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:

An increasing number of people in Sweden are claiming that they are hypersensitive to electricity. These patients suffer from skin as well as neurological symptoms when they are near computer monitors, fluorescent tubes, or other electrical appliances. Provocation studies with electromagnetic fields emitted from these appliances have, with only one exception, all been negative, indicating that there are other factors in the office environment that can effect the autonomic and/or central nervous system, resulting in the symptoms reported. Flickering light is one such factor and was therefore chosen as the exposure parameter in this study. Ten patients complaining of electrical hypersensitivity and the same number of healthy voluntary control subjects were exposed to amplitude-modulated light. The sensitivity of the brain to this type of visual stimulation was tested by means of objective electrophysiological methods such as electroretinography and visual evoked potential. A higher amplitude of brain cortical responses at all frequencies of stimulation was found when comparing patients with the control subjects, whereas no differences in retinal responses were revealed.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The development and use of practice guidelines, if framed as recommendations for best practices in the prevention, diagnosis, treatment, and management of occupationally related health concerns and disability, can improve the quality of occupational medical practice and worker health and well being. Adherence to guidelines should improve the efficiency and effectiveness of prevention, care, and disability management by reducing the present wide variance in practices and then by moving the mean or median of process and outcome statistics toward recommended levels. The information developed for guidelines can also be used for patient discussion and expectation management. Practicing in evidence-based, agreed-upon ways should also make occupational medical practices more defensible. Guidelines should be explicit, be based on a review of the available evidence and benefits vs risks, have clear medical logic, link findings to diagnosis to treatment to prevention, be time-based, and avoid recommending unproven approaches as a last resort. If possible, they should be reviewed and tested for usability. Guidelines that start with common occupational health concerns are best suited to prevention and outpatient care, because patients present in this way. The contents of a useful occupational health guideline would include a statement of purpose and scope; the method of development; the authors' and reviewers' names and affiliations; an analysis of the specificity, sensitivity, and predictive power of mechanisms of illness or injury, symptoms, signs and tests; findings that point to a serious or emergent condition requiring immediate referral or treatment; diagnostic criteria; and initial treatment, including work with the patient in a therapeutic partnership. The guideline should also present information on factors known to be associated with work, and predictors of delayed recovery. Disability-duration statistics and methods of matching job requirements with worker abilities are also helpful. Guidelines should then outline reassessment of those patients whose health concerns remain after a reasonable recovery period. The recommendations should again be evidence-based and conform to the other attributes listed above. A discussion of management after reassessment, including behavioral referral, further testing, and procedures, is also quite useful. Recommendations for restoration of function and return to work complete guidelines focused on diagnosing, treating, and resolving activity limitations among workers. Simply developing and publishing guidelines has not resulted in improvement in practice. However, if used as the basis for peer-group interactions and actions by occupational health opinion leaders, guidelines can contribute to marked improvements in quality, worker satisfaction, and worker health.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This is the first large-scale study of US workers that describes the demographic and cost differences between recurrent and nonrecurrent low back pain (LBP) disability claimants, using data from a large workers' compensation insurer. Persons with at least one LBP claim in 1990 and one or more additional claims in 1990 to 1996 were defined as recurrent. Persons with at least one LBP claim in 1990 but no subsequent claims were defined as nonrecurrent. Fourteen percent of claimants were recurrent. The percentage of recurrent claimants who were male (77.2%) was higher than the percentage that were female (22.8%). This difference was more pronounced in the younger age groups. The median total cost for recurrent LBP claims in 1990 was 4% greater than for nonrecurrent 1990 LBP claims, whereas the mean cost was 48% less. Most studies of LBP recurrence among US workers have followed single-corporation employees. Our rate of recurrence was lower than these previously reported rates. However, analysis of independent workers' compensation insurance company data may provide a more accurate assessment of LBP claim recurrence among US workers.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Although fatal work-related assault injury rates are routinely reported in the United States, reports of non-fatal injuries are not routinely examined. Non-fatal workplace assault injuries can be reported through many agencies. One of the most common reporting mechanisms California is the Employer's Report of Occupational Illness and Injury. Employer's Reports filed from October 1, 1994 through January 31, 1995 in the state of California were the source of workplace assault information for this study. All reports indicating an assault-related injury were identified and characterized by gender and occupation of the victim, type of assault and weapon used, and industry. Annual rates were determined based on the number of estimated annual reports and the civilian working population. The estimated annual rate of workplace assault injuries for California based on Employer's Reports is 72.9 per 100, 000 workers, which is approximately 50 times the fatal rate. Rates differed by industry, with retail, hospital, transportation and police workers exhibiting the highest rates. Assaults were predominantly Type I, which involve criminal activity, and Type II, which involve an assault by a client, patient, or inmate. The rates of non-fatal work-related assault injury are much greater and have different characteristics than fatal injuries. These non-fatal injury patterns need to be considered when estimating the burden of assault injuries on businesses, and can help identify the most effective prevention strategies.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Our aim was to establish whether the case-control design may be applied in surveillance for occupational asthma. In a region with intensive manufacturing industries, we carried out one case-control study from 1974 to 1978 and another from 1989 to 1993; 325 and 387 pairs of cases of asthma and of age- and sex-matched control subjects, respectively, were selected. Current risks were found to be higher than past estimates for painters, farmers, millers/bakers, textile, wood/furniture, and chemical workers. High risks for asthma have recently appeared in leather, polyurethane plastics, hospital and food industry workers, welders, and shoemakers. It is concluded that the case-control approach may be used to describe variations in asthma risk by occupational categories and time. A method to measure the efficiency of the diagnostic process for occupational asthma is also proposed.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A laboratory-based blood lead surveillance system in Colorado identified radiator repair workers as having the highest blood lead levels of all worker groups reported. A survey of 42 radiator repair shops in ten locales throughout Colorado was undertaken to estimate the prevalence of workers with elevated blood lead levels >25 µg/dL. The survey was designed to test the sensitivity of the surveillance system and to assess working conditions and practices in the radiator repair industry in Colorado. Of 63 workers, 39 (62%) had blood lead levels >25 µg/dL. The sensitivity of the surveillance system for detecting radiator repair workers with elevated blood lead levels was estimated at 11%. None of the radiator repair shops had adequate local exhaust ventilation. Work practice and engineering modifications are needed to reduce lead exposure in this industry.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Work stress is a growing and expensive problem. A model for group psychotherapy for disgruntled workers presenting with psychiatric symptoms was offered through Kaiser Permanente's outpatient psychiatry department. The findings of a 2-year follow-up study conducted on group participants indicate that this type of cognitive-behavioral group psychotherapy can be helpful in increasing employee satisfaction and adjustment at work. This also raises the possibility that early intervention through group psychotherapy may be effective in reducing the incidence of workers' compensation stress claims.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID