Effectiveness of an educational intervention to increase knowledge and reduce use of risky behaviors associated with cumulative trauma in office workers

OBJECTIVE: This pilot project assessed the effectiveness of an intervention to increase knowledge and reduce risky behaviors related to cumulative trauma disorders (CTD) in office workers. STUDY DESIGN: All 124 employees from the administrative offices of a health maintenance organization were invited to participate. Subjects were followed across time using an identification number. Data were collected via questionnaire in June 1994 (pretest1) (N=84), August 1994 (pretest II) (N= 63) and September 1995 (posttest) (N=40). The yearlong intervention focused on functional activities to prevent CTD. RESULTS: of chi-square analyses for the 40 subjects who completed all surveys indicated this intervention significantly increased overall knowledge of CTD (p =.002). Significant changes in self-reported hand/wrist (p =.016) and neck/shoulder (p =.003) posture were also found. CONCLUSIONS: This study is a first step in identifying effective educational interventions to increase knowledge and reduce risk factors related to CTD in office workers.     

Musculoskeletal symptoms and work ability among agricultural machinery operators

Those subjects whose employment has physical demands present more frequently musculoskeletal symptoms than others. The agricultural sector activities include tasks with important physical demands that may have a negative impact in the workers health. The aim of this study was to evaluate the presence of musculoskeletal symptoms and its association with work ability in agricultural machinery operators. It is a cross-sectional study. The participants (n = 204) answered a self-administered questionnaire on demographics, work and lifestyle characteristics, Work Ability Index and the Nordic Musculoskeletal Symptoms Questionnaire. The response rate was 89.78%. The mean age of the workers was 32.3 years, and 47.1% of them reported musculoskeletal symptoms at least one body part over the past 12 months. Those subjects who presented work ability index <37 points, 87.5% reported some kind of musculoskeletal symptom. This study showed that the work ability was significantly (p ≤ 0.05) correlated to musculoskeletal symptoms presence. It is recommended that measures to promote and improve the work ability are designed and deployed based on musculoskeletal disorders prevention.     

An investigation of a workplace-based return-to-work program for shoulder injuries

The purpose of this study was to investigate and evaluate the current workplace management of rotator cuff injuries in a manufacturing plant. The secondary aims were to examine the impact of the company's return-to-work processes, compare outcomes to current industry standards for work (re)entry and to identify the components that characterized this workplace-based return-to-work (RTW) program. This investigation involved a case study approach comprised of an examination of the program context using interviews, onsite visits, a document review and a retrospective analysis of the RTW experiences of 184 workers with shoulder injuries. Findings revealed that the workplace-based RTW program was consistent with and shaped by the organizational culture of problem solving, knowledge exchange and equitable participation of workers, supervisors and health professionals. These components contributed to the program in achieving the following outcomes for workers with shoulder injuries. One-third of workers were placed on modified duties within three days, 56% of workers who engaged in an early RTW program returned to work within one month. Overall, 87.8% of workers with rotator cuff injuries successfully returned to pre-injury work. The implications of developing capacity for workplace-based programs to manage injuries at work are discussed.     

Occupational health and safety issues affecting young workers: a literature review

Many overview articles, reports, book chapters and literature reviews have examined the health and safety of young workers. These sources discuss the relationships between the work conditions of young workers and the various indicators of accidents and occupational diseases. Breslin et al. [12,13] conducted two literature reviews of quantitative studies to determine which factors best predicted work accidents and occupational disorders in young people. The present article proposes a review of young people's occupational health and safety (OHS) factors (e.g., demographic, individual, professional, organizational, temporal and operational factors) in both qualitative and quantitative studies. Five types of problems were analyzed in greater depth, namely MSD symptoms, respiratory, allergy and toxicological problems, mental health and well-being, alcohol and drug consumption, and fatigue. This review likewise examines related dimensions that allow us to adopt a more global perspective on this subject by considering such elements as young people's values, their knowledge and attitudes, safety practices in companies, the safe integration of young people, and rehabilitation. A total of 189 scientific articles were selected on the basis of certain criteria. These articles came from refereed OHS journals published between 1994 and 2005.     

Exposure assessment in different occupational groups at a hospital using Quick Exposure Check (QEC) - a pilot study

In order to test the feasibility and sensitivity of the ergonomic exposure assessment tool Quick Exposure Check (QEC), a pilot-study was conducted. The aim was to test QEC in different occupational groups to compare the exposure in the most common work task with the exposure in the work task perceived as the most strenuous for the neck/shoulder region, and to test intra-observer reliability. One experienced ergonomist observed 23 workers. The mean observation time was 45 minutes, waiting time and time for complementary questions included. The exposure scores varied between the different occupational groups as well as between workers within the occupational groups. Eighteen workers rated their most common work task as also being the most strenuous for the neck/shoulder region. For the remaining five workers, the mean exposure score were higher both for the neck and shoulder/arm in the most common work task. Intra-observer reliability shows agreement in 86% of the exposure interactions in the neck and in 71% in the shoulder/arm. QEC seems to fulfill the expectations of being a quick, sensible and practical exposure assessment tool that covers physical risk factors in the neck, upper extremities and low back.     

Job prospects for mature workers

Can the economy in the United States generate enough jobs for mature workers who want to work? This article explores the prospects for jobs first in the high-skill sector and second in the area of contingent work, temporary and part-time jobs as well as contracting. It concludes that the high-skill market as a whole will be a source of opportunity to those who are flexible, but within this market there will be flux in the markets for particular skills. At the other end, the restructuring of jobs in the American economy is likely to lead to continued growth in certain forms of contingent labor but the rate of growth will not be constant and may not always be adequate to employ all those who would like the employment. Finding and obtaining work will remain a challenge for many older workers. Those who are flexible and who are willing to acquire new skills will be the most likely to find opportunities.     

Young workers in the construction industry and initial OSH-training when entering work life

Studies have found that young workers are at risk for injuries. The risk for accidents is high within construction, indicating that young workers may be especially vulnerable in this industry. In Norway, it is possible to enter the construction industry as a full time worker at the age of 18. The aim of this paper was to explore how young construction workers are received at their workplace with regards to OHS-training. The study was designed as a qualitative case study. Each case consisted of a young worker or apprentice (< 25 years), a colleague, the immediate superior, the OHS manager, and a safety representative in the company. The interviews were recorded and analyzed through content analysis. The results showed that there were differences between large and small companies, where large companies had more formalized routines and systems for receiving and training young workers. These routines were however more dependent on requirements set by legislators and contractors more than by company size, since the legislation has different requirements with impact on OHS.     

Work ability among nursing personnel in public hospitals and health centers in Campinas--Brazil

Nursing personnel is essential in hospital, health centers and enterprises and is the large work force in health system. A cross-sectional study was conducted in a large city in two public hospitals and five health centre with the objective of to evaluate the work ability and health aspects of nursing staff. The sample was composed by 570 workers. The Work Ability Index - WAI and a questionnaire with socio-demographic, health and life style data was applied. The majority of workers was women (83%), married (50.4%), and was working in night shift work (65.6%); 61.4% was auxiliary nursing, 22.3% was registered nurses (RN). The average age was 38.9 years (SD 7.8) and the Body Mass Index mean was 25.8 (SD 5.3). Only 17.2% referred to practice at least 150 minutes of physical exercise five times per week or more. 26.8% had a second job. The work ability mean was 39.3 (SD 5.3) points. Age had a negative correlation with WAI (p=0.0052). Public hospital and health centre workers had poor work ability score when compared with workers from another branches. Public policies related to workplace health promotion need to be implemented in public hospital and health centre to improve the work ability.     

The Influence of Substance Dependence and Mood Disorders on Outcome from Pathological Gambling: Five-Year Follow-Up

A prospective study of the role of comorbid substance abuse and dependence and mood disorders in the outcome from pathological gambling. A naturalistic sample of pathological gamblers who had recently quit gambling (N = 101) was followed and data were available for 83% of participants at 3 months, 80% at 12 months, and 52% at 5 years. Those participants with a drug diagnosis during their lifetime were less likely to have a minimum 3 month period of abstinence, and those who had been involved in gambling treatment were more likely to have a minimum 12 months of continuous abstinence. Lifetime gambling problem severity and involvement in gambling treatment were most commonly associated with a shorter time to achieving a period of abstinence of any length. Lifetime history of a mood disorder also predicted a longer time to reach a minimum 3 months of continuous abstinence. Both gambling treatment and an alcohol diagnosis follow up predicted an increase in the odds of experiencing a relapse from a minimum 6 month period of abstinence. Overall, comorbid mental health disorders are predictive of shorter term but not longer term outcome.     

The use of a vertical arm support device to reduce upper extremity muscle firing in sonographers

Work-related musculoskeletal disorders (WRMSD) in sonographers have increased over the past 20 years with shoulder injuries being the most prevalent. Advancing ultrasound technologies have reduced a sonographer's need to move when performing exams and increased prolonged arm abduction, resulting in static work postures and decreased joint perfusion. Work modifications in other industries have demonstrated that reducing arm abduction to 30° reduces muscle firing and fatigue. Although this is the ideal work posture for sonographers, there are many instances in which excessive arm abduction and static postures cannot be avoided. These positions are further complicated by the fact that the scanning arm is also supporting the weight of the ultrasound transducer. This observational case study evaluated the use of a moveable arm support system as a means to provide support for the scanning arm and reduce muscle firing during ultrasound exams in the scanning lab of a university diagnostic ultrasound educational program.     

Psychosocial indicators among aircraft maintenance workers with and without neck and shoulder musculoskeletal symptoms

In the aircraft maintenance industry, most of workers performs manual handling tasks of different materials, varying from small objects up to large pieces of the aircraft. It can increase the occurrence of work-related musculoskeletal disorders (WMSDs), which are strongly associated with high physical demands required by the task. Moreover, psychosocial demands are considered as risk factors for musculoskeletal disorders in both the upper limbs and lumbar spine. Thus, the objective of this study was to assess psychosocial indicators among aircraft maintenance workers according to the presence of neck and shoulder musculoskeletal symptoms. Eighty workers of an aircraft maintenance company were evaluated (32.69 ± 8.25 years, 79.8 ± 13.4 kg, 175 ± 7 cm). According to physical examination, 50 workers were classified as asymptomatic (AS - 4.1 ± 3.17 positive signs) whilst 30 workers were classified as symptomatic (SS - 26.72 ± 11.44 positive signs). AS and SS have shown similar profile of demand (p = 0.62), control (p = 0.66) and social support (p = 0.74) according to the Job Content Questionnaire. However, the groups are different when considering work engagement variables. In general, SS have higher scores than AS (p < 0.05).     

How can occupational health services in Sweden contribute to work ability?

Occupational health service in Sweden is often described as an important and strategic resource to reduce work-related diseases, improve work ability and successfully assess improvement of the workplace. However, not much research has been done on how OHS contribute to reduced absence due to work-related illness or improvement of the work ability of employees. In our study, the ambition has been to describe how OHS can contribute and give effects in client companies. Fifteen companies considered to be good examples were selected in cooperation with the social partners. Semi-structured interviews were carried out with representatives of the company and OHS. The results show that efficient collaboration depend strongly on the relationship between the OHS and the company, and were highly correlated with a continuously dialogue and contact. Good occupational safety and health management at company level was a key factor for effective use of OHS. The strategic collaborations also often led to that OHSs contribution was gradually shifted from a reactive or medical focus to a more proactive approach. Several of the interviewed OHSs also held this strategy to work more with prevention, and focusing on "treating the organization", not the individual, leaving the executive measures to the company.     

Ergonomic evaluation in a values transportation company in Venezuela

The objective was to analyze the work activity and identify risk factors that could account for musculoskeletal disorders in the upper extremities, shoulder and neck of workers of a transport values company in Venezuela. The methods used were: collective interview, tasks observation, evaluation of posture with RULA method and evaluation of repetitive motions with the OCRA method. Five workstations were evaluated. Main problem perceived by workers was: exposure to chemical and biological hazards when handling paper money and coins; inadequate chairs and close supervision. The postures level risk was 1 or 2 for the RULA scale. Only two workstations showed ligth and medium risk level by OCRA method. Conclusion: The factors identified that could explain the musculoskeletal changes were: wrist repetitive flexion and extension, shoulder elevation, lifting weight above shoulder height, elbow repetitive flexion and extension, neck flexion, extended work journey, work overload, high responsibility and strict supervision by a video camera.     

Minor psychiatric disorders among nursing workers--is there an association with current or former night work?

We aimed at analyzing whether Minor Psychiatric Disorders (MPD) is associated to night work either currently or in the past. A cross-sectional study was conducted at three public hospitals in Brazil, with female nursing workers. Data collection (N=1,134) was based on a comprehensive questionnaire that included the self-reported questionnaire (SRQ-20) for screening of MPD. Former night workers were subdivided into three groups according to their reasons for leaving night work: (i) directly related to work, (ii) related to better reconcile with studies or another job, and (iii) related to health, sleep, fatigue or stress. Binomial logistic regression was performed, with adjustment for potential confounders. A dose response gradient was observed between current night work and MPD (OR=1.5; 95% CI: 1.1-2.2 and OR=2.1; 95%CI: 1.5-3.1 for those who worked up to five nights and six or more nights per 2-week span, respectively). Potential detrimental effects of night work were confirmed. The association between working at night and MPD was not restricted to current night workers as workers who left night work for health/fatigue/sleep/strain also showed higher chances of reporting MPD (OR=1.8;95%CI:1.14-2.90). Results contribute to the scientific debate on the impact of night work on health and wellbeing.     

Commentary on 'Managing the process of change in residential child care: A consultancy approach'

This paper draws on a ten month British study completed in April 2001 investigating service responses to women of South Asian background who had attempted suicide or who self-harmed. The scope of the study is briefly outlined and an analysis of perspectives documented in the study is presented, drawing on research interviews with 18 staff from a variety of health and social care disciplines and with seven survivors of attempted suicide/self-harm. The implications of this analysis for improving practice are considered. Attitudes surrounding attempted suicide and self-harm are discussed. The issue of ‘race anxiety’ is also discussed. The factors seen by workers as contributing to South Asian women's attempted suicide are considered, with a particular focus on the difficulties caused in the delivery of services by common-sense accounts of cultural issues. Current approaches to the delivery of services to South Asian women are identified and analysed, showing how their current organisation can lead to circularity in referral systems and consequent non-intentional neglect of the needs of this client group. It is urged that proper consideration be given to the support and professional supervision of staff in this complex area of work.     

An analysis of VDT monitor placement and daily hours of use for female bifocal users

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are correlated with hours of VDT work and that there appears to be a threshold at approximately five hours for pain symptoms among bifocal wearers. No such correlation can be made for monitor placement     

The effects of health and environment on exercise-class participation in older, urban women

This research investigated the effects of health and environmental factors on the dropout and intermittent nonattendance of an exercise program designed specifically for older, female, primary-care patients living in the inner city. Class-attendance records (n = 21,538) from a cohort 110 women were analyzed. Women who dropped out early had poorer perceived health and were more likely to report pain as an exercise barrier at baseline. Those who lived in a census tract where a larger percentage of workers walk to work were less likely to drop out early. Intermittent nonattendance was associated with adverse weather conditions including heat index above 90 degrees F, wind-chill index below 20 degrees F, overcast sky, and snow. Better attendance was associated with greater atmospheric pressure, as well as lower number of sunlight hours per day. This research highlights the need to better understand environmental barriers when promoting physical activities in older women.     

Ergonomic basket design to reduce cumulative trauma disorders in tea leaf plucking operation

Work related musculoskeletal disorders are seen as an indicating parameter of occupational stress among the women workers engaged in tea leaf plucking operation. The hand plucking (no mechanized plucking is practiced in Assam) being a highly repetitive task requires forceful exertions to reach to the distant periphery of the tea bushes and mechanical compression (pressing against hard surfaces). Specifically it aggravates with awkward positions adopted. The current research addresses to minimize the risk factors associated with CTDs and to ascertain the role of ergonomic design development in improving the situation. Women workforce engaged in tea industry in Assam suffer from back, shoulder, arm and finger pains. Workers perform the activity for 440 minutes in the entire shift with one hour lunch break in between in the garden itself. An ergonomic investigation aiming at studying the strain index of plucking operation in tea industry was conducted. While performing the operation workers were found to assume unnatural posture which is static as well as highly dynamic with a load (tea leaf collecting basket up to weight of 30 kg when filled with plucked leaves) at back. With gradual increment of load and pain though the load is released intermittently the strain level found to remain at a high level. The total QEC scores found for plucking activity was 110 out of 138. To improve the situation and to reduce the work related upper limb disorder (WRULD) an ergonomically designed basket was conceived and trial results showed improvements. The newly designed plucking basket fits the back curvature of the workers well, which keeps the basket in place unlike the existing round basket. The new basket is light in weight having more leaf capacity. Significant reduction in energy expenditure and MSDs suffered was observed while using improved basket over existing basket.     

Dual Relationships: The Challenges for Social Workers in Recovery

ABSTRACT

Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.