Reliability of O*NET physical exposures between Italian and US databases.

BACKGROUND: Comparison between cross-national job-exposure matrices (JEMs) may provide indications of their reliability, particularly if created using the same items. This study evaluated concordance between two JEMs created from United States (US) and Italian O*NET data, using job codes linked through international job codes. METHODS: Twenty-one physical exposures were obtained from the US and Italian O*NET databases. Italian O*NET items were direct translations of US O*NET items. Six hundred and eighty-four US and 586 Italian job codes were linked via crosswalks to 281 ISCO-08 job codes. A sensitivity study also assessed concordance on 258 jobs matched one-to-one across the two national job classifications. Concordance of US and Italian O*NET exposures was estimated by intraclass correlation coefficients (ICC) in multilevel models adjusted and not adjusted for country. RESULTS: ICCs showed moderate to poor agreement for all physical exposures in jobs linked through ISCO-08 codes. There was good to moderate agreement for 14 out of 21 exposures in models with one-to-one matched jobs between countries; greater agreement was found in all models adjusted for country. Exposure to whole-body vibration, time standing, and working outdoor exposed to weather showed the highest agreement. CONCLUSIONS: These results showed moderate to good agreement for most physical exposures across the two JEMs when US and Italian jobs were matched one-to-one and the analysis was adjusted for country. Job code assignments through crosswalks and differences in exposure levels between countries might greatly influence the observed cross-country agreement. Future multinational epidemiological studies should consider the quality of the cross-national job matching, and potential cross-national differences in exposure levels.

Development of the St. Louis audit of fall risks at residential construction sites.

We describe the development and pilot testing of the St. Louis Assessment of Fall Risks, a worksite audit to assess fall prevention safety practices on residential construction sites. Surveillance data and feedback from carpenters and safety instructors regarding work tasks associated with falls from heights were used to develop the audit instrument. The audit focuses on the framing process, including general safety climate/housekeeping, floor joist/sub-floor installation, walking surfaces/edges, wall openings, truss setting, roof sheathing, ladders, scaffolds, and personal fall arrest equipment. The audit was tested at sixteen residential construction sites, documenting excellent inter-rater reliability (kappa = 0.93). Results suggest that the audit has good face and content validity and is a reliable instrument for measuring fall safety risks at residential construction sites. It is practical, easy, and safe to administer, making it a potentially useful instrument for field research as well as regular safety monitoring by foremen and crew.

Median and ulnar nerve conduction studies at the wrist: criterion validity of the NC-stat automated device.

OBJECTIVE: To compare results obtained with the NC-stat--an automated nerve testing device--to traditional nerve conduction studies relevant to carpal tunnel syndrome screening. METHODS: Thirty-three subjects recruited from patients referred for electrodiagnostic testing were studied. Measurements including the distal motor latency (DML), distal sensory latency (DSL), and median-ulnar latency difference (MUD) were obtained by the NC-stat and by standard nerve conduction studies. RESULTS: With modifications to the NC-stat's suggested reference ranges, sensitivity with respect to the traditional results ranged from 93.8% (sensory MUD) to 100% (median DML and DSL) and specificity ranged from 84.6% (motor MUD) to 94.1% (sensory MUD). Sensitivity was as high or higher and specificity was lower when using the manufacturer's suggested cutoffs. CONCLUSION: The NC-stat appears to be a convenient and sensitive method for detecting median nerve pathology at the wrist.