseline, post-keyboard task, and recovery. Ratings of perceived effort and task credibility were also obtained. Measures of work demands, perceived job stress, and upper extremity strength and flexibility were also collected. The results indicated group equivalence on reported work demands and upper extremity strength. Cases were more likely to receive a medical diagnosis of upper extremity cumulative trauma disorder, awaken from sleep due to symptoms, report higher levels of pain during work, experience greater impact of pain on function, and report higher workload pressure and lower support. Cases generated significantly higher keyboarding forces than controls, although both groups produced forces well above that required to operate the keyboard (4-5 times activation force). Cases reported higher levels of upper extremity symptoms and discomfort than controls, and these measures were highest after the keyboarding task for both groups. No significant correlation between keyforce and key rate was observed in either group. Results suggest that generation of excessive force while working on a computer keyboard may contribute to the severity of upper extremity symptoms. Clinically, the findings suggest that evaluating how an individual worker performs keyboarding tasks, or his or her workstyle, may be helpful in the management of these symptoms and disorders.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This paper is a critical review of the clinical and cost outcome evaluation studies of multifactorial, comprehensive, cardiovascular risk management programs in worksites. A comprehensive international literature search conducted under the auspices of the National Heart, Lung and Blood Institute identified 17 articles based on 12 studies that examined the clinical outcomes of multifactorial, comprehensive programs. These articles were identified through MEDLINE, manual searches of recent journals, and through direct inquiries to worksite health promotion researchers. All studies were conducted between 1978 and 1995, with 1978 being the date of the first citation of a methodologically rigorous evaluation. Of the 12 research studies, only 8 utilized the worksite as both the unit of assignment and as the unit of analysis. None of the studies analyzed adequately for cost effectiveness. Given this limitation, this review briefly considers the relevant worksite research that has demonstrated cost outcomes. Worksite-based, multifactorial cardiovascular intervention programs reviewed for this article varied widely in the comprehensiveness, intensity, and duration of both the interventions and evaluations. Results from randomized trials suggest that providing opportunities for individualized, cardiovascular risk reduction counseling for high-risk employees within the context of comprehensive programming may be the critical component of an effective worksite intervention. Despite the many limitations of the current methodologies of the 12 studies, the majority of the research to date indicates the following: (1) favorable clinical and cost outcomes; (2) that more recent and more rigorously designed research tends to support rather than refute earlier and less rigorously designed studies; and (3) that rather than interpreting the methodological flaws and diversity as inherently negative, one may consider it as indicative of a robust phenomena evident in many types of worksites, with diverse employees, differing interventions, and varying degrees of methodological sophistication. Results of these studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and insights regarding the essential components and characteristics of successful programs.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In this article, we construct a ranking of occupations based upon the costs of job-related injuries and illnesses. Data are drawn from large nationally representative Bureau of Labor (BLS) data sets. Information is obtained on occupation and workers' compensation (WC) category of the injury or illness, which are then matched to information on costs. Six broad occupations and 413 specific (3-digit) occupations are ranked by total costs. Six broad and 223 specific occupations are ranked by costs per worker (average cost). Operators and laborers is the broad occupation category that contributes both the highest total and average cost. Specific occupations that contributed the most to total costs include heavy truck drivers, non-construction laborers, machine operators (not specified), occupations not classified, janitors, nursing orderlies, construction laborers, assemblers, retail sales workers (not elsewhere specified), miscellaneous machine operators, and carpenters. Occupations high on the average cost list include not-specified mechanics, general and construction laborers, press apprentices, welders, stone cutters, and warehouse workers. Although the BLS data are limited, they can be used to provide a preliminary look at which occupations are contributing the most and the least to the overall economic costs of occupational injuries and illnesses.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The occupational and environmental medicine (OEM) gap in US medical education is widely recognized. In 1992, a federal initiative stimulated a primary care approach to improve residency training in South Carolina. This three-part report documents progress in designing and implementing an OEM curriculum, which is family medicine-centered. Each of the state's residency training programs participate in an ongoing Environmental Medicine Curriculum Committee* effort. Part 1, discusses the needs assessment; Part 2, the five key elements of curriculum; and Part 3 details a clinical guide to the OEM patient.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Part II of our three-part report examines five of the key elements for occupational and environmental medicine (OEM) training in family medicine residency. These were introduced by the Environmental Medicine Curriculum Committee (EMCC) faculty in South Carolina under a Department of Energy (DOE) grant to the Environmental Hazards Assessment Program (EHAP) of the Medical University of South Carolina, 1992-1997. Each element is being designed, tested, and updated by clinicians in the residency network. A pilot study of 100 third-year medical students conducted in 1996 suggests the difficulty in implementing OEM skills in current family medicine training.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A four-prototype approach to the occupational and environmental medicine (OEM) patient in a busy primary care setting is described. A 2x2 table illustrates the two diagnostic, interrelated tasks during the outpatient, non-urgent visit: (a) sick? yes/no, and (b) exposed? yes/no. One may have the basic skills for task (a) but feel insecure for task (b). With OEM experience, creative use of resources (databases and consultants), and patient cooperation, a better balance between task (a) and task (b) can be achieved. The Environmental Medicine Curriculum Committee (EMCC) initiative described in Part I and Part II of this study has developed this patient-centered model to help the resident in training cope as he or she tries to deal with emerging patient concerns from the workplace and beyond. In November 1996, an expert panel of consultants representing OEM, public health, and family medicine endorsed the prototype OEM patient model for further development.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID