Occupational lung disease survey of respiratory physicians in Northern Ireland.

BACKGROUND: Respiratory physicians are likely to encounter occupational lung disease (OLD) in their daily practice. AIMS: To assess the profile of cases being encountered by general respiratory physicians in Northern Ireland (NI) and determine satisfaction with training, confidence in diagnosis and management of OLD. METHODS: An online survey of all consultant respiratory physicians currently practising in NI. Questions assessed the numbers of new cases seen over the preceding year, case type, satisfaction with specialist registrar training in OLD and degree of confidence in the diagnosis and management of these conditions. RESULTS: Of the 40 consultants identified, the response rate was 80% (n = 32) with 94% of respondents (n = 30) indicating they had dealt with patients suspected of having occupation-related respiratory symptoms. The most commonly encountered OLDs were pleural plaques (91% of respondents), occupational asthma (88%), asbestosis (84%), non-asbestosis pulmonary fibrosis (76%), hypersensitivity pneumonitis (67%) and mesothelioma (66%). Just over one third of consultants (36%, n = 10) indicated a lack of confidence in diagnosis and management of OLD with almost half (48%) dissatisfied with OLD training as a registrar and a further 78% (n = 25) indicating they would value additional training in OLD as a consultant. CONCLUSIONS: The majority of respiratory consultants in NI encountered OLD in their day to day practice and half were dissatisfied with their specialist registrar training in OLD and express a lack of confidence in the diagnosis and management of these conditions. This highlights the need for additional training at both registrar and consultant level.

Psychosocial work environment and leisure-time physical activity: the Stormont study.

BACKGROUND: Research findings on the relationship between the psychosocial work environment and leisure-time physical activity (LTPA) are equivocal. This might partly be due to studies having focused on a restricted set of psychosocial dimensions, thereby failing to capture all relevant domains. AIMS: To examine cross-sectional associations between seven psychosocial work environment domains and LTPA in a large sample of UK civil servants and to profile LTPA and consider this in relation to UK government recommendations on physical activity. METHODS: In 2012 Northern Ireland Civil Service employees completed a questionnaire including measures of psychosocial working conditions (Management Standards Indicator Tool) and LTPA. We applied bivariate correlations and linear regression analyses to examine relations between psychosocial working conditions and LTPA. RESULTS: Of 26000 civil servants contacted, 5235 (20%) completed the questionnaire. 24% of men and 17% of women reported having undertaken 30min or more of physical activity on five or more days in the past week. In men, job control (-0.08) and peer support (-0.05) were weakly but significantly negatively correlated with LTPA, indicating that higher levels of exposure to these psychosocial hazards was associated with lower levels of LTPA. Job role (-0.05) was weakly but significantly negatively correlated with LTPA in women. These psychosocial work characteristics accounted for 1% or less of the variance in LTPA. CONCLUSIONS: Longitudinal research to examine cause-effect relations between psychosocial work characteristics and LTPA might identify opportunities for psychosocial job redesign to increase employees' physical activity during leisure time.

The impact of two workplace-based health risk appraisal interventions on employee lifestyle parameters, mental health and work ability: results of a randomized controlled trial.

Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental health and work ability in a UK context. A total of 180 employees were randomized into one of three groups: Group A (HRA augmented with health promotion and education activities), Group B (HRA only) and Group C (control, no intervention). After 12 months, changes in mean scoring in 10 lifestyle, mental health and work ability indices were compared, Groups A and B demonstrated non-significant improvements in 70% and 80%, respectively, compared with controls (40%). Odds ratios revealed that, compared with the control group, Group A was 29.2 (95% CI: 9.22-92.27) times more likely to report a perceived change in lifestyle behaviour; Group B 4.4 times (95% CI: 1.65-11.44). In conclusion, participation in the HRA was associated with a higher likelihood of perceived lifestyle behaviour change which was further increased in the augmented HRA group, thereby providing preliminary evidence that HRA and augmented HRA in particular may help UK employees make positive healthy lifestyle changes.

Psychosocial factors and economic recession: the Stormont Study.

BACKGROUND: Little research has explored changes in workers' psychosocial hazard exposures, work-related stress and stress-related absence associated with the onset of unprecedented severe economic recession. Knowledge of these could inform psychosocial risk management measures appropriate to austere economic times. AIMS: To examine civil servants' psychosocial hazard exposures, work-related stress and stress-related absence during a period of economic recession, relative to levels prior to the onset of this period. METHODS: Analyses compared the findings of two surveys of employees of the Northern Ireland Civil Service conducted in 2005 (n = 17,124), prior to the onset of recession, and in 2009 (n = 9913), during a period of economic recession. RESULTS: Psychosocial hazard exposures were significantly worse during the recession than prior to it. These results are considered in relation to UK government exposure targets. Work-related stress and absence ascribed to work-related stress were significantly greater during recession than prior to it. CONCLUSIONS: This study demonstrates adverse changes in psychosocial hazard exposures, work-related stress prevalence and stress-related sickness absence associated with the onset of an unprecedented economic recession. Its findings indicate the need for a concerted focus on psychosocial risk management activities during austere economic times as a means by which to promote worker health and minimize sickness absence.

Impact of a direct access occupational physiotherapy treatment service.

BACKGROUND: Musculoskeletal disorders (MSDs) cause significant morbidity and absence from work for both manual and sedentary occupations. AIMS: To examine the impact of a direct access physiotherapy treatment service in an occupational setting. METHODS: This was a pilot study carried out as a service audit. Physiotherapy patients were assessed pre- and post-treatment using the work function score (WFS), a visual analogue scale for pain (VASP) and adjusted clinical score (ACS). Self-report questionnaires were completed on sickness absence, attendance at work and the World Health Organization (five) Well-being Index. RESULTS: There were 231 participants. Patient improvement was reported in WFS (63%), ACS (84%) and VASP (94%). Compared with those who had one or two sessions, improvement was most likely after three to four sessions for WFS [odds ratio (OR): 4.5; 95% confidence interval: 1.4-14.3, P < 0.05], VASP (OR: 32.2; 95% confidence interval: 3.5-294.2, P < 0.01) and five to six sessions for ACS (OR: 6.9; 95% confidence interval: 1.9-25.9, P < 0.01). While the self-reported questionnaire response rate was low at 29%, respondents indicated that there was potential to reduce and prevent sickness absence and improve mental well-being. CONCLUSIONS: Brief physiotherapy treatment for MSDs may have the potential to improve not only clinical status and pain as expected but also work function, psychological well-being and sickness absence. Further research is warranted to confirm these positive impacts and to endorse physiotherapy as an effective intervention in occupational settings and a useful component in rehabilitation and 'Fit for Work' programmes.

Change in Sunday licensing laws and the effect on Monday absenteeism. A short report on a poultry processing plant.

Licensing laws were changed in Northern Ireland on 1st October 1987 to allow drinking of alcohol in public houses on Sundays. The effect on absenteeism was studied in the immediate period after this change using Monday absenteeism as a marker for change. The study was conducted in a small poultry processing plant employing approximately four hundred and forty people. Mean differences between Monday absenteeism for the month of October 1986 and 1985 prior to the change in laws and October 1987 were shown to be not significant.

How I address quality and teamwork issues in the occupational health department.

To be successful in today's climate an occupational health provider needs well-trained and motivated staff who are both professional and focused on delivering quality services that meet the needs of their customers. Achieving this goal is facilitated by having a clear sense of mission with systems in place within the organization of the department that support this and encourage continuous improvement. Good communication, performance measures and teamwork are identified as key elements in realizing the goal of a quality department. This article, in sharing the experiences of addressing quality and teamwork, discusses important issues relevant to many occupational health departments.

Developing programmes to achieve a healthy society: creating healthy workplaces in Northern Ireland.

Healthy workplaces help to prevent occupational disease and injury as well as promoting positive healthy lifestyle behaviours. The concept of creating healthy workplaces through workplace health promotion has been identified as a legitimate area of activity for public health policy in Northern Ireland, supporting as it does, the settings approach as a means of improving the health and well-being of the population at large. Benefits accrue to businesses, organizations and individuals from the enhancement of positive healthy lifestyle messages in addition to reinforcing the principles of good occupational health practices. Developing a framework for the creation of healthy workplaces is part of a joint initiative between the Northern Ireland Health Promotion and Health and Safety Agencies. Commitment to delivering the concept is required from all the key players who include: employers, employees, trade union groups and health and safety professionals. A healthy workplace model needs to be created which is flexible and adaptable to suit all types of business and in particular the needs of small businesses which predominate in Northern Ireland. The principles underpinning the Business Excellence Model may be a useful vehicle for delivering workplace health promotion onto an organization's agenda.

Irish rugby injury survey: Dungannon Football Club (1986-87).

The injuries sustained during one season by players at an Ulster Senior Rugby Club were documented with reference to time of injury, phase of play, team position, and nature of injury. The overall injury pattern in Irish rugby as found in this study is broadly comparable with that in similar studies in England and Scotland. Eighty-four players were injured in total. Three of these had fractures of which one required hospital admission for open reduction of a fractured wrist. The remaining eighty-one players had various types and grades of soft-tissue damage. The tackle accounted for approximately one-third of all injuries. There were few serious injuries and none involving the spine. Injuries to forwards made up almost sixty per cent of the total.

Creating healthy workplaces in Northern Ireland: evaluation of a lifestyle and physical activity assessment programme.

An observational study was carried out on 2595 Northern Ireland civil servants who attended a workplace lifestyle and physical activity assessment programme involving self-reported lifestyle history, measurement of physiological parameters and a 6 month follow-up postal questionnaire survey. Almost two-thirds of participants did not engage in regular moderate physical activity, with females twice as likely not to than men. Approximately one in six participants were smokers and three-quarters were found to have body fat estimations above the acceptable level, with females much more likely to be obese than men. Aerobic capacity was below average in 17% of participants and was associated with increasing age, smoking in the under 35s and poor physical activity levels. Excessive alcohol intake was found in 8% of all participants, and was more likely in men and smokers. In the follow-up survey, 83% needed to make one or more changes to their lifestyle. Smoking was the most difficult to change, with only 14% remaining abstinent after 6 months. Almost two-thirds were maintaining improved dietary habits and exercise activity, with around one-half moderating alcohol intake and achieving weight reduction. Overall, the average level of non-attempted behaviour change was one in five (19.6%), tried but failed accounted for almost one in three (31.2%) and successful maintenance of positive lifestyle change occurred in one-half (49.2%). Brief lifestyle and physical activity assessment programmes are effective interventions in getting employees to modify their lifestyles. The impact this has on wider organizational issues such as absenteeism and productivity needs further evaluation.

General practitioners' use of a mobile coronary care unit in a non-urban setting.

The use that general practitioners made of the mobile coronary care unit operating from a district general hospital was monitored. Over half of the patients referred by their general practitioners to hospital with suspected acute myocardial infarction were removed by the mobile unit rather than by an ordinary ambulance. However, general practitioner selection of the more compromised patient for admission via the mobile unit indicated that the chance of this category of patient being admitted by the proven best means could be improved. Of the definite cases of infarcts removed to hospital by whatever means, the high proportion which were uncomplicated raises the question whether the general practitioner is attempting to select such patients for home rather than hospital care. The figures for the use of the mobile coronary care unit also indicate that education of the public remains an important task.