Accuracy of professional judgments for dermal exposure assessment using deterministic models.

The accuracy of exposure judgments, particularly for scenarios where only qualitative information is available or a systematic approach is not used, has been evaluated and shown to have a relatively low level of accuracy. This is particularly true for dermal exposures, where less information is generally available compared to inhalation exposures. Relatively few quantitative validation efforts have been performed for scenarios where dermal exposures are of interest. In this study, a series of dermal exposure judgments were collected from 90 volunteer U.S. occupational health practitioners in a workshop format to assess the accuracy of their judgments for three specific scenarios. Accuracy was defined as the ability of the participants to identify the correct reference exposure category, as defined by the quantitative exposure banding categories utilized by the American Industrial Hygiene Association (AIHA®). The participants received progressively additional information and training regarding dermal exposure assessments and scenario-specific information during the workshop, and the relative accuracy of their category judgments over time was compared. The results of the study indicated that despite substantial education and training in exposure assessment generally, the practitioners had very little experience in performing dermal exposure assessments and a low level of comfort in performing these assessments. Further, contrary to studies of practitioners performing inhalation exposure assessments demonstrating a trend toward underestimating exposures, participants in this study consistently overestimated the potential for dermal exposure without quantitative data specific to the scenario of interest. Finally, it was found that participants were able to identify the reference or "true" category of dermal exposure acceptability when provided with relevant, scenario-specific dermal and/or surface-loading data for use in the assessment process. These results support the need for additional training and education of practitioners in performing dermal exposure assessments. A closer analysis of default loading values used in dermal exposure assessments to evaluate their accuracy relative to real-world or measured dermal loading values, along with consistent improvements in current dermal models, is also needed.

Lean on Your Land Grant: One University's Approach to Address the Food Supply Chain Workforce during the COVID-19 Pandemic.

During the spring 2020 COVID-19 outbreak, faculty and staff within Ohio State University's College of Food, Agricultural and Environmental Sciences came together from multiple disciplines to support essential agricultural workers. Concerted leadership from administration provided a framework for this interaction to occur while faculty worked off-campus to address the many issues identified by the agricultural community, the industry sector, and other state agencies. During the onset period, much of our work was reactive; our efforts to address worker safety and health involved three primary areas within: 1) production agricultural workers, 2) produce growers and direct marketing enterprises, and 3) meat supply chain workers. Communication to target audiences relied upon our ability to convert face-to-face programming into virtual webinars, social media, and digital publications. A Food System Task Force mobilized specialists to address emerging issues, with one specific topic related to Personal Protective Equipment (PPE). As we continue to face new seasons in agriculture production, and pockets of COVID-19 outbreaks within our state, we will continue to address the dynamic needs of our food supply systems. There are implications for how we will teach the agricultural workforce within a virtual platform, including the evaluation of the effectiveness of those training programs. There are renewed opportunities to integrate health and safety content into other Extension teams who conventionally focused on production practices and farm management topics. Several research themes emerged during subgroup dialog to pursue new knowledge in workers' cultural attitude and barriers, PPE design, PPE access, and overall attitude toward COVID-19 health practices.

O trabalho no campo da educação: o Fórum-Cosate como estratégia de resistência à máquina neoliberal / Labor in the field of education: fórum-cosate as a strategy of resistance against the neoliberal machine

O artigo introduz uma experiência de pesquisa-intervenção realizada na região metropolitana de Vitória, Espírito Santo, mais especificamente no município de Serra visando ao fortalecimento de práticas no contexto escolar que possam fazer frente à racionalidade neoliberal que toma a educação como bem privado de valor econômico. Apresenta a constituição de um fórum de trabalhadores da educação cujo objetivo é construir estratégias que possam desafiar o processo de adoecimento em curso nas escolas, decorrente da racionalidade econômica vigente no referido município. Aponta como direção ética a indissociabilidade entre clínica e política e aposta na criação de táticas coletivas de enfrentamento ao adoecimento nas unidades escolares da rede.

This article presents the experience of a research-intervention carried out in the municipality of Serra, metropolitan region of Vitória, Espírito Santo, aiming to strengthen practices in the school context that can face the neoliberal rationality that considers education as private goods of economic value. It describes the constitution of a forum for education workers to develop strategies that could challenge the sickness process underway in schools, due to the economics-guided thinking in that municipality. Its ethical direction, the inseparability between clinic and politics as well as the investment in the creation of collective tactics to fight sickness in the school units of the city are highlighted.

Prevention and health promotion at the workplace as a part of private medical care for employees in Poland - an overview.

This review includes information about the number of private health insurance and medical subscriptions in Poland, as well as the level of increases in premium rates, and the scale of health promotion and prevention conducted by Polish employers. The aim of this article is to present the current situation on the supplementary private medical market, which is involved in employees' healthcare, and the challenges that both employers and medical providers with health insurers are now facing, and also to present the reasons why prevention and health promotion are important factors of healthcare under private health insurance. For the purpose of this review, scientific publications devoted to health promotion at the workplace were used, along with statistical data presented in the studies released by the Polish Insurance Association, the Polish Social Security Institution, the World Health Organization and the Organization for Economic Co-operation and Development. The literature search was carried out using the electronic databases of PubMed. Search terms included medical subject headings and free text words. No year of publication restriction was imposed. The conducted analysis shows that the demand for private medical care is rising. Employers are willing to invest in private medical care for their employees, although the scale is much lower among small and medium-sized entrepreneurs due to fiscal burdens. Given the rising demand and an insufficient number of specialists, access to medical services is deteriorating, and the premium rates and costs are rising. More employers are investing in health promotion at the workplace in order to decrease absenteeism and presenteeism, lower the utilization of medical packages, and improve their attractiveness on the market. Although the interest in private medical care is rising, employers should focus on health promotion and prevention at the workplace, and adapt their actions to the employees' current needs and health issues. Med Pr. 2020;71(6):735-42.

The RAMP package for MSD risk management in manual handling - A freely accessible tool, with website and training courses.

In this paper the RAMP Package is presented with the objective to facilitate the application of the RAMP tool to systematically manage MSD risks. The package consists of the RAMP tool (Risk Assessment and Management tool for manual handling Proactively), the RAMP website, and free, globally available online, training courses (MOOCs). An Action module used for managing identified MSD risks is introduced. The tool, encompassing a wide range of risks, is applicable to the whole risk management process. Furthermore, RAMP is openly available for download, and free to use. The RAMP tool and training materials were developed using a participative iterative methodology including researchers and practitioners. RAMP was downloaded in 86 countries in the first 26 months since its' launch and over 2400 learners from high-, middle- and low-income countries have joined the MOOCs. The RAMP Package meets organisations' needs for an accessible, comprehensive risk assessment and management tool.

Educational needs of employees in work-related stress management.

BACKGROUND: Dynamic and intense socio-economic, scientific and technological development has both positive and negative effects on the business world. Due to increasing problems of work-related stress, the issue of stress management has arisen. Primary stress management and proactive interventions in work-related stress prevention are specifically activated. In this regard, the issue of educational needs of employees for the prevention of work-related stress is of particular importance. OBJECTIVE: The basic concern that has drawn our attention is whether employees generally show the desire and need to adopt the knowledge in the field of work-related stress prevention and relief and whether they are supported by the management of their business organization. METHODS: We used several methods to conduct this research: survey, scaling and comparative method. The comparative method was used for the analysis of legal documents in the field of occupational safety and health in six Balkan countries with the aim of determining the legal obligations of employers in managing workplace stress. The research population consisted of employees in small and medium-sized enterprises in the city of Kraljevo (the Republic of Serbia), while the research sample was determined by a random sampling method and included 450 respondents. RESULTS: Despite the recommendations of international organizations, the employers in most countries are not legally bound to deal with work-related stress management. The results have shown that there is a correlation between work-related risks/stressors and educational needs of employees for learning or acquiring knowledge in the field of work-related stress prevention. Employees express the desire to become acquainted with the possibilities of overcoming work-related stress. CONCLUSION: Employees' education and training have an invaluable role and considerable importance in primary, work-related stress management. The knowledge about the causes and mechanisms of work-related stress development is an important step towards its prevention. The research has shown that employees express the need for acquiring knowledge to prevent stress at work. In this regard, it is necessary to provide legally binding support of the manager in order to undertake the activities of work-related stress management. Interventions should target work-related stress at its source with a focus on prevention rather than an individual approach whose long-term benefits are uncertain.

Courses on Basic Occupational Safety and Health: A Train-the-Trainer Educational Program for Rural Areas of Latin America.

Integrating basic occupational health services into primary care is encouraged by the Pan American Health Organization. However, concrete initiatives are still scarce. We aimed to develop a training program focusing on prevention of occupational risks for primary healthcare professionals. This train-the-trainer program was piloted at four universities in Chile and Peru. Occupational health or primary healthcare lecturers formed a team with representative(s) of one rural primary healthcare center connected to their university (Nparticipants = 15). Training started with a workshop on participatory diagnosis of working conditions. Once teams had conducted the participatory diagnosis in the rural communities, they designed in a second course an active teaching intervention. The intervention was targeted at the main occupational health problem of the community. After implementation of the intervention, teams evaluated the program. Evaluation results were very positive with an overall score of 9.7 out of 10. Teams reported that the methodology enabled them to visualize hazardous working conditions. They also stated that the training improved their abilities for problem analysis and preventive actions. Aspects like time constraints and difficult geographical access were mentioned as challenges. In summary, addressing occupational health in primary care through targeted training modules is feasible, but long-term health outcomes need to be evaluated.

Job stress and needlestick injuries in nurses: a retrospective observational study.

BACKGROUND: The prevention of needlestick injuries (NSIs) in nurses employed in Emergency Departments (EDs) represents a special issue for healthcare organizations globally. Stressful working conditions, lack of organizational arrangements and lack of supporting one another at work, may contribute to increase the risk of NSIs. METHODS: We conducted an observational study to analyze: 1) the effectiveness of organizational interventions to minimize the occurrence of NSIs in ED nurses; 2) to measure the impact of such interventions on the safety budget. RESULTS: The occurrence of NSIs detected after organizational level interventions was significantly lower than the occurrence observed previously such interventions (p<0,05). By results, cost saving from managing fewer NSIs than the previous period was found. CONCLUSION: The study shows that the proactive, integrated and comprehensive management of organizational features at workplace brings benefits to employees and reduces the burden of the occurrence of NSIs. As result of the reduced NSIs frequency, the overall costs for follow-up of injured workers were reduced. (www.actabiomedica.it).

Occupational Safety and Health in a Community of Shellfish Divers: A Community-Based Participatory Approach.

In artisanal fishing communities in Chile, the access to occupational safety and health (OSH) is limited by factors such as the informality of employment. Our objective was to analyze the working and health conditions of workers in a coastal town in Southern Chile, under a community-based participatory approach. We carried out two independent social dialogue workshops within the community. The first one (N of participants = 25) was aimed to identify the strengths, weaknesses and challenges for preventing decompression sickness among divers. The second workshop (N of participants = 10) was set to identify the work processes and to map the occupational risks during seafood harvesting and processing in the community. Community members' training for handling and preventing decompression sickness among divers, and the collaboration between a local health representative, stakeholders and authorities, were identified as contributing factors in reducing fatalities and sequels among divers in the past. Technology and safety on board the vessels, training of healthcare personnel in OSH, and access to health programs, were identified as remaining challenges. Through risk mapping, the participants identified the relationship between working and health conditions in the community, reinforcing the necessity of improving access to health and social security. The community participation in identifying and analyzing working and health conditions could be the first step for a strategy to address OSH through primary health care in rural communities. Community empowerment and involvement in action plans, training on basic OSH for health care workers, and public policies are required.

Tracking Changes in US Organizations' Workplace Health Promotion Initiatives: A Longitudinal Analysis of Performance Against Quality Benchmarks.

PURPOSE: To examine changes in organizations' workplace health promotion (WHP) initiatives over time associated with repeated self-assessment using the Well Workplace Checklist (WWC). DESIGN: Well Workplace Checklist data include a convenience sample of US organizations that selected to assess their performance against quality WHP benchmarks. SETTING: Workplaces. SUBJECTS: In total, 577 US organizations completed the WWC in 2 or more years from 2008 to 2015. MEASURES: The WWC is a 100-item organizational assessment that measures performance against the original set of quality benchmarks that were established by the Wellness Council of America (WELCOA). ANALYSIS: This study examined changes in overall WWC scores as well as 7 separate benchmark scores. Multilevel modeling was used to examine changes in scores associated with repeated assessments, controlling for the year of assessment and organizational characteristics. RESULTS: There were significant increases in overall WWC scores (ß = 2.93, P < .001) associated with the repeated WWC assessments, after controlling for organizational characteristics. All 7 benchmark scores had significant increases associated with reassessment. Compared to other benchmarks, operating plan (ß = 6.18, P < .001) and evaluation (ß = 4.91, P < .001) scores increased more with each reassessment. CONCLUSION: Continued reassessment may represent more commitment to and investment in WHP initiatives which could lead to improved quality. Other factors that may positively influence changes in performance against benchmarks include company size, access to outside resources for WHP, and a history with implementing WHP.

Highlights from occupational safety and health continuing education needs assessment.

BACKGROUND: There is a lack of trained Occupational Safety and Health (OSH) professionals able to meet the current and future demand for such expertize in the United States. Many OSH professionals are required to perform duties, which are outside of their primary area of expertize; thus, expansion of continuing education (CE) may be necessary to properly train individuals for new OSH responsibilities. METHODS: The National Institute for Occupational Safety and Health-funded Education and Research Centers collectively developed and distributed an internet-based survey to gauge the CE needs and interests of the OSH workforce. RESULTS: A total of 2064 responses were received. The most common primary professions represented were safety (28%), occupational health nursing (18%), and industrial hygiene (12%). The majority of respondents (61%) reported that they perform work activities outside of those associated with their primary OSH profession. The CE offerings with the highest interest among respondents were related to safety. Other courses with high levels of interest included topics such as legal issues in OSH (88%), compliance (88%), risk management (85%), OSH management (83%), risk communication (83%), and communication in accident prevention (81%). Health and safety leadership (82%), health and safety culture (78%) and total worker health (74%) were also significant interests. CONCLUSIONS: It is important to be responsive to the evolving needs of the OS&H community. Developing relevant courses will help ensure that OS&H professionals have access to the training they need to perform essential job functions and keep employees healthy and safe.

A saúde do trabalhador da educação: a experiência de constituição de Cosates como dispositivo de intervenção numa rede municipal de ensino / The health of the education worker: an experience of citizenship as the devices of assistance in a municipal school network

O artigo apresenta uma experiência de pesquisa realizada em um município da Grande Vitória/ES no campo da educação pública, intitulada Programa de Formação e Investigação em Saúde e Trabalho. Visa a dar evidência ao modo como a pesquisa se efetivou, vislumbrando processos formativos no campo da educação com o objetivo de implantar Comissões de Saúde do Trabalhador. A proposta das comissões teve como direção metodológica as comunidades ampliadas de pesquisa para o exercício coletivo de análise da atividade docente. A direção metodológica foi a da pesquisa-intervenção e a produção de dados se efetivou a partir das narrativas produzidas nas rodas de conversa e do diário de campo. Apresenta como foram construídos esses instrumentos e ferramentas de análise para incrementar o debate sobre a saúde dos trabalhadores na Educação. Indica, ainda, o modo como a pesquisa, a partir da constituição de um fórum intersetorial buscou a experimentação da implementação de comissões de saúde do trabalhador da educação nas escolas. Os resultados indicam que a estratégia das Comissões por local de trabalho é um potente instrumento para intervir nas condições adversas de trabalho nas escolas.

This article presents a research experience made in a municipality of Grande Vitória / ES in the field of public education, entitled Training and Research Program in Health and Work. It aims at hilightimg the way in which educational processes were carried out in the field of education in the state of Espírito Santo, based on an intervention research, with the objective of implanting Workers’ Health Committees in the municipality. The proposal of the commissions was directed to the enlarged communities of research for the collective exercise of analysis of the teaching activity. Methodologi cal dire ction and data production took place through chat groups and the field diary. It presents how these instruments were built and their analysis to increase the debate about the health of workers in Education. It also indicates how research, based on the creation of an intersectoral forum sought to experiment with the implementation of health workers’ commissions on education in schools. The results show that the Commissions for Workplace strategy is a powerful tool to intervene in adverse working conditions in schools

Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study.

BACKGROUND: Assessing the cost effectiveness of training aimed at increasing general practitioners' (GP) work awareness and patients' work-related self-efficacy and quality of life. METHODS: A cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs' work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12 h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients' work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs' work awareness. Data were collected at baseline, after 6 and 12 months. RESULTS: Data of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of €770) in favor of the intervention group were not significant. CONCLUSIONS: The training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective.

From Research-to-Practice: An Adaptation and Dissemination of the COMPASS Program for Home Care Workers.

The COMmunity of Practice And Safety Support (COMPASS) program was developed to prevent injuries and advance the health and well-being of home care workers. The program integrates elements of peer-led social support groups with scripted team-based programs to help workers learn together, solve problems, set goals, make changes, and enrich their supportive professional network. After a successful pilot study and randomized controlled trial, COMPASS was adapted for the Oregon Home Care Commission's training system for statewide dissemination. The adapted program included fewer total meetings (7 versus 13), an accelerated meeting schedule (every two weeks versus monthly), and a range of other adjustments. The revised approach was piloted with five groups of workers (total n = 42) and evaluated with pre- and post-program outcome measures. After further adjustments and planning, the statewide rollout is now in progress. In the adaptation pilot several psychosocial, safety, and health outcomes changed by a similar magnitude relative to the prior randomized controlled trial. Preliminary training evaluation data (n = 265) show high mean ratings indicating that workers like the program, find the content useful, and intend to make changes after meetings. Facilitating factors and lessons learned from the project may inform future similar efforts to translate research into practice.

Outreach to Low-Wage and Precarious Workers: Concept Mapping for Public Health Officers.

OBJECTIVE: To explore concept mapping (CM) as a participatory methodology that can be used by public health officials to strategize approaches to reducing health inequities among low wage workers and workers with unstable employment. METHODS: In a workshop of 68 occupational health officers, mainly from government agencies, CM was demonstrated through gathering and prioritizing ideas for reaching underserved, at-risk working populations. RESULTS: Prior to the workshop, occupational health officers generated 99 brainstormed ideas on how to reach underserved workers. These were reduced to 39 unique items, which workshop participants then sorted into themes and prioritized based on perceived effectiveness and feasibility. Twelve specific approaches covering enhanced surveillance methods, occupational safety and health (OSH) training, and partnering with employers, other agencies, and community groups were considered most actionable by occupational/public health officers to address the health of low-wage, and precarious workers. In a follow-up session 1 year later, a subset of participants discussed the findings. CONCLUSION: Concept mapping can be used to elucidate actionable approaches by government agencies to better address occupational health inequities experienced by low wage and precarious workers.

Effectiveness of Health and Safety Training in Reducing Occupational Injuries Among Harvesting Forestry Contractors in KwaZulu-Natal.

Forestry work is generally characterized by a combination of personal and environmental risks in health and safety. Employers need to ensure intensive and continuous safety training to mitigate these risks; however, the efficacy of this training is seldom evaluated. The aim of this study was to assess the effectiveness of health and safety training in reducing injuries and improving knowledge, attitudes, and perceptions toward safety among forestry workers in KwaZulu-Natal (KZN), South Africa. A descriptive cross-sectional study was conducted among 300 harvesting contract workers employed at a forestry company in KZN. A questionnaire to assess the efficiency of health and safety training was administered. In addition, a retrospective review of the injury register and medical records of employees who sustained work-related injuries from 2009 to 2013 was completed. The company injury data for harvesting contractors reported 68 lost-time injuries during postcommencement of training. Slip, trip, and fall injuries were the most reported cause of injuries, particularly among manual harvesters. Respondents who were male, younger in age, and with less experience had an increased risk of occupational injury. Most participants displayed adequate knowledge of safety and were able to translate training into practice. The health and safety training initiative was successful in reducing injuries and increasing workers' awareness of, and responsibility for, health and safety issues.

Wellness room as a strategy to reduce occupational stress: quasi-experimental study.

OBJECTIVE: To compare occupational stress levels of nurse staff working in the surgical unit before and after the intervention "wellness room". METHOD: Quasi-experimental study with a sample of 60 nurse staff working in a surgical unit of a teaching hospital in the Southern Region of Brazil. The intervention was conducted in a room in the workplace for six months and consisted of sections of aesthetic care, relaxation, lectures and workshops to reduce occupational stress. Data were collected through the Demand-Control-Support Questionnaire before and after the intervention, and the comparative analysis was performed by the Wilcoxon test. RESULTS: After the intervention, there was a decrease in demand and an increase in control and in the social support received at work in all professional categories, but the differences were not statistically significant. CONCLUSION: The intervention "wellness room" reduced occupational stress levels in the sample studied; however, it was not a significant decrease.

Education and Training in Global Occupational Health and Safety: A Perspective on New Pathways to Sustainable Development.

The institution of specific Occupational Health and Safety (OHS) training programs open to international trainees from developing countries in some European, American and Asian universities is now a well-established reality. Courses and seminars that focus particularly on this subject, widely varying in approach and duration, have been held for years at these universities; these academic institutions have combined their potential to attract students from developing countries with the scheduling of interesting lectures and training activities, depending on the availability of funds sufficient to cover travel and lodging costs. Interdisciplinarity is the key to the entire program and is its main strength, as the trainees have the opportunity to condense the technical notions and methodological aspects of different disciplines (occupational health, industrial hygiene, safety management, ergonomics) in one course. We firmly believe that these programs are a precious instrument for the training of occupational health professionals from low-income countries, as they are able to address their choices correctly, hopefully achieving the goal of reducing the human costs of development.

The State of Higher Education in Occupational Health and Safety in Central Asian Countries.

A healthy workforce is vital for the sustainable social and economic development of any country. Assuring occupational health and safety (OHS) depends not only on the passing of quality working legislation and inspection of workplaces, but also on preparation of qualified specialists on OHS. Aimed at assessing of relevance of the content of training at Central Asian universities to the needs in prevention of risks of accidents and injuries and promotion of a preventive culture in the workplace, and finding out how they are compliant with the recommendations of the Mainstreaming occupational safety and health into the education (2010), we examined curricula of 20 medical and non-medical universities across Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.The analysis of training programs showed that education in OHS and preparation of qualified specialists in Central Asiana countries is up-to-date and tailored to local needs for prevention of risks of accidents and injuries and promotes the notion of a preventive culture in the workplace.