The effect of harness suspension on a simulated maintenance task efficacy in the renewable energy industry.

Building, bridge or wind turbine maintenance requires manual dexterity tasks by a specialist rope-access trained workforce via two principal means: harness suspension of individual workers from above, or deployment of a suspended platform or cradle from which workers access the structure to be maintained. Currently no published research compares accuracy and efficiency of simulated maintenance tasks between these modalities. This study investigated manual dexterity task performance of peg placement and shape delineation in seated, standing and suspended environments in 16 healthy controls and 26 professional rope-access trained individuals. Both seated and standing assessments were superior to those suspended, and height of suspension, total mass and years of experience had no influence on the task outcome. These findings suggest that, where feasible, cradle suspension mechanisms which permit standing maintenance are favourable in terms of task efficacy and where feasible, should be considered for deployment in wind energy and other engineering applications.

Development of an education and support framework for pharmacists working in GP practice.

OBJECTIVES: To evaluate the educational support provided for three cohorts of pharmacists to inform an educational support framework for this new career path. METHODS: This study evaluated training using mixed methods and measured the development of competence and confidence in the professional role as a pharmacist in GP Practice. Data were collected via pro formas before training events, and evaluation questionnaires immediately after events. Qualitative and quantitative content analysis was applied. The outcome evaluation collected data via a repeated measure of self-assessed competency and confidence via an online questionnaire at three time points. Logistic regression identified predictors of competency and confidence at the end of structured training. KEY FINDINGS: Evaluation of training events was very positive. The theme of clinical and consultation skills was the most professionally satisfying, followed by teamwork and support. However, early work in practice was focussed on management and systems. There were significant improvements in competence and confidence over time. Independent predictors of increased competence in the role in GP Practice were having an Independent prescriber (IP) qualification or undertaking the IP course and having had additional health board training and support. CONCLUSIONS: Formal training was well received. Early local support from health boards and GP Practices would enable pharmacists to get an earlier grasp of tasks relating to 'management and systems' so they could focus on more rewarding clinical tasks. Being an independent prescriber (or working towards this) is essential for the development of competence in this role. An educational support framework model is proposed.

Meta-analysis demonstrates Gly482Ser variant of PPARGC1A is associated with components of metabolic syndrome within Asian populations.

AIM: To determine the association of peroxisome proliferator activated receptor gamma coactivator 1 Gly482Ser variant with components of metabolic syndrome. MATERIALS AND METHODS: A systematic search was carried out using Web of Science, PubMed, EMBASE and the Cochrane library using the key words: Peroxisome proliferator activator receptor gamma coactivator 1, PPARGC1A, PGC-1, PGC-1alpha, and PGC1alpha alone or with polymorphism, Gly482Ser and rs8192678. RESULTS: Data from 19 articles generated 28 separate data sets. Under the recessive model fasting plasma glucose was significantly lower in AA genotypes when compared to GG + GA in the total sample group and in non-Asian group (p < .001). The AA genotype showed significantly lower levels of total cholesterol compared to GG + GA genotype using the recessive model with the non-Asian group (p < .05). Under the dominant model, body mass index of the GG genotype was significantly higher in Asian subgroups (p < .05). CONCLUSION: PPARGC1A Gly482Ser variant impacts differently in Asian population groups.

Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review.

OBJECTIVE: The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers' regular skin care regimen). INTRODUCTION: The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers. INCLUSION CRITERIA: The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation. METHODS: Published and unpublished literature in the English language was sought between 2004 and 2017. The databases searched included: COCHRANE CENTRAL, MEDLINE, CINAHL, AMED and Embase. The search for unpublished studies included: Google Scholar, Open DOAR and Robert Gordon University's thesis database, "OPEN AIR". RESULTS: There were no studies located that met the inclusion requirements of this review. CONCLUSION: There is currently no evidence available to determine the effectiveness of interventions to prevent OIHD amongst wet workers that met this review's inclusion criteria.

Shape change and obesity prevalence among male UK offshore workers after 30 years: New insight from a 3D scanning study.

OBJECTIVES: In 1984, male UK offshore workers had greater overweight and obesity prevalence and fat content than the general population. Since then, body weight has increased by 19%, but, without accompanying anthropometric measures, their size increase, current obesity, and fatness prevalence remain unknown. This study therefore aimed to acquire contemporary anthropometric data, profile changes since the original survey, and assess current obesity prevalence in the male offshore workforce. METHODS: A total of 588 men, recruited via quota sampling to match the workforce weight profile, underwent stature, weight, and 3D photonic scanning measurements from which anatomical girths were extracted, enabling computation of body mass index (BMI), total fat, and visceral adipose tissue (VAT). RESULTS: On average, UK male offshore workers are now 8.1 y older, 3.1 cm taller, 13.9 kg heavier, and have greater girths than in 1984, which are >97% attributable to increased weight, and <3% to age difference. Mean BMI increased significantly from 24.9 to 28.1 kg/m2 and of the contemporary sample, 18% have healthy weight, 52% are overweight, and 30% obese, representing an increase in overweight and obesity prevalence by 6% and 24%, respectively. Waist cutoffs identify 39% of the contemporary sample as healthy, 27% at increased health risk, and 34% at high risk. CONCLUSIONS: UK offshore workers today have higher BMI than Scottish men, although some muscular individuals may be misclassified by BMI. Girth data, particularly at the waist, where dimensional increase was greatest, together with predictions of total and visceral fatness, suggest less favorable health status in others.

Medical evacuations in the oil and gas industry: a retrospective review with implications for future evacuation and preventative strategies.

Background: Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken. Method: A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted. Employee records and Human Resource data were used as a denominator for the population. Analogous Medevac data from specific locations were used to compare patterns of diagnoses. Results: A total of 130 Medevacs were conducted during the study period, resulting in a Medevac rate of 4 per 1000 of population with 16 per 1000 for females and 3 per 1000 for males, respectively. The youngest and oldest age-groups required Medevacs in larger proportions. The evacuation rates were highest for countries classified as 'high' or 'extreme risk'. The most frequent diagnostic categories for Medevac were: trauma, digestive, musculoskeletal, cardiac and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to Medevac. Conclusion: This study uniquely provides a benchmark Medevac rate (4 per 1000) for EEs and FBTs and demonstrates that Medevac rates are highest from countries identified as 'high risk'; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for Medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travellers, and the application of modern technology and communication will reduce the need for Medevacs.

Survival suit volume reduction associated with immersion: implications for buoyancy estimation in offshore workers of different size.

RATIONALE: It is currently unknown how body size affects buoyancy in submerged helicopter escape. METHOD: Eight healthy males aged 39.6 ± 12.6 year (mean ± SD) with BMI 22.0-40.0 kg m-2 wearing a standard survival ('dry') suit undertook a normal venting manoeuvre and underwent 3D scanning to assess body volume (wearing the suit) before and after immersion in a swimming pool. RESULTS: Immersion-induced volume loss averaged 14.4 ± 5.4 l, decreased with increasing dry density (mass volume-1) and theoretical buoyant force in 588 UK offshore workers was found to be 264 ± 46 and 232 ± 60 N using linear and power functions, respectively. Both approaches revealed heavier workers to have greater buoyant force. DISCUSSION: While a larger sample may yield a more accurate buoyancy prediction, this study shows heavier workers are likely to have greater buoyancy. Without free-swimming capability to overcome such buoyancy, some individuals may possibly exceed the safe limit to enable escape from a submerged helicopter. Practitioner Summary: Air expulsion reduced total body volume of survival-suited volunteers following immersion by an amount inversely proportional to body size. When applied to 588 offshore workers, the predicted air loss suggested buoyant force to be greatest in the heaviest individuals, which may impede their ability to exit a submerged helicopter.

Variability in body size and shape of UK offshore workers: A cluster analysis approach.

Male UK offshore workers have enlarged dimensions compared with UK norms and knowledge of specific sizes and shapes typifying their physiques will assist a range of functions related to health and ergonomics. A representative sample of the UK offshore workforce (n = 588) underwent 3D photonic scanning, from which 19 extracted dimensional measures were used in k-means cluster analysis to characterise physique groups. Of the 11 resulting clusters four somatotype groups were expressed: one cluster was muscular and lean, four had greater muscularity than adiposity, three had equal adiposity and muscularity and three had greater adiposity than muscularity. Some clusters appeared constitutionally similar to others, differing only in absolute size. These cluster centroids represent an evidence-base for future designs in apparel and other applications where body size and proportions affect functional performance. They also constitute phenotypic evidence providing insight into the 'offshore culture' which may underpin the enlarged dimensions of offshore workers.

Defying geometric similarity: Shape centralization in male UK offshore workers.

OBJECTIVES: Applying geometric similarity predictions of body dimensions to specific occupational groups has the potential to reveal useful ergonomic and health implications. This study assessed a representative sample of the male UK offshore workforce, and examined how body dimensions from sites typifying musculoskeletal development or fat accumulation, differed from predicted values. METHODS: A cross sectional sample was obtained across seven weight categories using quota sampling, to match the wider workforce. In total, 588 UK offshore workers, 84 from each of seven weight categories, were measured for stature, mass and underwent 3D body scans which yielded 22 dimensional measurements. Each measurement was modeled using a body-mass power law (adjusting for age), to derive its exponent, which was compared against that predicted from geometric similarity. RESULTS: Mass scaled to stature 1.73 (CI: 1.44-2.02). Arm and leg volume increased by mass0.8 , and torso volume increased by mass1.1 in contrast to mass 1.0 predicted by geometric similarity. Neck girth increased by mass 0.33 as expected, while torso girth and depth dimensions increased by mass0.53-0.72 , all substantially greater than assumed by geometric similarity. CONCLUSIONS: After controlling for age, offshore workers experience spectacular "super-centralization" of body shape, with greatest gains in abdominal depth and girth dimensions in areas of fat accumulation, and relative dimensional loss in limbs. These findings are consistent with the antecedents of sarcopenic obesity, and should be flagged as a health concern for this workforce, and for future targeted research and lifestyle interventions.