RESUMO
BACKGROUND: Prenatal exposure to ambient air pollution is linked to a higher risk of unfavorable pregnancy outcomes. However, the association between pregnancy complications and exposure to indoor air pollution remains unclear. The Air Pollution on Pregnancy Outcomes research is a hospital-based prospective cohort research created to look into the effects of aerodynamically exposed particulate matter (PM)10 and PM2.5 on pregnancy outcomes. METHODS: This prospective multicenter observational cohort study was conducted from January 2021 to June 2023. A total of 662 women with singleton pregnancies enrolled in this study. An AirguardK® air sensor was installed inside the homes of the participants to measure the individual PM10 and PM2.5 levels in the living environment. The time-activity patterns and PM10 and PM2.5, determined as concentrations from the time-weighted average model, were applied to determine the anticipated exposure levels to air pollution of each pregnant woman. The relationship between air pollution exposure and pregnancy outcomes was assessed using logistic and linear regression analyses. RESULTS: Exposure to elevated levels of PM10 throughout the first, second, and third trimesters as well as throughout pregnancy was strongly correlated with the risk of pregnancy problems according to multiple logistic regression models adjusted for variables. Except for in the third trimester of pregnancy, women exposed to high levels of PM2.5 had a high risk of pregnancy complications. During the second trimester and entire pregnancy, the risk of preterm birth (PTB) increased by 24% and 27%, respectively, for each 10 µg/m3 increase in PM10. Exposure to high PM10 levels during the second trimester increased the risk of gestational diabetes mellitus (GDM) by 30%. The risk of GDM increased by 15% for each 5 µg/m3 increase in PM2.5 during the second trimester and overall pregnancy, respectively. Exposure to high PM10 and PM2.5 during the first trimester of pregnancy increased the risk of delivering small for gestational age (SGA) infants by 96% and 26%, respectively. CONCLUSION: Exposure to high concentrations of PM10 and PM2.5 is strongly correlated with the risk of adverse pregnancy outcomes. Exposure to high levels of PM10 and PM2.5 during the second trimester and entire pregnancy, respectively, significantly increased the risk of PTB and GDM. Exposure to high levels of PM10 and PM2.5 during the first trimester of pregnancy considerably increased the risk of having SGA infants. Our findings highlight the need to measure individual particulate levels during pregnancy and the importance of managing air quality in residential environment.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Diabetes Gestacional , Complicações na Gravidez , Nascimento Prematuro , Gravidez , Recém-Nascido , Feminino , Humanos , Resultado da Gravidez , Material Particulado/efeitos adversos , Material Particulado/análise , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Estudos Prospectivos , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , República da Coreia/epidemiologia , ChinaRESUMO
BACKGROUND: Mobile medical clinics have been used for decades to provide primary and preventive care to underserved populations. While several studies have examined their return on investment and impact on chronic disease management outcomes in the Mid-Atlantic and East Coast regions of the United States, little is known about the characteristics and clinical outcomes of adults who receive care aboard mobile clinics on the West Coast region. Guided by the Anderson Behavioral Model, this study describes the predisposing, enabling, and need factors associated with mobile medical clinic use among mobile medical clinic patients in Southern California and examines the relationship between mobile clinic utilization and presence and control of diabetes and hypertension. METHODS: We conducted a retrospective cohort study of 411 adults who received care in four mobile clinic locations in Southern California from January 1, 2018, to December 31, 2019. Data were collected from patient charts on predisposing (e.g., sex, race, age), enabling (e.g., insurance and housing status), and need (e.g., chronic illness) factors based on Andersen's Behavioral Model. Zero-truncated negative binomial regression was used to examine the association of chronic illness (hypertension and diabetes) with number of clinic visits, accounting for potential confounding factors. RESULTS: Over the course of the 2-year study period, 411 patients made 1790 visits to the mobile medical clinic. The majority of patients were female (68%), Hispanic (78%), married (47%), with a mean age of 50 (SD = 11). Forty-four percent had hypertension and 29% had diabetes. Frequency of mobile clinic utilization was significantly associated with chronic illness. Patients with hypertension and diabetes had 1.22 and 1.61 times the rate of mobile medical clinic visit than those without those conditions, respectively (IRR = 1.61, 95% CI, 1.36-1.92; 1.22, 95% CI, 1.02-1.45). CONCLUSIONS: Mobile clinics serve as an important system of health care delivery, especially for adults with uncontrolled diabetes and hypertension.
Assuntos
Hipertensão , Unidades Móveis de Saúde , Adulto , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Instituições de Assistência Ambulatorial , Assistência Ambulatorial , Hipertensão/epidemiologiaRESUMO
BACKGROUND: Accurate identification of work-related health problems is important to understand workplace safety issues and develop appropriate interventions. Although workers' reporting of work-related injuries or illnesses is the very first step of the reporting process, many workers may encounter challenges in reporting them to their management or workers' compensation (WC) programs. This systematic review aimed to identify the level of workers' underreporting of work-related injuries and illnesses and the contributing factors and reasons for underreporting among US workers. METHODS: This study searched PubMed (Medline), PsycINFO (ProQuest), CINAHL (EBSCOhost), EMBASE (Embase.com), and Social Science Citation Index (Web of Science) using search terms related to underreporting of work-related injury or illness. RESULTS: Twenty studies (17 quantitative and three mixed methods studies) were identified. The studies investigated reporting to management (n = 12), WC programs (n = 6), multiple organizations (n = 1), and not specified (n = 1). The timeframe used to measure reporting prevalence varied from three months to entire careers of workers, with the most common timeframe of 12 months. This review indicated that 20-91% of workers did not report their injuries or illnesses to management or WC programs. From quantitative studies, contributing factors for injury or illness underreporting were categorized as follows: injury type and severity, sociodemographic factors (e.g., age, gender, education, and race/ethnicity), general health and functioning, worker's knowledge on reporting, job and employment characteristics (e.g., work hour, job tenure, work shift, type of occupation, and physical demand), psychosocial work environment (e.g., supervisor support, coworker support, and safety climate), and health care provider factors. From the review of qualitative studies, the reasons for underreporting included the following: fear or concern, cumbersome time and effort in the reporting process, lack of knowledge regarding reporting, perceptions of injuries as not severe or part of the job, and distrust of reporting consequences. CONCLUSIONS: The review findings indicated that low wage earners, racial/ethnic minority workers, and workers who perceive a poor psychosocial work environment encounter more barriers to reporting a work-related injury or illness. This review also identified variations in the measurement of work-related injury reporting across studies and a lack of standardized measurement. TRIAL REGISTRATION: The review was registered in the PROSPERO, an international database of prospectively registered systematic reviews in health and social care (CRD42021284685).
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Doenças Profissionais , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/epidemiologia , Doenças Profissionais/epidemiologia , Etnicidade , Grupos Minoritários , Local de Trabalho , Indenização aos TrabalhadoresRESUMO
PURPOSE: This study examined whether job satisfaction and job security moderate the path from physical demands and job strain to impaired work performance via musculoskeletal symptoms in the upper extremities (MSUE). Moderation effects on five paths were examined: (1) from job strain to MSUE; (2) from job strain to work performance; (3) from physical demands to MSUE; (4) from physical demands to work performance; (5) from MSUE to work performance. METHODS: This was a cross-sectional study of 669 full-time workers from 9 manufacturing and 3 healthcare facilities. Data were collected via health interviews, on-site physical exposure assessments, and computation of the Strain Index by ergonomists, and self-administered questionnaires on psychosocial factors. Structural equation modeling and zero-inflated negative binomial regression analysis were performed to examine the moderation effect on each path. RESULTS: Job satisfaction moderated the relationship between MSUE and impaired work performance (B = - 0.09, 95% CI: - 0.15, - 0.04) and job security moderated the relationship between physical demands and MSUE (B = - 0.64, 95% CI: - 1.17, - 0.11). Interaction between job satisfaction and MSUE was significant on both the occurrence (OR: 0.92, 95% CI: 0.87, 0.97) and the degrees of impaired work performance (mean ratio: 0.99, 95% CI: 0.97, 0.99), while the interaction between job security and physical demands was significant only on the degrees of MSUE (mean ratio: 0.94, 95% CI: 0.89, 0.99). CONCLUSION: Job satisfaction and job security can, respectively, mitigate the adverse impacts of working with MSUE and physical demands on work performance. Workplace interventions to improve workers' job satisfaction and job security can contribute to their musculoskeletal health and work performance.
Assuntos
Desempenho Profissional , Humanos , Satisfação no Emprego , Estudos Transversais , Local de Trabalho/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Identifying and addressing work-related health problems early is crucial, but workers often perceive barriers in reporting these to management. This study aimed to investigate the factors associated with nurses' reporting of work-related low back pain to their managers and explored the reasons why nurses with patient handling injuries did not report them. METHODS: This study is a concurrent mixed-method analysis of data from two statewide cross-sectional surveys of California registered nurses conducted in 2013 and 2016. The reporting of work-related low back pain to management (n = 288) was examined for associations with individual, occupational, and organizational factors. For qualitative analysis, the reasons for not reporting patient handling injuries were explored using open-ended responses (n = 42). RESULTS: Reporting was associated with BIPOC (Black, Indigenous, and People of Color) men (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) compared to non-Hispanic White women; being a non-US educated nurse (AOR: 0.90, 95% CI: 0.80-1.01); experiencing greater low back pain (AOR: 1.07, 95% CI: 1.02-1.12); missing work (AOR: 1.38, 95% CI: 1.21-2.62); perceiving high physical workload (AOR: 0.89, 95% CI: 0.81-0.98); perceiving high people-oriented culture (AOR: 1.14, 95% CI: 1.04-1.25); and perceiving high ergonomic practices (AOR: 0.89, 95% CI: 0.81-0.98). Identified themes on the reasons for not reporting injuries included organizational-culture attitudes toward work-related injuries and injury characteristics of musculoskeletal disorders. CONCLUSIONS: The findings indicate a need for management to remove structural barriers and improve organizational practices, and for a culture that promotes trust and open communication between workers and management.
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Dor Lombar , Doenças Musculoesqueléticas , Enfermeiras e Enfermeiros , Doenças Profissionais , Masculino , Humanos , Feminino , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Estudos Transversais , Coleta de Dados , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologiaRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic greatly affected healthcare workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care facility workers during 2019-2021, to assess the impact of the pandemic on occupational injury risk. METHODS: This study used data from the California Workers' Compensation Information System. WC claims in prepandemic and pandemic periods were described and compared between nursing care facilities and other settings. Nursing facility cases were described by demographic, job, and injury characteristics. RESULTS: In 2019-2021, we identified 41,134 claims as nursing facility cases in California. Annual claims increased by 64.6% from 2019 to 2020 and then decreased in 2021, returning to levels similar to pre-COVID. In contrast, non-healthcare settings had decreases in claims during the pandemic. COVID-related claims accounted for 50.5% of claims in nursing facilities in 2020-2021; this proportion was much higher compared with other healthcare (35.7%) or nonhealthcare settings (14.3%). Non-COVID claims decreased during the pandemic but mental disorder or stress claims increased in nursing facilities, particularly in 2020 (+42.5%). CONCLUSIONS: Our findings show that nursing care facilities were more severely affected by the pandemic than other settings. We did not find evidence of an increased risk of occupational injuries during the pandemic, except for increased claims for stress or mental disorders. Our findings indicate a clear need to address psychological stress and mental health among nursing facility workers during a pandemic.
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COVID-19 , Cuidados de Enfermagem , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/epidemiologia , Indenização aos Trabalhadores , COVID-19/epidemiologia , California/epidemiologiaRESUMO
INTRODUCTION: Placental mesenchymal dysplasia (PMD) is a benign lesion that is often misdiagnosed as complete (CHM) or partial hydatidiform mole. PMD usually results in live birth but can be associated with several fetal defects. Herein, we report PMD with CHM in a singleton placenta with live birth. CASE PRESENTATION: A 34-year-old gravida 2, para 1, living 1 (G2P1L1) woman was referred on suspicion of a molar pregnancy in the first trimester. Maternal serum human chorionic gonadotrophin levels were increased during early pregnancy, with multicystic lesions and placentomegaly observed on ultrasonography. Levels decreased to normal with no fetal structural abnormalities observed. A healthy male infant was delivered at 34 gestational weeks. Placental p57KIP2 immunostaining and short tandem repeat analysis revealed three distinct histologies and genetic features: normal infant and placenta, PMD, and CHM. Gestational trophoblastic neoplasia was diagnosed and up to fourth-line chemotherapy administered. CONCLUSION: Distinguishing PMD from hydatidiform moles is critical for avoiding unnecessary termination of pregnancy. CHM coexisting with a live fetus rarely occurs. This case is unique in that a healthy male infant was born from a singleton placenta with PMD and CHM.
Assuntos
Doença Trofoblástica Gestacional , Mola Hidatiforme , Doenças Placentárias , Neoplasias Uterinas , Masculino , Gravidez , Feminino , Humanos , Adulto , Placenta/diagnóstico por imagem , Placenta/patologia , Nascido Vivo , Mola Hidatiforme/diagnóstico por imagem , Doenças Placentárias/diagnóstico por imagem , Doença Trofoblástica Gestacional/diagnóstico por imagem , Doença Trofoblástica Gestacional/complicações , Neoplasias Uterinas/diagnóstico por imagem , Período Pós-PartoRESUMO
AIM: This study used California's unique Workplace Violent Incident Reporting System (WVIRS) to describe changes in workplace violence (WV) exposure for hospital-based healthcare workers during the pandemic. DESIGN: Interrupted time series analysis. METHODS: We compared the linear trends in weekly WV incidents reported during the period before the COVID-19 pandemic (7/1/2017-3/20/2020) to the period following California's shutdown (3/21/2020-6/30/2021). We created mixed effects models for incidents reported in emergency departments (EDs) and in other hospital units. We used hospital volume data from the California Department of Health Care Access and Information. RESULTS: A total of 418 hospitals reported 37,561 incidents during the study period. For EDs, the number of reported incidents remained essentially constant, despite a 26% drop in outpatient visits between the first and second quarters of 2020. For other hospital units, weekly incidents initially dropped-parallel to a 13% decrease in inpatient days between the first and second quarters of 2020-but then continued parallel to the trend seen in the pre-COVID period. CONCLUSION: WV persists steadily in California's hospitals. Despite major reductions in patient volume due to COVID-19, weekly reported ED incidents remained essentially unchanged. IMPACT: Surveys and media reported that WV increased during the pandemic, but it has been difficult to measure these changes using a large-scale database. The absolute number of WV incidents did not increase during the pandemic; however, the trend in reported incidents remained constant in the context of dramatic decreases in patient volume. New federal WV prevention legislation is being considered in the U.S. California's experience of implementation should be considered to improve WV reporting and prevention. PUBLIC CONTRIBUTION: There was no public contribution to this study. The goal of this analysis was to summarize findings from administrative data. The findings presented can inform future discussion of public policy and action.
Assuntos
COVID-19 , Violência no Trabalho , Humanos , Análise de Séries Temporais Interrompida , Pandemias , COVID-19/epidemiologia , Hospitais , Recursos Humanos em Hospital , California/epidemiologia , Local de TrabalhoRESUMO
This study investigated the interaction between physical demands and job strain on musculoskeletal symptoms in upper extremities (MSUE) and work performance. Two years of prospective data were analysed from 713 full-time workers from twelve manufacturing and healthcare facilities in Washington in the United States. Physical exposure was measured by the Strain Index and Threshold Limit Value for hand activity, giving rise to safe, action, and hazardous physical demand groups. Job strain was calculated as the ratio of psychological job demands to job control. Multilevel modelling analysis showed that job strain affected MSUE and limited work performance less in the high physical demand group than the safe group because the protective effect of job control was smaller in these groups. Findings may suggest that high physical demand jobs are structured such that workers have low job control or high physical demand groups experience job strain not adequately captured by psychosocial variables.Practitioner Summary: The effects of job strain and job control on musculoskeletal symptoms in upper extremities and work performance were smaller among workers with higher physical demands. This could imply that high physical demand jobs limit job control or psychosocial variables may not adequately capture job strain among high physical demand groups.
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Doenças Profissionais , Desempenho Profissional , Humanos , Estados Unidos , Estresse Psicológico/psicologia , Estudos Prospectivos , Ocupações , Análise Multinível , Doenças Profissionais/etiologia , Fatores de RiscoRESUMO
Inhibitors for monoamine oxidase-B (MAO-B) were screened from an FV library with a randomized complementarity-determining region 3 (CDR3) region using a monoclonal antibody against dopamine. As the first step, the FV library was expressed on the outer membrane of E. coli by site-directed mutagenesis of the randomized CDR3 region. Among the FV library, variants with a binding affinity to monoclonal antibodies against dopamine were screened and cloned. From the comparison of the binding activity of the screened clones to a control clone with a modified FV antibody (only with CDR1 and CDR2), the CDR3 regions of screened clones were determined to directly interact with the monoclonal antibody against dopamine. These CDR3 sequences were then synthesized as mimotopes (mimicking peptides) of dopamine. The inhibitory activity of two mimotopes against MAO-B was analyzed using HeLa cells overexpressing MAO-B, as well as using activated human astrocytes; their inhibitory activity was compared to that of a commercial inhibitor of MAO-B, selegiline. The inhibition efficiency of the two mimotopes (in comparison with selegiline) was estimated to be 67.2% and 69.4% in the HeLa cells and 64.4% and 58.0% in the human astrocytes. The gene expression pattern in astrocytes after treatment with the two mimotopes was also analyzed and compared with that in the human astrocytes treated with selegiline. Finally, the interaction between two mimotopes and MAO-B was analyzed using docking simulation, and the candidate regions of MAO-B for the interaction with each mimotope were explored through the docking simulation.
Assuntos
Monoaminoxidase , Selegilina , Anticorpos Monoclonais , Dopamina/metabolismo , Escherichia coli/metabolismo , Células HeLa , Humanos , Monoaminoxidase/genética , Monoaminoxidase/metabolismo , Inibidores da Monoaminoxidase/farmacologia , Peptídeos , Selegilina/farmacologiaRESUMO
Self-assembled structures of high molecular-weight block copolymers (BCPs) can prematurely settle to local energy minima without reaching a time-averaged equilibrium, resulting in the emergence of intriguing morphologies, such as 3D micellar networks. This nonergodic behavior is evident in binary blends of BCPs with different molecular weights. This study reports the solution self-assembly of the blends of two branched-linear BCPs with similar block chemistries but different molecular weights of the hydrophobic blocks. A progressive transition of morphologies from hexosomes and cubosomes to 3D micellar networks, short cylinders, and spherical micelles is demonstrated, which is driven by the increase in the composition of low-molecular-weight BCP in the blend. The labeling of the micellar networks using Au nanoparticles confirms that lower molecular-weight BCP concentrates at the surface of micellar networks.
Assuntos
Ouro , Nanopartículas Metálicas , Micelas , Peso Molecular , Polímeros/químicaRESUMO
BACKGROUND: California requires general acute care hospitals to have a comprehensive plan to prevent patient handling injuries (PHIs) among employees. The California safe patient handling (SPH) law took effect in 2012. This study assessed the impact of the SPH law on workers' compensation claims for musculoskeletal disorders (MSDs) in California hospital workers. METHODS: We used California Workers' Compensation Information System data from 2007 to 2016 and analyzed claims for MSDs that occurred in acute care hospitals compared with nursing and residential care facilities. MSD claims were classified into PHI and non-PHI claims. RESULTS: We identified 199,547 MSD claims that occurred during 2007-2016 in acute care hospitals (62.8%) and nursing and residential care facilities (37.2%). MSDs accounted for 42.8% of all claims. Of the MSD claims, 81.0% were strains or sprains and 33.5% of MSDs were related to patient handling activities. From 2011 to 2016, MSD claim rates showed significant reductions among both hospital and nursing/residential care workers. However, the MSD-PHI claim rate showed a significant reduction only among hospital workers (7.3% per year, incidence rate ratio [IRR] = 0.927, 95% confidence interval [CI] 0.903-0.952). There was no significant change among nursing/residential care workers (IRR = 0.990, 95% CI 0.976-1.005). The non-PHI claim rate showed no significant change among hospital workers (IRR = 0.982, 95% CI 0.956-1.009). CONCLUSIONS: Our study identified significant reductions of PHI claims among California hospital workers after the passage of the SPH legislation, suggesting that SPH legislation played a crucial role in reducing the risk of injury among healthcare workers.
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Movimentação e Reposicionamento de Pacientes , Doenças Musculoesqueléticas , California/epidemiologia , Humanos , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/prevenção & controle , Recursos Humanos em Hospital , Indenização aos TrabalhadoresRESUMO
BACKGROUND: Available research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces. PURPOSE: To examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics. METHODS: We analyzed data from statewide random samples of California RNs (N=895). FINDINGS: Increased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings. DISCUSSION: The findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.
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Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem Hospitalar , Humanos , Etnicidade , Fatores Sociodemográficos , Satisfação no Emprego , Emprego , Inquéritos e Questionários , Reorganização de Recursos HumanosRESUMO
In this study, the binding domains for fluorescent dyes were presented that could be used as synthetic peptides or fusion proteins. Fv-antibodies against two fluorescent dyes (fluorescein and rhodamine B) were screened from the Fv-antibody library, which was prepared on the outer membrane of Escherichia coli using the autodisplay technology. Two clones with binding activities to each fluorescent dye were screened separately from the library using flow cytometry. The binding activity of the screened Fv-antibodies on the outer membrane was analyzed using fluorescent imaging with the corresponding fluorescent dyes. The CDR3 regions of the screened Fv-antibodies (11 amino acid residues) were synthesized into peptides, and each peptide was analyzed for its binding activity to each fluorescent dye using fluorescence resonance energy transfer (FRET) experiments. These CDR3 regions were demonstrated to have a binding activity to each fluorescent dye when the regions were co-expressed as a fusion protein with Z-domain.
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Fluoresceína , Rodaminas , Escherichia coli , Citometria de Fluxo , Biblioteca GênicaRESUMO
BACKGROUND: Cleaning tasks pose risks of hazardous chemical exposure and adverse health effects for cleaning workers. We examined gender differences among cleaning staff in the experience of chemical-related symptoms and in reporting to supervisors. METHODS: We analyzed cross-sectional reports from 171 university hospital or campus cleaning staff on chemical exposures to cleaning products, experience of acute symptoms, reporting of symptoms to supervisors, as well as demographic and psychosocial factors (risk perception, job demand/control, supervisor/co-worker support, and safety climate). Results were analized using multivariable logistic regression, adjusting for demographic, job, and psychosocial factors. Interactions of gender and psychosocial variables were also examined. RESULTS: Men and women reported different frequencies for exposure-related tasks. Acute symptoms of chemical exposure were more prevalent in women compared with men (46.0% vs. 25.4%; adjusted odds ratio [OR] = 2.63; 95% confidence interval [CI] 1.27-5.46). Women were more concerned about exposure to cleaning chemicals (p = 0.029) but reported symptoms to their supervisor less often than men (18.5% vs. 40.6%, adjusted OR = 0.28; 95% CI 0.09-0.93). More supervisor support was significantly associated with less frequent symptom experience among women (OR = 0.83; 95% CI 0.70-0.99). Asian workers and less educated workers were less likely than others to report symptoms to supervisors. Gender differences in symptom reporting to supervisors were not explained by psychosocial factors. CONCLUSIONS: Women may have increased susceptibility or perception of symptoms from cleaning compared to men, but this may be mitigated by supervisor support. Female Asian workers with lower education may perceive more significant barriers in reporting work-related symptoms to supervisors. Further research is needed to explore factors related to underreporting.
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Zeladoria , Doenças Profissionais/psicologia , Fatores Sexuais , Avaliação de Sintomas/psicologia , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Detergentes/toxicidade , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Razão de Chances , Cultura Organizacional , Gestão da Segurança , Mulheres Trabalhadoras/psicologia , Local de Trabalho/organização & administraçãoRESUMO
BACKGROUND: This study evaluated the impact of California's safe patient handling (SPH) legislation on musculoskeletal injury prevention among hospital nurses. METHODS: Two serial cross-sectional surveys were conducted using postal and online questionnaires in statewide random samples of California registered nurses in 2013 and 2016. Analysis included hospital nurses who performed patient handling (n = 254 and n = 281, respectively). RESULTS: In 2016, there were significant improvements in nurses' knowledge of a SPH policy in their hospital (87%), receipt of annual SPH training (73%), and availability of lift equipment (80%); 33% perceived their hospital's SPH programs as excellent or very good. Significant prevalence reduction was observed for work-related musculoskeletal symptoms (61% vs 52%; Adjusted Prevalence Ratio = 0.78, 95% CI 0.66-0.91). CONCLUSIONS: Our findings indicate the significant role of SPH legislation with positive impacts on SPH policies and programs at the hospital level and on musculoskeletal health outcomes at the worker level.
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Conhecimentos, Atitudes e Prática em Saúde , Movimentação e Reposicionamento de Pacientes/enfermagem , Doenças Musculoesqueléticas/prevenção & controle , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Adulto , California/epidemiologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Gestão da Segurança/métodos , São Francisco/epidemiologia , Inquéritos e QuestionáriosRESUMO
The objective of the present study was to investigate the relationship of IQ in children with maternal blood mercury concentration during late pregnancy. The present study is a component of the Mothers and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 553 children whose mothers underwent testing for blood mercury during late pregnancy. The children were given the Korean language version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R) at 60 months of age. Multivariate linear regression analysis, with adjustment for covariates, was used to assess the relationship between verbal, performance, and total IQ in children and blood mercury concentration of mothers during late pregnancy. The results of multivariate linear regression analysis indicated that a doubling of blood mercury was associated with the decrease in verbal and total IQ by 2.482 (95% confidence interval [CI], 0.749-4.214) and 2.402 (95% CI, 0.526-4.279), respectively, after adjustment. This inverse association remained after further adjustment for blood lead concentration. Fish intake is an effect modifier of child IQ. In conclusion, high maternal blood mercury level is associated with low verbal IQ in children.
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Desenvolvimento Infantil/efeitos dos fármacos , Inteligência/efeitos dos fármacos , Mercúrio/efeitos adversos , Mercúrio/sangue , Alimentos Marinhos/efeitos adversos , Pré-Escolar , Estudos de Coortes , Dieta/efeitos adversos , Feminino , Humanos , Inteligência/fisiologia , Testes de Inteligência , Masculino , GravidezRESUMO
OBJECTIVE: The study aim was to examine the relationships of organizational safety practices with nurses' perceptions about job and risk and experiences of work-related injury and symptoms. BACKGROUND: Nursing professions report high rates of work-related injuries. Organizational safety practices have been linked to workers' safety outcomes and perceptions about work. METHODS: This study analyzed data from a random sample of 280 California RNs in a cross-sectional statewide survey. Data were collected by both postal and online surveys. RESULTS: Higher perceptions of organizational safety practices (safety climate, ergonomic practices, people-oriented culture) were significantly associated with lower physical workload, lower job strain, higher job satisfaction, lower risk perception, and lower work-related injury and symptom experiences. Ergonomic practices and people-oriented culture were associated with less intention of leaving job. CONCLUSIONS: Organizational safety practices may play a pivotal role in improving positive perceptions about jobs, reducing injury risks, and promoting nurse retention.
Assuntos
Atitude do Pessoal de Saúde , Satisfação no Emprego , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Recursos Humanos de Enfermagem Hospitalar/psicologia , Traumatismos Ocupacionais , Cultura Organizacional , Reorganização de Recursos Humanos/estatística & dados numéricos , Gestão da Segurança/organização & administração , Carga de Trabalho/psicologia , Adulto , California , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Our objective is to evaluate the relationships between prenatal maternal stress and depressive symptoms, respectively, and infant neurodevelopment at 6 months, adjusted for heavy metals and oxidative stress. This research is a part of a multi-center birth cohort study in South Korea. Information on stress and depressive symptoms was collected during the first trimester using Psychosocial Well-Being Index Short Form (PWI-SF) and Center for Epidemiological Studies Depression Scale (CES-D). The Korean Bayley Scales of Infant Development-II assessment (BSID-II), which includes the standardized mental development index (MDI) and psychomotor developmental index (PDI), and Korean Ages & Stages Questionnaires (K-ASQ) were applied to infants at six months of age. A higher index score indicates better development. Among 641 babies, 320 were female (50%). Maternal PWI ≥ 29 (vs. PWI ≤ 18) during early pregnancy was associated with a decrease in MDI scores of 5.37 points (P = 0.02) after adjusting for socioeconomic factors. Maternal CES-D ≥ 26 (vs. CES-D ≤ 10) during early pregnancy was associated with a decrease in MDI scores of 8.18 points (P = 0.01). The associations remained significant even after adjustment for lead, cadmium, and MDA levels (P < 0.05). However, no association was found between maternal PWI/CES-D and PDI score. No interaction was observed between stress and lead exposure. We found an inverse association between prenatal maternal stress and depressive symptoms, and MDI scores in 6-month-old infants after adjustment for prenatal lead exposure, which is known to affect cognitive function negatively.