Fuzzy Logic Modeling of Factors Affecting Musculoskeletal Disorders in a Steel Factory in Iran: A Cross-Sectional Study.

OBJECTIVES: The aim of this study was to model associated factors affecting musculoskeletal disorders (MSDs), using fuzzy logic in a steel factory in Iran. METHODS: A cross-sectional study was conducted on steel industry workers. A 6-part questionnaire was used, consisting of demographic characteristics, occupational stress, work-family conflict, general health, occupational postures, and Nordic Musculoskeletal Questionnaire. Pearson correlation was used for statistical analysis. RESULTS: The prevalence of MSDs for 270 participants in the studied factory was 94.8%. Job stress, work-family conflict, general health, and work posture had a statistically significant relationship with MSDs (P < .05). The fuzzy model demonstrated 23.8% predictability for the actual data of the study. The defuzzification data had significant correlation with real data of MSDs. CONCLUSIONS: The results of this study provided a new perspective about associated factors affecting MSDs and demonstrate that fuzzy logic can be used as a possible tool for evaluating MSDs.

The asymmetric effect of air quality on cross-industries' stock returns: evidence from China.

This paper offers a perspective for the link between air quality and stock returns in China through quantile Granger causality test. Compared to previous studies, the study makes the following innovations. Given the Chinese government plays an important role in economic development, its industrial policies are regarded as a new indispensable supplement of analysis framework apart from investor mood. Next, due to different reflections from cross-industries for different AQ levels, the industry heterogeneity is further considered. Also, nine industries are chosen as a sample, including environmental protection, wind power equipment, steel, photovoltaic equipment, thermal power, tourism, coal, medical service, and medical equipment. Besides, the quantile Granger causality test is robust to misspecification errors when detecting the potential dependence structure between the variables of air quality and stock returns. The empirical results show that the causal link exists in all industries, except medical service. Meanwhile, this impact presents asymmetrical features that when air quality is unhealthy, it has an influence on stock returns of the remaining eight industries. It can be explained by increasing cortisol level, more stringent environmental protection, and industrial policies. These conclusions have essential implications for market participants due to the fact that air quality generates various influences on the stock market. That is why a sustainable environmental design, strict regulatory framework, and special monitoring activities should be highly regarded in China.

Dirty work: cultural iconography and working-class pride in industrial apprenticeships.

In the seemingly routine and the everyday, lie layers of cultural and social symbolism. So it is with dirt. This article examines the social and cultural roles of dirt within socialization practices in working-class industrial and ex-industrial communities. Drawn from oral history accounts with 46 former and current engineering apprentices, the discussion demonstrates dirt as a concept and a practicality, and how the idea of 'getting dirty' provided a cultural imagery used to renegotiate moral boundaries that devalue working class, masculine experiences and identities. Building on from the work of Skeggs (1997, 2004, 2011), it demonstrates the lived experience of value within the industrial workplace past and present. Through dirt, the role of cultural artefacts and iconography within working-class experience and workplace training is explored. Additionally, the role of a cultural icon like dirt in the intergenerational dialogues of workplace communities is given new attention. In doing so the article argues that while after decades of underinvestment in apprenticeships as a model for training in the UK, a recent resurgence in interest can go some way in overcoming the long-term effects of the loss of large-scale industrial work. However, the cultures of work attached to the apprenticeships of the past are, within deindustrialization, much more complicated to develop or recreate.

Caring for Workers' Health: Do German Employers Follow a Comprehensive Approach Similar to the Total Worker Health Concept? Results of a Survey in an Economically Powerful Region in Germany.

Similar to 'Total Worker Health' in the United States (USA), 'Workplace Health Management' in Germany is a holistic strategy to protect, promote, and manage employees' health at the workplace. It consists of four subcategories. While the subcategories 'occupational health and safety' and 'reintegration management' contain measures prescribed by law, 'workplace health promotion' and 'personnel development' can be designed more individually by the companies. The present study focused on the current implementation of voluntary and legally required measures of the four subcategories, as well as companies' satisfaction with the implementation. A total of N = 222/906 companies (small, medium, and big enterprises of one German county) answered a standardized questionnaire addressing the implementation of health-related measures, satisfaction with the implementation, and several company characteristics. In the subcategory 'occupational health and safety', 23.9% of the companies fulfilled all of the legally required measures, whereas in the category 'reintegration management', that rate amounted to 50.9%. There was a positive correlation between company size and the implementation grade, and as well between company size and the fulfilling of measures required by law. Companies tended to be more satisfied with higher implementation grades. Nevertheless, a surprisingly high proportion of the companies with poor implementation indicated satisfaction with the measures' implementation.

Using risk elasticity to prioritize risk reduction strategies for geographical areas and industry sectors.

The total quantity of chemical emissions does not take into account their chemical toxicity, and fails to be an accurate indicator of the potential impact on human health. The sources of released contaminants, and therefore, the potential risk, also differ based on geography. Because of the complexity of the risk, there is no integrated method to evaluate the effectiveness of risk reduction. Therefore, this study developed a method to incorporate the spatial variability of emissions into human health risk assessment to evaluate how to effectively reduce risk using risk elasticity analysis. Risk elasticity analysis, the percentage change in risk in response to the percentage change in emissions, was adopted in this study to evaluate the effectiveness and efficiency of risk reduction. The results show that the main industry sectors are different in each area, and that high emission in an area does not correspond to high risk. Decreasing the high emissions of certain sectors in an area does not result in efficient risk reduction in this area. This method can provide more holistic information for risk management, prevent the development of increased risk, and prioritize the risk reduction strategies.

Work-related injuries in a state trauma registry: relationship between industry and drug screening.

BACKGROUND: Work-related injuries exert a great financial and economic burden on the US population. The study objectives were to identify the industries and occupations associated with worker injuries and to determine the predictors for injured worker drug screening in trauma centers. METHODS: Work-related injury cases were selected using three criteria (expected payer source of workers' compensation, industry-related e-codes, and work-related indicator) from the Kentucky Trauma Registry data set for years 2008 to 2012. Descriptive analyses and multiple logistic regression were performed on the work-related injury cases. RESULTS: The "other services" and construction industry sectors accounted for the highest number of work-related cases. Drugs were detected in 55% of all drug-screened work-related trauma cases. Higher percentages of injured workers tested positive for drugs in the natural resources and mining, transportation and public utilities, and construction industries. In comparison, higher percentages of injured workers in the other services as well as transportation and public utilities industries were drug screened. Treatment at Level I trauma centers and Glasgow Coma Scale (GCS) scores indicating a coma or severe brain injury were both significant independent predictors for being screened for drugs; industry was not a significant predictor for being drug screened. The injured worker was more likely to be drug screened if the worker had a greater than mild injury, regardless of whether the worker was an interfacility transfer. CONCLUSION: These findings indicate that there may be elevated drug use or abuse in natural resources and mining, transportation and public utilities, as well as construction industry workers; improved identification of the specific drug types in positive drug screen results of injured workers is needed to better target prevention efforts. LEVEL OF EVIDENCE: Epidemiologic study, level III.

Lead exposure and blood pressure among workers in diverse industrial plants in Kenya.

The study evaluated airborne exposures and blood lead (BPb) levels in 233 production workers at six diverse industrial plants in Kenya. Blood and personal breathing zone air samples were collected and analyzed for lead (Pb) using atomic absorption spectroscopy. Blood pressure (BP) levels were measured using a standard mercury sphygmomanometer. The results indicated mean airborne Pb levels ± standard deviation (SD) as follows: 183.2 ± 53.6 µg/m(3) in battery recycling, 133.5 ± 39.6 µg/m(3) in battery manufacturing, 126.2 ± 39.9 µg/m(3) in scrap metal welding, 76.3 ± 33.2 µg/m(3) in paint manufacturing, 27.3 ± 12.1 µg/m(3) in a leather manufacturing, and 5.5 ± 3.6 µg/m(3) in a pharmaceutical plant. The mean airborne Pb levels exceeded the U.S. Occupational Safety and Health Administration (OSHA) 8-hr time-weighted average (TWA) permissible exposure limit (PEL) for Pb of 50 µg/m(3) in the battery manufacturing, battery recycling, welding, and paint manufacturing plants. Similarly, mean BPb concentrations exceeded the American Conference of Governmental Industrial Hygienists (ACGIH®) biological exposure index (BEI) for Pb of 30 µg/dl. A significant positive association was observed between BPb and breathing zone air Pb (R(2) = 0.73, P < 0.001). Approximately 30% of the production workers (N = 233) were in the hypertensive range with an average systolic and diastolic blood pressure (BP) of 134.7 ± 12.7 mmHg and 86.4 ± 8.9 mmHg, respectively. In the multivariate regression analysis, age, duration of work, airborne Pb and BPb levels were significantly associated (P < 0.05) with a change in BP. We recommend improved engineering controls, work practices, and personal hygiene to reduce Pb exposures. In addition, workers should undergo comprehensive medical surveillance to include BPb and BP testing, and airborne Pb assessments in all industries with significant lead exposures.

WNA's worldwide overview on front-end nuclear fuel cycle growth and health, safety and environmental issues.

This paper presents the WNA's worldwide nuclear industry overview on the anticipated growth of the front-end nuclear fuel cycle from uranium mining to conversion and enrichment, and on the related key health, safety, and environmental (HSE) issues and challenges. It also puts an emphasis on uranium mining in new producing countries with insufficiently developed regulatory regimes that pose greater HSE concerns. It introduces the new WNA policy on uranium mining: Sustaining Global Best Practices in Uranium Mining and Processing-Principles for Managing Radiation, Health and Safety and the Environment, which is an outgrowth of an International Atomic Energy Agency (IAEA) cooperation project that closely involved industry and governmental experts in uranium mining from around the world.

An ecological and economic assessment methodology for coastal ecosystem management.

An adaptation of the Drivers-Pressure-State-Impact-Response methodology is presented in this work. The differential DPSIR (DeltaDPSIR) was developed to evaluate impacts on the coastal environment and as a tool for integrated ecosystem management. The aim of the DeltaDPSIR is to provide scientifically-based information required by managers and decision-makers to evaluate previously adopted policies, as well as future response scenarios. The innovation of the present approach is to provide an explicit link between ecological and economic information related to the use and management of a coastal ecosystem within a specific timeframe. The application of DeltaDPSIR is illustrated through an analysis of developments in a Southwest European coastal lagoon between 1985 and 1995. The value of economic activities dependent on the lagoon suffered a significant reduction (ca. -60%) over that period, mainly due to a decrease in bivalve production. During that decade the pressures from the catchment area were managed (ca. 176 million Euros), mainly through the building of waste water treatment plants. Notwithstanding this, the ecosystem state worsened with respect to abnormal clam mortalities due to a parasite infection and to benthic eutrophication symptoms in specific problematic areas. The negative economic impacts during the decade were estimated between -565 and -315 million Euros, of which 9-49% represent the cost of environmental externalities. Evaluation of these past events indicates that future management actions should focus on reducing the limitation on local clam seeds, which should result in positive impacts to both the local socio-economy and biodiversity.

Backyard of the rich north: the climate change-related vicious circle of the Arctic zone.

The Arctic zone is full of controversies, unknowns, contrasts, and challenges. The following example is enlightening. Saudi Arabia is a country that has been considered to have almost unlimited possibilities because of its enormous oil earnings. The country has US$60 thousand million purchasing power parity oil income each year for its mere 22 million inhabitants. Astonishingly, the Arctic zone's income from oil, gas, and minerals is at least as large as that of Saudi Arabia, modestly estimated, but the Arctic has less than 4 million people. Most money, however, flows away from the tundra, yet social and environmental problems remain there. A part of the side effect of consuming these resources-largely fossil fuels-returns to the Arctic in the form of greenhouse warming and all its consequences. The Arctic zone now warms at approximately double the rate of the world average.

[Medical insurance consultation through the medical society in the PKV--a quantitative analysis]. / Versicherungsmedizinische Beratung durch den Gesellschaftsarzt in der PKV--eine quantitative Analyse.

Insurance medical consultation by a medical consultant or medical director is well established at many companies in the German private health insurance sector. Nevertheless, the field of activity of the medical consultant is hardly known to the public and even less scientifically investigated. The present study deals with a quantitative analysis of insurance medical enquiries to medical consultants. For this, the total of all insurance medical enquiries in a whole year have been checked and classified. The total of 5116 enquiries shows that a large demand for consultation refers to the medical necessity of medicaments, followed by consultation on complementary and alternative medicine (CAM). Further important fields of consultation are the assessment of out-patient and in-patient psychotherapy, the verification of the extent of physical measures, the duration of hospital treatments, the extent of laboratory testing, the examination of new medical methods and the definition of cure measures in comparison with hospital treatment. Increasing demand exists for the definition of the necessity of out-patient and in-patient operations, the definition of cosmetic surgery and medically necessary plastic surgery and for questions of reproductive medicine. There is also increasing demand for consultation regarding lifestyle drugs and anti-aging medicine.

Review of 1 year's activity in the Grampian travel clinic: the importance of the oil industry.

BACKGROUND: A review of the activities of the Grampian travel clinic was carried out over 1 year to obtain an overall perspective of the clinic workload and to determine how much of the workload was dependent on the oil industry. METHODS: A specially designed data collection sheet was completed for each of the 669 consultations conducted at the Grampian travel clinic, Aberdeen, between February 1, 2002, and January 31, 2003. RESULTS: Patients attending the clinic came in equal numbers from the city of Aberdeen and the Grampian region. Twenty-five percent were traveling for work purposes: 87.4% of this travel was oil related, and most patients were headed to Africa. The commonest vaccines given were for yellow fever, Japanese B encephalitis, and rabies, reflecting the specialist nature of the clinic. Most travelers did leave adequate time for immunization before travel. The public is still apprehensive about using mefloquine as malarial prophylaxis. CONCLUSIONS: Most attendees were traveling on holiday, but a quarter of the consultations were for travel related to the oil industry. Almost 70% of attendees had already visited their general practitioner and were therefore attending the clinic for specialist advice and vaccines. There is a need for increased clinic capacity.

How much do kids count in corporate board rooms? Results from the first survey of Fortune 1000 companies.

OBJECTIVE: The objective of this study was to characterize the extent of the business community's commitment to children, particularly with respect to understanding its role in assuring children's health and development, by conducting a survey of the largest US companies. METHODS: A survey of year 2001 Fortune 1000 companies was performed to determine whether their mission statements, vision statements, or guiding principles include a commitment to children; whether they employ people under the age of 18 years in the United States; whether they encourage their employees to mentor children under the age of 18 years; whether they have an affiliated philanthropic foundation; whether their company's philanthropy focuses specifically on children; and whether they participate in any activities that particularly help disadvantaged children. The survey consisted of 2 mailings followed by phone calls to companies to obtain answers to the questions listed above and answers to additional questions that asked specifically about the company's financial expenditures for parental leave, child care, and healthcare for children of employees and about the company's specific philanthropic giving aimed at helping children. Descriptive information about some of the ways that companies impact the lives of children was also obtained to provide context for the responses. RESULTS: Data were obtained from 333 year 2001 Fortune 1000 companies (33%) between March 20, 2002 and March 20, 2003, with a good representation of all industry sectors. These data suggest that approximately 33% of the companies that responded have mission statements, vision statements, or guiding principles that specifically include a commitment to children. Employment opportunities for children under the age of 18 years in the United States exist at approximately 41% of these companies. These companies clearly see mentoring as a major theme, with 77% of them encouraging their employees to mentor children under the age of 18 years. Approximately 60% of the companies that responded support affiliated, independent philanthropic foundations, and approximately 55% of companies indicated that they focus their philanthropy specifically (although not exclusively) on children. Approximately 80% of these companies indicated that they participate in at least one activity that helps disadvantaged children. Many companies faced challenges in estimating their overall investments in children, particularly given their large and decentralized nature, but they were able to provide an overall sense of their commitment and they indicated that they could provide quantitative data prospectively if they knew it would be requested. CONCLUSION: Many companies that responded play a major role in supporting children's health and development in the United States both directly and indirectly. Further efforts to better quantify the business community's aggregate commitments to improving children's health and development should be sought to allow better estimation of the amount of resources expended and the impact of these investments on children.

The effectiveness of standard care, early intervention, and occupational management in worker's compensation claims.

STUDY DESIGN: A retrospective and prospective cohort. OBJECTIVES: To compare the effectiveness of occupational intervention, early intervention, and standard care in the management of Worker's Compensation injury claims. SUMMARY OF BACKGROUND DATA: The current management of occupational back pain and work-related upper extremity disorders with either standard care or early intervention appears to be ineffective. METHODS: A retrospective cohort compared injury claim incidence, duration, and costs between one company with access to standard care and another similar company with access to early intervention. A prospective cohort looked at the effect of one company changing from standard care to occupational management in comparison with the control group with early intervention. Survival analysis was used to attempt to explain differences in injury claim duration. RESULTS: Standard care resulted in lower injury claim incidence, duration, and costs than early intervention, whereas occupational management resulted in lower injury claim incidence, duration, and costs than standard care. The covariates of physical therapist involvement, chiropractor involvement, injury severity, and relationship between Worker's Compensation and the employer were associated with delayed time to claim closure in the company with access to early intervention with the most important covariate being physical therapist involvement (hazard rate ratio 19.88, 95% confidence interval 7.95-39.77). Only the covariate of injury severity was associated with delayed time to claim closure in the company with access to occupational management (hazard rate ratio 1.67, 95% confidence interval 1.05-27.20). CONCLUSIONS: It is recommended that an occupational management approach, in comparison with standard care or early intervention, be considered for management of occupational injuries.

Life style and occupational risk factors for bladder cancer in Germany. A case-control study.

A hospital-based, case-control study of 531 male and 144 female matched pairs was conducted in Germany to analyze the role of nonoccupational and occupational risk factors in the etiology of tumors of the lower urinary tract (bladder cancer). Smoking of cigarettes was associated with an odds ratio (OR) of 3.6 for men and 3.2 for women, compared with not smoking and showed a significant dose- and time-response relationship for both sexes. Heavy pipe smoking significantly increased the risk (OR = 1.9 in men), and smoking of cigars did not alter the risk of bladder cancer. Controlling for smoking, a significantly twofold or more increase in risk was found for heavy consumption of coffee in both sexes and for heavy intake of beer in males. Increasing levels of total fluid intake were associated with increasing, smoking-adjusted risks in men. Significant associations were found for chronic infection of the lower urinary tract (OR = 1.8), familial history of bladder cancer (OR = 2.5), and frequent consumption of high fat meals (OR = 1.4) among men and for frequent consumption of canned food in both sexes (OR = 1.7 for males, 2.4 for females). With regard to occupational history, significantly elevated odds ratios were found for ever-employment in the printing (5.0), plastics and synthetics (2.6), rubber (2.5), mining (2.0), and dyestuffs (1.9) industries, for exposure to spray paints (2.9), zinc (2.3), chromium/chromate (2.2), oils (1.5), petroleum (1.4), stone dust (1.4) and metal dust/fumes (1.3), and for occupation as mining worker (2.0) and truck driver (1.8) among men. Multivariate logistic regression analysis showed significant contribution of coffee and beer drinking, ingestion of canned food, and familial occurrence of urothelial tumors to the risk of bladder cancer in men after accounting for the effects of tobacco smoking, occupational exposures, and a history of bladder infection. These other variables did not influence the risk attributable to occupational exposures.