American journal of industrial medicine最新文献

The construction has always been a large economic sector that is very hazarous to work in. Over the past 40 years there have been major improvements in safety and health practices driven by increased research and more rapid adoption of best practices, not just in the developed countries but also in emerging economices. This special issue aims to showcase a specturm of perspectives from research to practice, about the current state of construction safety and health.

The transfer of innovation to practice is one of the fundamental challenges of efficient social advancement. Because of its structure, with mostly small employers with limited working capital and short-term thinking arising from working on time-limited projects, historically the construction industry has been a slow adopter of technological advances. Now it is faced with a barrage of new technologies that not only can help solve some of the most pressing occupational safety and health needs but at the same time also contribute to productivity improvements. To address this, we-and others-have been finding ways to bring together tech start-ups and their innovations with construction companies who are willing to put them to use. We present four examples to illustrate how this can be accomplished and discuss the lessons we have learned in doing so.

Objective: This study examines the incidence of injuries among active component service members in Military Working Dog (MWD) handler occupations compared to three other active component occupational groups.

Methods: A retrospective cohort study was conducted with a total of 2,524,092 active component service members including, 3935 MWD handlers, 2025 veterinary personnel, 113,413 military police, and 2,404,719 all other active component service members (ACSM). Incidence rate and incident rate ratios of injuries were determined.

Results: MWD handlers had the second highest rates of injuries (14,194.42 injuries per 10,000 p-yrs.) with veterinary personnel having the highest rate of injuries (17,320.11 injuries per 10,000 p-yrs.). Military police (11,521.71 injuries per 10,000 p-yrs.) and other ACSM (11,708.60 injuries per 10,000 p-yrs.) had similar incidence rates. Risk for injury was highest among women and older service members.

Conclusion: This study is among the first investigations into MWD handlers' occupational health outcomes. These results suggest the importance of continued MWD handler health assessment.

Background: Housecleaning work has been characterized as precarious employment with unstable work hours, arbitrary and low pay and benefits, and exposures to chemical, physical, and psychosocial stressors. Understanding how interpersonal power dynamics between workers and clients, a component of precarious work, contributes to work exposures can inform and improve prevention programs.

Methods: We used reflexive thematic analysis of data from seven focus groups with Latinx immigrant housecleaners in New York City to explore workers' experience of interpersonal power dynamics with their clients-whom they referred to as their "employers"-and its influences on working conditions.

Results: Employer direction and monitoring varied and mostly reduced workers' autonomy to choose products, sometimes leading workers to complete tasks in more hazardous ways. Housecleaners reported using larger quantities of products, products with stronger scents, and more physical exertion to increase the efficiency of their cleaning, to complete tasks quickly, and to please their clients. Allotted time, tasks, and pay were interconnected, often resulting in negative reports about health and well-being. As immigrants, they also experienced discrimination and intimidation, which compounded their anxiety due to their employment insecurity. Nevertheless, participants learned and navigated high variance in employers' cleaning preferences and attempted to take control over the conduct of their work, when possible, and sometimes expressed self-advocacy.

Conclusions: Housecleaners' precarious employment arrangements affect how they navigate interpersonal relationships with employers, which impairs their working conditions and occupational exposures. Improvements in labor and social protections, such as designing supportive policies and training for workers and employers, are needed to improve working conditions.

Background: The fabrication and installation of artificial (engineered) stone countertops is a relatively new cause of silicosis. Our aim was to investigate silicosis rates in Victoria, Australia, and the association with stone countertop industry work.

Methods: Workers' compensation claims for silicosis from January 1, 1991 to December 31, 2022 were analyzed across 8-year time periods. Incidence rates per 100,000 persons were calculated by time period, age, and sex. Additionally, incident silicosis cases were reported to a clinical registry by respiratory physicians from May 1, 2019 to December 31, 2022, and analyzed by referral source and occupational history.

Results: Over 32 years, there were 536 workers' compensation claims for silicosis (98.9% male, median age 40 years). In total, 482 (89.9%) were received between 2015 and 2022, a 27-fold increase from the previous 8-year period. The incidence rate for silicosis claims in the adult population increased from 0.12 per 100,000 in 1991-1998 to 2.38 per 100,000 in 2015-2022. In the clinical registry there were 210 incident cases between 2019 and 2022; 97% worked in the countertop industry, 95% with artificial stone. Almost all (89%) cases had been referred following participation in a government screening program for stone countertop industry workers.

Conclusion: There has been a major rise in compensation claims for silicosis in Victoria. Active screening of stone countertop workers led to the diagnosis of almost all registered incident silicosis cases. This underscores the risk to stone countertop workers and highlights the potential for under-recognition of silicosis without screening at-risk workers, especially in countries where artificial stone has become popular.

Background: Precarious employment, a specific part of the conceptual spectrum of employment quality (EQ), has been established as an important risk to individual and population health and well-being when compared to a standard employment circumstance. There remains a need, however, to explore whether and how EQ might be used as a tool to not only protect but also advance population health and well-being.

Methods: The purposes of this scoping review were to assess the analytic treatment of the multiple dimensions of EQ and the stances researchers take to characterize the state of knowledge of EQ that supports the idea that better EQ is a health-promoting factor. Quantitative, qualitative, and mixed-methods primary studies that included at least three of the seven conceptually-informed EQ dimensions were eligible. Studies were assessed for EQ dimensions represented, how dimensions were treated analytically, the pathogenic, ambivalent, or salutogenic stances used by investigators, and what each might tell us about how to leverage aspects of better-quality employment to improve population health.

Results: A total of 78 studies were included; 54 of these treated EQ dimensions in an interrelated way. Of the analytically interrelated studies, none had an explicit salutogenic stance. Some evidence suggests that a handful of EQ types might present an equal or reduced risk of poor health than the standard employment relationship, frequently used as a historic gold standard.

Conclusion: Research with a salutogenic stance might build our understanding of whether and how employment could be used to advance our collective well-being.

Increased fatigue risk has been associated with safety-critical events such as work-related injuries. While control measures are needed to reduce these risks, the wide range and complexities of fatigue risk management strategies can make it difficult for organizations to prioritize efforts given limited resources and time. Given these challenges, the aims of this commentary are two-fold. The first is to conceptualize fatigue risk management strategies within the Total Worker Health (TWH) Hierarchy of Controls, a conceptual framework used to prioritize strategies to advance worker safety, health, and wellbeing. As an extension to the traditional Hierarchy of Controls, the TWH version presents strategies in order of effectiveness, ranging from "eliminate," "substitute," "redesign," "educate," and "encourage" categories. The second aim of this paper is to use the TWH Hierarchy of Controls to identify control measures which reflect the level of fatigue risk for adverse safety and health outcomes.

Background: The MATES in Construction suicide prevention program was adapted to the manufacturing sector and evaluated in a pilot of the program.

Methods: Ten manufacturing worksites were randomly assigned to intervention (5 sites) and wait-list control (5 sites) conditions in a two-arm cluster randomized design. 1245 workers responded at baseline (87% response rate) and 648 at final (35% response rate). Literacy of Suicide Scale (LOSS) was assessed as a process outcome, and help-seeking intentions as the primary outcome (General Help-Seeking Questionnaire [GHSQ] score). Secondary outcomes included help sought, suicidal thoughts and likelihood of suicide attempt scores, and Kessler-6 scores. Linear mixed models for repeated measures were used in intention-to-treat (ITT) and completer analyses.

Results: All sites finished the trial, with intervention periods ranging from 8 to 11 months; however, none of the five intervention sites fully implemented the intervention as planned. ITT analyses showed an improvement in LOSS scores within the intervention group (0.49, 95% CI 0.13-0.49), but the mean difference in change between intervention and control included the null (0.34, 95% CI -0.10 to 0.80). The primary outcome of GHSQ scores also improved within the intervention group, but the difference in change included the null (mean difference 1.52, 95% CI -0.69 to 3.74). No secondary outcomes improved relative to control in ITT or completers analyses. Exploratory analysis of disaggregated GHSQ help sources showed greater improvement in mean difference in change for the main MATES message of seeking help from MATES Connectors.

Conclusion: The intervention, as implemented, was not effective at achieving the primary or secondary outcomes.

Trial registration: Australian and New Zealand Clinical Trial Registry: ACTRN 12622000122752.