Education and Training to Build Capacity in Total Worker Health®: Proposed Competencies for an Emerging Field.

OBJECTIVE: Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®. METHODS: Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs. RESULTS: A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination. CONCLUSIONS: Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.

Obesity, Prediabetes, and Perceived Stress in Municipal Workers.

The primary cause of death for men and women in the United States is heart disease. Obesity and diabetes are major contributors to heart disease, and the risk is worsened in the presence of stress. It is clinically useful to identify predictors of obesity and prediabetes in a working population. The purpose of this current cross-sectional, correlational study was to examine relationships among obesity, prediabetes, and perceived stress in municipal workers using a subset of worksite wellness program data from employees screened in 2010 and 2011. Multiple regression models indicated that age, gender, race, HA1c, shift schedule, physical activity, and occupation were significant predictors of obesity in municipal workers ( p < .01). Prediabetes in municipal workers was predicted by age, Black race, and body mass index (BMI; p < .01). Perceived stress was not a significant predictor of obesity or prediabetes in municipal workers. Overall, the findings of this study provide guidance to occupational health nurses when evaluating individuals in an occupational health setting. Further research is needed to examine relationships among the variables and validate the models.

Incorporating occupational risk in heat stress vulnerability mapping.

Both obesity and strenuous outdoor work are known risk factors for heat-related illness (HRI). These risk factors may be compounded by more and longer periods of extreme heat in the southeastern U.S. To quantify occupational risk and investigate the possible predictive value of a GIS-based tool, a weighted occupation-based metabolic equivalent (MET) index was created. The correlation between current MET-weighted employment rates or obesity rates and 2012 HRI report rates in Alabama were then determined. With the current dataset, results indicate occupational and obesity rates may explain some of the geographical variation seen in HRI report rates, although results are not statistically significant with this limited dataset. Mapping occupational and physiological risk factors with HRI rates may be useful for environmental and occupational health professionals to identify "hotspots" that may require special attention.

Occupational stress in veterinary support staff.

A mixed-method study was used to characterize the occupational stress, health status, and coping strategies of 104 members of the Alabama Veterinary Technician Association. A Web-based survey was used to administer three validated and reliable instruments to gather the quantitative data, and interviews were conducted to gather qualitative data. Quantitative and qualitative data validated each other in all aspects of mental health, indicating that veterinary support staff's mental health status was low. Participants' mental health scores were lower than the US norm of 50, and a correlation between health status and occupational stressors indicated that those with higher perceived stress had lower mental and physical health. Interviews supported this finding. The results suggest that workload, death and dying, and conflict with veterinarians were prominent sources of stress and that veterinary support staff experience high stress that affects their health. Coping strategies were found to be related to mental health status, and those used by this workforce have been linked to negative outcomes. This study's findings indicate that staff health may have negative economic implications for practice owners and staff members.

Relationship of blood pressure self-monitoring, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with hypertension.

Uncontrolled blood pressure remains a major public health issue. Medication adherence is a key factor in blood pressure management; however, adherence behavior is not clearly understood and the most significant factors contributing to poor medication adherence and blood pressure control are unknown. The purpose of this study was to determine the relationship of self-monitoring of blood pressure, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with access to health insurance. Stage of change was a significant independent predictor of self-monitoring of blood pressure, but not blood pressure control. A strong relationship was found between medication adherence and medication adherence self-efficacy (r = .549, p < .05).

Prevalence of blood pressure self-monitoring, medication adherence, self-efficacy, stage of change, and blood pressure control among municipal workers with hypertension.

Despite the availability of effective medications, hypertension remains inadequately managed in the United States. It has been established that medication adherence is a major strategy for controlling blood pressure. Combined interventions to promote adherence are promising, but further research is needed to understand which behaviors to target. The frequency of self-monitoring of blood pressure among municipal workers is unknown, and the literature is limited regarding assessing individuals' readiness and confidence to engage in medication adherence. The purpose of this study was to determine the prevalence of medication adherence, readiness, self-efficacy, self-monitoring of blood pressure, and blood pressure control among hypertensive municipal workers. The study population was enrolled in a wellness program established more than 20 years ago to promote health and safety for a work force in a large southeastern U.S. city. The majority of the study participants (75.7%) demonstrated controlled blood pressure, reported adherence to antihypertensive medication (70%), and self-monitored blood pressure (70%).

Occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda.

AIMS: To assess levels of occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda; and how they are influenced by work and personal characteristics. BACKGROUND: Occupational stress is reported to affect job satisfaction and job performance among nurses, thus compromising nursing care and placing patients' lives at risk. Although these factors have been studied extensively in the US and Europe, there was a need to explore them from the Ugandan perspective. METHODS: A correlational study was conducted with 333 nurses from four hospitals in Kampala, Uganda. A questionnaire measuring occupational stress, job satisfaction and job performance was used. Data were analysed using descriptive statistics and anova. RESULTS: There were significant differences in levels of occupational stress, job satisfaction and job performance between public and private not-for-profit hospitals, nursing experience and number of children. CONCLUSIONS: Organizational differences between public and private not-for-profit hospitals influence the study variables. IMPLICATIONS FOR NURSING MANAGEMENT: On-the-job training for nurse managers in human resource management to increase understanding and advocacy for organizational support policies was recommended. Research to identify organizational, family or social factors which contribute to reduction of perceived occupational stress and increase job satisfaction and job performance was recommended.

Wood dust sampling: field evaluation of personal samplers when large particles are present.

Recent recommendations for wood dust sampling include sampling according to the inhalable convention of International Organization for Standardization (ISO) 7708 (1995) Air quality--particle size fraction definitions for health-related sampling. However, a specific sampling device is not mandated, and while several samplers have laboratory performance approaching theoretical for an 'inhalable' sampler, the best choice of sampler for wood dust is not clear. A side-by-side field study was considered the most practical test of samplers as laboratory performance tests consider overall performance based on a wider range of particle sizes than are commonly encountered in the wood products industry. Seven companies in the wood products industry of the Southeast USA (MS, KY, AL, and WV) participated in this study. The products included hardwood flooring, engineered hardwood flooring, door skins, shutter blinds, kitchen cabinets, plywood, and veneer. The samplers selected were 37-mm closed-face cassette with ACCU-CAP™, Button, CIP10-I, GSP, and Institute of Occupational Medicine. Approximately 30 of each possible pairwise combination of samplers were collected as personal sample sets. Paired samplers of the same type were used to calculate environmental variance that was then used to determine the number of pairs of samples necessary to detect any difference at a specified level of confidence. Total valid sample number was 888 (444 valid pairs). The mass concentration of wood dust ranged from 0.02 to 195 mg m(-3). Geometric mean (geometric standard deviation) and arithmetic mean (standard deviation) of wood dust were 0.98 mg m(-3) (3.06) and 2.12 mg m(-3) (7.74), respectively. One percent of the samples exceeded 15 mg m(-3), 6% exceeded 5 mg m(-3), and 48% exceeded 1 mg m(-3). The number of collected pairs is generally appropriate to detect a 35% difference when outliers (negative mass loadings) are removed. Statistical evaluation of the nonsimilar sampler pair results produced a finding of no significant difference between any pairing of sampler type. A practical consideration for sampling in the USA is that the ACCU-CAP™ is similar to the sampler currently used by the Occupational Safety and Health Administration for purposes of demonstrating compliance with its permissible exposure limit for wood dust, which is the same as for Particles Not Otherwise Regulated, also known as inert dust or nuisance dust (Method PV2121).

The practice of the 10 essential services and abilities in the 14 core competencies of Alabama environmental health practitioners.

Leading public health agencies have developed guidelines for essential services and core competencies. The study described here was conducted to determine the level of practice of the 10 essential services and abilities in the 14 core competencies among environmental public health practitioners in Alabama. Questionnaires about the practice of the essential services, abilities in the core competencies, and demographics were collected from 255 (88%) practitioners and analyzed by statistical methods. According to the results of this study, these practitioners spent most of their time diagnosing, investigating, enforcing, educating, and linking people to public health services. They had increasing levels of practice as they were promoted to higher-level jobs, and the level of practice was greater in rural counties than in urban. They rated their skill in all of the core competencies to be at least pretty good. Practitioners with high school degrees had lower abilities than those with college degrees. Overall, these professionals were better educated, younger, and had better skills than expected.