Exploring Occupational Health Professionals Understanding and Needs in Regard to Total Worker Health (TWH).

BACKGROUND: Occupational health professionals (OHPs) are in a unique position to impact the health and well-being of employees at work and outside of work. One way of achieving this holistic health goal is to integrate the concept of Total Worker Health® (TWH) into the organization's culture. It is critical for OHPs to develop the ability to incorporate TWH into their practices, yet there are gaps in our understanding of OHP's attitudes toward change and toward TWH, their level of TWH knowledge, and the number of OHPs who have adopted TWH. METHODS: An electronic survey was administered to a national sample of 4,777. This cross-sectional study used Qualtrics to record survey responses measuring knowledge of TWH, attitude toward change, resistance to change, transformational leadership ability, perception of organizational readiness, and leadership commitment. FINDINGS: The total sample size was 253 (5.3%). Most respondents were bachelors prepared nurses (75.1%) with greater than 10 years' experience (71.5%) and employed in manufacturing (42.6%). Approximately 74% (n = 125) of respondents knew about TWH, but did not have a program in place or were unsure of the existence of one. A high percentage (74.0%) were open to implementing TWH, had favorable attitudes toward change (M = 3.9 on a 5-point Likert-type scale), but needed education on how to move forward (56.0%). CONCLUSIONS/APPLICATION TO PRACTICE: Findings suggest that most OHPs know about TWH, but generally have not adopted the TWH concept at their worksites. However, they are open to implementing TWH programs and have favorable attitudes toward change.

Fetal Diagnosis and Therapy during the COVID-19 Pandemic: Guidance on Behalf of the International Fetal Medicine and Surgery Society.

The COVID-19 pandemic has stressed patients and healthcare givers alike and challenged our practice of antenatal care, including fetal diagnosis and therapy. This document aims to review relevant recent information to allow us to optimize prenatal care delivery. We discuss potential modifications to obstetric management and fetal procedures in SARS-CoV2-negative and SARS-CoV2-positive patients with fetal anomalies or disorders. Most fetal therapies are time sensitive and cannot be delayed. If personnel and resources are available, we should continue to offer procedures of proven benefit, acknowledging any fetal and maternal risks, including those to health care workers. There is, to date, minimal, unconfirmed evidence of spontaneous vertical transmission, though it may theoretically be increased with some procedures. Knowing a mother's preoperative SARS-CoV-2 status would enable us to avoid or defer certain procedures while she is contagious and to protect health care workers appropriately. Some fetal conditions may alternatively be managed neonatally. Counseling regarding fetal interventions which have a possibility of additional intra- or postoperative morbidity must be performed in the context of local resource availability. Procedures of unproven benefit should not be offered. We encourage participation in registries and trials that may help us to understand the impact of COVID-19 on pregnant women, their fetuses, and neonates.

Occupational Well-Being in Sexual Assault Victims and Survivors.

Purpose: While researchers have established that sexual assault may adversely affect successful employment and academic achievement, little is known about the barriers and facilitators of occupational well-being from the perspective of sexual assault survivors. This study assessed the barriers and facilitators of occupational well-being. Design: Constructivist grounded theory. Method: Digitally recorded, semistructured interviews were used to collect data. Data were collected from 22 adult female sexual assault survivors. Analysis consisted of coding, creation of data matrices, and within and across case analysis. Findings: Theoretical saturation was achieved after interviews with 22 participants. Barriers to occupational well-being were mental health symptoms and diagnoses, substance abuse, inflexible attendance policies, and workplace bullying. Facilitators to occupational well-being were personal coping strategies, and organizational and social support. Conclusions: Sexual assault has significant effects on the occupational well-being of women. The work or academic environment can exacerbate the harms of sexual assault or facilitate healing in sexual assault survivors. To facilitate the occupational well-being of sexual assault survivors, workplaces and academic institutions can adopt a trauma-informed approach, create policies that allow for time off to deal with sequela of sexual assault, implement anti-bullying programs, and make resources for gendered violence available.

Demands for multidimensional information on the work environment: A methodological framework for regular studies.

BACKGROUND: Development of methodologies for making economic decisions on designing work environment studies is a theoretical challenge for researchers in occupational health sciences. There are well-defined tools available in the relevant literature for analysis of cost-efficiency associated with the assessment of an occupational exposure of interest. However, these analytical tools are not appropriate for holistic studies of the work environment as a multidimensional reality. OBJECTIVE: This article introduces an appropriate methodology for designing cross-sectional comprehensive studies of the work environment, in order to optimize the production of information on the psychosocial, ergonomic, and physical dimensions of the work environment in regular studies. METHODS: The employment of a translog cost-utility function is suggested as a suitable way to provide cost-minimized designs for regular studies which are aimed at providing or developing multidimensional information systems of the work environment. RESULTS: The translog cost-utility function is not subject to predetermined restrictions, but has a flexibility property allowing it to be transformed to any specification that is adaptable to the specific work environmental characteristics and research requirements. CONCLUSION: The translog cost-utility function is an appropriate econometric model for optimizing the production of multidimensional information on occupational exposures in regular cross-sectional workplace studies.

Developing an Integrated Approach to Workplace Mental Health: A Hypothetical Conversation with a Small Business Owner.

An integrated approach to workplace mental health encompasses three main areas of activity: (i) protecting mental health by reducing work-related and other risk factors for mental health problems, (ii) promoting mental health by developing the positive aspects of work as well as worker strengths and positive capacities, and (iii) responding to mental health problems as they manifest at work regardless of cause (work-related or otherwise). This represents an effort to distil what is a complex issue warranting a correspondingly complex set of responses into information for action that is accessible and engaging to workplace stakeholders, and that enables workplaces to begin from varying starting points to build over time towards mature multicomponent workplace mental health programs. This article, based on a plenary presentation at the Understanding Small Enterprises 2017 international conference (25-27 October 2017, Denver), is presented in two parts. Part I is a concise summary of our integrated approach to workplace mental health. Part II presents a hypothetical conversation with a small business owner/operator who has yet to implement workplace mental health programs, but is considering doing so. In this Conversation, representing an effort in knowledge translation, we attempt to convince the small business owner/operator to begin taking action.

Occupational Noise-Induced Hearing Loss.

: Occupational hearing loss is preventable through a hierarchy of controls, which prioritize the use of engineering controls over administrative controls and personal protective equipment. The occupational and environmental medicine (OEM) physician plays a critical role in the prevention of occupational noise-induced hearing loss (NIHL). This position statement clarifies current best practices in the diagnosis of occupational NIHL.

[Influencing factors for reproductive health of female workers in petrochemical industry].

Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[OR]= 1.856) , unhealthy living habits (OR=1.542) , and positive events (OR=1.516) had greater impact on reproductive system diseases. Conclusion: Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

Condições de trabalho de equipes de saúde da família do Pará / Working conditions of Family Health Teams from Pará / Condiciones de trabajo de los Equipos de Salud Familiar de Pará

Esta pesquisa investiga as condições de trabalho das equipes de saúde da família do estado do Pará com base nos dados do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Foram selecionados registros referentes às condições de trabalho de 776 equipes, tais como: agentes contratantes, tipo de vínculo, materiais e estrutura das unidades. Realizou-se uma Estatística Descritiva. Como resultado, percebeu-se que a maioria dos contratos de trabalho são temporários (65,4%) e a maior forma de seleção dos trabalhadores é por meio de indicação (36,7%). As unidades de saúde têm, em sua quase totalidade, sala de recepção e espera (94,5%) e sala de vacina (89,2). A melhoria das condições de trabalho das equipes é fundamental para sustentar a saúde destes trabalhadores e trabalhadoras. Ela pode reduzir adoecimentos e acidentes no trabalho, além de aumentar a resolutividade do cuidado.(AU)

This study investigates the working conditions of the family health teams from state of Pará based on the data of the National Program for Access and Quality Improvement in Primary Care. Records were selected that refer to the working conditions of 776 teams from the State of Pará, such as: forms of employment, type of employment contract, materials and the structural part of the health units. Descriptive Statistics were performed. As a result, it was noticed that most of the employment contracts are temporary (65.4%) and the largest form of employee selection is by indication (36.7%). Almost all of the health units have reception and waiting room (94.5%) and vaccine room (89.2). The improvement of the working conditions of the teams is fundamental to sustain the health of these workers. It can reduce illness and accidents at work. As well as increasing the resolution of the care.(AU)

Este estudio investiga las condiciones de trabajo de los equipos de salud familiar del estado de Pará con base en los datos del Programa Nacional de Acceso y Mejoramiento de la Calidad en Atención Primaria. Se seleccionaron registros que se refieren a las condiciones de trabajo de 776 equipos, tales como: formas de empleo, tipo de contrato de trabajo, materiales y la parte estructural de las unidades de salud. Se realizaron Estadísticas Descriptivas. Como resultado, la mayoría de los contratos de trabajo son temporales (65,4%) y la mayor forma de selección de empleados es por indicación (36,7%). Casi todas las unidades de salud disponen de recepción y sala de espera (94,5%) y sala de vacunas (89,2). La mejora de las condiciones de trabajo de los equipos es fundamental para sostener la salud de estos trabajadores. Puede reducir la enfermedad y los accidentes en el trabajo y aumentar la resolución del cuidado.(AU)

Health-promoting leadership: An integrative review and future research agenda.

AIM: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions. BACKGROUND: Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments. DESIGN: Integrative literature review. DATA SOURCES: Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016. REVIEW METHODS: Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo. RESULTS: Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity. CONCLUSION: Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership.

Fitness-for-Duty Assessments of Industrial Firefighters: Guidance for Occupational Medicine Physicians.

: Industrial firefighters share many characteristics with municipal firefighters; however, employers frequently have not addressed or characterized the unique job duties, hazards, and specific physical/mental demands associated with industrial firefighting. In addition, gaps exist in the medical literature with regard to industrial firefighter demographics, behavioral risk factors, and chronic diseases. Finally, the proper methodologies for fitness-for-duty assessment of employees acting in this capacity are lacking. To address these gaps, the American College of Occupational and Environmental Medicine (ACOEM) convened a Task Force in 2014, to develop fitness-for-duty guidance for industrial firefighters. This document highlights these gaps and suggests research opportunities to enhance the health and safety of this population. While an extensive literature review found a lack of studies for this population-thus excluding the development of an evidence-based document-sufficient materials were available from which to draw preliminary conclusions, considerations for best practices, and recommendations for future studies.

Situation of Occupational and Environmental Health in Mexico.

BACKGROUND: Mexico has a great diversity and richness of natural resources, but evaluations of the quality of life of Mexicans show the deep inequalities and the gap between rich and poor. While 5% of families concentrate 58% of the wealth, the health spending in environment and health is 0.2 and 2.7 of the GDP respectively. This has repercussions both on the gradual deterioration of the environment and on the insufficient health and social security coverage of the working population. OBJECTIVE: To describe the current situation of occupational and environmental health in Mexico. METHODS: A bibliographic review was performed on the socioeconomic, demographic, environmental, legal and health status of the Economically Active Population (EAP). FINDINGS: There is a constant deterioration of terrestrial and marine ecosystems, accompanied by an increase in environmental pollution in large cities. The unemployment rate of the EAP has decreased in one year to 3.4%, but the informal labor rate reached 57.3%, which translates into population without social security. Compliance with legislation for the protection of workers' health is insufficient. The recent amendments to the law have meant a setback in these respects. The reported information on accidents and occupational diseases corresponds to only 34% of workers. There has been a decrease in the rate of work accidents in the last six years, but an increase in diseases and permanent disabilities. During 2016, the first cause of occupational illness was hearing loss, but the profile was dominated by musculoskeletal diseases, which together reached 36.5%. CONCLUSIONS: To improve the occupational and environmental health situation, it is necessary to implement general and particular measures against inequalities, increase the budget in health and environment, enforce legislation and expand social security coverage to the population. These measures should be part of public policies as well as actions of academics and researchers.

Vitamin D Status and Supplementation in Employer-Sponsored Wellness Program.

PURPOSE: To assess the response to information about vitamin D status by participants enrolled in employer-sponsored wellness programs. DESIGN: A self-reported health risk assessment questionnaire was used to categorize vitamin D supplementation. PARTICIPANTS: A total of 50 209 participants of 12 employer-sponsored wellness programs that included vitamin D testing and services provided by Quest Diagnostics in 2014 and 2015. MEASURES: Vitamin D status based on laboratory testing results and responses to vitamin D supplementation in a health risk assessment questionnaire for initial and subsequent years. RESULTS: Among 50 209 participants, 29% had deficient and 37% had suboptimal levels of vitamin D. Many participants appeared to act counter to their informed vitamin D status by starting supplements when vitamin D level was initially optimal (20%) or discontinuing supplements when vitamin D level was initially deficient (36%). Three-quarters of participants who had deficient or suboptimal vitamin D levels and were not taking supplements in 2014 continued not taking supplements in 2015. CONCLUSION: Deficient and suboptimal vitamin D levels remain prevalent in a working-age population. Many participants do not seem to be taking appropriate actions after receiving vitamin D testing results. Accordingly, employer-sponsored wellness programs have an opportunity to better educate participants.