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.

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.

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.

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.

Social factors in occupational health: a history of hard hats.

Personal protective equipment (PPE) is the least desirable way to ensure workplace safety, and it is difficult to use consistently. Hard hats are different; they have cachet and are often worn even when they are not required. We investigated the history of this personal protective equipment to see if there were any lessons that could be applied to other forms of PPE. We learned that what makes hard hats special are social factors that are specific to a certain time and place. The importance of social factors illuminates the requirement that cultural and social norms of workers be included in any kind of worker safety and health training.

Negotiating indoor air-case report on negotiation of teachers' union, school board on air contaminants.

School districts increasingly understand the need for an indoor air quality plan, but may have difficulty in producing a plan that all necessary parties will accept. This article provides a case study of how one Massachusetts school district, after experiencing environmental problems in an elementary school, worked with parents and unions to develop a comprehensive indoor air quality plan.

It will take persistence: the dynamics of a university-community partnership to sustain the New England worker health and safety movement.

The New England Consortium (TNEC) is a university-community partnership that since 1987 has delivered health and safety training for hazardous waste operations and emergency response (HAZWOPER) workers. Through two decades of the relative loss of power by the labor and environmental movements and subsequent reductions in state support for worker health and safety, this selective history of TNEC demonstrates its ability to sustain a worker health and safety movement in New England. The evolution of TNEC's partnership process and the principles and policies by which it operates have helped to resolve several critical conflicts and strengthen its working relationships. Partnership dynamics are explored within their political and economic contexts and the need of member organizations to balance fiscal solvency with political objectives.

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.