Bio-mechanical risk factors for uterine prolapse among women living in the hills of west Nepal: A case-control study.

OBJECTIVE: To investigate whether heavy load carrying, wearing a patuka, and body position at work are risk factors for uterine prolapse among Nepali women. METHODS: Community-based case-control study of 448 women (170 cases of uterine prolapse; 278 controls) aged 18-60 years in Kaski district, Nepal was conducted. Women diagnosed with uterine prolapse were cases. Two controls were recruited for each case, frequency-matched by residential area and age. Multivariate logistic regression was used to investigate associations between outcome and exposures. RESULTS: No association of heavy load carrying with uterine prolapse was observed; women who never used a patuka had lower odds of uterine prolapse (odds ratio = 0.18, 95% confidence interval = 0.05-0.71). Women working in a sitting position had higher odds than those working in a standing position (odds ratio = 2.94, 95% confidence interval = 1.74-4.96), as did women who mainly worked in a bending position (odds ratio = 2.45, 95% confidence interval = 1.12-5.34). Housewives were more prone to uterine prolapse than women engaged in farming (odds ratio = 2.13, 95% confidence interval = 1.31-3.47). CONCLUSION: Using a patuka, occupation, and body position during work were all associated with uterine prolapse. No association was found with heavy load carrying, although that might be attributable to the cross-sectional nature of study recruitment.

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.

1st place, PREMUS best paper competition: workplace and individual factors in wrist tendinosis among blue-collar workers--the San Francisco study.

OBJECTIVE: Workplace studies have linked hand/wrist tendinosis to forceful and repetitive hand exertions, but the associations are not consistent. We report findings from a prospective study of right wrist tendinosis among blue-collar workers. METHODS: Workers (N=413) at four industries were followed for 28 months with questionnaires and physical examinations every 4 months to identify incident cases of right wrist tendinosis. Exposure assessment of force and repetition were based on field measurements and video analysis to determine repetition rate and the percent time (% time) in heavy pinch (>1 kg-force) or power grip (>4 kg-force). All exposure variables were measured at the level of the individual and task. For workers responsible for >1 task, a time-weighted average exposure was calculated based on task hours per week. A proportional hazards model was used to assess the relationship between exposures and incidence of wrist tendinosis. RESULTS: During the 481 person-years of follow-up, there were 26 incident cases of right wrist tendinosis [incidence rate (IR) 5.40 cases per 100 person-years]. Adjusting for age, gender, and repetition, wrist tendinosis was associated with % time spent in heavy pinch [hazard ratio (HR) 5.01, 95% CI 1.27-19.79). Composite exposure measure American Conference of Industrial Hygienists Threshold Limit Value (ACGIH-TLV) for hand activity level (HR 3.95, 95% CI 1.52-10.26) was also associated with the outcome for the medium-exposure group using video-based total repetition rate. CONCLUSIONS: The workplace factors predicting wrist tendinosis were time-weighted average values of % time spent in heavy pinch and the ACGIH-TLV for Hand Activity Level. The % time spent in power grip was not a significant predictor, nor were any measures of repetition. An exposure-response relationship was observed for the % time spent in heavy pinch. These findings may improve programs for preventing occupational wrist tendinosis.