American journal of industrial medicine最新文献

Background

This review synthesizes evidence from etiologic and intervention studies of workplace-related determinants of mental health in workers in food and bar workers in the hospitality industry in Western high-income countries.

Methods

Peer-reviewed literature published between January 2000 and August 2023 was gathered from five bibliographic databases. Any study design was eligible. Study quality was assessed using the Joanna Briggs Institute tools for appraisal.

Results

A narrative analysis was conducted for 26 included studies (total n = 15,069 participants) across Australia (3), Ireland (1), Norway (1), Spain (2), the United States (17) and the United Kingdom (2).

Individual and task-related factors such as high emotional job demands and low job control were associated with high burnout and depression. Uncivil and hostile interpersonal interactions with customers, management, and colleagues were found to contribute to poor mental health outcomes, including depression, anxiety, and burnout.

Conclusion

Findings from included studies highlight the impact of workplace culture, including management practices and workplace social support, on mental health. Organization-level interventions may therefore be most effective for addressing individual, interpersonal, and organizational determinants of mental health in food and bar occupations, particularly when implemented as part of broader organizational efforts to support health and wellbeing. Industry-wide policy changes may also be necessary to address structural concerns, including job and financial insecurity, job strain and access to benefits, such as secure sick leave and minimum contract hours.

Background

The US Department of Labor (DOL) does not fund diffusing capacity (D_LCO) or metabolic measurements from cardiopulmonary exercise testing (CPET) for coal miners' disability evaluations. Although exercise arterial blood gas testing is covered, many miners are unable to perform maximal tests, and sampling at peak exercise can be challenging. We explored the relationship between resting D_LCO, radiographic disease severity, and CPET abnormalities in former US coal miners.

Methods

We analyzed data from miners evaluated between 2005 and 2015. Multivariable linear and logistic regression analyses were used to examine relationships between percent predicted (pp) forced expiratory volume in 1 s (FEV₁pp), D_LCOpp, VO₂maxpp, A-a oxygen gradient (A-a)pp, dead space fraction (Vd/Vt), disabling oxygen tension (PO₂), and radiographic findings of pneumoconiosis.

Results

Data from 2015 male coal miners was analyzed. Mean tenure was 28 years (SD 8.6). Thirty-twopercent had an abnormal A-a gradient (>150 pp), 20% had elevated Vd/Vt (>0.33), and 34% a VO₂max < 60 pp. D_LCOpp strongly predicted a disabling PO₂, with an odds ratio (OR) of 2.33 [2.09−2.60], compared to 1.18 [1.08−1.29] for FEV₁. Each increase in subcategory of small opacity (simple) pneumoconiosis increased the odds of a disabling PO₂ by 42% [1.29−1.57], controlling for age, body mass index, pack-years of tobacco smoke exposure, and years of coal mine employment.

Conclusions

D_LCO is the best resting pulmonary function test predictor of CPET abnormalities. Radiographic severity of pneumoconiosis was also associated with CPET abnormalities. These findings support funding D_LCO testing for impairment and suggest the term “small opacity” should replace “simple” pneumoconiosis to reflect significant associations with impairment.

Background

Drug mortality risks vary among industries, creating distinctive geographic patterns across US counties. However, less is known about how local labor market structure relates to drug overdose mortality amid the synthetic opioid era in the United States. This study investigates the relationship between industry-specific job composition and drug overdose mortality at the county level while exploring how fentanyl's presence in illicit drug supplies may moderate the relationship.

Methods

Data were derived from the National Center for Health Statistics' Multiple Cause of Death files for the rates of drug overdose mortality of any intent, linked with four other sources on industry-specific job shares, drug supply, and county-level sociodemographic characteristics and opioid prescribing rates from the US Census Bureau, the CDC, and the Drug Enforcement Administration. Negative binomial regression models were employed to examine associations between county industry-specific job composition and drug overdose mortality, with tests for moderating effects of state-level fentanyl seizure rates.

Results

Our models indicate negative associations between job shares of manufacturing, retail trade, and educational services industries and drug overdose mortality. Positive associations were found for arts/entertainment/recreation and public administration. State-level fentanyl seizure rates had moderating effects on administrative/support/waste management/remediation (A/S/WM/R) and educational services.

Conclusion

Counties with a higher concentration of arts/entertainment/recreation and public administration jobs need targeted efforts to mitigate drug-related overdose risks. Additionally, areas with higher concentrations of A/S/WM/R service jobs, particularly where fentanyl seizure rates are higher, may require proactive harm reduction strategies for reducing overdose risks.

Introduction

Worker trust in employer-provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office.

Methods

Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short-answer qualitative data.

Results

Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0-3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0–20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests.

Conclusion

Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well-being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended.

Background

Knee osteoarthritis (OA) has been quite consistently associated with high physical workload and specific physical factors at work, while for hip OA, fewer studies are available, which still indicate possible associations with heavy lifting and physical workload. The objective of the study was to assess the association between exposure to workplace physical factors and incidence of knee and hip arthroplasty, as markers of severe OA in these joints.

Methods

The study population was composed of employees 25–60 years who participated in the Turin 2011 census. For each job held since 1995, exposure to physical factors was assigned to individuals in the cohort through a Job-Exposure Matrix constructed from the Italian O*NET database. Using Poisson regression models, the incidence of knee and hip arthroplasty for OA, identified through hospitalizations from 2012 to 2018, was examined in relation to cumulative exposure to 7 different physical hazards and a composite indicator of physical workload constructed from 17 physical factors (Ergo-Index).

Results

The risk of knee OA was significantly increased in the highest cumulative exposure quartile of physical workload (incidence rate ratio = 1.98, 95% confidence interval: 1.24–3.16) and of all single hazards examined, compared to the lowest quartile, with significant trends in risk with increasing exposure. In contrast, no association was found with hip OA, whose relative risks were close to or below one in all higher-exposure quartiles of physical workload and of each single hazard.

Conclusions

Our results indicate that exposure to physical hazards at work increases the likelihood of developing knee OA, but not hip OA.

Objectives

Traumatic injury surveillance can be enhanced by describing injury severity trends. This study reports trends in work-related injury severity for males and females over the period 2004–2017 in Ontario, Canada.

Methods

A weighted measure of workers' compensation benefit expenditures was used to define injury severity, obtained from the linkage of workers' compensation claims to emergency department (ED) records where the main injury or illness was attributed to work. Denominator counts were obtained from Statistics Canada's Labor Force Survey. Trends in the annual incidence of injury, classified as low, moderate, or high severity, were examined using regression modeling, stratified by age and sex.

Results

Over a 14-year observation period, there were 1,636,866 ED records included in the analyses. Overall, 57.6% of occupational injury records were classified as low severity, 29.5% as moderate severity, and 12.8% as high severity conditions. There was an increase in the incidence of high severity injuries among females (annual percent change (APC): 1.52%; 95% CI: 0.77, 2.28), while the incidence of low and moderate severity injuries generally declined for males and females. Among females, injuries attributed to animate mechanical forces and assault increased as causes of low, moderate, and high severity injuries. The incidence of concussion increased for both males (APC: 10.51%; 95% CI: 8.18, 12.88) and females (APC: 16.37%; 95% CI: 13.37, 19.45).

Conclusion

The incidence of severe work-related injuries increased among females in Ontario between 2004 and 2017. The methods applied in this surveillance study of traumatic injury severity are plausibly generalizable to applications in other jurisdictions.

Background

Hospital patient-care workers have high occupational injury rates. While physical hazards within hospital work environments are established determinants of injury, social exposures may also contribute. This study examined how reports of unfair treatment at work, a dimension of work-related experiences of discrimination, were associated with injury among hospital-based patient-care workers.

Methods

We used data from the Boston Hospital Workers Health Study, a longitudinal cohort of nurses and nursing assistants at two Boston-area hospitals. In 2018, we conducted a worker survey asking about three types of unfair treatment at work and occupational injuries during the past year. We used mixed-effects logistic regression models to evaluate associations between specific types, total load, and high-frequency exposure of unfair treatment with injury, adjusting for age, gender, race and ethnicity, job title, and unit type.

Results

Among 1001 respondents, 21% reported being humiliated in front of others at work, 28% reported being watched more closely than other workers, and 47% reported having to work twice as hard as others for the same treatment. For each type of unfair treatment, we observed a monotonic relationship with occupational injury wherein increasing frequency of exposure was associated with increased odds of injury. We also observed monotonic relationships between total load and high-frequency exposure to unfair treatment and odds of injury.

Conclusions

Work-related unfair treatment is associated with injury among hospital workers. Programs and policies that focus on preventing unfair treatment may lessen injury burden in hospital workers.