Health surveillance: effective components of a successful program.

1. Using the nursing process, the occupational health nurse plays a key role in the health surveillance of workers at risk for exposure to chemical, biological, or physical hazards. 2. To implement and manage a successful occupational surveillance program, the occupational health nurse must be familiar with walk through procedures, test selection and interpretation issues, toxicology and epidemiology concepts and budgeting processes. 3. Employee education and program evaluation are integral and ongoing components of a comprehensive occupational health surveillance program. Anticipation of legal and ethical problems is also critical during the design, implementation, and evaluation of the program. 4. Quality data collection and management aid the occupational health nurse in decision making and accurate and timely record keeping.

Ergonomic risk exposure and upper-extremity cumulative trauma disorders in a maquiladora medical devices manufacturing plant.

Workers at a Nogales, Mexico, maquiladora plant that assembles medical devices were studied to determine the prevalence of upper-extremity cumulative trauma disorders (CTD). Subjects included production workers employed 6 months or longer; of the 148 eligible workers, 145 (98%) participated. Subjects had a mean age of 24.6 years (SD = 5.2; range, 17 to 45) and the mean length of employment was 3.5 years (SD = 2.5; range, 0.5 to 14). Job tasks were videotaped and analyzed for ergonomic risk factors, using pre-defined criteria. All jobs performed by study subjects were found to involve one or more ergonomic risk factors associated with the development of CTD. A CTD questionnaire and screening physical examination format, similar to that used by the National Institute of Occupational Safety and Health (NIOSH) in a chicken processing plant study, were administered. Period prevalence of CTD within the previous year, as reported on the questionnaire, was 28%. Prevalence of CTD was 17%, using data from the screening physical examination. Point prevalence (current pain data from the questionnaire plus positive symptoms on the screening physical examination) was 15%. CTD was reported more frequently in women than men (46% and 25%, respectively; P < 0.05) and in subjects who had worked at the plant less than one year (50%; P < 0.05). Workforce turnover (3% monthly) may have resulted in those affected by CTD leaving employment, reducing the apparent CTD rate in experienced workers.