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1.
Workplace Health Saf ; : 2165079920914322, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32364022

RESUMO

Background: Although nurses are well described as being at risk of work-related asthma, certified nurse aides (CNAs) are understudied. Using a statewide registry in Texas, we measured prevalence and risk factors for work-related asthma and bronchial hyperresponsiveness (BHR) symptoms among CNAs. Methods: For this cross-sectional study, a questionnaire was mailed to a random sample of CNAs (n = 2,114) identified through the Texas Department of Aging and Disability Services registry, working in health care during 2016-2017, to collect data on job history, asthma symptoms, and sociodemographics. Two outcomes were defined: (a) new-onset asthma (NOA) after entry into the health care field and (b) BHR-related symptoms. Job exposures to cleaning compounds and tasks were assigned using an externally coded CNA-specific job-exposure matrix. Logistic regression modeling was used to measure associations between cleaning exposures and the two asthma outcomes. Findings: The final sample consisted of 413 CNAs (response rate 21.6%). The prevalence of NOA and BHR symptoms were 3.6% and 26.9%, respectively. In adjusted models, elevated odds for BHR symptoms were observed for patient care cleaning (odds ratio [OR] = 1.71, 95% confidence interval [CI] = [0.45, 6.51]), instrument cleaning (OR = 1.33, 95% CI = [0.66, 2.68]), building-surface cleaning (OR = 1.39, 95% CI = [0.35, 5.60]), exposure to glutaraldehyde/orthophthalaldehyde (OR = 1.33, 95% CI = [0.66, 2.68]), and latex glove use during 1992-2000 (OR = 1.62, 95% CI = [0.84, 3.12]). There were too few NOA cases to warrant meaningful regression analysis. Conclusion/Application to Practice: Although not statistically significant, we observed elevated odds of BHR symptoms among nurse aides, associated with cleaning exposures, suggesting this is an at-risk group of health care professionals for work-related respiratory disease, meriting further study.

2.
Arch Environ Occup Health ; 75(2): 70-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31033410

RESUMO

The occupational hazards and respiratory symptoms of domestic cleaners in USA are largely unknown. We conducted a cross-sectional study among 56 Hispanic female domestic cleaner on their health status and frequency of cleaning products used and tasks performed. While women used multi-use products (60.0%) and toilet bowl cleaners (51.8%) most days of the week, many (39.3%) reported not using personal protective equipment while cleaning. Itchy/watery eyes (61.8%) and itchy nose (56.4%) were the most frequently reported symptoms. A history of physician-diagnosed asthma was reported by 14.3% while 33.9% had symptoms of bronchial hyperresponsiveness (BHR). In conclusion, this vulnerable population has high prevalence of physician-diagnosis asthma and BHR symptoms and is potentially exposed to myriad occupational hazards. Further research exploring associations between products use, cleaning tasks and respiratory symptoms is warranted.

3.
Inj Prev ; 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685530

RESUMO

OBJECTIVE: To examine the reciprocal longitudinal associations between depression or anxiety with work-related injury (WRI) at a large employer in the southwestern United States. METHOD: Three administrative datasets (2011-2013) were merged: employee eligibility, medical and prescription claims, and workers' compensation claims. The sample contained 69 066 active employees. Depression and anxiety were defined as episodes of medical visits care (ie, claims) with corresponding ICD-9-CM codes. For an individual's consecutive claims, a new case of depression or anxiety was defined if more than 8 weeks have passed since the prior episode. The presence of a workers' compensation injury claim was used to identify WRI. Three-wave (health plan years 2011 or T1, 2012 or T2, and 2013 or T3) autoregressive cross-lagged models were used to estimate whether depression or anxiety predicted WRI, also if WRI predicted depression or anxiety in the following year(s). RESULTS: Depression predicted injury from T1 to T2 (ß=0.127, p<0.001) and from T2 to T3 (ß=0.092, p=0.001). Injury predicted depression from T1 to T3 (ß=0.418, p<0.001). Effects of anxiety on WRI were small and inconsistent, from T1 to T2 (ß=0.013, p=0.622) and from T2 to T3 (ß=-0.043, p=0.031). T1 injury had a protective effect on T3 anxiety (ß=-0.273, p<0.001). CONCLUSIONS: We found evidence of reciprocal effects for depression with WRI after adjustment for prior injuries and depression. The evidence for the relationship between anxiety and WRI is less clear. WRI prevention and management programmes should incorporate depression prevention and management.

4.
Mil Med ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31642489

RESUMO

INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a recognized military service-connected condition. Prior prevalence studies of ALS among U.S. war Veterans were not able to address concerns related to neurodegenerative sequelae of traumatic brain injury (TBI) and disregarded risk heterogeneity from occupational categories within service branches. MATERIALS AND METHODS: We identified the prevalence of definite and possible ALS and cumulative incidence of definite ALS among Post-9/11 U.S. Veterans deployed in support of Post-9/11 conflicts (mean age 36.3) who received care in the Veterans Health Administration during fiscal years 2002-2015. Using a case-control study design, we also evaluated the association of TBI and major military occupation groups with ALS adjusting for demographics and comorbidities. RESULTS: The prevalence of ALS was 19.7 per 100,000 over 14 years. Both prevalence and cumulative incidence of definite ALS were significantly higher among Air Force personnel compared to other service branches and among tactical operation officers and health care workers compared to general and administrative officers. Neither TBI nor younger age (<45 years) was associated with ALS. Depression, cardiac disease, cerebrovascular disease, high blood pressure, and obstructive sleep apnea were clinical comorbidities significantly associated with ALS in this population of Veterans. CONCLUSION: This study among a cohort of relatively young Veterans showed a high ALS prevalence, suggesting an early onset of ALS among deployed military service members. The higher prevalence among some military specific occupations highlights the need to determine which occupational exposures specific to these occupations (particularly, Air Force personnel, tactical operations officers, and health care workers) might be associated with early onset ALS.

7.
J Dairy Sci ; 102(8): 7494-7502, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31178196

RESUMO

Removal of teat-end debris is one of the most critical steps in the premilking process. We aimed to estimate inter- and intra-rater reliability of an observation-based rating scale of dairy parlor worker teat-cleaning performance. A nonrandom sample of 8 experienced raters provided teat swab debris ratings scored on a 4-point ordinal visual scale for 175 teat swab images taken immediately after teat cleaning and before milking unit attachment. To overcome the uncertainty associated with visual inspection and observation-based rating scales, we assessed the reliability of an automated observer-independent method to assess teat-end debris using digital image processing and machine learning techniques to quantify the type and amount of debris material present on each teat swab image. Cohen's kappa coefficient (κ) was used to assess inter-rater score agreement on 175 teat swab images, and the intraclass correlation coefficient was used to assess both intra-rater score agreement and machine reliability. The reliability of debris scoring of teat swabs by raters was low (overall κ = 0.43), whereas the machine-based rating system demonstrated near-perfect reliability (Pearson r > 0.99). Our findings suggest that machine-based rating systems of worker performance are much more reliable than observational-based methods when evaluating premilking teat cleanliness. Teat swab image analysis technology can be further developed for training and quality control purposes to enable more efficient, reliable, and independent feedback on worker milking performance. As automated technologies are becoming more popular on dairy farms, machine-based teat cleanliness scoring could also be incorporated into automated milking systems.


Assuntos
Bovinos , Indústria de Laticínios/métodos , Higiene , Glândulas Mamárias Animais , Animais , Feminino , Leite , Mamilos , Variações Dependentes do Observador , Reprodutibilidade dos Testes
8.
Int Arch Occup Environ Health ; 92(3): 403-413, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30806784

RESUMO

PURPOSE: Exposure to organic solvents and noise may be causal agents in the development of hearing loss and tinnitus. The objectives of the present study were to examine the association of organic solvents with hearing loss and tinnitus and to assess the interaction of organic solvent and occupational noise exposure on hearing loss and tinnitus. METHODS: A secondary data analysis of data from the National Health and Nutrition Examination Survey and Occupational Information Network (O*NET) among a study population ranging from 1085 to 2471 study participants from 1999 to 2004. Multiple multivariate logistic regression models were used to assess the associations of individual organic solvent exposures as measured by blood biomarkers (1,4-dichlorobenzene, benzene, ethylbenzene, styrene, toluene, o-xylene, and m-/p-xylene) with self-reported hearing loss, audiometrically assessed hearing loss, and self-reported tinnitus. Models were adjusted for age, gender, race/ethnicity, diabetes, non-occupational noise exposure, smoking, and income. Organic solvents found to be statistically significantly associated with the outcome after adjusting for covariates were tested for interaction with occupational noise exposure. RESULTS: Solvent exposure was not statistically significantly associated with self-reported tinnitus. Benzene (OR 1.43, 95% CI 1.15-1.78), ethylbenzene (OR 1.24, 95% CI 1.02-1.50), and toluene (OR 1.27, 95% CI 1.06-1.52) concentrations were statistically significantly associated with increased adjusted odds of high-frequency hearing loss. No statistically significant interaction was observed between these solvents and occupational noise on high-frequency hearing loss. CONCLUSIONS: We found no evidence of an association between organic solvents and tinnitus; however, there was evidence of an association between organic solvent exposure and prevalence of high-frequency hearing loss.


Assuntos
Perda Auditiva/epidemiologia , Ruído Ocupacional/efeitos adversos , Solventes/efeitos adversos , Zumbido/epidemiologia , Adulto , Benzeno , Derivados de Benzeno/efeitos adversos , Biomarcadores/sangue , Feminino , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Exposição Ocupacional/efeitos adversos , Fatores de Risco , Zumbido/etiologia , Tolueno/efeitos adversos , Estados Unidos/epidemiologia
9.
J Agromedicine ; 24(2): 197-204, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30624154

RESUMO

BACKGROUND: Logging is recognized as one of the most dangerous industries in the United States (US), ranking among those with the highest occupational injury and fatality rates. Although logging operations in the Southeastern US have lower rates of injuries and fatalities compared to other regions of the US, due in part to the use of large machinery to fell timber as opposed to chainsaw felling, safety hazards continue to persist. The hazards present in the logging cut sites in which loggers operate may result in worker injury, illness, or fatality. Our objective was to develop, deliver, and evaluate a safety management and leadership training among logging contractors and supervisors using mobile tablets as a personal learning environment. METHODS: A safety leadership and management training vignette was developed based on previously collected focus group needs assessment data. A non-random sample of 31 male logging supervisors received the safety leadership and management training on a mobile tablet. Kirkpatrick Levels 1, 2, and 3 training effectiveness evaluations were performed. RESULTS: A statistically significant large effect size suggests safety knowledge was gained among training participants when comparing post-test scores to pre-test scores (Level-2). Participants rated their training experience favorably (Level-1), and applied knowledge gained from the training throughout their weekly work activities three months after training (Level-3). CONCLUSION: Our findings suggest the utilization of mobile learning techniques can be an effective means to deliver safety management and leadership training content to logging contractors and supervisors. Future trainings should be linguistically and literacy-level appropriate, as well as comprehensive in nature, including meaningful and relevant content. Our observations support the use of mobile devices as just one component of a more comprehensive health and safety management program for workers in the logging industry.


Assuntos
Computadores de Mão , Agricultura Florestal/educação , Liderança , Gestão da Segurança/métodos , Adulto , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Ensino/normas
10.
J Agromedicine ; 24(2): 167-176, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30624156

RESUMO

BACKGROUND: The U.S. logging sector is among the most dangerous industrial sectors, with high fatality and non-fatal injury rates. Limited research has addressed work-related musculoskeletal disorders among logging machine operators (LMOs). The purpose of this study was to estimate the 12-month prevalence of musculoskeletal symptoms and the associated work-related risk factors among LMOs in the Arkansas, Louisiana, and Texas (Ark-La-Tex) logging region. METHODS: A self-administered 93-item questionnaire with six different sections: (1) demographics, (2) lifestyle and medical background, (3) work experience, (4) job training, (5) occupational heat-related stress, and (6) occupational injuries and MSS was administered to LMOs (n = 88) using Qualtrics Mobile Survey Software®. Poisson regression models were used to estimate crude prevalence ratios (PR), adjusted PR [aPR], and corresponding 95% confidence intervals (95% CI). RESULTS: Regarding organizational, ergonomic, and handling equipment occupational factors and 12-month MSS prevalence, the adjusted model controlled for age, BMI, smoking status, and drinking status. For organizational, the most problematic factors for the lower back were performing a task over and over (63.2%) and working very fast, for short periods (60.0%). For ergonomics, the most problematic factor for the lower extremities was awkward or cramped conditions (58.1%) and for the lower back was bending/twisting back awkward (55.9%). Last, for handling equipment, the most problematic for both the lower back and lower extremities was handling or grasping small objects (57.1%). CONCLUSION: Our findings revealed associations between work-related MSS and specific job factors (e.g., organizational, ergonomic, handling equipment, etc.), extreme environmental conditions or environmental, and personal risk factors. In particular, study findings suggest lower back and lower extremities MSS are associated with the a majority of job-related risk factors, lower extremities with extreme environmental conditions, and neck and upper back with personal risk factors.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Traumatismos Ocupacionais/epidemiologia , Adulto , Arkansas/epidemiologia , Ergonomia , Fazendeiros/psicologia , Feminino , Agricultura Florestal , Humanos , Louisiana/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/psicologia , Doenças Profissionais/psicologia , Traumatismos Ocupacionais/psicologia , Fatores de Risco , Inquéritos e Questionários , Texas/epidemiologia , Adulto Jovem
11.
Arch Environ Occup Health ; 74(3): 115-129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29522380

RESUMO

We examined whether physicians' personality traits moderate the association between medical specialty and well-being at work. Nationally representative sample of Finnish physicians (n = 2,815; 65% women; aged 25-72 years in 2015) was used. Personality was assessed with the shortened Big Five Inventory. Indicators of well-being at work were measured with scales from Work Ability Index, General Health Questionnaire, Jenkins' Sleep Problems Scale and Suicidal Ideation. Higher extraversion, openness to experience and agreeableness showed as personality traits beneficial for higher well-being at work among person-oriented specialties whereas higher conscientiousness but lower openness and agreeableness showed as personality traits beneficial for higher well-being at work among technique-oriented specialties. The role of neuroticism remains minor in general. Physicians' personality traits may moderate the association between medical specialty and well-being at work.


Assuntos
Escolha da Profissão , Medicina , Personalidade , Médicos/psicologia , Adulto , Idoso , Feminino , Finlândia , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Estresse Psicológico , Inquéritos e Questionários
12.
Arch. prev. riesgos labor. (Ed. impr.) ; 21(4): 196-202, oct.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-177484

RESUMO

Objetivo: Valorar la fiabilidad y cumplimentación de las preguntas sobre condiciones de trabajo del cuestionario Condiciones de Trabajo, Empleo y Salud en América Latina y el Caribe (CTESLAC). Método: A partir de una muestra de 500 entrevistas del Estudio sobre Condiciones de Trabajo, Seguridad y Salud en Perú realizada en 2017 en una muestra de hogares y basada en el Cuestionario CTESLAC, se calculó: 1) porcentaje de respuesta No sabe/No contesta; 2) porcentaje de pregunta sin respuesta (perdidas); 3) varianza de los ítems; 4) porcentaje de cada una de las categorías de respuesta; 5) matriz de correlación pregunta-pregunta en cada una de las dimensiones y; 6) matriz de correlación pregunta-dimensión. Resultados: Observamos una alta cumplimentación (<1% de no sabe/no contesta y perdidos) en la mayoría de preguntas sobre Condiciones de Seguridad, Higiene y Ergonomía, y sobre Condiciones Psicosociales hubo tres preguntas con perdidos entre un 6% y 4% y no sabe/no contesta entre el 2% y 5%. Las matrices de correlación alcanzaron coeficientes entre 0,3 y 0,7 tanto entre los ítems de las mismas dimensiones como en las correlaciones con las dimensiones del instrumento, a excepción de la dimensión psicosocial, así como bajos niveles de correlación entre los ítems de la dimensión psicosocial. Conclusión: Se demuestra buena cumplimentación del cuestionario, así como la fiabilidad de las dimensiones de condiciones de seguridad, de higiene y ergonómicas. Sin embargo la dimensión psicosocial no alcanzó los criterios de fiabilidad, sugiriendo que sus preguntas requieren ser revisadas


Objective: To assess the reliability and degree of completion of items on working conditions in the Working Conditions, Employment Conditions and Health in Latin America and the Caribbean (CTESLAC by its Spanish acronym) survey questionnaire. Methods: In 2017, we conducted 500 household-based interviews in Peru using the Survey on Working Conditions, Safety and Health CTESLAC Questionnaire. We calculated: 1) percentage of respondents indicating "Do not know"/"No answer"; 2) percentage of unanswered items; 3) variance of these items; 4) percentages for each of the response categories; and we generated 5) an item-item correlation matrix for each dimension; and 6) an item-dimension correlation matrix. Results: We observed a high level of completion (<1% of missing items and "do not know"/"do not answer" responses) for items related to safety, hygiene and ergonomics. In regards to psychosocial items, three items had between 4% and 6% non-response, and between 2% and 5% for "do not know"/"do not answer" responses. All items exhibited moderate to high correlations with other items in the corresponding dimension. However, some items related to the psychosocial work environment showed low correlations. Conclusion: Overall, the questionnaire showed a high proportion of completion, and good reliability for the safety, hygiene and ergonomics dimensions. However, the psychosocial dimension did not show good reliability, suggesting these items should be revised


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Condições de Trabalho , Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador/normas , Reprodutibilidade dos Testes , Inquéritos e Questionários , Peru/epidemiologia
13.
Arch Prev Riesgos Labor ; 21(4): 196-202, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30372603

RESUMO

OBJECTIVE: To assess the reliability and degree of completion of items on working conditions in the Working Conditions, Employment Conditions and Health in Latin America and the Caribbean (CTESLAC by its Spanish acronym) survey questionnaire. METHODS: In 2017, we conducted 500 household-based interviews in Peru using the Survey on Working Conditions, Safety and Health CTESLAC Questionnaire. We calculated: 1) percentage of respondents indicating "Do not know"/"No answer"; 2) percentage of unanswered items; 3) variance of these items; 4) percentages for each of the response categories; and we generated 5) an item-item correlation matrix for each dimension; and 6) an item-dimension correlation matrix. RESULTS: We observed a high level of completion (<1% of missing items and "do not know"/"do not answer" responses) for items related to safety, hygiene and ergonomics. In regards to psychosocial items, three items had between 4% and 6% non-response, and between 2% and 5% for "do not know"/"do not answer"r responses. All items exhibited moderate to high correlations with other items in the corresponding dimension. However, some items related to the psychosocial work environment showed low correlations. CONCLUSION: Overall, the questionnaire showed a high proportion of completion, and good reliability for the safety, hygiene and ergonomics dimensions. However, the psychosocial dimension did not show good reliability, suggesting these items should be revised.

14.
J Occup Environ Med ; 60(7): 594-602, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29634612

RESUMO

OBJECTIVE: To examine the association between air pollution and diabetes prevalence in the United States, 2002 to 2008. METHODS: Annual average particulate matter (PM2.5) and ozone concentrations were calculated using daily county-level data from the CDC's Tracking Network. Individual-level outcome and covariate data were obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System for 862,519 individuals. We used Poisson regression analyses to examine associations between each air pollutant (per 10-unit increase) with diabetes, including regional sub-analyses. Analyses were adjusted for year, age, sex, race, ethnicity, education, income, smoking status, body mass index, exercise, and asthma. RESULTS: Positive associations between each pollutant and diabetes were found (PM2.5: prevalence ratio [PR] = 1.10; 95% confidence interval [CI] = 1.03, 1.17; ozone: PR = 1.06; 95% CI = 1.03, 1.09). There was limited evidence of effect modification by region. CONCLUSIONS: Interventions to reduce ambient air pollution may help alleviate the diabetes burden in the US.


Assuntos
Diabetes Mellitus/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Ozônio , Material Particulado , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Monitoramento Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho da Partícula , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
15.
BMC Med Educ ; 18(1): 52, 2018 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-29587722

RESUMO

BACKGROUND: Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. METHODS: Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). RESULTS: Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with patients. CONCLUSIONS: The results showed distinctive personality traits to be associated with physicians' career and specialty choices after medical school independent of known confounding factors. Openness was the most consistent personality trait associated with physicians' career choices in terms of employment sector, amount of clinical patient contact, specialty choice and change of specialty. Personality-conscious medical career counseling and career guidance during and after medical education might enhance the person-job fit among physicians.


Assuntos
Escolha da Profissão , Personalidade , Médicos/psicologia , Especialização/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Estudos Transversais , Emprego , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Estudantes de Medicina
16.
Obesity (Silver Spring) ; 26(1): 176-184, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29152913

RESUMO

OBJECTIVE: The association between socioeconomic status (SES) and body mass index (BMI) in middle-income countries is mixed. Heterogeneity in SES indicators used could explain some differences. This study aimed to identify SES indicators consistently associated with BMI in Mexican adults in 2006, 2012, and 2016. METHODS: Data were obtained from the Mexican National Health and Nutrition Surveys of 2006, 2012, and 2016, including adults 20 to 59 years old. Given expected differences by sex, sex-stratified linear regression models were fitted for each survey. Age-adjusted and multivariate models were fit by using seven noncollinear SES indicators. RESULTS: In age-adjusted models, most SES indicators were associated with a higher BMI in men; mixed associations were found for women. In multivariate models, living in urban areas was associated with a higher BMI for both men and women in 2006 and 2012. Across all surveys, education was associated with a lower BMI in women, while household assets were associated with a higher BMI in men. CONCLUSIONS: The association between SES indicators and BMI is complex. Differences by sex need to be explicitly recognized when modeling this association. Approaches that rely on a single indicator could be confounded by other SES indicators. Adjusted models show the specific SES attributes that may influence BMI.


Assuntos
Índice de Massa Corporal , Classe Social , Fatores Socioeconômicos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Am J Epidemiol ; 186(2): 173-183, 2017 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-28459945

RESUMO

Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed.


Assuntos
Doenças Cardiovasculares/epidemiologia , Nível de Saúde , Neoplasias/epidemiologia , Tolerância ao Trabalho Programado , Adulto , Teorema de Bayes , Doenças Cardiovasculares/etiologia , Escolaridade , Características da Família , Feminino , Humanos , Incidência , Masculino , Neoplasias/etiologia , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Distribuição de Poisson , Prevalência , Estudos Retrospectivos , Risco , Autorrelato , Estados Unidos/epidemiologia
18.
Occup Environ Med ; 74(9): 645-651, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28442543

RESUMO

INTRODUCTION: The constant increase on the psychosocial demands experienced at work seems to contribute to the increase in health problems such as musculoskeletal pain (MSP). This association may be especially important in low-income and middle-income countries, where there is a large proportion of informal workers among whom there is little research. We analysed the association between psychosocial work risk factors and MSP among formal and informal workers using the First Central American Survey of Working Conditions and Health. METHODS: This is a representative sample (n=12 024) of the economically active population of the six Spanish-speaking countries of Central America. Prevalence ratios (PR) and corresponding 95% CIs from Poisson regression models were used to estimate the association between psychosocial work risk factors and the MSP. RESULTS: Compared with formal workers, informal workers reported higher prevalence of MPS in the body regions analysed (ie, cervicodorsal, lumbosacral, upper extremities) and higher exposure to psychosocial work risk factors. However, on the whole, the associations between the exposure to psychosocial work risk factors and the prevalence of MSP were similar for both formal and informal workers. Only the association between exposure to high demands and MSP in the upper extremities was higher (p=0.012) among formal (PR=1.69, 95% CI 1.46 to 1.96) than among informal workers (PR=1.40; 95% CI 1.30 to 1.51). CONCLUSION: Exposure to adverse levels of psychosocial work risk factors is associated with higher prevalence of MPS among both formal and informal workers. However, the role of employment informality in this association is complex and requires further examination.


Assuntos
Emprego/psicologia , Dor Musculoesquelética/etiologia , Doenças Profissionais/complicações , Exposição Ocupacional/efeitos adversos , Estresse Psicológico/complicações , Trabalho/psicologia , Adolescente , Adulto , América Central/epidemiologia , Países em Desenvolvimento , Emprego/classificação , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/psicologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Carga de Trabalho , Local de Trabalho , Adulto Jovem
19.
Arch. prev. riesgos labor. (Ed. impr.) ; 20(1): 14-25, ene.-mar. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-159043

RESUMO

Objetivo: La gestión de la incapacidad temporal por contingencias comunes (ITcc) en España se centra más en el control de su duración que en prevenir su incidencia. El objetivo de este trabajo es proporcionar valores de la incidencia de ITcc por ramas de actividad económica para orientar su gestión hacia la prevención. Métodos: Estudio retrospectivo basado en 646.337 afiliados al régimen general incluidos en la Muestra Continua de Vidas Laborales de 2009, que notifican 133.812 primeros episodios de ITcc iniciados en 2009. La tasa de incidencia, y su IC95%, se calculó con modelos de regresión de Poisson, cruda y ajustada por edad, tamaño de la empresa y categoría ocupacional, separadamente para hombres y mujeres. Resultados: La tasa de incidencia total por 100 personas-años fue de 29,8 (hombres: 24,7; IC95%:24,5-24,9 y mujeres: 36,3; IC95%: 36,0-36,5). Según ramas de actividad económica, las tasas de incidencia crudas más elevadas en los hombres fueron «Suministro de agua, saneamiento y residuos» (35,4) y «Actividades sanitarias» (33,9), y en las mujeres en «Actividades sanitarias» (48,3), «Administración pública» (41,2) y «Transporte y almacenamiento» (41,0). Conclusiones: Las empresas podrán comparar su incidencia de ITcc con estos valores de referencia para determinar si su incidencia está dentro del rango de valores esperados, lo que puede ayudarles a tomar decisiones orientadas a la prevención de las bajas por enfermedad común


Introduction: The management of sickness absence due to non-work-related diseases in Spain has typically focused on the control of its duration. The goal of this study was to provide estimates for the incidence of sickness absence due to nonwork-related diseases by economic activity to help shift the focus of management of sickness absence towards prevention. Methods: Retrospective study based on 646,337 workers and 133,812 episodes of sickness absence started in 2009, from the Working Continuous Life Sample. Incidence rate and its 95% confidence interval (CI) were calculated using Poisson regression models, crude and adjusted for age, company size, and occupational category, separately for men and women. Results: The overall incidence rate was 29.8 per 100 person-years; 24.7 (95%CI: 24.5-24.9) in men and 36.3 (36.0- 36.5) in women. By economic activity, the highest crude incidence rates in men were found in «Water supply, sanitation and wastes» (35.4) and «Health activities» (33.9); for women, «Health activities» (48.3), «Public administration» (41.2) and «Transportation and storage» (41.0) were the highest sectors. Conclusions: Companies can compare their sickness absence incidence rates to these benchmark values to determine if they are within the expected reference range, which may guide management decisions more towards the prevention of sickness absence


Assuntos
Humanos , Masculino , Feminino , Saúde do Trabalhador/classificação , Licença Médica/classificação , Espanha/etnologia , Prevenção de Doenças , Estudos Retrospectivos , Previdência Social/legislação & jurisprudência , Licença Médica/economia , Programa de Prevenção de Riscos no Ambiente de Trabalho , Previdência Social/organização & administração , Políticas Públicas de Saúde
20.
Am J Ind Med ; 60(3): 255-263, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28195657

RESUMO

BACKGROUND: Inhalation exposure to organic dust causes lung inflammation among agricultural workers. Due to changes in production and work organization, task-based inhalation exposure data, including novel lung inflammation biomarkers, will inform exposure recommendations for dairy farm workers. METHODS: Linear regression was used to estimate the associations of airborne exposure to dust concentration, endotoxin, and muramic acid with pulmonary outcomes (i.e., FEV1 , exhaled nitric oxide). Logistic regression was used to estimate associations with self-reported pulmonary symptoms. RESULTS: Mean exposure concentration to inhalable dust, endotoxin, and muramic acid were 0.55 mg/m3 , 118 EU/m3 , and 3.6 mg/m3 , respectively. We found cross-shift differences for exhaled nitric oxide (P = 0.005) and self-reported pulmonary symptoms (P = 0.008) but no association of exposure with respiratory outcomes. CONCLUSIONS: Inhalation exposures during parlor tasks, which were lower than previously reported and were not associated with cross-shift measures of pulmonary health among dairy workers. Modern milking parlor designs may be contributing to lower inhalation exposure. Am. J. Ind. Med. 60:255-263, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Aerossóis/toxicidade , Poluentes Ocupacionais do Ar/toxicidade , Indústria de Laticínios , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , Adulto , Aerossóis/análise , Poluentes Ocupacionais do Ar/análise , Estudos Transversais , Poeira/análise , Endotoxinas/análise , Endotoxinas/toxicidade , Feminino , Humanos , Exposição por Inalação/análise , Pneumopatias/etiologia , Pneumopatias/fisiopatologia , Masculino , Ácidos Murâmicos/análise , Ácidos Murâmicos/toxicidade , Doenças Profissionais/etiologia , Doenças Profissionais/fisiopatologia , Exposição Ocupacional/análise , Testes de Função Respiratória
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