Health Comparisons Between Truck Drivers and the General Population Using the Canadian Community Health Survey.

BACKGROUND: This study examined and compared risk factors and health conditions of truck drivers compared with the general Canadian population. METHODS: This study used the Canadian Community Health Survey consisting of 991 male truck drivers and 29,958 male respondents of the general population. RESULTS: Compared with the general population, truck drivers were older, less educated, had lower incomes, worked more hours, and were more likely to be widowed/separated/divorced. In addition, truck drivers had significantly higher rates of cardiovascular disease and obesity and were more likely to be sedentary, smoke, drive when fatigued, and eat unhealthy compared with the general population. CONCLUSIONS: Multicomponent interventions are needed to address the poor lifestyle practices of truckers to reduce the high rates of morbidity.

Evolving pipe joining methods and their association to musculoskeletal symptoms for residential plumbers.

BACKGROUND: Recently the plumbing trade has transitioned from traditional copper piping to flexible plastic piping (PEX) for residential water distribution systems. However, there has been very limited research into the ergonomic implications of the modernized processes. OBJECTIVE: This research documents the physical workload and risks of musculoskeletal disorders (MSDs) with the use of new tools and processes for joining piping. The research also identifies the factors which can facilitate or limit the use of new ergonomically beneficial tools. METHODS: This mixed methods research included workplace observations, interviews, an experiment, a survey of plumbers in residential construction and focus groups with both plumbers and plumbing contractors. RESULTS: Advantages and disadvantages of the various techniques for joining pipes showed that manual crimping has advantages (i.e., productivity and lower cost) that make it desirable for plumbing contractors. Power devices, which were not widely used, have great potential to reduce MSD risks especially if the size and weight of the tools decreases with newer technologies. A continuing barrier is the cost of power equipment. CONCLUSION: The move to provide ergonomically beneficial tools was not as rapid as the willingness to change piping materials. Productivity and costs of tools are barriers to ergonomic interventions.

Biological Embedding of Psychosocial Stressors Within a Sample of Canadian Firefighters: An Exploratory Analysis.

OBJECTIVE: We wanted to determine whether the biological embedding of perceived psychosocial stress could be observed within a sample of Canadian firefighters. METHODS: We collected sociodemographic and general health-related information from 58 firefighters. In addition, measures of work-related and general life psychosocial stress, perceived social support, and physiological parameters thought to reflect the embedding of stress were gathered and analyzed using analysis of variance and linear regression models. RESULTS: Despite observing a positive relationship between psychosocial stress and allostatic load, the association was not significant; however, age did significantly predict allostatic load ( B = 0.09, P = 0.04). Notably, our participants reported abundant social support that was inversely associated with perceived stress. CONCLUSIONS: Although perceived stress did not significantly affect allostatic load in our sample, high levels of social support may have provided an important countervailing force.

Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape.

BACKGROUND AND OBJECTIVES: Much of the research surrounding firefighter health has concerned the hazards intuitively associated with the occupation, such as physical, thermal, and chemical risks. However, an additional aspect of their work environment, psychosocial stressors, has begun to attract a growing level of attention. Work-related psychosocial stress may best be described as mental and emotional strain caused by a combination of workplace events and characteristics, and the objective of our review was to identify the health outcomes associated with these stressors in firefighters. METHODS: A systematic review was performed of studies reporting on the psychosocial stressors and the associated health outcomes experienced by firefighters. Data sources included the MEDLINE, PsychInfo, and CINAHL databases. RESULTS: Twenty-nine studies met the inclusion criteria. Upon analysis, we found that firefighters experienced a range of psychosocial stressors (including interpersonal conflict and concerns over organizational fairness) and observed that these stressors were associated with a number of health-related outcomes that could be arranged into six areas: depression-suicidality, non-depressive mental health problems, burnout, alcohol use disorders, sleep quality, and physiological parameters and somatic disorders. CONCLUSION: Our findings strongly suggest that work-related psychosocial stressors can affect the health and well-being of those in the fire service, and highlight that interventions meant to address these psychosocial risk factors should focus upon promoting self-esteem, enhancing self-efficacy, and strengthening social support.

The impact of different seats and whole-body vibration exposures on truck driver vigilance and discomfort.

Laboratory studies have shown that exposure to whole-body vibration (WBV) increases physical and mental fatigue, which are common issues professional drivers face. The objective of this study was to determine whether altering WBV exposures had any effect on driver vigilance and discomfort. A repeated measures crossover design of five truck drivers with regular 10-h routes was used. Active and passive suspension truck seats were evaluated. For each seat, WBV exposures were measured. Participants completed a discomfort questionnaire and a reaction time task before and after their shift for two weeks, one week per seat. Compared with the passive seat, the active seat significantly reduced WBV exposures, decrements in the optimal and mean reaction times (p = 0.02, 0.047, respectively), and discomfort in the lower back and wrist(s)/forearm(s) (p < 0.01, 0.01, respectively). Study results indicated that reducing WBV helps reduce discomfort and maintain vigilance, which may improve drivers' health and reduce the risk of truck collisions. Practitioner Summary: The active suspension seat used in this study reduced truck drivers' exposure to whole-body vibration (WBV) by over 33% in relation to their current industry standard passive suspension seat. This study demonstrated that reducing truck drivers' exposure to WBV reduced fatigue and discomfort development over a workday.

Using standard clinical assessments for home care to identify vulnerable populations before, during, and after disasters.

OBJECTIVES: Several studies have shown the increased vulnerability of and disproportionate mortality rate among frail community-dwelling older adults as a result of emergencies and disasters. This article will discuss the applicability of the Vulnerable Persons at Risk (VPR) and VPR Plus decision support algorithms designed based on the Resident Assessment Instrument-Home Care (RAI-HC) to identify the most vulnerable community-dwelling (older) adults. DESIGN: A sample was taken from the Ontario RAI-HC database by selecting unique home care clients with assessments closest to December 31, 2014 (N = 275,797). Statistical methods used include cross tabulation, bivariate logistic regression as well as Kaplan-Meier survival plotting and Cox proportional hazards ratios calculations. RESULTS: The VPR and VPR Plus algorithms, were highly predictive of mortality, long-term care admission and hospitalization in ordinary circumstances. This provides a good indication of the strength of the algorithms in identifying vulnerable persons at times of emergencies. CONCLUSIONS: Access to real-time person-level information of persons with functional care needs is a vital enabler for emergency responders in prioritizing and allocating resources during a disaster, and has great utility for emergency planning and recovery efforts. The development of valid and reliable algorithms supports the rapid identification and response to vulnerable community-dwelling persons for all phases of emergency management.

Impacts of Industrial Wind Turbine Noise on Sleep Quality: Results From a Field Study of Rural Residents in Ontario, Canada.

The objectives of this study were to determine whether grid-connected industrial wind turbines (IWTs) are a risk factor for poor sleep quality, and if IWT noise is associated with sleep parameters in rural Ontarians. A daily sleep diary and actigraphy-derived measures of sleep were obtained from 12 participants from an IWT community and 10 participants from a comparison community with no wind power installations. The equivalent and maximum sound pressure levels within the bedroom were also assessed. No statistically significant differences were observed between IWT residents and non-IWT residents for any of the parameters measured in this study. Actigraphy and sleep diaries are feasible tools to understand the impact of IWTs on the quality of sleep for nearby residents. Further studies with larger sample sizes should be conducted to determine whether the lack of statistical significance observed here is a result of sample size, or reflects a true lack of association.

Serving the food nation: Exploring Body Mass Index in food service workers.

BACKGROUND: Obesity is a public health concern in North America. Consumption of food prepared outside of the home is often discussed as a contributing factor. OBJECTIVE: To determine whether or not Canadian food service workers are more likely to have high Body Mass Indices (BMIs) as compared with the general population, and to examine factors that contribute to BMI in this population. METHODS: Analyses of secondary survey data from Cycle 5.1 of the Canadian Community Health Survey were performed. Descriptive statistics were generated to examine food service workers' risk of having above normal BMI compared to other Canadians. Logistic regression analysis was used to identify factors contributing to variation in BMI among food service workers. Analyses were stratified by age. RESULTS: Canadian food service workers are less likely to have BMIs in the overweight and obese ranges than the general population. Stratification by age demonstrated that this decreased risk can be attributed to the fact that food service workers tend to be younger than the general population. As age increases among food service workers, the odds of having a BMI in the overweight and obese ranges increases. CONCLUSIONS: Food service workers in general were not at higher risk for high BMI, but those between the ages of 41 and 64 are at higher risk of having a BMI in the overweight or obese ranges. The findings suggest that proximity to food service outlets may not be the most salient factor in explaining BMI.

Detecting within- and between-day manifestations of neuromuscular fatigue at work: an exploratory study.

Cumulative neuromuscular fatigue may result from exposure to physically demanding work, such as repetitive and/or sustained work with insufficient recovery. The aims of this exploratory study were to develop a battery of field usable fatigue measures and to document hand/arm fatigue in physically demanding work over multiple workdays and after a weekend break. Sixteen plumbers were observed for five days and measures of handgrip force, variability, tremor and discomfort were obtained pre-, mid- and post-shift. This exploratory study demonstrated increasing fatigue of the hand/arm over the day and persistent fatigue from Tuesday to Friday, and that a number of the measures did not return to baseline values following a weekend break. The findings provide preliminary evidence of cumulative fatigue in residential plumbing and insight into neuromuscular fatigue measurement. However, further work is needed to develop and refine a set of fatigue measures to detect neuromuscular fatigue at the workplace. PRACTITIONER SUMMARY: Cumulative fatigue has been linked to long-term health outcomes, including work-related musculoskeletal disorders. This paper presents findings from a physically demanding job (i.e. plumbing) revealing persistent fatigue over the work shift(s) and insufficient recovery after a weekend break, and provides insight into fatigue measurement at the workplace.

Measurement properties of occupational health and safety management audits: a systematic literature search and traditional literature synthesis.

OBJECTIVE: The measurement properties of Occupational Health and Safety (OHS) management audits might be important in some applications, especially when audit scores are treated as performance measures. The review, therefore, sought to identify and summarize the research evidence on the measurement properties (e.g., reliability, validity) of methods of OHS management audit. METHODS: Bibliographic databases in business, medicine and OHS were systematically searched. Evidence from relevant publications was synthesized using traditional narrative review methods. SYNTHESIS: The literature on the measurement properties of OHS management audit methods is sparse. Seventeen relevant audit methods were identified. Content validity was demonstrated for only five audit methods. Inter-rater reliability was formally tested for only three audit methods and construct validity for only one. There were no studies of test-retest reliability or responsiveness. The investigations of inter-rater reliability (i.e., consistency among auditors) showed that it is often unacceptably low. CONCLUSION: There is a research gap concerning the measurement properties of OHS management audit methods. The available research raises questions about the properties of audit methods in current use.

Something might be missing from occupational health and safety audits: findings from a content validity analysis of five audit instruments.

OBJECTIVE: The objective was to examine the content validity of occupational health and safety (OHS) management audit methods. METHODS: The documentation used by five broader public sector service organizations to audit OHS management in workplaces was analyzed with reference to a recent OHS management standard (CSA Z1000). RESULTS: A relatively high proportion of CSA Z1000's content (74%) was partially or fully represented on average in the audit methods. However, six management elements were found to be incompletely represented in three or more of the methods. The most extreme example is the Internal Audits element whose content was completely missing for three of the audit methods. CONCLUSION: Some OHS management audit instruments in current use are incomplete relative to a recent OHS management standard. It may be that some instruments warrant revision to better reflect current expert consensus.

Searching for needles in a haystack: identifying innovations to prevent MSDs in the construction sector.

This study identified innovations that could potentially reduce the risk of MSDs in the construction sector. The action research approach was based on a collaborative model of researchers working with workplace representatives. We searched for innovations being used by construction companies. From a potential database of 125 innovations, the study focused on 20 innovations that varied in their penetration into worksites in the geographical area, represented a variety of trades, and were a cross-section of tools and work organizational processes. It examined the attributes of the innovations, and the barriers to their adoption. The analysis was based on observations of workers, surveys of workers and construction-safety consultants, and company interviews. The study found that innovations were adopted by companies for multiple advantages including productivity and quality, but not necessarily ability to reduce MSD risks, their non-complexity, and cost. The major barriers for adoption were the traditional culture of the construction sector rather than financial ones.

Low back pain among residential carpenters: ergonomic evaluation using OWAS and 2D compression estimation.

Occupational low back pain (LBP) remains a leading safety and health challenge. This cross-sectional investigation measured the prevalence of LBP in residential carpenters and investigated ergonomic risk factors. Ninety-four carpenters were investigated for LBP presence and associated risk factors. Ten representative job-tasks were evaluated using the Ovako Working Posture Analysis System (OWAS) and ErgoMaster 2D software to measure elements of posture, stress, and risk. Job-tasks were found to differ significantly for total lumbar compression and shear at peak loading (p < .001), ranging from 2 956 to 8 606 N and 802 to 1 974 N respectively. OWAS indicated that slight risk for injury was found in 10 job-tasks while distinct risk was found in 7 of the 10 job-tasks. Seven of the 10 job-tasks exceeded the National Institute for Occupational Safety and Health (NIOSH) action limit of 3 400 N for low back loading. The point prevalence for LBP was 14% while the annual prevalence was 38%.

Low back pain in Hispanic residential carpenters.

OBJECTIVE: Low back pain (LBP) is a leading cause of lost work time and has been recognized as America's number one workplace safety challenge. Low back pain is occurring at epidemic proportions among construction workers, and minority populations have been underinvestigated for risk of back injury. This project investigated the multiple potential risk factors for occupational LBP among Hispanic residential carpenters. METHODS: This investigation evaluated 241 Hispanic residential framing carpenters. Data for this study were collected using a 91-question survey. End points of interest included point, annual, and lifetime prevalence of LBP. RESULTS: Nineteen percent of respondents reported they had an episode of LBP in their lifetime. CONCLUSIONS: Hispanic residential carpenters reported less than expected prevalence of LBP compared with non-Hispanic counterparts in the same trade and location. Job tasks and personal and workplace risk factors, including psychological and morphological characteristics, affect the prevalence of LBP among Hispanic framing carpenters.

Evaluation of potential toxicity from co-exposure to three CNS depressants (toluene, ethylbenzene, and xylene) under resting and working conditions using PBPK modeling.

Under OSHA and American Conference of Governmental Industrial Hygienists (ACGIH) guidelines, the mixture formula (unity calculation) provides a method for evaluating exposures to mixtures of chemicals that cause similar toxicities. According to the formula, if exposures are reduced in proportion to the number of chemicals and their respective exposure limits, the overall exposure is acceptable. This approach assumes that responses are additive, which is not the case when pharmacokinetic interactions occur. To determine the validity of the additivity assumption, we performed unity calculations for a variety of exposures to toluene, ethylbenzene, and/or xylene using the concentration of each chemical in blood in the calculation instead of the inhaled concentration. The blood concentrations were predicted using a validated physiologically based pharmacokinetic (PBPK) model to allow exploration of a variety of exposure scenarios. In addition, the Occupational Safety and Health Administration and ACGIH occupational exposure limits were largely based on studies of humans or animals that were resting during exposure. The PBPK model was also used to determine the increased concentration of chemicals in the blood when employees were exercising or performing manual work. At rest, a modest overexposure occurs due to pharmacokinetic interactions when exposure is equal to levels where a unity calculation is 1.0 based on threshold limit values (TLVs). Under work load, however, internal exposure was 87%higher than provided by the TLVs. When exposures were controlled by a unity calculation based on permissible exposure limits (PELs), internal exposure was 2.9 and 4.6 times the exposures at the TLVs at rest and workload, respectively. If exposure was equal to PELs outright, internal exposure was 12.5 and 16 times the exposure at the TLVs at rest and workload, respectively. These analyses indicate the importance of (1) selecting appropriate exposure limits, (2) performing unity calculations, and (3) considering the effect of work load on internal doses, and they illustrate the utility of PBPK modeling in occupational health risk assessment.

Measuring success in a pesticide risk reduction program among migrant farmworkers in Colorado.

BACKGROUND: Farmworkers in the US largely consist of young undocumented Hispanics with a median education of 6 years and limited English skills. The High Plains Intermountain Center for Agricultural Health and Safety bilingual pesticide risk reduction program, which complied with the Worker Protection Standard for migrant farmworkers was evaluated. METHODS: A pretest/posttest comparison of farmworkers (n = 152) assigned to either the experimental or control group was used. Independent variables included demographics, agricultural experience, and health locus of control. Dependent variables were pesticide knowledge, safety risk perception (SRP), and safety-behavior outcomes. RESULTS: The bilingual pesticide program effectively increased farmworker's pesticide knowledge (P = 0.0001), SRP (P = 0.0001), and two (out of four) behavior outcomes. Workers with external health locus of control were less likely to adopt safety behaviors (P = 0.0001). CONCLUSIONS: The cognitive decision-making process whereby farmworkers' readiness to change and permanently adopt safety behaviors was supported by the pesticide program. Our results support the need for long-term sustained bilingual, intervention programs that demonstrated effectiveness using integrative methodology.

Occupational exposure limits in the context of solvent mixtures, consumption of ethanol, and target tissue dose.

Individuals are exposed to mixtures, and never to single chemicals. Depending on the composition of the elements of mixtures, significant toxicological interactions between the components may occur. These interactions are complex and often difficult to predict, ranging from synergistic to additive and subadditive interactions. The nature of the interactions needs to be evaluated as the target tissue dose of the active form of each chemical. PBPK modeling is an effective tool for determining the target tissue dose and evaluating these interactions when data are available for model development. Some of the interactions are pharmacokinetic in nature, affecting the disposition of other chemicals in the body. Other interactions can be pharmacodynamic in nature, altering the effects that other chemicals have on the organism. For many organic solvents, these interactions occur principally at the level of the metabolizing enzyme, cytochrome P-450 2E1 (CYP2E1). Many solvents are known to induce or inhibit CYP2E1, or both. Mixtures may be comprised of concomitant exposures to chemicals or from components encountered separately on-the-job, off-the-job, through the diet, and otherwise. Examples of mixtures where the exposure to separate components occurs off the job will be discussed, with special emphasis on ethanol consumption as a modifier of solvent pharmacokinetics. The present practice of the linear extrapolation of the toxicity of individual mixture components in the interpretation of occupational exposure limits will also be critiqued.

Construction work practices and conditions improved after 2-years' participation in the HomeSafe pilot program.

This study reevaluated changes in job-site safety audit scores for a cohort of residential construction workers that had protracted exposure to the HomeSafe pilot program for 2(1/2) years. The investigation was a repeated measure of a cohort study underway in the six-county metro area of Denver, Colo. The larger study was a longitudinal, quasi-experimental design with a cohort of residential construction workers within the HomeSafe strategic partnership between Occupational Safety and Health Administration Region VIII and the Home Builders Association of Metropolitan Denver (HBA). Audits were conducted on residential construction sites. Study subjects were construction workers employed by partner or control companies within the study. Repeated measures of 41 companies showed significant improvement (p=.01) in audit scores, increasing from 71.8 to 76.8 after 2(1/2) years in the program. HomeSafe companies out-performed controls (p=.01) for both the retest group and previously unaudited HomeSafe companies. Prolonged exposure in the HomeSafe pilot program resulted in improved audit scores for companies within the program for at least 2 years.

Management commitment to safety and health in residential construction: HomeSafe spending trends 1991-1999.

The support of good management is fundamental to the success of any safety and health program. Residential construction is a high-risk industry requiring significant commitment by management to impact day-to-day safety and health challenges. Investigators have evaluated management practices and spending trends in a cohort of 228 residential homebuilders in the Denver metro area of Colorado. Findings suggest that companies significantly increased dollars allocated to support safety and health practices between 1991 and 1999. In addition, the HomeSafe Pilot Program has positively impacted financial commitments of partner companies. Resource allocations were significantly greater for specific expense categories when comparing pre to post HomeSafe intervention. This paper presents data on the use of written safety and health programs, safety committees, and workers compensation premium cost containment certification, as well as allocations to safety incentive programs (SIP), personal protective equipment (PPE), other safety equipment (OSE), and safety training (ST).