[Analysis of use of personal protective equipment among rural-to-urban migrant workers in small and medium enterprises in Zhongshan and Shenzhen, China].

OBJECTIVE: To investigate the current supply and use of personal protective equipment (PPE) among rural-to-urban migrant workers in small and medium enterprises (SMEs) in Zhongshan and Shenzhen, China and the influential factors for the use of PPE, and to provide a basis for better occupational health services and ensuring the health of migrant workers. METHODS: Multi-stage sampling was used to select 856 migrant workers from 27 SMEs in Zhongshan and Shenzhen, and face-to-face questionnaire survey was conducted in these subjects. Statistical analysis was performed by one-way analysis of variance, chi-square test, and logistic regression. RESULTS: Of all migrant workers, 38.67%were supplied with free PPE by the factory, and this rate varied across industries (furniture industry: 45.81%; electronic industry: 31.46%) and SMEs (medium enterprises: 42.13%; small enterprises: 39.20%; micro enterprises: 22.16%); 22.43% insisted on the use of PPE. The logistic regression analysis showed that factors associated with the use of PPE included sex, age, awareness of occupational health knowledge, and the size of enterprise. CONCLUSION: The rates of supply and use of PPE among migrant workers are low. The larger the enterprise, the better the supply of PPE. Male gender, being elder, and high occupational health knowledge score were favorable factors for the use of PPE, while small enterprise size was the unfavorable factor for the use of PPE.

Demonstrating high performance at an on-site corporate health center.

Employers need to control health costs while also keeping their workers healthy, productive and on the job. To those ends, BP America leased space to a full-service health and wellness center clinic on its Houston West-Lake campus, where rates of asthma, diabetes, coronary artery disease and other chronic conditions are high. Despite growing interest in worksite clinics, there is remarkably little quantifiable evidence demonstrating their value. This study uses a comprehensive value-chain approach to compare utilization, clinical outcomes and medical and pharmacy costs for medical center users and nonusers in Houston and other BP locations. Return on investment is also estimated. Overall utilization at the WestLake campus spiked in the 2012 plan year, pushing medical and pharmacy cost trends higher and highlighting the importance of shifting community-delivered services to the worksite medical center. Medical center users had fewer emergency room, inpatient hospital and outpatient hospital visits than nonusers as well as higher generic dispensing rates. While ROI fell slightly short of the break-even point in the medical center's first year based on an "intent to treat" methodology, indicators suggest that utilization and outcomes are moving in the desired direction.

[Evaluating regional system of occupational medical service organization].

The article covers analysis of regional occupational pathology service designed for primary medical and sanitary care for workers and specialized care in occupational pathology center. The authors proved cooperation between occupational pathology center and Occupational Pathology department of the Medical University to be optimal.

Health service use and health outcomes among international migrant workers compared with non-migrant workers: A systematic review and meta-analysis.

OBJECTIVES: The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers. METHODS: A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration. RESULTS: Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512). CONCLUSIONS: Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.

Physician, heal thyself: Survey of users of the Quebec Physicians Health Program.

OBJECTIVE: To document the opinions of the users of the Quebec Physicians Health Program (QPHP) about the services they received. DESIGN: Mailed questionnaire. SETTING: Quebec. PARTICIPANTS: A total of 126 physicians who used QPHP services between 1999 and 2004. MAIN OUTCOME MEASURES: Users' overall rating of the QPHP services, their opinions about the program, and whether their situations improved as a result of accessing QPHP services. RESULTS: Ninety-two of the 126 physicians surveyed returned their completed questionnaires, providing a response rate of 73%. Most respondents thought that the QPHP services were good or excellent (90%), most would use the program again (86%) or recommend it (96%), and most thought the Quebec physician associations and the Collège des médecins du Québec should continue funding the QPHP (97%). Most respondents thought the service confidentiality was excellent (84%), as was staff professionalism (82%), and 62% thought the quality of the services they were referred to was excellent. However, only 57% believed their situations had improved with the help of the QPHP. CONCLUSION: The QPHP received good marks from its users. Given the effects of physician burnout on patients and on the health care system, it is not only a personal problem, but also a collective problem. Thus, actions are needed not only to set up programs like the QPHP for those suffering from burnout, but also to prevent these types of problems. Because family physicians are likely to be the first ones consulted by their physician patients in distress, they play a key role in acknowledging these problems and referring those colleagues to the appropriate help programs when needed.

[Health promotion in enterprises counteracting the consequences of workforce ageing. How does it differ from interventions in other companies and what kind of barriers does it face?] / Promocja zdrowia w zakladach pracy przeciwdzialajacych skutkom starzenia sie personelu. Czym rózni sie od dzialan w innych firmach i jakie przeszkody napotyka?

BACKGROUND: The aim of the article is to address the question of whether companies implementing personnel's health promotion to counteract the consequences of workforce ageing differ in their health-related activities from enterprises not having such a motivation. The analyzed differences concern the frequency of implementing and evaluating selected health promotion interventions, assessing employees' health needs and expectations, managers' interest in population ageing, and other motives of health promotion implementation. Moreover, obstacles to health promotion in the context of ageing are analyzed. Directions of supporting enterprises in diminishing the consequences of this demographic process via health promotion are recommended. MATERIAL AND METHODS: Quantitative analysis: standardized computer-assisted personal interviews with representatives of management boards (October- November 2017). Sample: 940 companies from Poland implementing health promotion activities (including 424 organizations willing przedsiewzieto counteract the consequences of workforce ageing), selected from a representative sample of 1000 enterprises employing ≥50 people. Qualitative analysis: focus groups interviews (FGIs) with employers concerning their attitudes to managing personnel's health in the context of population ageing (March 2017). Sample: 64 respondents in 8 FGIs. RESULTS: Companies promoting employees' health to diminish the consequences of workforce ageing more often implement and evaluate most workplace health-related activities, and provide more reasons for promoting personnel's health. Their managers are more often interested in the issue of demographic changes, and they less frequently complain about the obstacles of health promotion implementation. Major obstacles are employers' reluctance or impossibility to pay for health promotion, low managers' awareness/know-how concerning health promotion, insufficient human and infrastructure resources, unfavorable employees' attitudes, and disadvantageous legal/fiscal issues. CONCLUSIONS: Companies' willingness to counteract implications of personnel's ageing is conducive to their engagement in health promotion. The dissemination/intensification of workplace health-oriented activities, which fosters minimizing the consequences of demographic changes, requires increasing employers' interest in the issue of population ageing and health promotion as a tool of coping with this problem, facilitating gaining the knowledge of workplace health promotion management by companies' representatives, and diminishing legislative/fiscal barriers to the implementation of workplace health-related activities. Med Pr. 2020;71(3):289-307.

Predictors of Japanese workers' motivation to use the results of worksite health checkups in their daily health management.

Japanese law stipulates that workers undergo worksite health checkups. If workers do not use their results of those checkups in their daily health management, the merit of this law will not be realized. Therefore, it is important to identify the predictors to improve their motivation to use the results of health checkups. We investigated those predictors by using a questionnaire survey. Multiple linear regression analysis was conducted for 1,791 subjects (1,530 males and 261 females) at a Japanese manufacturing plant. The average age of enrolled subjects was 42.0 years (standard deviation [S.D.], 13.4 years). The average age of male subjects was 42.3 (S.D., 13.8) years and that of the female subjects was 39.9 (S.D., 10.4) years. The results revealed that as workers advanced in age, they maintained their motivation more to use those results. Women maintained their motivation more than men. Workers who believe that their health depends on the influence from physicians and healthcare providers in hospitals felt motivated. Workers who realized the effectiveness of those checkups to maintain good health, who knew how to adopt an appropriate lifestyle, and who were given consultations with physicians when they received their health checkups, felt motivated. Regarding the healthcare organizations' and occupational health staffs' responsibilities, only detecting illness early is not sufficient. Those healthcare providers must value more primary prevention. Our findings can be applied to various occupational health activities, including health consultations, health education seminars, and providing appropriate instruction on how to interpret the results of the worksite health checkups.

[Work-related musculoskeletal disorders: appropriateness of the requests of clinical consultation in occupational medicine departments]. / Le patologie muscoloscheletriche lavoro-correlate: l'appropriatezza nell'invio dei pazienti a strutture di secondo livello.

BACKGROUND AND OBJECTIVES: The authors analyze the results of the clinical assessment of patients suffering from suspected work-related muscular-skeletal disorders (WMSDs), observed during the course of 2008 in the Department of Occupational Medicine of the Ospedali Riuniti hospital in Bergamo. The aim was to analyse the appropriateness of the requests of clinical consultation, comparing the cases sent by general practitioners and by occupational physicians. METHODS: We assessed 149 patients (mean age 47 years, DS 9.4; mean work seniority 29.5 years, DS 10.2), investigating 218 disorders in different muscular-skeletal segments. The majority of patients (63.7%) for whom a clinical consultation was requested were sent by general practitioners, 32.9% by occupational physicians, 3.4% by the National Insurance Institute for Occupational Accidents and Diseases (INAIL). The assessment was made in two steps: first a clinical and instrumental definition of the disorders, prescribing the necessary medical investigations were the diagnosis was not already clear; secondly a definition of the aetiology, requesting documentation about working conditions when this was not clear from the medical history, experience and literature, or making an inspection. RESULTS: A majority of the patients (40.2%) were employed in the construction industry. Regarding symptoms, 54.4% of the subjects reported low back pain, 74.5% upper limb disorders (some of the patients reported several problems in different segments). The clinical diagnosis was already clear at the first consultation for 62.8% of all cases; for the other 37.2% it was necessary to prescribe some instrumental examinations or specialistic (neurologic, physiatric, orthopaedic) medical examinations. We concluded for a diagnosis of WMSDs in 99 (45.4%) of the 218 cases (50% of the assessments requested by occupational physicians, 45.3% of the assessments requested by general practitioners). The most frequent reason for rejecting an occupational aetiology was the lack of correlation between type of disease and occupational exposure, both for patients referred by occupational physicians (58.1%) and by general practitioners (51.8%). DISCUSSION: The results demonstrated that the appropriateness requests for clinical consultation was identical for general practitioners and occupational physicians. All physicians showed a high degree of attention for the upper limb disorders, which is a topical subject of great epidemiological interest. General practitioners and occupational physicians need to take more advantage of the diagnostic support and clinical evaluations offered by Occupational Medicine Departments and Universities for WMSDs.

Worksite-based weight loss programs: a systematic review of recent literature.

OBJECTIVE: To update a previous systematic review on the effectiveness of worksite-based weight loss programs. DATA SOURCE: The following databases were searched: Medline, PsychlNFO, Embase, The Cochrane Library, and LexisNexis. STUDY INCLUSION AND EXCLUSION: Studies were limited to those published in English from 1995 to 2006 to which the following inclusion criteria were applied: (1) worksite intervention, (2) body weight assessed before and after intervention, and (3) study duration of at least 8 weeks. DATA EXTRACTION: Data were extracted on the following: study design; funding source; purpose of evaluation; participant and worksite characteristics; type, intensity and duration of intervention; primary and secondary outcomes; and methodological quality. DATA SYNTHESIS: Heterogeneity of study designs precluded quantitative data synthesis. Results. We identified 11 randomized controlled trials, most of which focused on education and counseling to improve diet and increase physical activity. Follow-up ranged from 2 to 18 months, with 56% to 100% of subjects completing the studies. The overall methodological quality of the studies was poor. Intervention groups lost significantly more weight than controls, with the mean difference in weight loss ranging from -0.2 to -6.4 kg. CONCLUSION: Worksite-based weight loss programs can result in modest short improvements in body weight; however, long-term data on health and economic outcomes are lacking. So What? There is a need for rigorous controlled studies of worksite-based interventions that integrate educational, behavioral, environmental, and economic supports.

The Impact of Worksite Clinics on Teacher Health Care Utilization and Cost, Self-Reported Health Status, and Student Academic Achievement Growth in a Public School District.

OBJECTIVE: The aim of this study was to examine the impact of worksite clinics on health care utilization and cost, self-reported health status, and student achievement growth in a public school district. METHODS: We used insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007 to 2015. A difference-in-differences approach was applied to measure the impact of worksite clinics. RESULTS: Compared with using a community-based clinic as the usual source of primary care, using a worksite clinic was associated with significantly lower inpatient admissions (53 vs 31 per 1000 teacher years), annual health care cost ($5043 vs $4298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs 61). No significant differences were detected in self-reported health status or student achievement growth. CONCLUSION: Worksite clinics reduce teacher health care cost and absenteeism.

Do Working Conditions of Patients in Psychotherapeutic Consultation in the Workplace Differ from Those in Outpatient Care? Results from an Observational Study.

In previous studies, it was found that patients treated at a psychosomatic outpatient clinic (PSOC) for common mental disorders showed more severe symptoms than those who used a psychotherapeutic consultation service at the workplace (PSIW). This study examines whether the higher symptom severity of the PSOC patients in comparison to their PSIW counterparts is also related to higher levels of occupational stress as measured by the demand-control-support model (DCS). N = 253 participants (PSIW n = 100; PSOC n = 153) provided self-reported data on demands, decision latitude, social support, and health before consultation. The association between mental health care setting, symptom level and demands, decision latitude, and social support was assessed by means of a path model. Results of the path model indicated that the higher level of depression in PSOC patients was related to higher levels of demands and lower levels of social support. Demands and social support were found to be indirectly associated with treatment setting. No interaction effect between demands, decision latitude, social support, and depression was found. Results of this study reveal that the working conditions influenced the pathway to care process via symptom severity.

Basic Occupational Health Services for Agricultural Workers in the South of Iran.

The agricultural sector has by far the world's largest labour force, there are more than one billion workers in this industry worldwide, which contains half of the total world labour force. On the other hand, agriculture is one of the most hazardous occupations, and many workers suffer occupational accidents and ill health each year. Farming and animal breeding are associated with exposure to a wide variety of risk factors, including zoonotic agents, dust, elements of the thermal environment, noise, vibration and chemicals. Although half of the world's population are economically active and spend at least one third of their time in the workplace, only 15% of the workers have access to basic occupational health services. According to a WHO report, Iran has a well-structured health care system through which basic health care services are available to the entire population, and health indicators in Iran have consistently improved. The agricultural health program in Iran is being carried out in the cities and rural areas, and occupational health services are mainly integrated into the health network. This paper aims to describe the health care system and basic occupational health services (BOHs) available to 5,300 agricultural enterprises with 8,380 employees in the cities of Abadan, Khorramshahr and Shadegan in the Abadan region (Abadan, Khoramshahr and Shadegan districts), in the south of Iran.

Emerging aspects of psychosocial risks: violence and harassment at work.

In the last twenty years, psychosocial risks have become crucial in Occupational Health. Particularly, there is an increasing interest about psychological and physical violence at the workplaces. Psychological violence (mobbing or workplace bullying) is described as a situation in which the person has been the victim of negative acts directed to the person and work, with offences, discriminations and isolation. Physical violence at work, still underestimated in many parts of the world, is becoming a topical subject both for its frequency and its pathogenic potential and consist of violence among workers (internal violence) and between workers and external persons (external violence). Examples of external violence are bank robberies, which are prevalent in many European countries, particulary in Italy. The costs of psychological and physical workplace violence are very high at all levels; individual, for the implication of violence for health and quality of life as well as organizational, for the increase of absenteeism, turnover and health care demands and claims. The Medical Centre for Occupational Stress and Harassment (CDL) of the "Clinica de Lavoro Luigi Devoto" was set up in 1996 with a day-hospital service for the diagnosis, rehabilitation and prevention of work related psychological diseases. From its opening, about 5000 patients have been examined.

Health and Stress Management and Mental-health Disability Claims.

This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd.

[Human resources and activities in the occupational medicine service of Poland in 2003]. / Kadry i dzialalnosc sluzby medycyny pracy w Polsce w 2003 r.

BACKGROUND: The presented paper shows the most essential data concerning the state of human resources and activities of occupational medicine services in Poland in 2003. MATERIALS AND METHODS: The reports (around 10 000) obtained from primary occupational medicine service units and regional occupational medicine centers (forms: MZ-35A and MZ-35) are the source of information about human resources and occupational medicine services activities. RESULTS: A majority of regional centers, due to their restructuring, have approached the legal and organizational model described in the Occupational Medicine Service Act. The assessment of activities of primary occupational medicine centres units, performed by regional occupational medicine centers, indicates the need for constant training of physicians authorized to perform prophylactic examinations of employees. CONCLUSIONS: The year 2003 did not witness any new significant changes in the structure of occupational medicine service. One can speak rather about the continuation of trends observed in previous years.

Early warnings: health care preparedness.

As nurses, we represent the backbone of the health care system. It is essential that we have a core understanding of infectious disease emergencies and begin to use the strengths that characterize nursing. These strengths include the ability to evaluate situations and use evidence on which to base our actions. Early identification of an infectious disease emergency is one example of using nursing skills to strengthen emergency preparedness. During an infectious disease emergency, nurses certainly will bear the burden of patient management. Because of this, the need for infectious disease emergency preparedness has become a national priority and a moral imperative for all nurses. One topic necessary for ED and OH nurses' preparedness has been discussed in this article, but nurses must take the initiative to learn more about disaster preparedness and incorporate these skills into everyday practice.

The effect of Employee Assistance Programs use on healthcare utilization.

OBJECTIVE: To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. DATA SOURCES: A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. STUDY DESIGN: Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare resources and the EAP, we perform our analyses in two steps. First, for those employees who visited the EAP, we test whether post-EAP claims differ from pre-EAP claims. Second, we combine claims data of individuals who went to an EAP with those of individuals who did not use an EAP to test whether differences in utilization exist between EAP users and nonusers. DATA COLLECTION METHODS: From the EAP we obtained the date of first EAP contact for all employees who used the service, and from the company's human resources department we obtained limited demographic data on all employees. We obtained healthcare utilization claims data on all employees and their dependents from the company's two healthcare plans: a fee-for-service (FFS) plan and a health maintenance organization (HMO) plan. PRINCIPAL FINDINGS: We found that going to an EAP substantially increases both the probability of an alcohol, drug abuse, or mental health (ADM) claim and the number of ADM claims in the same quarter as EAP contact. The increased probability of an ADM claim persists for approximately 11 quarters after the initial contact, while the increased ADM charges persist for approximately six quarters after the initial EAP contact. CONCLUSIONS: Our results strongly suggest that the EAP is able to identify behavioral and other health problems that may affect workplace performance and prompt EAP users to access ADM and other healthcare. Consistent with the stated goals of many EAPs, including the one examined in this study, this process should improve individuals' health, family functioning, and workplace performance.