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1.
PeerJ ; 12: e16956, 2024.
Article in English | MEDLINE | ID: mdl-38495761

ABSTRACT

Background: Sexual dimorphism, driven by sexual selection, leads to varied morphological distinctions in male and female insects, providing insights into selection pressures across species. However, research on the morphometric variability within specific taxa of tiger beetles (Coleoptera: Cicindelidae), particularly arboreal and semi-arboreal species, remains very limited. Methods: We investigate sexual dimorphism in six semi-arboreal Therates tiger beetle taxa from the Philippines, focusing on morphological traits. We employed morphometric measurements and multivariate analyses to reveal patterns of sexual dimorphism between sexes within the taxa. Results: Our results indicate significant sexual dimorphism in elytra width, with females consistently displaying broader elytra, potentially enhancing fecundity. Notable sexual size dimorphism was observed in Therates fulvipennis bidentatus and T. coracinus coracinus, suggesting heightened sexual selection pressures on male body size. Ecological factors, mating behavior, and female mate choice might contribute to the observed morphological variation. These findings emphasize the need for further studies to comprehend mating dynamics, mate choice, and ecological influences on morphological variations in semi-arboreal and arboreal tiger beetles.


Subject(s)
Coleoptera , Sex Characteristics , Female , Male , Animals , Philippines , Sexual Selection , Biodiversity , Trees
2.
J Occup Rehabil ; 2023 Nov 06.
Article in English | MEDLINE | ID: mdl-37932500

ABSTRACT

PURPOSE: Musculoskeletal disorders (MSDs) are common worldwide and gender differences exist in terms of prevalence and disability. MSDs are a leading cause of sick leave and physical work exposures. To assess the association between physical exposures assessed by the gender-specific CONSTANCES Job-Exposure Matrix (JEM) and musculoskeletal pain in six areas: neck pain, shoulder pain, elbow/arm pain, hand/wrist pain, low back pain, knee/leg pain; and to compare the results with those obtained using the non-gendered CONSTANCES JEM and with individual self-report exposures. METHODS: We included 48,736 male and 63,326 female workers from the CONSTANCES cohort (France). The association between 27 physical exposures and musculoskeletal self-reported pain in six body areas was assessed using logistic regression. We conducted the analysis with three types of exposures: (1) individual self-reported exposures; (2) gender-specific CONSTANCES JEM; (3) non-gendered CONSTANCES JEM, and adjusted for age and Body Mass Index (BMI). Analyses were stratified by gender. RESULTS: The associations to the gender-specific and non-gendered JEM were similar. The odds ratios using individual self-reported exposures were comparable to the JEM-based associations, with the exceptions of the exposures 'change tasks', 'rest eyes' and 'reach behind'. In some comparisons, there were differences in the direction and/or significance of effects between genders (regardless of whether the JEM used was gender-specific or not). CONCLUSION: The gender-specific and non-gendered JEMs gave similar results, hence, developing physical work exposures JEMs that are gender-specific may not be essential. However, when predicting musculoskeletal pain, it seems relevant to stratify the analysis by gender.

3.
Scand J Work Environ Health ; 49(8): 549-557, 2023 11 01.
Article in English | MEDLINE | ID: mdl-37669536

ABSTRACT

OBJECTIVES: This study aimed to construct and evaluate a gender-specific job exposure matrix (JEM) for 27 physical work exposures, based on self-report. METHODS: We constructed a JEM using questionnaire data on current physical exposures from 29 381 male and 35 900 female asymptomatic workers aged 18-69 years in the French CONSTANCES cohort study. We excluded workers with musculoskeletal pain to reduce potential reporting bias. We grouped 27 self-reported physical exposures using the French national job codes and stratified by gender. We compared individual and group-based exposures using the performance indicators Cohen's kappa (κ), sensitivity, specificity, and area under the receiver operating curve (AUC). RESULTS: JEM validation showed fair-to-moderate agreement (κ 0.21-0.60) for most physical exposures for both genders except for 'reach behind' (poor), 'bend neck' (poor), 'finger pinch' (poor), standing' (good), 'use computer screen' (good), and 'use keyboard or scanner' (good). We found the highest AUC for 'standing' (men 0.85/ women 0.87), 'kneel/squat' (men 0.80/women 0.81), 'use computer screen' (men/women 0.81), and 'use keyboard or scanner' (men 0.82/ women 0.84). The AUC was <0.60 for only three exposures: 'bend neck' (men 0.58/women 0.57), 'finger pinch' (men 0.56/ women 0.55), and 'reach behind' (men 0.54/ women 0.51). CONCLUSION: The constructed JEM validation measures were comparable for men and women for all exposures. Further research will examine the predictive ability of this gender-specific JEM for musculoskeletal disorders and the relevance of gender-stratification in this process, knowing accuracy of each exposure.


Subject(s)
Occupational Exposure , Humans , Male , Female , Cohort Studies , Occupational Exposure/adverse effects , France , Risk Factors , Surveys and Questionnaires
4.
Occup Environ Med ; 80(10): 558-563, 2023 10.
Article in English | MEDLINE | ID: mdl-37770181

ABSTRACT

OBJECTIVES: Musculoskeletal disorders (MSDs) are a leading cause of disability and sick leave among workers. Although MSDs are associated with physical exposures, there are gender differences in the prevalence and related disability. This study aimed to compare self-reported physical work exposures by gender for people within the same occupational group. METHODS: We used cross-sectional data from 65 281 asymptomatic workers aged 18-69 years from the CONSTANCES cohort study (France). We compared 27 physical exposures between men and women in the same occupational groups ('Profession et Categorie Sociale' group) using Mann-Whitney U tests. RESULTS: Men and women performing the same job often reported different levels of exposure. 38 of 365 occupational groups had a gender difference in reported exposure for 10 or more of 27 physical exposures, with men reporting higher exposures in 79% of these jobs. Women reported higher exposures in nursing and other healthcare professions. The probability that a random man had an exposure value higher than a random woman varied widely, from 8% to 92%, and was highly dependent on occupational groups and the specific exposure. CONCLUSIONS: Men and women working in the same jobs reported different physical exposures for some jobs and some exposures. Further research should further define and explore these reported differences to improve prevention and research.


Subject(s)
Musculoskeletal Diseases , Occupational Diseases , Occupational Exposure , Female , Humans , Male , Cohort Studies , Cross-Sectional Studies , France/epidemiology , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Occupational Diseases/epidemiology , Occupational Diseases/etiology , Occupational Exposure/adverse effects , Occupations , Risk Factors , Adolescent , Young Adult , Adult , Middle Aged , Aged
5.
Scand J Work Environ Health ; 49(1): 53-63, 2023 01 01.
Article in English | MEDLINE | ID: mdl-36228192

ABSTRACT

OBJECTIVES: Physically-demanding occupations may increase rotator cuff disease (RCD) risk and need for surgery. We linked a job-exposure matrix (JEM) to the UK Biobank cohort study to measure physical occupational exposures and estimate associations with RCD surgery. METHODS: Jobs and UK Standard Occupational Classification (SOC) codes were recorded during the UK Biobank verbal interview. Lifetime job histories were captured through a web-based survey. UK SOC codes were linked to a JEM based on the US O*NET database. O*NET-based scores [static strength, dynamic strength, general physical activities, handling/moving objects (range=1-7), time spent using hands, whole body vibration, and cramped/awkward positions (range=1-5)] were assigned to jobs. RCD surgeries were identified through linked national hospital inpatient records. Multivariable Cox regression was used to calculate hazard ratios (HR) as estimates of associations with RCD surgery. Among those with lifetime job histories, associations were estimated for duration of time with greatest exposure (top quartile of exposure). RESULTS: Of 277 808 people reporting jobs, 1997 (0.7%) had an inpatient RCD surgery. After adjusting for age, sex, race, education, area deprivation, and body mass index, all O*NET variables considered were associated with RCD surgery (HR per point increase range=1.10-1.45, all P<0.005). A total of 100 929 people reported lifetime job histories, in which greater exposures were significantly associated with RCD surgery after >10 years of work (eg, HR for 11-20 versus 0 years with static strength score ≥4 = 2.06, 95% confidence interval 1.39-3.04). CONCLUSIONS: Workplace physical demands are an important risk factor for RCD surgery, particularly for workers with more than a decade of exposure.


Subject(s)
Biological Specimen Banks , Occupational Exposure , Humans , Cohort Studies , Rotator Cuff/surgery , Occupations , United Kingdom
6.
J Healthy Eat Act Living ; 2(2): 73-87, 2022.
Article in English | MEDLINE | ID: mdl-36381293

ABSTRACT

Physical activity (PA) has many benefits; however, groups facing barriers to health-promoting behaviors are less likely to be physically active. This may be addressed through workplace interventions. The current study employs objective (accelerometry) and perceived (International Physical Activity Questionnaire [IPAQ]) measures of PA among a subset of participants from the "Working for You" study, which tests a multi-level (work group and individual) workplace intervention targeted at workers with low-incomes. Linear mixed and hierarchical logistic regression models are used to determine the intervention's impact on moderate- to vigorous-PA (MVPA) and achieving the PA Guideline for Americans (≥150 minutes MVPA/week), respectively from baseline to 6- and 24-months, relative to a control group. Correlations (Spearman Rho) between perceived and objective PA are assessed. Of the 140 workers (69 control, 71 intervention) in the sub-study, 131 (94%) have valid data at baseline, 88 (63%) at 6-months, and 77 (55%) at 24-months. Changes in MVPA are not significantly different among intervention relative to control participants assessed by accelerometer or IPAQ at 6- or 24-months follow-up. The percent achieving the PA Guideline for Americans does not vary by treatment group by any measure at any time point (e.g., baseline accelerometry: [control: n=37 (57%); intervention: n=35 (53%)]). This study identifies limited agreement (correlation range: 0.04 to 0.42, all p>.05) between perceived and objective measures. Results suggest the intervention did not improve PA among the sub-study participants. Though agreement between objective and perceived MVPA is low, similar conclusions regarding intervention effectiveness are drawn.

7.
BMC Public Health ; 22(1): 1884, 2022 10 10.
Article in English | MEDLINE | ID: mdl-36217157

ABSTRACT

BACKGROUND: Occupational exposures may play a key role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection risk. We used a job-exposure matrix linked to the UK Biobank to measure occupational characteristics and estimate associations with a positive SARS-CoV-2 test. METHODS: People reporting job titles at their baseline interview in England who were < 65 years of age in 2020 were included. Healthcare workers were excluded because of differential access to testing. Jobs were linked to the US Occupational Information Network (O*NET) job exposure matrix. O*NET-based scores were examined for occupational physical proximity, exposure to diseases/infection, working outdoors exposed to weather, and working outdoors under cover (score range = 1-5). Jobs were classified as remote work using two algorithms. SARS-CoV-2 test results were evaluated between August 5th-November 10th, 2020, when the UK was released from lockdown. Cox regression was used to calculate adjusted hazard ratios (aHRs), accounting for age, sex, race, education, neighborhood deprivation, assessment center, household size, and income. RESULTS: We included 115,451 people with job titles, of whom 1746 tested positive for SARS-CoV-2. A one-point increase in physical proximity score was associated with 1.14 times higher risk of SARS-CoV-2 (95%CI = 1.05-1.24). A one-point increase in the exposure to diseases/infections score was associated with 1.09 times higher risk of SARS-CoV-2 (95%CI = 1.02-1.16). People reporting jobs that could not be done remotely had higher risk of SARS-CoV-2 regardless of the classification algorithm used (aHRs = 1.17 and 1.20). Outdoors work showed an association with SARS-CoV-2 (exposed to weather aHR = 1.06, 95%CI = 1.01-1.11; under cover aHR = 1.08, 95%CI = 1.00-1.17), but these associations were not significant after accounting for whether work could be done remotely. CONCLUSION: People in occupations that were not amenable to remote work, required closer physical proximity, and required more general exposure to diseases/infection had higher risk of a positive SARS-CoV-2 test. These findings provide additional evidence that coronavirus disease 2019 (COVID-19) is an occupational disease, even outside of the healthcare setting, and indicate that strategies for mitigating transmission in in-person work settings will remain important.


Subject(s)
COVID-19 , Occupational Exposure , Biological Specimen Banks , COVID-19/epidemiology , Cohort Studies , Communicable Disease Control , Humans , Occupational Exposure/adverse effects , SARS-CoV-2 , United Kingdom/epidemiology
8.
Am J Ind Med ; 65(10): 790-799, 2022 10.
Article in English | MEDLINE | ID: mdl-35985834

ABSTRACT

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.


Subject(s)
Occupational Exposure , Humans , Job Description , Occupational Exposure/analysis , Occupations , Reproducibility of Results , United States/epidemiology
9.
JAMA Netw Open ; 5(3): e222954, 2022 03 01.
Article in English | MEDLINE | ID: mdl-35297970

ABSTRACT

Importance: Alcohol use disorder (AUD) is common and associated with increased morbidity. The degree to which AUD currently factors into workplace absenteeism needs further characterization in the US. Objective: To examine the association between AUD and workplace absenteeism in a nationally representative sample. Design, Setting, and Participants: This cross-sectional study used data from a nationally representative sample of noninstitutionalized US residents from the 2015-2019 National Survey on Drug Use and Health to examine the association of AUD with workplace absenteeism. Eligible respondents were aged 18 years and older who reported full-time employment. Data were analyzed from March to September 2021. Main Outcomes and Measures: Primary outcomes were markers of workplace absenteeism as defined by the number of days missed from work because of illness or injury and days skipped from work in the last 30 days. Descriptive statistics, prevalence ratios, and logistic regression analyses were performed to assess the association between AUD and absenteeism. Results: A total of 110 701 adults aged 18 years and older reported current full-time employment (58 948 [53.2%] men, 51 753 [46.8%] women; 12 776 [11.5%] Black, 18 096 [16.3%] Hispanic, and 69 506 [62.8%] White respondents). Weighted prevalence of AUD in this sample of working adults was 9.3% (95% CI, 9.0%-9.5%); 6.2% (95% CI, 6.0%-6.4%) of respondents met criteria for mild AUD, 1.9% (95% CI, 1.7%-2.0%) for moderate AUD, and 1.2% (95% CI, 1.1%-1.3%) for severe AUD. Mean days missed from work annually increased in a stepwise fashion with increasing AUD severity (no AUD, 13.0 days; 95% CI, 12.7-13.2 days; mild AUD, 17.7 days; 95% CI, 16.4-19.1 days; moderate AUD, 23.6 days; 95% CI, 21.5-25.7 days; severe AUD, 32.3 days; 95% CI, 27.5-37.0 days). People with AUD represented 9.3% of the full-time workforce and contributed to 14.1% of total reported workplace absences. Conclusions and Relevance: In this cross-sectional study, AUD was disproportionately associated with an increased prevalence of workplace absenteeism, with individuals with AUD contributing over 232 million missed workdays annually. These results provide economic incentive for increased investment in AUD prevention and treatment, both for employers and policy makers.


Subject(s)
Absenteeism , Alcoholism , Adolescent , Adult , Alcohol Drinking , Alcoholism/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Workplace
10.
Occup Environ Med ; 79(7): 442-451, 2022 07.
Article in English | MEDLINE | ID: mdl-35074886

ABSTRACT

BACKGROUND: Although recent studies have identified important risk factors associated with incident carpal tunnel syndrome (CTS), risk factors associated with its severity have not been well explored. OBJECTIVE: To examine the associations between personal, workplace psychosocial and biomechanical factors and incident work disability among workers with CTS. METHODS: Between 2001 and 2010 five research groups conducted coordinated prospective studies of CTS and related work disability among US workers from various industries. Workers with prevalent or incident CTS (N=372) were followed for up to 6.4 years. Incident work disability was measured as: (1) change in work pace or work quality, (2) lost time or (3) job change following the development of CTS. Psychosocial factors were assessed by questionnaire. Biomechanical exposures were assessed by observation and measurements and included force, repetition, duty cycle and posture. HRs were estimated using Cox models. RESULTS: Disability incidence rates per 100 person-years were 33.2 for changes in work pace or quality, 16.3 for lost time and 20.0 for job change. There was a near doubling of risk for job change among those in the upper tertile of the Hand Activity Level Scale (HR 2.17; 95% CI 1.17 to 4.01), total repetition rate (HR 1.75; 95% CI 1.02 to 3.02), % time spent in all hand exertions (HR 2.20; 95% CI 1.21 to 4.01) and a sixfold increase for high job strain. Sensitivity analyses indicated attenuation due to inclusion of the prevalent CTS cases. CONCLUSION: Personal, biomechanical and psychosocial job factors predicted CTS-related disability. Results suggest that prevention of severe disability requires a reduction of both biomechanical and organisational work stressors.


Subject(s)
Carpal Tunnel Syndrome , Occupational Diseases , Carpal Tunnel Syndrome/epidemiology , Carpal Tunnel Syndrome/etiology , Humans , Occupational Diseases/epidemiology , Occupational Diseases/etiology , Occupational Diseases/prevention & control , Prospective Studies , Risk Factors , Workplace/psychology
11.
J Hand Ther ; 35(1): 24-31, 2022.
Article in English | MEDLINE | ID: mdl-33250395

ABSTRACT

INTRODUCTION: Patients with upper extremity conditions may also experience symptoms of depression, anxiety, and pain that limit functional recovery. PURPOSE OF THE STUDY: This study examined the impact of mental health and pain symptoms on referral rates to therapy and utilization of therapy services to achieve functional recovery among patients with common hand conditions. STUDY DESIGN: This is a retrospective cohort study of patients from one orthopedic center. METHODS: Data extraction provided demographics, the International Classification of Diseases, 10th revision diagnoses, therapy referral, therapy visit counts, treatment goal attainment, and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Pain Interference scores. The chi-square test, t-test, and logistic regression analyses assessed associations between baseline PROMIS depression, anxiety, and pain interference to therapy referral, the number of therapy visits, and goal attainment. RESULTS: Forty-nine percent (172/351) of patients were referred to hand therapy. There was no relationship between three baseline PROMIS scores based on physician referral (t-test P values .32-.67) and no association between PROMIS scores and therapy utilization or goal attainment (Pearson correlation (r): 0.002 to 0.020, P > .05). Referral to therapy was most strongly associated with having a traumatic condition (P < .01). Patients with high depression, anxiety, and pain interference scores on average required one more therapy visit to achieve treatment goals (average visits: 3.7 vs 3.1; 4.1 vs 2.7; 3.4 vs 2.3, respectively). Fewer patients with high depression scores (50%) achieved their long-term goals than patients with low depression scores (69%, P = .20). CONCLUSIONS: Patients' baseline level of depressive symptoms and anxiety do not predict referrals to hand therapy by orthopedic hand surgeons. There is some indication that patients with increased depressive symptoms, anxiety, and pain interference require more therapy with fewer achieving all goals, suggesting that mental health status may affect response to therapy. Therapists may address mental health needs in treatment plans. Future studies should examine if nonreferred patients with depressive symptoms achieve maximal functional recovery.


Subject(s)
Depression , Patient Reported Outcome Measures , Anxiety/diagnosis , Anxiety/etiology , Anxiety/therapy , Depression/diagnosis , Depression/etiology , Depression/therapy , Humans , Pain , Referral and Consultation , Retrospective Studies
12.
Am J Ind Med ; 64(12): 1018-1027, 2021 12.
Article in English | MEDLINE | ID: mdl-34490655

ABSTRACT

BACKGROUND: Suicide is a leading cause of death for working-age adults. Suicide risk varies across occupations. The National Violent Death Reporting System (NVDRS) collects information about violent deaths occurring in the United States. Occupation can be determined using autocoding programs with NVDRS data. The objective of this analysis is to determine the accuracy of autocoding programs for assigning occupations in the NVDRS. METHODS: Deaths from suicide were identified in NVDRS for individuals age 16 and older from 2010 to 2017. Occupations were assigned after processing job description free text with autocoding programs. Job assigned by autocoding program were compared with the occupation code recorded on the death certificate. RESULTS: Assignment of major occupation group had substantial agreement (Cohen's kappa > 0.7) for the two autocoding programs evaluated. Agreement of assigned code varied across race/ethnicity and occupation type. CONCLUSIONS: Autocoding programs provide an efficient method for identifying the occupation for decedents in NVDRS data. By identifying occupation, circumstances of suicide and rates of suicide can be studied across occupations.


Subject(s)
Homicide , Suicide , Adolescent , Adult , Cause of Death , Humans , Occupations , Population Surveillance , United States/epidemiology
13.
Article in English | MEDLINE | ID: mdl-34501489

ABSTRACT

There are substantial differences in work organization between residential and commercial construction sectors. This paper examined differences in work factors between construction sectors and examined the association between sector and health behaviors, health outcomes, and work outcomes. We surveyed 929 male construction apprentices (44% residential and 56% commercial) and found that residential apprentices reported fewer workplace safety policies, higher frequency of heavy lifting, and greater likelihood of reporting musculoskeletal pain compared to apprentices in commercial work. Residential apprentices reported higher job strain, lower supervisor support, more lost workdays due to pain or injury, and lower productivity related to health than commercial apprentices. Multivariate Poisson regression models controlling for multiple work factors showed that residential construction work, high job strain, heavy lifting, low coworker support, and low supervisor support were each independently associated with one or more work or health outcomes. These findings suggest that interventions should seek to improve coworker and supervisory supportive behaviors, decrease job strain, and reduce organizational stressors, such as mandatory overtime work. Our study shows disparities in health and safety between construction sectors and highlights the need for interventions tailored to the residential sector.


Subject(s)
Musculoskeletal Pain , Workplace , Commerce , Humans , Male , Organizations , Surveys and Questionnaires
15.
Zookeys ; 1017: 37-75, 2021.
Article in English | MEDLINE | ID: mdl-33633482

ABSTRACT

The knowledge about tiger beetle fauna of the Northern Mindanao region (Philippines) is summarized based on literature data and new records. Thirty species classified in ten genera (Tricondyla, Neocollyris, Protocollyris, Therates, Prothyma, Heptodonta, Thopeutica, Lophyra, Calomera, and Cylindera) were documented from the area (56% of tiger beetle fauna of Mindanao and 21% of Philippine species). Twelve species were noted from Northern Mindanao region for the first time, including five taxa, Neocollyris speciosa, Calomera angulata, Cylindera minuta, Lophyra striolata tenuiscripta, and Thopeutica virginea, not recorded from Mindanao before. Distribution maps for all recorded species and the first photographs of habitats for some species in Mindanao and/or in the Philippines are provided. Eight species (27% of recorded fauna) were noted from riverine habitats while 18 tiger beetles (60%) were typical forest taxa; in the case of four species, their habitats in Northern Mindanao region are not known.

16.
Saf Sci ; 1422021 Oct.
Article in English | MEDLINE | ID: mdl-35531092

ABSTRACT

Small and medium construction firms have high injury rates but lack resources to establish and maintain effective safety programs. General contractors with exemplary safety programs may serve as intermediaries to support development of smaller firm's safety programs. The purpose of this study was to examine the flow-down influence of general contractors' safety programs on the safety climate and safety behaviors among workers employed by small and medium sized subcontractors. This study collected workers' perception of safety climate and safety behaviors while working on projects with general contractors with exemplary safety programs and other general contractors. We also documented the safety program policies and practices of subcontractors, and recorded the changes in safety policies required from general contractors with exemplary programs. We examined differences in safety program changes between small and medium sized subcontractors. Results showed workers perceived general contractors with exemplary safety programs had stronger safety climates than other general contractors. Smaller subcontractors had less robust safety programs with fewer safety elements than larger subcontractors, and therefore, many of the smaller subcontractors had to adopt more safety policies and practices to work for general contractors than large subcontractors. These findings suggest that general contractors with robust safety programs can serve as intermediaries and influence the development of the safety programs of small sized firms. Future work will need to determine if smaller firms eventually adopt safety policies and practices as part of their permanent safety program.

17.
Arch Environ Occup Health ; 76(5): 243-247, 2021.
Article in English | MEDLINE | ID: mdl-32935642

ABSTRACT

INTRODUCTION: Decline in physical performance with age varies among workers. We studied the association between lifetime exposure to carrying heavy loads and limitations in climbing stairs. METHODS: We used data from the French CONSTANCES study. A biomechanical Job-Exposure Matrix (JEM) was combined with lifetime job histories to build a cumulative exposure score, and compared with reported limitations in climbing stairs using robust Poisson models, stratified by sex and educational level. RESULTS: Of the 26,255 subjects, 618 men and 1,080 women reported difficulties in climbing stairs; this outcome was associated with cumulative exposure to carrying heavy loads: adjusted PR= 2.17 (1.75-2.73) for men, 1.50 (1.30-1.74) for women. The association was primarily seen among less educated subjects. CONCLUSION: Cumulative work exposure to carrying heavy loads across the working life was associated with physical limitations in climbing stairs among the less educated in both genders.


Subject(s)
Activities of Daily Living , Occupational Exposure/statistics & numerical data , Weight-Bearing/physiology , Adult , Aged , Cohort Studies , Female , France , Humans , Male , Middle Aged , Risk Factors , Young Adult
18.
J Hand Surg Am ; 46(2): 99-105, 2021 02.
Article in English | MEDLINE | ID: mdl-33277101

ABSTRACT

PURPOSE: We aimed to test the utility of screening for depressive symptoms in the hand surgical office focusing on chances of heightened depressive symptoms in patients with no history of diagnosed depression and by quantifying ongoing depressive symptoms among patients diagnosed with depression accounting for antidepressant use. The clinical importance of this study was predicated on the documented negative association between depressive symptoms and hand surgical outcomes. METHODS: This cross-sectional study analyzed 351 patients presenting to a tertiary hand center between April 21, 2016, and November 22, 2017. Adult patients completed self-administered Patient-Reported Outcomes Measurement Information System (PROMIS) Depression computer adaptive tests at registration. Health records were examined for a past medical history of diagnosed depression and whether patients reported current use of prescription antidepressants. Mean PROMIS Depression scores were compared by analysis of variance (groups: no diagnosed depression, depression without medication, depression with medication). Four points represented a clinically relevant difference in PROMIS Depression scores between groups and Depression scores greater than 59.9 were categorized as having heightened depressive symptoms. RESULTS: Sixty-two patients (18%) had been diagnosed with depression. Thirty-four of these patients (55%) reported taking antidepressant medications. The PROMIS Depression scores indicated greater current depressive symptoms among patients with a history of diagnosed depression when not taking antidepressants (11 points worse than unaffected) and also among patients taking antidepressants (7 points worse than unaffected). Heightened depressive symptoms were detected in all groups but were more prevalent among those diagnosed with depression (36% with no medication, 29% with antidepressant medication) compared with unaffected patients (7%). CONCLUSIONS: Depression screening for heightened depressive symptoms identifies 1 in 14 patients without diagnosed depression and 1 in 3 patients diagnosed with depression as having currently heightened depressive symptoms. Hand surgeons can use PROMIS Depression screening in all patients and using this to guide referrals for depression treatment to ameliorate one confounder of hand surgical outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Symptom prevalence study II.


Subject(s)
Depression , Patient Reported Outcome Measures , Adult , Antidepressive Agents/therapeutic use , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Hand/surgery , Humans
19.
Am J Ind Med ; 64(1): 48-57, 2021 01.
Article in English | MEDLINE | ID: mdl-33231876

ABSTRACT

BACKGROUND: Construction workers have high rates of work-related musculoskeletal disorders, which lead to frequent opioid use and opioid use disorder (OUD). This paper quantified the incidence of opioid use and OUD among construction workers with and without musculoskeletal disorders. METHODS: We conducted a retrospective study using union health claims from January 2015 to June 2018 from 19,909 construction workers. Claims for diagnoses of chronic musculoskeletal disorders, acute musculoskeletal injuries, musculoskeletal surgery, and other conditions were linked to new opioid prescriptions. We examined the effects of high doses (≥50 morphine mg equivalents per day), large supply (more than 7 days per fill), long-term opioid use (60 or more days supplied within a calendar quarter), and musculoskeletal disorders, on the odds of a future OUD. RESULTS: There were high rates (42.8% per year) of chronic musculoskeletal disorders among workers, of whom 24.1% received new opioid prescriptions and 6.3% received long-term opioid prescriptions per year. Workers receiving opioids for chronic musculoskeletal disorders had the highest odds of future OUD: 4.71 (95% confidence interval 3.09-7.37); workers prescribed long-term opioids in any calendar quarter had a nearly 10-fold odds of developing an OUD. CONCLUSIONS: Among construction workers, opioids initiated for musculoskeletal pain were strongly associated with incident long-term opioid use and OUD. Musculoskeletal pain from physically demanding work is likely one driver of the opioid epidemic in occupations like construction. Prevention of work injuries and alternative pain management are needed for workers at risk for musculoskeletal injuries.


Subject(s)
Analgesics, Opioid/therapeutic use , Construction Industry/statistics & numerical data , Musculoskeletal Pain/epidemiology , Occupational Diseases/epidemiology , Opioid-Related Disorders/epidemiology , Adult , Chronic Disease , Drug Prescriptions/statistics & numerical data , Humans , Illinois/epidemiology , Kansas/epidemiology , Male , Middle Aged , Missouri/epidemiology , Musculoskeletal Pain/drug therapy , Musculoskeletal Pain/etiology , Occupational Diseases/drug therapy , Occupational Diseases/etiology , Odds Ratio , Opioid-Related Disorders/etiology , Retrospective Studies
20.
J Safety Res ; 74: 279-288, 2020 09.
Article in English | MEDLINE | ID: mdl-32951793

ABSTRACT

PROBLEM: Safety management programs (SMPs) are designed to mitigate risk of workplace injuries and create a safe working climate. The purpose of this project was to evaluate the relationship between contractors' SMPs and workers' perceived safety climate and safety behaviors among small and medium-sized construction subcontractors. METHODS: Subcontractor SMP scores on 18 organizational and project-level safety items were coded from subcontractors' written safety programs and interviews. Workers completed surveys to report perceptions of their contractor's safety climate and the safety behaviors of coworkers, crews, and themselves. The associations between SMP scores and safety climate and behavior scales were examined using Spearman correlation and hierarchical linear regression models (HLM). RESULTS: Among 78 subcontractors working on large commercial construction projects, we found striking differences in SMP scores between small, medium, and large subcontractors (p < 0.001), related to a number of specific safety management practices. We observed only weak relationships between SMP scales and safety climate scores reported by 746 workers of these subcontractors (ß = 0.09, p = 0.04 by HLM). We saw no differences in worker reported safety climate and safety behaviors by contractor size. DISCUSSION: SMP only weakly predicted safety climate scales of subcontractors, yet there were large differences in the quality and content of SMPs by size of employers. SUMMARY: Future work should determine the best way to measure safety performance of construction companies and determine the factors that can lead to improved safety performance of construction firms. Practical applications: Our simple assessment of common elements of safety management programs used document review and interviews with knowledgeable representatives. These methods identified specific safety management practices that differed between large and small employers. In order to improve construction safety, it is important to understand how best to measure safety performance in construction companies to gain knowledge for creating safer work environments.


Subject(s)
Construction Industry/statistics & numerical data , Occupational Health/statistics & numerical data , Organizational Culture , Safety Management/statistics & numerical data , Workplace/psychology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , United States
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