The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: An exploratory, randomized placebo controlled study.

BACKGROUND: Epidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency. Calcium supplementation has been associated with a modest reduction in pre-eclampsia, and also in blood pressure (BP). METHODS: This exploratory sub-study of the WHO Calcium and Pre-eclampsia (CAP) trial aims to determine the effect of 500mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia. Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24weeks after randomization were included. RESULTS: Of 836 women randomized by 9 September 2014, 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia, 2nd visit data were available in 201 women. There was an overall trend to reduced BP in the calcium supplementation group (1-2.5mmHg) although differences were small and not statistically significant. In the subgroup with previous severe pre-eclampsia, the mean diastolic BP change in the calcium group (-2.6mmHg) was statistically larger than in the placebo group (+0.8mmHg), (mean difference -3.4, 95% CI -0.4 to -6.4; p=0.025). The effect of calcium on diastolic BP at 12weeks was greater than in those with non-severe pre-eclampsia (p=0.020, ANOVA analysis). CONCLUSIONS: There is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia. This is consistent with our hypothesis that this group is more sensitive to calcium supplementation, however results need to be interpreted with caution.

Predictors and economic burden of serious workplace falls in health care.

AIMS: To examine the demographic and workplace risk factors of serious falls and associated economic burden in Canadian health care workers. METHODS: Fall injury data during 2005-2008 from a workplace health and safety surveillance system were linked with workers' compensation claims and payroll records. The costs for treatment and wage loss and days lost for accepted time-loss claims were calculated. Demographic and work-related factors were identified to distinguish the risk for more serious falls from less serious falls. RESULTS: Nine hundred and thirty-eight fall injury claims were captured among 48 519 full-time equivalent workers. Workers >60 years, part time or employed in the long-term care sector sustained a higher proportion of serious falls (>70%). Over 75% of falls were serious for care aides, facility support service workers and community health workers. In the multivariate analysis, the risk of serious falls remained higher for workers in the long-term care sector [odds ratio (OR) 1.71; P < 0.05] compared with those in acute care and for care aides (OR 1.72; P < 0.05), facility support service workers (OR 2.58; P < 0.01) and community health workers (OR 3.61; P < 0.001) compared with registered nurses (RNs). The median number of days lost was higher for females, long-term care workers, licensed practical nurses and care aides. Females, long-term care workers, RNs, licensed practical nurses, care aides and maintenance workers had the most costly falls. CONCLUSIONS: Reducing work-related serious fall injuries would be expected to bring about significant benefits in terms of reduced pain and suffering, improved workplace productivity, reduced absenteeism and reduced compensation costs.

Risks and causes of musculoskeletal injuries among health care workers.

BACKGROUND: Musculoskeletal injuries (MSIs) persist as the leading category of occupational injury in health care. Limited evidence exists regarding MSIs for occupations other than direct patient care providers. An evaluation of the risks, causes and activities associated with MSIs that includes non-patient care health care occupations is warranted. AIMS: To examine the risks and causes of time-loss MSIs for all occupations in health care. METHODS: Workers employed by a health region in British Columbia were followed from April 2007 to March 2008 using payroll data; injuries were followed using an incidence surveillance database. Frequency and rates were calculated for all occupational injuries and MSIs and relative risks (RRs) were computed using Poisson regression. Causes and occupational activities leading to MSIs were tabulated for direct care occupations and non-patient care occupations. RESULTS: A total of 944 injuries resulting in time-loss from work were reported by 23 742 workers. Overall, 83% injuries were musculoskeletal. The two occupations showing highest RR of MSIs relative to registered nurses were facility support service workers [RR = 3.16 (2.38-4.18), respectively] and care aides [RR=3.76 (3.09-4.59)]. For direct patient care occupations, the leading causes of MSIs were awkward posture (25%) and force (23%); for non-patient care occupations were force (25%) and slip/fall (24%). Patient handling activities accounted for 60% of all MSIs for direct care occupations. For non-patient care occupations, 55% of MSIs were due to material/equipment handling activities. CONCLUSIONS: Prevention efforts for MSIs should be directed to non-patient care occupations as well and consider their occupation-specific causes and activities.