Acculturation, Work-Related Stressors, and Respective Coping Strategies among Male Indonesian Migrant Workers in the Manufacturing Industry in Taiwan: A Post-COVID Investigation.

Globalization has prompted cross-cultural migration in search of employment opportunities, and poor adaptation during acculturation is widely known to cause additional psychosocial stress. Hence, the objective of this study was to investigate migrant workers' perceptions of acculturation, identify work-related stressors, and understand the respective coping strategies among male Indonesians in the manufacturing industry, particularly during the COVID-19 pandemic. Fifteen workers were recruited and interviewed on their acculturation experiences. We found that the workers were susceptible to forced adaptation to stressful conditions relating to work organization, economic distress, interaction with the manpower agencies, language barriers, and so on. During the pandemic, workers experienced overload, economic hardship, suspended home visits, isolation, discrimination, and fear of cluster infection in the crowded dormitory. We also found that workers were able to adopt coping strategies by capitalizing on resources at the individual, institutional, and governmental policy levels to actively solve problems, increase emotional support, and fortify self-appraisals. The identified coping strategies could inform policy development to assist with positive adaptation and promote the well-being of the migrant worker population.

Respiratory health effects of the fiberglass-reinforced plastic lamination process in the yacht-building industry.

Objectives Fiberglass-reinforced plastics (FRP) manufacturing has been related to cases of severe airway obstruction and elevated risk of respiratory mortality. But the specific job content risk is not clear. This study evaluated the respiratory health effects of the FRP lamination process. Methods A questionnaire was used to evaluate respiratory symptoms of workers in two yacht-building plants. Pre-shift (07:30-08:30 hours) and post-shift (17:00-18:00 hours) lung function was measured, while post-shift induced sputum was collected on the first day of the week. The participants were grouped into FRP laminators and non-laminators. Linear and logistic regression was used to investigate the effects of the lamination process on lung function. Results Laminators had a higher prevalence of chronic cough, lower pre-shift forced expiratory volume in first second (FEV1) and FEV1/force vital capacity (FVC) (-3.3% and -1.5%), lower post-shift FVC and FEV1 (-3.6% and -4.9%), and larger post-shift reduction of FVC (-2.1%) compared to non-laminators. The laminators also had higher risk of early obstructive and overall (obstructive plus restrictive) lung function impairment, and post-shift reduction of FVC >10% [odds ratio (OR) 5.98, 4.98, and 3.87, respectively). They also had higher percentages of neutrophils and lymphocytes in the induced sputum. Conclusion Laminators should undergo regular check-ups of respiratory symptoms and lung function. Further toxicologic studies are warranted to identify the specific causal agent in the FRP lamination process.

Development of the Nurses' Occupational Stressor Scale.

Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses' Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses' stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses' work environments. Nine subscales were included: (1) work demands, (2) work-family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach's α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.

Patient-Nurse Ratio is Related to Nurses' Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction.

In healthcare settings, nurses' workload, burnout, and job satisfaction are associated to the patient-nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient-nurse ratio on nurses' intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient-nurse ratio (ADPNR), nurses' personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient-nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.

Psychological Work Environment and Suicidal Ideation Among Nurses in Taiwan.

PURPOSE: Nurses are exposed to a poor psychological work environment; this may cause poor mental health, which is a risk factor for suicidal ideation. We investigated the association between psychological work environment and suicidal ideation among hospital nurses in Taiwan. DESIGN: We conducted a cross-sectional survey in Taiwan female nurses using stratified sampling by region (north, central, south, and east) to select representative centers for this study. METHODS: A self-report questionnaire including items on demographic data, the psychological work environment, and suicidal ideation was sent to nurses working in hospitals. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of the psychological work environment on suicidal ideation. FINDINGS: A total of 2,734 eligible questionnaires (76.8%) were returned. The prevalence of suicidal ideation was 18.3%, and higher risk was found to be associated with the educational level of junior college or below, higher personal burnout, higher client-related burnout, and always feeling stressed at work. Estimation of population attributable risk showed that higher personal burnout, client-related burnout, and always feeling stressed at work were the most crucial factors among nurses, accounting for 19.4%, 8.6%, and 10.5% of suicidal ideation, respectively. CONCLUSIONS: A considerable proportion of nurses developed suicidal ideation. A poor psychological work environment was a relevant factor for suicidal ideation. CLINICAL EVIDENCE: This study provides relevant knowledge for nursing management levels in preventing the development of suicidal ideation among nurses. Not only for nurses' mental health, but for patient safety and care quality, further studies in improving nurses' psychological work environment are warranted.

Effect of nanoparticles exposure on fractional exhaled nitric oxide (FENO) in workers exposed to nanomaterials.

Fractional exhaled nitric oxide (FENO) measurement is a useful diagnostic test of airway inflammation. However, there have been few studies of FENO in workers exposed to nanomaterials. The purpose of this study was to examine the effect of nanoparticle (NP) exposure on FENO and to assess whether the FENO is increased in workers exposed to nanomaterials (NM). In this study, both exposed workers and non-exposed controls were recruited from NM handling plants in Taiwan. A total of 437 subjects (exposed group = 241, non-exposed group = 196) completed the FENO and spirometric measurements from 2009-2011. The authors used a control-banding (CB) matrix to categorize the risk level of each participant. In a multivariate linear regression analysis, this study found a significant association between risk level 2 of NP exposure and FENO. Furthermore, asthma, allergic rhinitis, peak expiratory flow rate (PEFR), and NF-κB were also significantly associated with FENO. When the multivariate logistic regression model was adjusted for confounders, nano-TiO2 in all of the NM exposed categories had a significantly increased risk in FENO > 35 ppb. This study found associations between the risk level of NP exposure and FENO (particularly noteworthy for Nano-TiO2). Monitoring FENO in the lung could open up a window into the role nitric oxide (NO) may play in pathogenesis.

Six-month follow-up study of health markers of nanomaterials among workers handling engineered nanomaterials.

The aim of this study was to identify the health hazards and possible exposure surveillance markers of workers exposed to nanoparticles during manufacturing and application in comparison to a group of unexposed workers. For this longitudinal study, we recruited 158 nanomaterial-handling workers and 104 non-exposed workers from 14 manufacturing plants in Taiwan (baseline). Among them, 124 nanomaterial-handling workers and 77 unexposed workers were monitored 6 months later. We investigated pulmonary and cardiovascular disease markers, inflammation and oxidative stress markers, antioxidant enzymes and genotoxicity markers. Antioxidant enzymes (superoxide dismutase, glutathione peroxidase) and cardiovascular markers (vascular cell adhesion molecule, paraoxonase) were significantly associated with nanomaterial-handling during the 6-month follow-up period. In addition, the small airway damage marker (Clara cell protein 16) and lung function test parameters were also significantly associated with handling nanomaterials. The study markers and lung function tests are possible markers that could be useful for surveillance of nanomaterial-handling workers.

Life-expectancy estimations and the determinants of survival after 15 years of follow-up for 81 249 workers with permanent occupational disabilities.

OBJECTIVES: This study attempts to estimate life expectancy and explore the determinants of survival for workers with permanent occupational disabilities. METHODS: A database on permanent occupational disabilities occurring between 1986 and 2000 was linked with the national death registry database to construct the survival function. A method with Monte Carlo simulation was used to extrapolate survival for up to 600 months to derive the life expectancy for different disability grades (N=81249). A Cox (proportional hazard) regression was carried out to explore the determinants and to estimate the hazard ratios. Demographic variables, including age, gender, insured wage, severity of disability, injury causes, and organ-system disability, were included in the model as covariates. RESULTS: The results indicate that the survival period for workers suffering permanent occupational disabilities is shorter than that of the general population, amounting to an estimated loss of life expectancy ranging from 5 to 19 years. After adjustment for age and gender, a higher severity of disability, impairment of vital organs or lower extremities, and a lower insured wage had a significant association with shorter survival. Injury types, including transportation incidents, being struck by sliding objects, or a trip, slip or stumble, and collapse injury, indicated hazard ratios of between 1.24 and 1.34, as compared with injuries such as being trapped or caught in machinery. CONCLUSIONS: The findings identify major determinants for predicting survival for workers with permanent occupational disabilities; these determinants may be of use in improving the equity of the compensation system for workers.

Estimation of reduced life expectancy from serious occupational injuries in Taiwan.

This study assesses the loss of life expectancy and potential working life in Taiwan, between 1986 and 2000, from various types of occupational accidents resulting in mortality or permanent disability. The databases on occupational mortality and permanent disability were obtained from the Bureau of Labor Insurance, with this information then being linked to national death registry data to construct the survival function. A Monte Carlo simulation method was subsequently used to extrapolate the survival rate for up to 600 months, to derive the life expectancy for different types of occupational accidents leading to permanent disability (n=81,249). Based upon the life table for each calendar year, the life expectancy lost by age-gender cohort was also estimated for cases of mortality (n=20,001). In those cases resulting in permanent occupational disability, variations in the expected years of life lost (EYLL) were demonstrated by different occupational injuries, ranging from 7.4 to 13.6 years per case. The overall EYLL through permanent occupational disability is found to be almost identical to that of occupational mortality, with a ratio of 1.04:1. We conclude that permanent disability resulting from occupational injuries has a significant impact on society as a whole.

Stated preferences for the removal of physical pain resulting from permanently disabling occupational injuries. A contingent valuation study of Taiwan.

Within the process of calculating the true costs of illness, physical pain is a component of intangible, or human, costs. One method of estimating the monetary value of such costs is the 'contingent valuation method' (CVM), a stated preference method based upon the elicitation of levels of willingness to pay (WTP) facilitated through surveys. This study is amongst the first of its kind to apply CVM to the estimation of the cost of the removal of physical pain resulting from permanently disabling occupational injuries. We assume that a painkilling drug has been invented to mitigate physical pain with the advantages of validity and instantaneity, and without any side effects. The WTP of each of the respondents is determined by a two-step sequential-bidding process. The maximum WTP under log normal distribution was NT 1791 US dollars/day (65.1 US dollars), whilst under Weibull distribution it was NT 1913 US dollars/day (69.6 US dollars). Older respondents, those with higher household income, fall injuries, longer periods of hospitalization, or with a perceived demand for the painkilling drug in excess of one day, displayed a positive independent effect on the eliciting of their WTP. In addition, respondents with higher 'out-of-pocket' expenses, or where the interview took place 2 years or more after the injury occurred, responded with a lower WTP.

Occupational health research in Taiwan.

This article gave a brief introduction of population, labor force, general status of occupational safety and health in Taiwan. Statistics of occupational injuries and health disorders, laws and regulations relevant to occupational health were also covered. Research activities driven by universities, research institutes, society/association were provided. Two multi-lateral collaborative research examples were presented: an intoxication outbreak-initiated CS2 study and an information-demand-motivated 2-methoxy-ethanol study. Industrial hygienists, engineers, epidemiologists, and occupational physicians from both universities and research institutes, governmental agencies, and from non-profit R&D organizations and academic associations were involved in these researches, presenting a promise that integrated collaboration of inter-disciplinary specialty cooperated with governmental participation could benefit not only academic achievement, governmental policy-makeup, but also to the employees themselves.