The Association of Occupational Psychosocial Factors with the Prevalence of Irritable Bowel Syndrome in the Chilean Working Population.

BACKGROUND: Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. OBJECTIVE: A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. METHODS: IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level. RESULTS: The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001). CONCLUSIONS: Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.

Clearing the air: the evolution of organized labor's role in tobacco control in the United States.

As efforts to make U.S. worksites smoke-free took shape in the 1980s, the tobacco industry sought to defeat them by forming alliances with organized labor. The alliance between the tobacco industry and organized labor was based on framing the regulation of environmental tobacco smoke (ETS) as a threat to jobs, an example of management unilateralism, and an issue that divided smoking and nonsmoking union members. The dynamics of organized labor and tobacco control began to change in the late 1980s with attempts to ban smoking on airlines and in the hospitality industry. Flight attendants, bar and restaurant workers, and casino dealers-all subject to ETS in their work environments-confronted ETS as an occupational health issue. Against the backdrop of increasing awareness of the hazards of ETS, and the acceptance of tobacco control policy, this framing changed the basis of organized labor's role in tobacco control. Because service workers share the workplace with the general public, their occupational health issues are also public health issues. This fact presents new opportunities for coalition building to protect the health of service workers and the public alike.

A decade of work on organized labor and tobacco control: reflections on research and coalition building in the United States.

Labor unions can and should make strong allies in tobacco control efforts. Through much of the 1980s and 1990s, however, the organized labor and tobacco control communities rarely formed coalitions to achieve mutual gains. Recently, labor unions and tobacco control organizations have begun to work together on smoking cessation programs, smoke-free worksite policies, and increased insurance coverage for cessation treatments. This paper explores the historic and present-day intersections among organized labor and tobacco control advocates. We summarize research in this area and report on our recent programmatic efforts to promote collaboration between the labor and tobacco control communities. We discuss lessons learned with the aims of promoting deeper understanding among tobacco control and labor advocates of how each views tobacco control issues, and most importantly, stimulating further collaboration toward mutual gains in protecting workers' health.

FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe.

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

Teachers Union Organizes Members to Enforce AHERA Law--A Work in Progress.

The Massachusetts Teachers Association's Environmental Health and Safety Committee is using a number of approaches to evaluate and improve the enforcement of the U.S. Asbestos Hazard Emergency Response Act legislation intended to ensure the proper management of asbestos in public buildings, including schools. The committee first approached state regulators directly concerning enforcement concerns, with limited success. Next, the Massachusetts Teachers Association developed an organizing strategy and a curriculum focusing on the requirements of the Asbestos Hazard Emergency Response Act and on building a membership-run health and safety committee infrastructure in local unions. Five trainings took place throughout Massachusetts over a 2-month period in 2015. The committee implemented follow-up procedures and support for locals to continue to engage in this ongoing effort. This work illustrates that the passage of the Asbestos Hazard Emergency Response Act in 1986 was insufficient action to remediate school asbestos exposures. It is necessary for unions representing school employees to systematically hold regulators and school districts accountable for enforcement and compliance.

Change in the world of occupational health: silica control, then and now.

To control silicosis, we need to understand how change happens in occupational health. Science alone does not drive policy, because we have known the causes of silicosis, and how to prevent it for decades, yet the disease persists. To control occupational disease, we need to enter the social realm of work. To investigate the determinants of a successful silicosis control program, we wrote a social history of the Vermont Granite Industry from 1938 to 1960, examining union journals, newspapers, industry journals, scientific literature and government documents, and interviewing key informants. The crucial factor of the successful program was a strong public health movement to control tuberculosis, rather than pressure to control the occupational disease. Using this lesson, to protect workers from silica exposure now, we chose to regulate silica under an environmental law, the Massachusetts Toxics Use Reduction Act. Science is but one small factor, necessary but insufficient, in policy change. We in occupational health need to hitch onto a stronger movement, currently the environmental movement. Where unions are too weak to demand safe technologies, we need to learn to speak the language of employers, because they may have little idea of the costs of interventions. We need to gather more economic information about the costs of interventions.

Net-cost model for workplace interventions.

PROBLEM: Few methods exist for comprehensively examining the costs and benefits of ergonomic interventions applicable to a variety of economic sectors and settings. METHODS: An instrument for data collection and data analysis at the facility level is presented. In this net-cost model intervention costs are defined by equipment and labor costs for the interventions as well as the avoided costs of lost work time, medical care, and productivity improvements. RESULTS: Net-cost estimates for three case studies show that ergonomic interventions applied appropriately can result in substantial cost savings for the companies. DISCUSSION: It would be prudent to incorporate a protocol for collecting cost and effectiveness data in the standard operating procedures of companies introducing ergonomic interventions. Validation of the net-cost model through prospective studies is necessary. IMPACT ON INDUSTRY: This model may be used to determine the net-cost of implemented or proposed ergonomic interventions in industrial facilities.

Fire and worker health and safety: an introduction to the special issue.

One century ago, the landmark fire at the Triangle Shirtwaist Factory in New York City claimed the lives of 146 garment workers and helped spur the adoption of fire safety measures and laws targeting dangerous working conditions. Since that time, continuing advances have been made to address the threat of fire-in workplace fire safety practices and regulations, in training and safety requirements for firefighters and first responders, and in hazard communication laws that enhance disaster planning and response. Recent high profile events, including the West, Texas fertilizer plant explosion, derailments of fuel cargo trains, and garment factory fires in Bangladesh, have brought renewed attention to fire as a workplace health and safety issue and to the unevenness of safety standards and regulatory enforcement, in the United States as well as internationally. In this article, we provide an overview of fire as a workplace health and safety hazard and an introduction to the essays included in this special issue of New Solutions on fire and work.

The occupational health of Southeast Asians in Lowell: a descriptive study.

To assess the occupational health of a group of vulnerable workers, Southeast Asians, in Lowell, Massachusetts, researchers surveyed 160 residents of Cambodian or Lao ethnicity regarding working conditions, health problems, and use of medical services. Over 40% reported work in electronics and computer assembly. A fourth of those currently employed held temporary jobs. Workplace hazards included soldering fumes; inadequate ventilation; prolonged sitting or standing; awkward postures; unguarded machinery; shift work; long hours; and pressure to produce quickly. Common work-related health problems included sprains and strains, headache, dizziness, and flu-like symptoms. Less than a third of the respondents knew about workers' compensation. Household surveys can provide otherwise unavailable occupational health data for defined populations.

Wounding the messenger: the new economy makes occupational health indicators too good to be true.

The U.S. Bureau of Labor Statistics and workers' compensation insurers reported dramatic drops in rates of occupational injuries and illnesses during the 1990s. The authors argue that far-reaching changes in the 1980s and 1990s, including the rise of precarious employment, falling wages and opportunities, and the creation of a super-vulnerable population of immigrant workers, probably helped create this apparent trend by preventing employees from reporting some injuries and illnesses. Changes in the health care system, including loss of access to health care for growing numbers of workers and increased obstacles to the use of workers' compensation, compounded these effects by preventing the diagnosis and documentation of some occupational injuries and illnesses. Researchers should examine these forces more closely to better understand trends in occupational health.

[Robbers on board: exposure to violence, insecurity, and other health hazards among mass transportation workers and passengers in Salvador, Bahia, Brazil]. / Assaltantes a bordo: violência, insegurança e saúde no trabalho em transporte coletivo de Salvador, Bahia, Brasil.

This paper examines the impact of violent crime on working conditions, health, and security for bus drivers and ticket takers in the mass transportation system in Salvador, Bahia, Brazil. The research included 195 interviews with workers, labor union officials, passengers, management, and police. In the last ten years there have been 20,572 robberies in a fleet of 2,400 buses operated by 10,151 workers, with 67 deaths and more than US$500,000 in company losses. Perpetrators are typically poor, unemployed youths, the majority of whom first offenders, seeking easy money primarily for leisure pursuits. The average "take" from such robberies is minimal. The authors observed a pattern of bus robberies as a psychological power game which, for bus workers, apart from physical injuries and fatalities, generates fear, identity conflicts, tense relations with passengers, and labor conflicts involving the recovery of stolen fares and worker and passenger security issues. The article also outlines and evaluates the efficiency of security measures including the use of lethal force by police.

Building the new schoolhouse: the Massachusetts school building authority.

In a 2010 special issue of New Solutions on school health and environment, Paulson and Barnett asked who is responsible for the environmental health of schools. The Massachusetts School Building Authority (MSBA), the product of liberals trying to bring organization and efficiency to school construction, is an "off-label" and only partial answer to the question. The MSBA, established in 2004, lent its ear to health and safety advocates who seized an opportunity to implement regulations, guidelines, and education reforms at the level of school construction. The MSBA's progressiveness is a model to localities and states across the United States facing the dual crisis of attacks on public education and financial inefficiency. However, the MSBA is still in its infancy. Time will tell whether the MSBA, viewed as a limited state pilot program, can survive and expand its environmental health programs or whether its initiative is only as good as its current leadership.

Creative mistrust.

Based on six years spent investigating worker health and safety conditions at U.S. Department of Energy sites that were formerly engaged in the production of nuclear weapons, the authors report on a set of common themes that emerged in their interviews with workers. The initial focus of the authors was on behavior-based safety programs and their investigation revealed deep-seated mistrust of management by workers. The authors discuss the importance of trust issues for worker training and suggest that "creative mistrust" should be cultivated in training programs.

From (before) Bhopal to (after) BP: trade secrets and the right to know.

This paper discuses the tensions between, on the one hand, workers' and communities' right to know about occupational and environmental hazards, and on the other hand, trade secrets and the rights of their corporate owners. We first discuss the role of trade secrets in economic development in the context of the benefits claimed for free markets. We then describe the ongoing struggles of workers and communities in the United States for access to information about hazards. The third section of the paper is a discussion of the reformulation of labor and occupational health and safety regulation as matters of human rights, again focusing on the situation in the United States. The final section is a discussion of the implications of the human rights approach for the occupational and environmental health practitioner. Although the paper focuses primarily on the U.S. experience, we believe that the lessons learned may be broadly applicable.