Work organization research at the National Institute for Occupational Safety and Health.

For 25 years, the National Institute for Occupational Safety and Health (NIOSH) has conducted and sponsored laboratory, field, and epidemiological studies that have helped define the role of work organization factors in occupational safety and health. Research has focused on the health effects of specific job conditions, occupational stressors in specific occupations, occupational differences in the incidence of stressors and stress-related disorders, and intervention strategies. NIOSH and the American Psychological Association have formalized the concept of occupational health psychology and developed a postdoctoral training program. The National Occupational Research Agenda recognizes organization of work as one of 21 national occupational safety and health research priority areas. Future research should focus on industries, occupations, and populations at special risk; the impact of work organization on overall health; the identification of healthy organization characteristics; and the development of intervention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecosystem health as a clinical rotation for senior students in Canadian veterinary schools

A research nurse interviewed 55 practice staff in 11 general practices to ascertain their views about their needs for occupational health care. In a second parallel study, a specialist in occupational medicine undertook an in-depth audit of occupational health provision in five other general practices with respect to the organization, the health and safety process, the services and the working environment. In the first study, the majority of practice staff reported the need for various aspects of occupational health care, particularly stress at work. In the second study, general practitioners and practice managers possessed a basic awareness of occupational health matters such as Health and Safety legislation, but their limited knowledge was not translated into effective management. General practice staff did not know where to obtain occupational health advice; most practices had no policies or procedures in place to manage health and safety. Both studies illustrate the need for expert occupational health advice in primary care.     

Introduction to the Special Section on Psychological and Behavioral Approaches to Occupational Health.

The history of the International Commission on Occupational Health is deeply bound to that of the 20th century. First and only international scientific society of such an importance, it was founded in 1906 to bring solutions to the problems caused by a great number of occupational injuries and diseases due to the developing of industry. With the passing years, from a small medical group it has become a multidisciplinary society, present in 90 countries, where researchers, government authorities, and practitioners are coexisting in a permanent exchange between practice and research. It is composed of international scientific committees, which organize regular conferences and meet every 3 years on the occasion of the great International Congress in Occupational Health. Owing to the changes due to the new technologies of work and to the globalization of economy, the orientation of its activities is in progress: larger opening toward developing countries and the phenomenon of development in general, emphasis on prevention in occupational health, and opening of a new field of research on the psychosocial factors and work organization. At the first conference on this theme, held in Copenhagen in August 1998, occupational health and occupational psychology specialists to meet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification and sequence analysis of Treponema pallidum tprJ, a member of a polymorphic multigene family

This study examines occupational health and safety provision from farmers' perspectives, to address the question 'Are farmers' health and safety needs being met?' Given that farmers encounter a variety of health and safety risks in the course of their daily work, and that available statistics clearly indicate they are a high risk group, a review of the literature suggests that this area has attracted little research attention. No study has critically examined the system of occupational health and safety provision for farmers and no attempts have been made to elicit farmers' perspectives on the subject. A telephone survey using a questionnaire divided into four sections, involving a random sample of 150 farmers from the counties of Cumbria, Cheshire and Cambridgeshire in England, found that farmers considered the system of occupational health and safety provision to be inadequate and that their occupational health and safety needs were not being met. Recommendations for improvements are made based on the results of the survey.     

Work and leisure: transcending the dichotomy

The contribution of a balance of work and leisure to health and a sense of well-being is a common sense assumption in everyday knowledge as well as in occupational therapy. The impact of the organization and balance of occupations in daily life on health, adaptation, life satisfaction, and a sense of well-being are central issues in occupational science. One of occupational science's potential contributions to society is the ability to provide understanding and insights that transcend common sense assumptions and everyday knowledge about occupations. This article will address, through a review of the literature, some of the limitations inherent in beliefs about a healthy balance of work and leisure. It will demonstrate how distinctions between work and leisure are culturally bound and perpetuate the assumption that they are dichotomous experiences. This dichotomy is shown to be a false one and must be transcended in order to explore the question of what is a healthy balance within daily life. This article concludes with considerations for occupational therapy research and practice that may arise from transcendence of the dichotomy of work and leisure.     

Managing the occupational environment of managed care

The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient's occupational performance and to designing and implementing an appropriate clinical intervention.     

Review of Occupational health psychology.

Reviews the book, Occupational health psychology edited by Stavroula Leka and Jonathon Houdmont (see record 2010-10988-000). Leka and Houdmont describe their book as the first textbook devoted to occupational health psychology intended for undergraduate instruction in the field. Leka and Houdmont have chosen an interesting strategy in creating an edited textbook with individual chapters written by established experts in the field. In doing so, they have in many cases gotten “the best” people in a particular area to write chapters in their area of expertise. Despite their reliance on multiple authors, the editors have maintained a consistent style throughout the volume—each chapter begins with a chapter outline and ends with a chapter summary. Textboxes throughout are used to highlight individuals prominent in the field (e.g., Tom Cox) or to highlight applications and research issues and to provide definitions of key terms. I would expect that students will appreciate such pedagogical features in addition to the depth of expertise that underlies each chapter. Although not divided into sections, one can intuit a structure to the book that begins with a broad perspective on occupational health psychology and then progressively adopts a narrower focus. When I first heard of this book, I was pleased at the prospect of being able to assign a single textbook that would offer a survey of occupational health psychology. Although the authors met their explicit goal of covering the core education curriculum defined by the European Academy of Occupational Health Psychology, I am not convinced that they have produced a “stand-alone” text that provides an adequate coverage of the field. In particular, issues of workplace safety are strikingly absent from the text. Personally, I would feel the need to supplement this text with specific readings on issues of occupational safety and occupational disease in order to cover the major topics that comprise the field of occupational health psychology. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Health and safety strategies in a changing Europe

This article presents a synthesis of some of the more significant findings from two recent surveys on working conditions and national strategies for their improvement in the European Union in the 1990s. As patterns and organization of employment have changed in the past decade, the consequences for health and safety present new challenges for legislators, the social partners, the regulatory agencies, and the specialists. These challenges are only partially met in most European member states. Because of the continued deregulation of employment, reduced public expenditure, and reduced trade union presence, the operation of strategies to implement a common framework of E.U. legislation is limited and often incomplete. This issue must be confronted if systems for promoting the well-being of people at work in Europe are to keep up with the rapidly changing nature of the risks that they face.     

The role of exhaustion and workarounds in predicting occupational injuries: A cross-lagged panel study of health care professionals.

Occupational injuries remain an important concern for employers, particularly in the health care industry where injury rates have increased despite decreases in other industries. Testing the notion of resource investment from conservation of resources theory, I predicted that exhaustion would be associated with a greater likelihood of safety workarounds (alternative work processes undertaken to “work around” a perceived block in work flow, such as a safety procedure). Furthermore, I hypothesized that safety workarounds would lead to a greater frequency and severity of occupational injuries. I found support for this mediation model with a 2-sample, 3-wave survey study of a variety of health care professionals (nurses, sonographers, and others). I discuss the implications of this research for future research in occupational safety and provide ideas for the reduction of injuries through action research strategies that reduce burnout and workarounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Karoshi--death from overwork: occupational health consequences of Japanese production management

There is considerable international interest in Japanese production management (JPM), known in the West as "lean production." Advocates of this new form of management argue that it improves both economic productivity and health. In Japan, however, the relationship between JPM and sudden death due to cardiovascular and cerebrovascular disease has been an important topic of debate since the 1970s. Japanese have named these types of deaths karoshi, which means "death from overwork." In North America and Western Europe a number of studies have demonstrated a significant relationship between high job strain (high production demands and low levels of control and social support) and cardiovascular disease. This article reviews the elements of JPM and examines their potential health consequences. The authors present an overview of karoshi, discuss its possible connections to specific ideological and organizational characteristics of JPM, and suggest the job strain mechanism as a possible pathway between karoshi and JPM. They conclude by discussing the need for comparative research that examines the health effects of work organization and management methods cross-culturally.     

Work Stress, Support, and Mental Health in Construction

Construction professionals are subjected to a plethora of occupational demands that can have a negative effect on their psychological wellbeing. Such demands can have an adverse influence on individual and organizational performance. To investigate the nature of self and social supports and mental health among construction professionals, an exploratory study was undertaken using the Stress and Mental Health Survey. The survey was distributed to construction professionals throughout Australia and 449 responses were received. Analysis revealed that those working for a contracting organization on-site reported higher levels of poor mental health and greater work stress than consultants. Those working on-site also experienced greater levels of self-stress, whereas consultants reported higher levels of self and work support. Work support was a significant predictor of poor mental health for consultants. Good health, however, was predicted by self, situational, and work support, whereas those working for a contractor only self-support predicated good mental health. It is concluded that while supports are essential in the fostering of good mental health, the absence of these supports can have a significant impact on poor mental health.     

A questionnaire study on improving occupational safety and health services provided by part-time industrial physicians

In order to evaluate factors improving part-time industrial physicians' services, a questionnaire study on occupational safety and health services was conducted on 237 part-time industrial physicians (PIPs) and 628 enterprises in Kochi. PIPs who received physician's fees visited enterprises and consulted with employees about their health conditions, communicated with employers and licensed occupational health supervisors (LOHSs) in enterprises more frequently than PIPs who did not receive physician's fees (p < 0.1-0.001). The rates of performing regular duties related on occupational safety and health, and PIPs' participations in health promotion programs and health consultations with employees among enterprises which paid physician's fees were significantly higher than those among enterprises which did not pay physician's fees (p < 0.05-0.001). Significantly higher rates of health consultation with employees and communications with employers and LOHSs, participation in occupational safety and health committees, recommendations of health promotion programs were found where physicians visited enterprises frequently(p < 0.1-0.01). Although no significant changes in PIPs' occupational safety and health services were observed for hazardous risk factors in enterprises, the rates of performing regular duties on occupational safety and health, and walk-through inspections by LOHSs and PIPs, estimating PIPs' advice and suggestions in enterprises with hazardous risk factors were significantly higher than those in enterprises without hazardous risk factors (p < 0.05-0.001). It is important for PIPs to have a written contract concerning physicians' fees and occupational safety and health services with enterprises and visit enterprises frequently in order to improve PIPs' occupational safety and health services and promote occupational safety and health programs in enterprises.     

Contrast-sensitivity testing with scanning-laser ophthalmoscope stimulation in normal, ocular hypertensive, and glaucomatous patients

This article reviews the history, growth, and evolution of managed care in mental health and substance abuse treatment. Specific issues described are stigma, the important social dimensions and chronicity of some types of mental illness and chemical dependency, and reliance on the public sector for care. Opportunities and challenges for occupational therapists in the rapidly changing mental health system are discussed, including the use of interdisciplinary teams, the importance of measuring functional outcomes of interventions, the need to develop clinical guidelines, the importance of the community setting and a continuum of services, ethical dilemmas, and the importance of assertive occupational therapy advocacy and involvement in health care reform.     

Correspondence of supervisor and subordinate perspectives during major organizational change.

Staff members (N?=?2,605) and supervisors (N?=?55) of 39 administrative units in 2 healthcare organizations completed a survey measuring confidence in the organization, engagement with their work, and occupational hazards. A correlational analysis determined correspondence between the perspectives of supervisors with those of staff reporting to them as their facilities adjusted to major organizational changes. Supervisors' scores were significantly and positively correlated with the corresponding scores of staff members on cynicism, meaningfulness, acceptance of change, goals, hospital reputation, and health risks. Regression analysis found that relationships were relatively domain specific: Supervisor engagement with work was positively related to that of their staff members, and supervisor evaluations of the organization were positively related to those of their staff members. Supervisor assessment of occupational hazards was related to all 3 areas of staff perception. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of third-party certification approaches using an occupational health and safety conformity-assessment model

The occupational health and safety conformity-assessment model presented in this article was developed (1) to analyze 22 public and private programs to determine the extent to which these programs use third parties in conformity-assessment determinations, and (2) to establish a framework to guide future policy developments related to the use of third parties in occupational health and safety conformity-assessment activities. The units of analysis for this study included select Occupational Safety and Health Administration programs and standards, International Organization for Standardization-based standards and guidelines, and standards and guidelines developed by nongovernmental bodies. The model is based on a 15-cell matrix that categorizes first-, second-, and third-party activities in terms of assessment, accreditation, and accreditation-recognition activities. The third-party component of the model has three categories: industrial hygiene/safety testing and sampling; product, equipment, and laboratory certification; and, occupational health and safety management system registration/certification. Using the model, 16 of the 22 programs were found to have a third-party component in their conformity-assessment structure. The analysis revealed that (1) the model provides a useful means to describe and analyze various third-party approaches, (2) the model needs modification to capture aspects of traditional governmental conformity-assessment/enforcement activities, and (3) several existing third-party conformity-assessment systems offer robust models that can guide future third-party policy formulation and implementation activities.     

Women's occupational health: a critical review and discussion of current issues

Action to improve women's occupational health has been slowed by a notion that women's jobs are safe and that any health problems identified among women workers can be attributed to unfitness for the job or unnecessary complaining. With increasing numbers of women in the labor force, the effects of work on women's health have recently started to interest health care providers, health and safety representatives and researchers. We begin our summary of their discoveries with a discussion of women's place in the workplace and its implications for occupational health, followed by a brief review of some gender-insensitive data-gathering techniques. We have then chosen to concentrate on the following four areas: methods and data collection; directing attention to women's occupational health problems; musculoskeletal disease; mental and emotional stress. We conclude by pointing out some neglected occupational groups and health issues.     

The politics of reproductive hazards in the workplace: class, gender, and the history of occupational lead exposure

Over the past two decades, several U.S. companies have sought to bar women from jobs that expose them to potential reproductive hazards, justifying these exclusionary policies by their professed concerns for the well-being of unborn children and potential liability. Although recent court cases have stimulated academic interest in this issue, a historical review of the public health and medical literature reveals that this debate is not new. To understand the logic behind the emergence of "fetal protection" policies, one must examine the scientific history of occupational teratogens and the socio-political and economic forces that have driven scientific research in this field. Using lead as an example, the author argues that research on the reproductive hazards of employment has historically emphasized the risks to women and downplayed the risks to men. This results in environmental health policies that do not uphold the ultimate goal of occupational safety for all workers, but rather reinforce the systemic segregation of men and women in the workplace. Although the political struggle over exclusionary policies has a feminist orientation, it also has important class dimensions and ultimately must be viewed within the broader context of American capitalist production.     

Microcirculation of the islets of Langerhans. Long Beach Veterans Administration Regional Medical Education Center Symposium

The passing of the Prevention of Occupational Hazards Act, (Ley 31/1995), constituted a change in direction in the development of occupational safety and health in Spain. This article describes the most salient points of this new legislation, from the criteria and principles that have to govern preventive activities, to the obligations and rights of both employers and workers, together with the co-operation and co-ordination of the activities of the various Administrations which have jurisdiction and the participation of employers' and workers' organisations, as the backbone of policy in matters concerning the prevention of occupational hazards.     

Disability and work: risk assessment

Recent parliamentary debate has brought the rights of disabled people back into the spotlight of media attention. In the workplace, the occupational health nurse (OHN) is uniquely placed to make a positive contribution to the achievement of equal opportunities for people with disabilities. The author describes a risk assessment approach to the occupational health and safety of disabled persons and their employers. Such approaches can help to ensure that the work skills of all employees are used to maximum potential.