American journal of industrial medicine最新文献

Background: U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.

Methods: A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.

Results: Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.

Conclusion: This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

Previously published analyses of suicide case investigations suggest that work or working conditions contribute to 10%–13% of suicide deaths. Yet, the way in which work may increase suicide risk is an underdeveloped area of epidemiologic research. In this Commentary, we propose a definition of work-related suicide from an occupational health and safety perspective, and review the case investigation-based and epidemiologic evidence on work-related causes of suicide. We identified six broad categories of potential work-related causes of suicide, which are: (1) workplace chemical, physical, and psychosocial exposures; (2) exposure to trauma on the job; (3) access to means of suicide through work; (4) exposure to high-stigma work environments; (5) exposure to normative environments promoting extreme orientation to work; and (6) adverse experiences arising from work-related injury or illness. We summarise current evidence in a schema of potential work-related causes that can also be applied in workplace risk assessment and suicide case investigations. There are numerous implications of these findings for policy and practice. Various principle- and evidence-based workplace intervention strategies for suicide prevention exist, some of which have been shown to improve suicide-prevention literacy, reduce stigma, enhance helping behaviours, and in some instances maybe even reduce suicide rates. Prevailing practice in workplace suicide prevention, however, overly emphasises individual- and illness-directed interventions, with little attention directed to addressing the working conditions that may increase suicide risk. We conclude that a stronger emphasis on improving working conditions will be required for workplace suicide prevention to reach its full preventive potential.

Background: The construction industry in India heavily relies on unorganized workers, who often lack adequate access to safety measures, placing them at significant risk of accidents and injuries. The objective was to determine risk perceptions of construction workers, and explore their safety practices, facilitators, and barriers.

Methods: A mixed-methods approach with a convergent parallel design (QUAN + qual) was undertaken. Quantitative strand included face-to-face interviews with 203 randomly selected building construction workers from 10 construction sites in five selected municipal wards in Kolkata. Questions pertained to socio-demographics, occupational characteristics, risk perception, and safety practices. The qualitative arm involved key informant interviews to unravel the facilitators and barriers affecting safety practices and nonparticipant observation.

Results: The perceived risk for respiratory problems due to dust, pain from carrying loads, slips, trips or falls, and heat-related illnesses was in the medium- to high category for 64.0%, 58.6%, 39.9%, and 36.5% of the study participants, respectively. However, the safety practices for these respective domains were in the good practice category for 6.9%, 4.9%, 54.2%, and 34.5% of the workers. From the qualitative arm, it was evident that availability of PPE, a conducive environment, and availability of worker-friendly technology could be important predictors of safety practices. Barriers such as time constraints and feasibility due to discomfort and expenditure were also identified.

Conclusion: Despite high-risk perception, safety practices were not consistently good among construction workers. Further research is crucial to enhance the health and safety of unorganized workers in India.