Health Behavior Adherence in a Metropolitan-Based Metabolic Syndrome Management Program during the COVID-19 Pandemic.

Background: The COVID-19 pandemic increased the worldwide prevalence of metabolic syndrome. The purpose of this study was to assess health behavior adherence during the pandemic in adults who had engaged in a metabolic syndrome management program for at least six months. This assessment included an evaluation of health behavior changes, factors influencing adherence, and clinical parameters. The city-wide program was operated by the Seoul Metropolitan Government. Methods: Baseline and follow-up data were compared in 116 participants who engaged in the program for at least 6 months prior to the pandemic. Health behaviors and clinical parameters were examined. Generalized estimating equation analysis was used to identify sociodemographic variables influencing health behavior adherence over time. Results: Systolic blood pressure, waist circumference, and blood glucose improved (all P<0.05), and risk factors decreased (P<0.001) from baseline to follow-up (mean±standard deviation, 1.13±0.91 years). All six health behaviors, physical activity and weight control, eating habits, alcohol consumption and smoking, stress management, sleep and rest, and medication compliance and medical examination improved (all P<0.001) from baseline to follow-up (2.37±1.05 years). Smoking and employment negatively influenced adherence to health behaviors (P<0.05). Participants felt the most beneficial part of the program was receiving sequential medical examination results with follow-up consultations by public health professionals without charge. Conclusion: Our study demonstrated the durability of the impact of the Seoul Program on all six targeted health behaviors as well as clinical parameters. Findings encourage participation in such broad-based programs and development of novel approaches to facilitate success for smokers and employed participants.

Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome.

BACKGROUND: Metabolic syndrome has a high global prevalence, affecting 26% of South Koreans. Lifestyle modifications have shown benefits in studies involving health behavior enhancement, specifically through workplace eating and exercise interventions. However, workplace interventions focusing on health behaviors have been inadequately explored. OBJECTIVES: This study examined factors affecting health promotion behaviors of workers at high risk of metabolic syndrome by applying Theory of Planned Behavior constructs (attitude, subjective norm, perceived behavioral control, and intention). METHODS: This correlational cross-sectional study collected survey data from 164 hotel workers in South Korea. The study applied factor analysis and structural equation modeling for the data analysis. RESULTS: Analysis revealed five health promotion behaviors: exercise, making healthy food choices, avoiding fatty foods, eating a nutritious and balanced diet, and eating regular moderate meals. Participants were grouped as total participants, those with one risk factor, and those with two risk factors. In the "total" group, four behaviors were influenced by perceived behavioral control: exercise, making healthy food choices, eating a nutritious and balanced diet, and eating regular moderate meals. In the "one risk factor" group, intention and attitude influenced the eating regular moderate meals behavior, and two other behaviors were influenced by perceived behavioral control: exercise and eating a nutritious and balanced diet; in the "two risk factor" group, only perceived behavioral control directly affected exercise. DISCUSSION: Perceived behavioral control was a key predictor of health behaviors, and theory constructs partially explained behaviors. Perceived behavioral control influenced four behaviors and influenced exercise in all three groups. Also, theory constructs showed a greater effect on behaviors in the one risk factor group than in the two risk factor group, indicating that participants with one risk factor more effectively managed their behaviors on their own and with healthcare providers' support. Occupational health providers should conduct early assessments of workers showing metabolic syndrome risk factors to identify their particular risks, intention, and behaviors. As the number of risk factors affects behaviors and perceived behavioral control primarily influences exercise, these findings should be incorporated in metabolic syndrome interventions.

Systematic Review of the Influence of Physical Work Environment on Office Workers' Physical Activity Behavior.

BACKGROUND: Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored. METHODS: Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review. RESULTS: Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks (n = 16), office arrangements (n = 5), and building design (n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit-stand desks reduced overall sitting time, but had a minimal effect on physical activity. CONCLUSION/APPLICATION TO PRACTICE: Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.

Time-Trends of U.S. Occupational Noise Standard Violations by OSHA Region and Industry Type 1972 to 2019.

OBJECTIVE: We examined time-trends in Occupational Noise Standard violations by OSHA region and industry type over 48 years. METHODS: Along with descriptive analysis of original data, negative binomial regression and Poisson regression were applied to the analysis of 1972 to 2019 and 1972 to 2012 data, respectively. RESULTS: A small annual decrease in violation units over the periods was revealed. The three analyses produced differing timetrends. The manufacturing industry had more violations, and Region 4 had the most violations. Regarding numbers of units, the 10 regions and 2 industries were jointly significant. Some interaction between regions and industry types appeared in both regressions. CONCLUSIONS: OSHA should specify how many regions report noise violations each year to ensure accurate identification of noise-related health risks to American workers. Further time-trend studies are needed for specific regions and industry types.

The Association Between Yoga Use, Physical Function, and Employment in Adults With Rheumatoid Arthritis.

Mind-body exercises such as yoga offer patients with rheumatoid arthritis (RA) a symptom management strategy for improving physical and mental health. Studies have evaluated yoga to manage symptoms of RA and improve physical function; however, none has examined the relationship between yoga and work status in adults with RA. The objective was to describe differences in RA symptomatology, physical function scores, and work status between adults with RA who participate in yoga and those who do not. This cross-sectional study surveyed adults with rheumatologist-diagnosed RA regarding yoga use in the past year, symptoms, physical function, and work status. Differences between yoga and non-yoga participation groups were assessed with 2-sided t tests or Pearson χ tests. Multivariate linear regression analyses were conducted to identify significant associations between yoga participation and primary outcomes. The sample included 398 adults with RA; 88% were females, 66% were white, mean age 61.8 years, mean disease duration 24.8 years; 10.6% participated in yoga. Vinyasa, Bikram, Hatha, Iyengar, and restorative yoga styles were practiced, mostly in a group setting. Yoga participants were significantly more likely to work full-time, less likely to be unable to work due to disability, and had better physical function. These findings characterize yoga practice and practitioners among adults with RA. In adults with RA, yoga participation is associated with full-time work status and better physical function than nonparticipation. This study adds additional information to the growing body of literature about adults with RA who practice yoga.

Psychometric Testing of the Effort-Reward Imbalance-Short Form Among Blue-Collar Workers Employed in Small Industrial Settings in Korea.

The Effort Reward Imbalance tool is a measure of psychosocial work characteristics used to identify work-related stress. The purpose of this study was to assess the reliability and validity of the Korean version of the effort-reward imbalance-short form (ERI-SF) in industrial workers. The Korean version of ERI-SF was tested among 250 blue-collar workers. The reliability, content validity, and construct validity with confirmatory factor analysis, as well as interaction terms were analyzed. Reliability assessed by Cronbach's alpha coefficients were satisfactory for all three subscales: effort 0.75, reward 0.74, and over-commitment 0.72. Confirmatory factor analysis showed an acceptable model fit with the three component theoretical structure (root mean square error of approximation = 0.07, comparative fit index = 0.84). Content validity was assessed with respect to a measure of perceived health. In addition, a significant synergistic interaction of ERI and over-commitment on job strain was found. In conclusion, the ERI-SF demonstrated good psychometric properties with Korean industrial workers. The ERI-SF is ideal for examining work-related stress in the workplace by occupational health professionals. This shorter version makes it easier to administer and score in the occupational health setting.

Lifestyles and Health-Related Outcomes of U.S. Hospital Nurses: A Systematic Review.

BACKGROUND: Nurses' modifiable lifestyles have important health-related consequences. PURPOSE: To examine the literature on U.S. hospital nurses' activity, diet, and health outcomes of cardiovascular disease (CVD) risks and health-related quality of life (HRQOL). METHOD: A systematic review using of the literature from June 2006 to June 2016 resulted in 13 studies on U.S. hospital nurses' diet, physical activity and CVD and HRQOL outcomes. Methodological rigor was assessed using Cummings et al., adapted quality rating tool. DISCUSSION: Nurses are at risk for poor health outcomes due to inadequate physical activity (60%-74%) and eating a poor quality diet (53%-61%). Fewer than 5% of U.S. nurses engage in five healthy lifestyle behaviors (diet, activity, no tobacco, alcohol, and weight). Adequate physical activity contributes to better HRQOL and a healthy diet reduces CVD risks (hypertension, diabetes mellitus, obesity, stroke). CONCLUSIONS: Nurses' inactivity and poor diet increases risks for CVD and diminished HRQOL.

Characteristics and Predictors of Occupational Injury Among Career Firefighters.

The purpose of this study was to assess occupational injury characteristics and predictors among career firefighters. A total of 249 firefighters from central Texas and northern California participated in this Internet-based survey. Approximately 27% of firefighters had reported an occupational injury within the previous 12 months. The majority of injuries occurred on the scene of a non-fire call while performing an activity that required lifting, pushing, or pulling. Firefighters' backs were most frequently injured. Of the reported injuries, approximately 18% returned to work on modified duty, but 46% were not allowed to work due to their occupational injuries. Firefighters who reported occupational injuries were more likely to be older and experiencing occupational stress compared with their coworkers who did not report occupational injuries. Injured firefighters were also more likely to report fewer job rewards (money/salary), overcommitment, less esteem (respect and support), and fewer promotional prospects. These injury factors should be incorporated into interventions to reduce or prevent workplace injuries.

A Qualitative Study Exploring Community Yoga Practice in Adults with Rheumatoid Arthritis.

OBJECTIVE: Yoga may improve physical function and reduce disease symptoms in adults with rheumatoid arthritis (RA). However, little is known about how patients with RA are practicing yoga in the community. The objective of this qualitative study was to explore community yoga practice characteristics and thoughts about yoga practice for adults with RA. DESIGN: Participants completed a semi-structured telephone interview with open-ended questions. Thematic analysis was used to analyze interview transcripts. PARTICIPANTS: A convenience sample of 17 adults with rheumatologist-diagnosed RA who had participated in yoga within the past year were asked about the decision to start, continue, and stop yoga; the perceived benefits of yoga; components of yoga sessions; and general thoughts about yoga as it relates to RA. RESULTS: Although eight different styles of yoga were practiced, commonalities in yoga class components (such as stretching, strengthening, deep breathing, meditation, and positive messaging from the instructor) reveal examples of preferred types of yoga for patients with RA. Three main themes emerged, each with multiple subthemes: (1) motivators (physical fitness, influence of others, reduced price), (2) barriers (cost, symptom burden, class difficulty), and (3) benefits of yoga practice (mind-body, a tool for coping, pride/achievement, social, and "yoga meets you where you are"). CONCLUSION: In this study, patients with RA described how yoga practice helped improve physical and psychosocial symptoms related to their disease. Yoga practice, a dynamic exercise, encompassing many different styles, can provide many benefits for adults with RA; however, yoga may not be beneficial for every adult with RA.

Hearing among male firefighters: a comparison with hearing data from screened and unscreened male population.

We investigated whether hearing loss is associated with firefighting. We conducted cross-sectional study comparing hearing threshold levels (HTLs) of 912 male firefighters with two hearing databases obtained from an otologically normal male Korean population (KONP) and a non-industrial noise-exposed male Korean population (KNINEP), considering age and the main roles of firefighters. Firefighters' age-adjusted HTLs were significantly worse than those of KONP (prevalence ratio (PR)=5.29, P<0.001)but not different from those of KNINEP (PR=0.99, P=0.550). Rescuers (PR=1.005, P<0.001) had worse hearing than the KNINEP after age adjustment. Comparison of firefighters' HTLs (50th and 90th percentiles) with those of KONP and KNINEP by age and frequency showed that firefighters' HTLs had significant increases (poorer hearing) across most age groups and frequencies compared with KONP. Compared with KNINEP, firefighters' HTLs were worse in the younger age groups (<45 years) but not different in the older age groups (>45 years). In conclusion, the hearing thresholds of younger firefighters and rescuers were worse than expected by normal aging alone. Future research should include longitudinal studies to consider variable risk factors, such as military service, smoking, and so on.

Predictors of health-promoting behavior associated with cardiovascular diseases among Korean blue-collar workers.

The aim of this study was to investigate the contribution of actual cardiovascular disease (CVD) risks, psychosocial and work-related factors as predictors of health behavior. A sample of 234 Korean blue-collar workers, who worked in small companies, was included in this cross-sectional study. Data collection included a survey; anthropometric and blood pressure measures; and blood sampling. Multiple regression analyses showed that the model explained 30% of the variance in health behavior of blue-collar workers. The significant predictors for health behavior included education level, perceived general health, greater family function, higher social support, decision latitude, and non-shift work. Future research should focus on incorporating these significant predictors into effective behavioral interventions designed to promote cardiovascular health in this population.

Multi-ethnic minority nurses' knowledge and practice of genetics and genomics.

PURPOSE: Exploratory studies establishing how well nurses have integrated genomics into practice have demonstrated there remains opportunity for education. However, little is known about educational gaps in multi-ethnic minority nurse populations. The purpose of this study was to determine minority nurses' beliefs, practices, and competency in integrating genetics-genomics information into practice using an online survey tool. DESIGN: A cross-sectional survey with registered nurses (RNs) from the participating National Coalition of Ethnic Minority Organizations (NCEMNA). Two phases were used: Phase one had a sample of 27 nurses who determined the feasibility of an online approach to survey completion and need for tool revision. Phase two was a main survey with 389 participants who completed the revised survey. The survey ascertained the genomic knowledge, beliefs, and practice of a sample of multi-ethnic minority nurses who were members of associations comprising the NCEMNA. METHODS: The survey was administered online. Descriptive survey responses were analyzed using frequencies and percentages. Categorical responses in which comparisons were analyzed used chi square tests. FINDINGS: About 40% of the respondents held a master's degree (39%) and 42% worked in direct patient care. The majority of respondents (79%) reported that education in genomics was important. Ninety-five percent agreed or strongly agreed that family health history could identify at-risk families, 85% reported knowing how to complete a second- and third-generation family history, and 63% felt family history was important to nursing. Conversely, 50% of the respondents felt that their understanding of the genetics of common disease was fair or poor, supported by 54% incorrectly reporting they thought heart disease and diabetes are caused by a single gene variant. Only 30% reported taking a genetics course since licensure, and 94% reported interest in learning more about genomics. Eighty-four percent believed that their ethnic minority nurses' organizations should have a visible role in genetics and genomics in their communities. CONCLUSIONS: Most respondents felt genomics is important to integrate into practice but demonstrated knowledge deficits. There was strong interest in the need for continuing education and the role of the ethnic minority organizations in facilitating the continuing education efforts. This study provides evidence of the need for targeted genomic education to prepare ethnic minority nurses to better translate genetics and genomics into practice. CLINICAL RELEVANCE: Genomics is critical to the practice of all nurses, most especially family health history assessment and the genomics of common complex diseases. There is a great opportunity and interest to address the genetic-genomic knowledge deficits in the nursing workforce as a strategy to impact patient outcomes.

Willingness-to-accept Gamma knife radiosurgery for tinnitus among career San Francisco firefighters.

OBJECTIVE: Measure willingness-to-accept novel Gamma knife (GK) radiosurgery of the caudate nucleus to treat tinnitus among career firefighters who are at higher risk of hearing loss because of occupational noise exposure. STUDY DESIGN: Cross-sectional survey. MATERIALS AND METHODS: A Web-based 80-item survey was distributed to 800 San Francisco firefighters and satisfactorily completed by 101 respondents. Demographic and work-related characteristics including occupational noise exposure, hearing handicap using the Hearing Handicap Inventory for Adults (HHIA), and tinnitus severity using the tinnitus functional index (TFI) were assessed. Willingness-to-accept GK radiosurgery for tinnitus was profiled using a 7-point scale for 6 decremental levels of expected tinnitus improvement. RESULTS: Respondents were a majority male (82%) and Caucasian (56%). Nearly all (95%) reported significant daily or weekly occupational noise exposure. Mean HHIA (16.3) and mean TFI (14.6) were mild. At the 100% (complete) tinnitus improvement level, more than 60% of respondents were "likely" willing-to-accept Gamma knife radiosurgery. At the 75% tinnitus improvement level, 43% of respondents were "likely" willing-to-accept GK radiosurgery. Below the 75% tinnitus improvement level, willingness-to-accept dropped off steeply. CONCLUSION: Gamma knife radiosurgery to area LC, a locus of the caudate nucleus, for tinnitus would be of interest to a large population with moderate or lower tinnitus distress. Should this innovative intervention be considered in the future, a rigorous clinical trial will be necessary to establish safety and efficacy.

Actual cardiovascular disease risk and related factors: a cross-sectional study of Korean blue collar workers employed by small businesses.

Actual cardiovascular disease (CVD) risk and related factors among blue collar workers employed by small businesses were investigated. This cross-sectional study of 238 Korean blue collar workers used surveys, anthropometric and blood pressure measurements, and blood sampling for lipid and glucose levels to answer the research questions. Multiple regression techniques were used to analyze study data. The prevalence of actual CVD risk among blue collar workers was 32 cases per 100 workers. A multiple regression model showed that a combination of individual, psychosocial, and work-related factors explained 34% of the variance in actual CVD risk. The significant predictors of actual CVD risk included knowledge of CVD risk, risk perception, job stress, and waist-to-hip ratio. It is important for clinicians to consider all of these significant predictors of actual CVD risk when designing an intervention program to reduce CVD among Korean blue collar workers.

Work and health conditions of sugar cane workers in Brazil / Condições de trabalho e saúde dos trabalhadores do corte da cana-de-açúcar no Brasil / Condiciones de trabajo y salud de los trabajadores del corte de caña de azúcar em Brasil

This is an exploratory research, with a quantitative approach, developed with the objective of analyzing the work and of life situations that can offer risks to the workers' health involved in the manual and automated cut of the sugar cane. The sample was composed by 39 sugar cane cutters and 16 operators of harvesters. The data collection occurred during the months of July and August of 2006, by the technique of direct observation of work situations and workers' homes and through interviews semi-structured. The interviews were recorded and later transcribed. Data were analyzed according to Social Ecological Theory. It was observed that the workers deal with multiple health risk situations, predominantly to the risks of occurrence of respiratory, musculoskeletal and psychological problems and work-related accidents due to the work activities. The interaction of individual, social and environmental factors can determine the workers' tendency to falling ill.

Trata-se de uma pesquisa exploratória, com abordagem quantitativa dos dados, realizada no intuito de analisar as situações de trabalho e de vida que podem oferecer riscos à saúde de trabalhadores envolvidos no corte manual e mecanizado da cana-de-açúcar. A amostra foi composta por 39 cortadores de cana e 16 operadores de colhedeiras. A coleta de dados ocorreu nos meses de julho e agosto de 2006, utilizando-se a técnica de observação direta das situações de trabalho e moradia dos trabalhadores, e por meio de entrevistas semi-estruturadas, que foram gravadas e posteriormente transcritas. Os dados foram analisados a partir da Teoria Social Ecológica. Foi constatado que os trabalhadores estão expostos a inúmeras situações de risco à saúde, predominantemente a riscos de ocorrência de problemas respiratórios, osteomusculares e psicológicos. Além disso, estão sujeitos a acidentes de trabalho em decorrência de sua atividade laboral. Constatou-se também que o adoecimento é determinado pela interação de fatores individuais, ambientais e sociais.

Se trata de una investigación exploratoria con abordaje cuantitativo de los datos, realizada con la meta de analizar las situaciones de trabajo y de vida que pueden generar riesgos sanitarios a los trabajadores involucrados en el corte manual y mecanizado de la caña de azúcar. La muestra se compuso de 39 cortadores de caña y 16 operadores de cose-cha-do-ras. La recolección de datos tuvo lugar en los meses de julio y agosto de 2006, utilizándose la técnica de observación directa de las situaciones de trabajo y residencia de los trabajadores y a través de entrevistas semiestructuradas, las cuales fueron grabadas y posteriormente transcriptas. Los datos fueron analizados a partir de la Teoría Social Ecológica. Se constató que los trabajadores están expuestos a innumerables situaciones de riesgo sanitario, en particular a los riesgos de sufrir problemas respiratorios, osteo-mus-culares y psicológicos, así como accidentes de trabajo derivados de su actividad laboral, y que su posibilidad de enfermar se determina por la interacción de factores individuales, ambientales y sociales.

The roles and functions of occupational health nurses in Brazil and in the United States.

Cross-sectional exploratory research developed to outline the roles and functions of occupational health nurses (OHNs) in Brazil and compare them with those in the United States. The sample consisted of 154 Brazilian occupational health nurses. First, the instrument Job Analysis Survey of Occupational Health Nursing Practice was translated into Portuguese, followed by data collection and data analysis, comparing the results of the proposed study in Brazil with the findings of a job delineation study conducted in the United States. It was found that most were women, white, between 41 and 50 years of age and working primarily at hospitals or medical centers as clinicians and managers/administrators. Besides, it was found that most Brazilian OHNs spend more time in managerial roles, followed by consultant and educator responsibilities while, in the United States, OHNs spend significantly more time in education/advisory roles.

The roles and functions of occupational health nurses in Brazil and in the United States / Atribuições e funções dos enfermeiros do trabalho no Brasil e nos Estados Unidos / Los papeles y funciones del enfermero de salud laboral en Brasil y en los Estados Unidos de America

Cross-sectional exploratory research developed to outline the roles and functions of occupational health nurses (OHNs) in Brazil and compare them with those in the United States. The sample consisted of 154 Brazilian occupational health nurses. First, the instrument Job Analysis Survey of Occupational Health Nursing Practice was translated into Portuguese, followed by data collection and data analysis, comparing the results of the proposed study in Brazil with the findings of a job delineation study conducted in the United States. It was found that most were women, white, between 41 and 50 years of age and working primarily at hospitals or medical centers as clinicians and managers/administrators. Besides, it was found that most Brazilian OHNs spend more time in managerial roles, followed by consultant and educator responsibilities while, in the United States, OHNs spend significantly more time in education/advisory roles.

Estudo transversal desenvolvido com o objetivo de delinear as responsabilidades e funções das enfermeiras do trabalho no Brasil e compará-las às atribuições das enfermeiras de saúde ocupacional nos Estados Unidos. A amostra foi composta por 154 enfermeiras do trabalho. Inicialmente, foi realizada a tradução para a língua portuguesa do instrumento de coleta de dados Job Analysis Survey of Occupational Health Nursing Practice, seguido da coleta e análise dos resultados, comparando-os aos dados obtidos num estudo realizado nos EUA. Foi constatado que a maioria das enfermeiras eram mulheres, brancas, com faixa etária entre 41 e 50 anos e trabalhavam em hospitais e centros médicos como enfermeiras clínicas ou administradoras. Além disso, observou-se que as enfermeiras brasileiras despendem maior tempo em funções administrativas, atividades de consultoria e ações educativas, enquanto que as enfermeiras norte-americanas gastam um tempo significativamente maior desenvolvendo papéis educativos e de consultoria.

Investigación transversal realizada con el objetivo de definir los papeles y funciones de los enfermeros de salud laboral (ESLs) en Brasil y compararles con los de los Estados Unidos de América (EUA). La muestra fue compuesta por ciento cincuenta y cuatro enfermeros de salud laboral brasileños. Primero, fue realizada la traducción de lo instrumento Job Analysis Survey of Occupational Health Nursing Practice para el Portugués, seguido de la recolecta y análisis de los datos, comparándolos con los hallazgos de un estudio conducido en los EUA. Se encontró que la mayoría eran mujeres, blancas, entre 41 y 50 años e trabajan en hospitales y centros médicos como enfermeros clínicos y administradores. También se encontró que ESLs brasileños dedican más tiempo en funciones administrativas, seguidas de responsabilidades de consultoría y educador, mientras en los EUA los ESLs dedican significativamente más tiempo en funciones educativas y de asesoría.

Predictors of hearing protection behavior among power plant workers.

PURPOSE: This study aimed to identify factors affecting the use of the hearing protection devices (HPDs) among workers exposed to noise using the Pender Health Promotion Model. METHODS: The 222 subjects came from thermal power plants with similar noise levels, which are between 80 dB and 90 dB in South Korea. Data were collected with self-administered questionnaires designed to measure concepts from the Health Promotion Model. RESULTS: Mean percent times of using the HPDs at their most recent job site were 50.9%, and 20.3% had never the HPDs. The predictors of HPD use were social modeling (OR = 1.380), perceived benefits (OR = 1.150), and working at noisy worksites (OR = 4.925) when the outcome was based on the "non-use" versus "used at least once". However, the predictors of HPD use were social modeling (OR = 1.795) and perceived benefits (OR = 1.139) based on the "less than half-of-the-time-use" versus "more than half-of-the-time-use". CONCLUSION: Social modeling and perceived benefits of using the HPDs are important for workers to keep minimal or certain level of using the HPDs.

Work and health conditions of sugar cane workers in Brazil.

This is an exploratory research, with a quantitative approach, developed with the objective of analyzing the work and of life situations that can offer risks to the workers' health involved in the manual and automated cut of the sugar cane. The sample was composed by 39 sugar cane cutters and 16 operators of harvesters. The data collection occurred during the months of July and August of 2006, by the technique of direct observation of work situations and workers' homes and through interviews semi-structured. The interviews were recorded and later transcribed. Data were analyzed according to Social Ecological Theory. It was observed that the workers deal with multiple health risk situations, predominantly to the risks of occurrence of respiratory, musculoskeletal and psychological problems and work-related accidents due to the work activities. The interaction of individual, social and environmental factors can determine the workers' tendency to falling ill.

Uncovering factors contributing to under-utilization of breast cancer screening by Chinese and Korean women living in the United States.

OBJECTIVE: This study investigated factors influencing breast cancer screening utilization by Chinese and Korean women, living in the United States, and examined similarities and differences between the 2 sub-populations. DESIGN: Population-based cross-sectional surveys were used for comparisons. METHODS: A random sample of 180 women (Chinese = 117, Korean = 63), aged 40 years and older, who resided in an urban county of Michigan participated in the mail survey. Existing English questionnaires were modified for cultural appropriateness, translated into Chinese and Korean, and pre-tested. Data analysis included descriptive statistics, testing differences between means/percentages, and logistic regression. RESULTS: The sample population, similar to the Asian American population in general, was composed predominantly of immigrants with varying socioeconomic and health status. Approximately 56% of the women had received mammograms in the past 2 years, about 21% lower than the statewide rate for Michigan. The logistic regression indicated that women's mammography use was significantly associated with their ability to speak English, availability of health insurance, and knowledge of mammography (P < .05). Similarities and differences between sampled Chinese and Korean women existed in terms of their socio-demographic characteristics and the factors influencing their use of breast cancer screening. CONCLUSIONS: Understanding minority women's cancer screening behavior has implications for designing appropriate interventions to meet their unique healthcare needs, thereby increasing screening rates and reducing mortality.