The Journal of the Society of Occupational Medicine最新文献

Behavioural studies were conducted on a random sample of 38 glass bangle workers engaged in various occupations and exposed to high ambient temperature (38.2 +/- 3.4 degrees C) and radiant heat (46.2 +/- 5.1 degrees C) during their work in the glass bangle industries at Firozabad, India. Twenty-two control subjects of similar age and socio-economic status unexposed to heat during their work were also studied for comparison. The digit span test, digit symbol test, Bourdon-Wiersma vigilance test, flicker fusion test and Maudsley personality inventory (MPI) were used to assess the behavioural changes induced by the existing heat stress. The mean scores of immediate memory were much lower in the exposed population than in the controls thereby indicating impairment of immediate memory in the study group. The visuo-motor coordination and vigilance were also significantly affected. Visual perception showed a downward trend among the glass bangle workers, although the MPI test indicated no personality changes.

When looking for facts, fallacies and uncertainties of the use of biological exposure limits one has at first to discuss the general principles of biological monitoring (BM) and biological effect monitoring (BEM) because they determine the validity of the data that underpin the biological exposure limits. A difference between countries in preferred BM-methods can be observed. The terminology is still confusing: in addition to BM and BEM, biomonitoring and biological markers also are used. There are a number of problems in respect of the inter- and intra-individual variability in internal exposure and effect at similar exposure levels due to differences in for example, physical workload, body composition and genetics. Toxicokinetic models based on data from individual workers should be developed in order to get information on the variability and the cause of this. Both kinetics and dynamics may be sex-dependent. To date, BM methods have been tentatively suggested for only about 10 per cent of the regulated industrial chemicals. BM and BEM programmes yield important extra information on exposure and health risk, not to be gained by environmental monitoring alone.

Identification of accurate source lists for workplace health service research is problematic. Using the national list of health professionals registered to dispense medicines at 981 worksites in South Africa, a third of questionnaires were undelivered. A 33 per cent response rate was obtained to delivered questionnaires. Non-responders appeared to lack the information required. Although the number of employees at a worksite may influence sickness absenteeism, it does not appear to affect the absolute cost per employee nor the relative expenditure on different categories of costs incurred by worksite health services. Expenditure on staff and consumables accounts for nearly 80 per cent of worksite health service costs, regardless of workforce size. In 1988, the average cost of registered workforce health services at which medicines were dispensed and information was available, was R125 (35 pounds) per employee per year. Establishing standards and applying them to intra and inter industrial economic evaluation of workforce health services using sickness absenteeism and percentage breakdown of costs appears feasible in South African industries with both large and small workforces, provided that health professionals have access to adequate management information systems.

The study describes the demographic details and smear results of women attending a Well Woman Clinic in an Occupational Health setting over a two year period. The clinic is located close to the place of work, run during working hours, and operated by a doctor and nurse. Charging fees acceptable to women attending or their employers, the service has made a modest profit and offers scope for increasing the income against fixed costs. The age range attending is older than commonly found at screening clinics. The abnormal smear detection rate, 115 per 1000 is high while the proportion of inadequate results at 50 per 1000 compares favourably with other clinics. In an area with 13 per cent Asian population, only 5 per cent of attenders were Asian but of these one fifth had abnormal smears. A cervical cytology screening facility timed and located for the convenience of the working woman is found to attract a group of women in the older age range who have a high abnormal smear rate, and those who fail to attend elsewhere.

A cross-sectional comparative study was carried out in two chemical manufacturing plants in order to ascertain the effect of an occupational physiotherapy service on absence attributed to sickness. There was no overall effect on total sickness absence rates in this study, but a possible reduction in short-term sickness absence was noted. Changes in management attitudes to absence attributed to sickness at the comparison site caused a significant reduction in short-term absences. It is concluded that physiotherapy in an occupational setting has little effect on sickness absence compared to management attitudes, but the unquantifiable benefits, such as increased employee mobility, better industrial relations and employee morale may be significant benefits, worthy of further study.