Determination of consumer satisfaction: a basic step for quality improvement of an occupational hygiene service.

In order to define priorities for improvement of the Occupational Hygiene Service, Institute for Occupational Health, Tel Aviv University, consumer satisfaction was evaluated by postal questionnaire. The questionnaire covered items on service accessibility and quality, including staff courtesy and respect for the consumer, cost, satisfaction with the service in general over time, and satisfaction with the last service received, and was sent to all 144 regular clients of the institute during the years 1990 and 1991. Satisfaction items were rated from 1 (not at all satisfied) to 5 (completely satisfied). Multivariant analysis showed that: (i) satisfaction with the waiting period for the last service report and satisfaction with the courtesy of the last service and respect for the consumer had the strongest influence on general satisfaction with the service over time; (ii) satisfaction with the waiting period for the last service report was also the most important component in satisfaction with the last service received. Despite the increasing interest in Israel in health service costs, and because the price of the service is subsidized (50%), this item was not found to be significant with regard to satisfaction with the service. In conclusion, we recommend the use of this relatively easy and inexpensive methodology which allowed us to define precisely the key factor for service improvement, ie the waiting period for the service report.

Monitoring blood lead levels in workers overexposed to occupational lead: an analysis of Israeli data.

In a retrospective cohort study, we followed the blood lead [Pb(B)] and zinc protoporphyrin (ZPP) determinations of 292 workers found to have Pb(B) levels above the biological exposure index (BEI) during 1987-1993. The results indicated that (a) 22.6% of these workers were never retested for Pb(B) during the follow-up period; (b) 38.5% of the workers tested in the first year of the follow-up continued to exhibit Pb(B) levels above the BEI (84.7% of them also had ZPP > or = 100 micrograms/dl); (c) about 25% of the remaining cohort had at least one more result above the BEI during the fourth, fifth, and sixth years of follow-up; and (d) the incidence density rate of recurrence of Pb(B) concentrations above the BEI was 0.236. We recommend the establishment of a target value lower than the BEI that should be reached before the reinstatement of the overexposed worker. In our view this target value, combined with an efficient control of industrial hygiene conditions, will decrease the rate of recurrence of overexposure.