The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME). Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry (systematic literature search and expert meeting), specific job demands and related requirements were defined and instruments proposed. Finally, a work ability assessment was linked to the instruments' outcomes, resulting in the modular character of the developed PE-ME. Twenty-two specific job demands for all Dutch construction jobs were identified, including kneeling/squatting, working under time pressure, and exposure to hazardous substances. The next step was proposing self-report questions, screening questionnaires, clinical tests, and/or performance-based tests, leading to a work ability judgment. "Lifting/carrying" is described as an example. The new modular PE-ME enables a job-specific assessment of work ability to be made for more than 100 jobs in the Dutch construction industry.
Construction Industry* ; Hazardous Substances ; Judgment ; Mass Screening ; Surveys and Questionnaires

Obesity is a significant problem affecting United States (US) firefighters. While body mass index (BMI) is widely used to diagnose obesity, its use for this occupational group has raised concerns about validity. We examined rates and types of misclassification of BMI-based obesity status compared to body fat percentage (BF%) and waist circumference (WC). Male career firefighters (N = 994) from 20 US departments completed all three body composition assessments. Mean BMI, BF%, and WC were 29 kg/m2, 23%, and 97 cm, respectively. Approximately 33% and 15% of BF%- and WC-defined obese participants were misclassified as non-obese (false negatives) using BMI, while 8% and 9% of non-obese participants defined by BF% and WC standards were identified as obese (false positives) using BMI. When stratified by race/ethnicity, Pacific Islanders showed high rates of false positive misclassification. Precision in obesity classification would be improved by using WC along with BMI to determine firefighters' weight status.
Adipose Tissue ; Body Composition ; Body Mass Index ; Classification ; Firefighters* ; Humans ; Male ; Obesity* ; Occupational Groups ; United States ; Waist Circumference

Investigation and analysis of accidents are critical elements of safety management. The over-riding purpose of an organization in carrying out an accident investigation is to prevent similar accidents, as well as seek a general improvement in the management of health and safety. Hundreds of workers have suffered injuries while installing, maintaining, or servicing machinery and equipment due to sudden re-energization of power lines. This study presents and analyzes two electrical accidents (1 fatal injury and 1 serious injury) that occurred because the power supply was reconnected inadvertently or by mistake.
Electric Power Supplies ; Greece* ; Safety Management

Control Banding (CB) strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into ergonomics and injury prevention. CB is an action-oriented qualitative risk assessment strategy offering solutions and control measures to users through "toolkits". Chemical CB toolkits are user-friendly approaches used to achieve workplace controls in the absence of firm toxicological and quantitative exposure information. The model (technical) validation of these toolkits is well described, however firm operational analyses (implementation aspects) are lacking. Consequentially, it is often not known if toolkit use leads to successful interventions at individual workplaces. This might lead to virtual safe workplaces without knowing if workers are truly protected. Upcoming international strategies from the World Health Organization Collaborating Centers request assistance in developing and evaluating action-oriented procedures for workplace risk assessment and control. It is expected that to fulfill this strategy's goals, CB approaches will continue its important growth in protecting workers.
Drug Industry ; Human Engineering ; Nanostructures ; Occupational Exposure ; Qualitative Research ; Risk Assessment ; Risk Management ; World Health Organization

OBJECTIVES: This study was designed to investigate whether long-term, low-level exposure to monocyclic aromatic hydrocarbons (MAHs) induced insulin resistance. METHODS: The subjects were 110 male workers who were occupationally exposed to styrene, toluene, and xylene. One hundred and ten age-matched male workers who had never been occupationally exposed to organic solvents were selected as a control group. Cytokines, which have played a key role in the pathogenesis of insulin resistance, and oxidative stress indices were measured. Assessment of exposure to MAHs was performed by measuring their ambient levels and their urinary metabolites in exposed workers, and the resulting parameters between the exposed group and non-exposed control groups were compared. RESULTS: There was no significant difference in general characteristics and anthropometric parameters between the two groups; however, total cholesterol, fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance levels were significantly higher in the exposed group. Phenylglyoxylic acid levels showed significant association with tumor necrosis factor-alpha, total oxidative status, and oxidative stress index via multiple linear regression analysis. Further, there was a negative correlation between methylhippuric acid levels and total anti-oxidative capacity, and there was a significant relationship between MAHs exposure and fasting glucose levels, as found by multiple logistic regression analysis (odds ratio = 3.95, 95% confidence interval = 1.074-14.530). CONCLUSION: This study indicated that MAHs increase fasting glucose level and insulin resistance. Furthermore, these results suggested that absorbing the organic solvent itself and active metabolic intermediates can increase oxidative stress and cytokine levels, resulting in the changes in glucose metabolism and the induction of insulin resistance.
Cholesterol ; Cytokines ; Fasting ; Glucose ; Glyoxylates ; Homeostasis ; Humans ; Hydrocarbons, Aromatic ; Insulin ; Insulin Resistance ; Linear Models ; Logistic Models ; Male ; Mandelic Acids ; Occupations ; Oxidative Stress ; Solvents ; Styrene ; Toluene ; Tumor Necrosis Factor-alpha ; Xylenes

OBJECTIVES: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning,although localized effects in the upper airways can be expected.This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. METHODS: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender.Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of SO2. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. RESULTS: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/m3. CONCLUSION: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.
Human Experimentation ; Humans ; Lung ; Occupational Exposure ; Odors ; Reflex ; Respiration ; Respiratory Mechanics ; Risk Assessment ; Sensory Thresholds ; Sulfur Dioxide

OBJECTIVES: This cross-sectional study was performed in the Dental School of Prince of Songkla University to ascertain noise exposure of dentists, dental assistants, and laboratory technicians. A noise spectral analysis was taken to illustrate the spectra of dental devices. METHODS: A noise evaluation was performed to measure the noise level at dental clinics and one dental laboratory from May to December 2010. Noise spectral data of dental devices were taken during dental practices at the dental services clinic and at the dental laboratory. A noise dosimeter was set following the Occupational Safety and Health Administration criteria and then attached to the subjects' collar to record personal noise dose exposure during working periods. RESULTS: The peaks of the noise spectrum of dental instruments were at 1,000, 4,000, and 8,000 Hz which depended on the type of instrument. The differences in working areas and job positions had an influence on the level of noise exposure (p < 0.01). Noise measurement in the personal hearing zone found that the laboratory technicians were exposed to the highest impulsive noise levels (137.1 dBC). The dentists and dental assistants who worked at a pedodontic clinic had the highest percent noise dose (4.60 +/- 3.59%). In the working areas, the 8-hour time-weighted average of noise levels ranged between 49.7-58.1 dBA while the noisiest working area was the dental laboratory. CONCLUSION: Dental personnel are exposed to noise intensities lower than occupational exposure limits. Therefore, these dental personnel may not experience a noise-induced hearing loss.
Cross-Sectional Studies ; Dental Assistants ; Dental Clinics ; Dental Instruments ; Dentists ; Hearing ; Hearing Loss, Noise-Induced ; Humans ; Laboratories, Dental ; Laboratory Personnel ; Noise ; Occupational Exposure ; Schools, Dental ; United States Occupational Safety and Health Administration

OBJECTIVES: In Korea, an average of 258 workers claim compensation for their noise-induced hearing loss (NIHL) on an annual basis. Indeed, hearing disorder ranks first in the number of diagnoses made by occupational medical check-ups. Against this backdrop, this study analyzed the impact of 19 types of noise-generating machines and equipment on the sound pressure levels in workplaces and NIHL occurrence based on a 2009 national survey on work environments. METHODS: Through this analysis, a series of statistical models were built to determine posterior probabilities for each worksite with an aim to present risk ratings for noise levels at work. RESULTS: It was found that air compressors and grinding machines came in first and second, respectively in the number of installed noise-generating machines and equipment. However, there was no direct relationship between workplace noise and NIHL among workers since noise-control equipment and protective gear had been in place. By building a logistic regression model and neural network, statistical models were set to identify the influence of the noise-generating machines and equipment on workplace noise levels and NIHL occurrence. CONCLUSION: This study offered NIHL prevention measures which are fit for the worksites in each risk grade.
Compensation and Redress ; Hearing Disorders ; Hearing Loss, Noise-Induced ; Hypogonadism ; Korea ; Logistic Models ; Mitochondrial Diseases ; Models, Statistical ; Noise ; Ophthalmoplegia ; Porphyrins ; Workplace

OBJECTIVES: Depressive disorder (DD) is a complex disease, and the assessment of work ability in patients with DD is also complicated. The checklist depression (CDp) has recently been developed to support such work ability assessments and has been recommended for implementation in insurance medicine, starting with an analysis of the organisational and social contexts. The aim of this study was to identify the potential facilitators and barriers in the use of the CDp by insurance physicians (IPs) during work ability assessments of employees on sick leave due to DD. METHODS: A qualitative research was conducted based on semi-structured interviews. The participants were IPs with at least one year of work experience in performing work ability assessments. The interviews were audiotaped, transcribed and analysed qualitatively. RESULTS: Ten IPs (7 males, 3 females; mean 53 years) were interviewed. Important facilitators, which emerged for use of the CDp, were an oral introduction for colleagues and staff, support from management, valuing the increased transparency in work ability assessments with using the CDp, having adequate time for assessments as well as modification of the appearance (colour, plasticised form) and content (clarifying aspects of the examples) of the assessment tool. The fear of the loss of autonomy, lack of added value of the CDp, high workload, inadequate instructions and lack of time were mentioned as barriers. CONCLUSION: Adequate introduction to the use of CDp and the fear of the loss of autonomy of IPs need special attention in planning its implementation.
Checklist ; Cytidine Diphosphate ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Insurance ; Male ; Occupational Medicine ; Qualitative Research ; Sick Leave

OBJECTIVES: To find out from an analysis of empirical data the levels of influence, which a labor union (LU) and Occupational Safety and Health Committee (OSHC) have in reducing the occupational injury and illness rate (OIIR) through their accident prevention activities in manufacturing industries with five or more employees. METHODS: The empirical data used in this study are the Occupational Safety and Health Tendency survey data, Occupational Accident Compensation data and labor productivity and sales data for the years 2003 to 2007. By matching these three sources of data, a final data set (n = 280) was developed and analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). RESULTS: It was found that a workplace with a LU has a lower OIIR than one without a LU. In manufacturing industries with five or more employees in 2007, the OIIR of the workplaces without a LU was 0.87%, while that of workplaces with a LU was much lower at 0.45%. In addition, workplaces with an established OSHC had a lower OIIR than those without an OSHC. CONCLUSION: It was found that the OIIR of workplaces with a LU is lower than those without a LU. Moreover, those with the OSHC usually had a lower OIIR than those without. The workplace OIIR may have an impact on management performance because the rate is negatively correlated with labor productivity and sales. In the long run, the OIIR of workplaces will be reduced when workers and employers join forces and recognize that the safety and health activities of the workplace are necessary, not only for securing the health rights of the workers, but also for raising labor productivity.
Accident Prevention ; Accidents, Occupational ; Chicago ; Commerce ; Compensation and Redress ; Efficiency ; Human Rights ; Labor Unions ; Occupational Diseases ; Occupational Health ; Occupational Injuries